Statistical Comparison Research Articles

The Relationship Between Weight Indices and Blood Levels of Immunosuppressive Drugs in Renal Transplant Recipients

Background: Calcineurin inhibitors and mammalian target of rapamycin (mTOR) inhibitors are essential for maintaining transplanted organs. However, determining the appropriate dosage and predicting blood concentrations of these drugs based solely on net body weight may be inadequate. Previous studies have presented contradictory results regarding the impact of obesity on drug concentrations and transplant success. Objectives: This study aims to evaluate various weight indices to identify the most reliable indicator of weight that correlates with the blood levels of drugs used in organ transplantation. Methods: This retrospective descriptive study included patients from nephrology clinics affiliated with Isfahan University of Medical Sciences who were taking calcineurin and/or mTOR inhibitor drugs. Data extracted from medical records included demographic and clinical information, such as height, weight, and various weight indices (total/ideal/adjusted body weight, lean body mass (LBM), Body Mass Index, and predicted normal weight), as well as blood levels of immunosuppressive drugs at each patient's visit. The dosages of each drug (mg/kg) were analyzed to determine which weight indices best correlated with the obtained blood concentrations, using the Generalized Estimating Equation (GEE) model with logistic regression, an independent correlation matrix, and a binary distribution for data analysis. Results: The study analyzed the medical records of 71 patients. Trough (C0) concentrations of drugs were evaluated in relation to each weight index, and odds ratios (OR) were calculated for statistical comparison. All weight indices increased the likelihood of achieving appropriate concentrations for cyclosporine, tacrolimus, and sirolimus. Drug dosing based on LBM (OR: 1.028), ideal body weight (OR: 1.075), and total body weight (OR: 1.041) showed the strongest correlations with achieving proper blood levels for cyclosporine, tacrolimus, and sirolimus, respectively. Conclusions: Integrating various weight indices for calculating individualized doses (mg/kg) of each immunosuppressive drug increases the likelihood of achieving appropriate blood concentrations. However, the optimal weight index varies for each drug. Further studies, particularly those incorporating therapeutic drug monitoring (TDM) plans in transplant centers, are warranted to validate and generalize these findings, providing a potential avenue for improving immunosuppressive therapy and enhancing transplant outcomes.

Assessment of the impact of low-density lipoprotein cholesterol on retinal vessels using optical coherence tomography angiography

BackgroundLow-density lipoprotein cholesterol (LDL-C) is acknowledged as an independent risk factor (IRF) for atherosclerotic cardiovascular disease. Nevertheless, studies on the impact of LDL-C on microvasculature are still scarce. The retina, abundant in microvasculature, can now be examined for microvascular alterations through the novel, non-invasive, and quantitative optical coherence tomography angiography (OCTA) technique.MethodsIn this cross-sectional study, 243 patients from the geriatric department were recruited (between December 2022 and December 2023). Individuals were classified into four groups based on their LDL-C levels: Group 1 (≤ 1.8 mmol/L), Group 2 (> 1.8 mmol/L to ≤ 2.6 mmol/L), Group 3 (> 2.6 mmol/L to ≤ 3.4 mmol/L), and Group 4 (> 3.4 mmol/L). The OCTA results including retinal vessel density (VD), foveal avascular zone (FAZ) area, macula thickness, and retinal nerve fiber layer (RNFL) thickness were contrasted across these groups. T-tests, analysis of variance, Welch’s tests, or rank-sum tests were employed for statistical comparisons. In cases where significant differences between groups were found, post-hoc multiple comparisons or rank-sum tests were performed for pairwise group comparisons. Spearman’s correlation coefficient was employed to perform bivariate correlation analysis to evaluate the relationship between LDL-C levels and various OCTA measurements. Multivariable regression analysis was used to evaluate the association between LDL-C levels and various OCTA measurements. Linear regression analysis or mixed-effects linear models were applied.ResultsIt was discovered that individuals with LDL-C levels exceeding 2.6 mmol/L (Groups 3 and 4) exhibited reduced VD in the retina, encompassing both the optic disc and macular regions, compared to those with LDL-C levels at or below 2.6 mmol/L (Groups 1 and 2). A negative correlation among LDL-C levels and retinal VD was identified, with r values spanning from − 0.228 to -0.385. Further regression analysis presented β values between − 0.954 and − 2.378. Additionally, no notable disparities were detected among the groups regarding FAZ area, macular thickness, and RNFL thickness.ConclusionsThe outcomes of this study suggest that elevated LDL-C levels constitute an IRF for decreased VD across the entire retina.Trial registrationNCT05644548, December 1, 2022.

Return to work and self-reported swallowing following transoral robotic surgery for early-stage oropharyngeal squamous cell carcinoma: A retrospective cohort study

BackgroundTreatment de-intensification, including transoral robotic surgery (TORS), may outcomes in HPV-positive oropharyngeal squamous cell carcinoma (OPSCC). Early return to work (RTW) improves quality of life in oncology patients. Our objective was to compare the RTW time in OPSCC patients undergoing primary TORS or chemoradiotherapy (CRT). We investigated the role of treatment modality on self-reported swallowing function. MethodsAll patients were adults diagnosed with early-stage (T1–2, N0–2) OPSCC and treated via primary TORS or CRT. We performed 1:1 exact case matching based on tumor stage and subsite. We collected RTW outcomes for all patients. We also reported MD Anderson Dysphagia Index (MDADI) scores up to 24 months from the end of treatment. We performed statistical analyses and comparison of RTW and MDADI outcomes based on treatment group. ResultsOverall, 26 patients undergoing primary TORS and 25 undergoing primary CRT were included. We found a significant improvement in RTW in TORS patients compared to CRT (TORS: 54 days (1.8 months), IQR: 30.8; CRT: 164 days (5.4 months), IQR: 109; W=587, p = 9.28e-08) independent of HPV status, tonsillar subsite, and radiotherapy alone. Primary TORS had a 16.2-fold (95 % CI: 5.78–45.5) higher likelihood of returning to work than primary CRT patients. Primary TORS also had better MDADI scores within two years of treatment. ConclusionsIn OPSCC, primary TORS accelerated RTW and improved swallowing when compared to primary CRT. The potential economic advantage of returning to work sooner should be discussed when reviewing treatment options with patients.

Multiscale neural dynamics in sleep transition volatility across age scales: a multimodal EEG-EMG-EOG analysis of temazepam effects.

Recent advances in computational modeling techniques have facilitated a more nuanced understanding of sleep neural dynamics across the lifespan. In this study, we tensorize multiscale multimodal electroencephalogram (EEG), electromyogram (EMG), and electrooculogram (EOG) signals and apply Generalized Autoregressive Conditional Heteroskedasticity (GARCH) modeling to quantify interactions between age scales and the use of pharmacological sleep aids on sleep stage transitions. Our cohort consists of 22 subjects in a crossover design study, where each subject received both a sleep aid and a placebo in different sessions. To understand these effects across the lifespan, three evenly distributed age groups were formed: 18-29, 30-49, and 50-66years. The methodological framework implemented here employs tensor-based machine learning techniques to compute continuous wavelet transform time-frequency features and utilizes a GARCH model to quantify sleep signal volatility across age scales. Support Vector Machines are used for feature ranking, and our analysis captures interactions between signal entropy, age, and sleep aid status across frequency bands, sleep transitions, and sleep stages. GARCH model results reveal statistically significant volatility clustering in EEG, EMG, and EOG signals, particularly during transitions between REM and non-REM sleep. Notably, volatility was higher in the 50-66 age group compared to the 18-29 age group, with marked fluctuations during transitions from deep sleep to REM sleep (standard deviation of 0.35 in the older group vs. 0.30 in the 18-29 age group, p < 0.05). Statistical comparisons of volatility across frequency bands, age scales, and sleep stages highlight significant differences attributable to sleep aid use. Mean conditional volatility parameterization of the GARCH model reveals directional influences, with a causality index of 0.75 from frontal to occipital regions during REM sleep transition periods. Our methodological framework identifies distinct neural behavior patterns across age groups associated with each sleep stage and transition, offering insights into the development of targeted interventions for sleep regularity across the lifespan.

Psychopathy traits explain variance shared between features of substance use disorders and violence.

There is a substantial research literature on identifying risk and protective factors for violence perpetration. Substance use disorders have long been identified as constituting a significant predictor of violent behaviour. Psychopathy traits have also been similarly recognised, but inter-relationships between psychopathy traits, features of substance use disorders and violence have been little explored. To determine the degree to which shared variance between substance dependence symptoms and violence, as indicated by criminal charges for violent offences, among jailed men can be explained by psychopathy traits. Features of dependence on substances in three drug classes (alcohol, cannabis and cocaine) were assessed in a sample of 682 men in a county jail awaiting trial on criminal charges, many for violent offences. Statistical comparisons of zero-order and partial correlations tested whether accounting for psychopathy total and facet scores, assessed by the Psychopathy Checklist-Revised (PCL-R), affected associations between substance dependence symptoms and violent charges. Total PCL-R scores accounted for a significant proportion of the shared variance between the history of criminal charges for violence offences and lifetime substance dependence symptoms in all three drug classes. At the facet level, controlling for ratings on the interpersonal and modified antisocial facets reduced the association between criminal charges for violent offences and symptoms of cocaine dependence; controlling for ratings on a modified antisocial facetalso attenuated links between alcohol and cannabis dependence symptoms and history of charges for violent offences. These findings build on the sparse literature to date on the role of psychopathy traits on relationships between features of substance use disorders and violence. Given that the observed connection between substance dependence symptoms and charges for violent offences is partly accounted for by individual differences in psychopathy traits, it follows that effective treatment for those traits may be useful, perhaps essential to reducing links between features of some substance use disorders and violent offending.

Addressing the implementation challenge of risk prediction model due to missing risk factors: The submodel approximation approach.

Clinical prediction models have been widely acknowledged as informative tools providing evidence-based support for clinical decision making. However, prediction models are often underused in clinical practice due to many reasons including missing information upon real-time risk calculation in electronic health records (EHR) system. Existing literature to address this challenge focuses on statistical comparison of various approaches while overlooking the feasibility of their implementation in EHR. In this article, we propose a novel and feasible submodel approach to address this challenge for prediction models developed using the model approximation (also termed "preconditioning") method. The proposed submodel coefficients are equivalent to the corresponding original prediction model coefficients plus a correction factor. Comprehensive simulations were conducted to assess the performance of the proposed method and compared with the existing "one-step-sweep" approach as well as the imputation approach. In general, the simulation results show the preconditioning-based submodel approach is robust to various heterogeneity scenarios and is comparable to the imputation-based approach, while the "one-step-sweep" approach is less robust under certain heterogeneity scenarios. The proposed method was applied to facilitate real-time implementation of a prediction model to identify emergency department patients with acute heart failure who can be safely discharged home.

Parsing the thyroid cytopathology suspicious for malignancy diagnosis through molecular-derived risk of malignancy and other related parameters: Insights into nodule characteristics and practice patterns.

Thyroid cytopathology cases with suspicious for malignancy (SFM) diagnosis often result in resection. However, molecular testing offers details that may provide additional insights. In this study, the molecular profiles of SFM cases from two institutions that routinely used ThyroSeq v3 (TSV3) were examined. Following institutional review board approval, SFM thyroid cytopathology cases with TSV3 results were retrieved from the databases of two institutions. Molecular information including molecular-derived risk of malignancy (MDROM), cytologic-histologic correlation data, and other related parameters were calculated. Statistical comparisons were made with a p <.05 considered significant. The core data set comprised 114 SFM cases that passed TSV3 quality assurance. All TSV3 results were reported as positive or negative for genomic alterations and all except five cases provided a probability of malignancy estimate. The overall combined baseline MDROM of 75.7% (95% CI, 70.0-81.4) was comparable to the risk of malignancy (74%) published in the Bethesda System. There was a statistically significant difference between the combined MDROMs of resected and unresected cohorts (79.0% vs 58.6%; p=.0153). Interestingly, the MDROMs of the resected cohorts from the two institutions were statistically different (75.0% vs 85.3%; p=.020). Cytologic-histologic correlation revealed malignant outcome in 88.5% of resected cases. Molecular analyses of SFM cases demonstrated higher risk genomic alterations that were associated with histologically overt neoplasms, resulting in increased malignancy outcome compared to baseline. MDROM analysis revealed differences in the cytopathologic practice patterns regarding follicular-patterned neoplasms at the two institutions.

Towards a data platform for multimodal 4D mechanics of material microstructures

This paper presents advances in the data management strategy applied to 4D multimodal mechanics of material sample microstructures. Guidelines to build a data platform allowing for complex workflows, involving several high-throughput experimental and numerical techniques, and complying with FAIR data management principles, are discussed. Next, their implementation within the open-source Python package Pymicro is presented, offering a high-level interface to build complex datasets through multimodal methodologies. Its capability to enable and automate complex workflows by building a digital twin of a commercially pure titanium sample under tension are then demonstrated. The digital twin contains microstructural and mechanical data for thousands of grains gathered on the same sample through synchrotron DCT and in-situ SEM experiments, as well as full-field numerical simulation. Finally, a local and statistical comparison between simulation and measurements of plastic slip and crystal rotation in hundreds of grains is shown, as an example of the contribution of this platform to multimodal data convergence and its importance for the development of a new generation of material models.

Does change in area-level deprivation, change health outcomes? A latent class growth analysis of population data.

BackgroundWhile the link between deprivation and health is established, little is known about the association of persistent deprivation or deprivation trajectories over time with adverse health outcomes. AimTo examine latent class trajectories of area level-deprivation from 2010-2016 and their association with social distress indicators from 2017-2021. MethodAnalysis was based on linked administrative data (N=1,569,110) from NI GP Registrations Index, emergency department records (2017-21), enhanced prescribing data (2017-21) and biennial area-level deprivation (2010-2016). Latent class growth analysis (LCGA) identified deprivation trajectories between 2010 and 2016; and regression-based models, adjusted for age, sex and urbanicity, examined their association with indicators of individual level distress: occurrence of death, any accident and emergency (A&amp;E) visit, and any psychotropic medication between 2017 and 2021. ResultsBased on comparison of models and fit statistics, a non-linear LGCA model identified six trajectories: consistently deprived (21.2%); slight improvement (7.1%); substantial improvement (1.2%); consistently average deprivation (31.7%); slight worsening (18.5%); and consistently non-deprived (20.4%). Consistently living in a deprived area was associated with higher likelihood of death, A&amp;E visits and receipt of hypnotics, anxiolytics, and anti-depressants. Compared to consistent deprivation, slight improvement was associated with lower likelihood of death (OR=0.94, CI: 0.91-0.97) and all psychotropic medication in the follow-up period. ImplicationsFindings indicate that even a slight improvement in deprivation status can have a positive influence on health outcomes. Further population-wide analysis of deprivation trajectories, their determinants and associated health impact will inform targeted interventions that promote social mobility and improved health.

Adverse drug reactions and drug-related problems with supportive care medications among the oncological population

AimThe current study emphasizes the impact of adverse drug reactions (ADRs) and Drug-Related Problems (DRPs) caused by supportive care medications administered with chemotherapy.MethodThis is a longitudinal observational study carried out at the Ramaiah Medical College Hospital in Bengaluru, Karnataka, India, at the Department of Oncology. The data was recorded using a specifically created data collecting form. Based on the PCNE (Pharmaceutical Care Network Europe), DRPs are identified. The WHO probability scale, Modified Hartwig and Siegel for ADR severity assessment, Naranjo's algorithm for causality assessment, Rawlins and Thompson for predictability assessment, and Modified Shumock and Thornton for preventability assessment were all utilized. The OncPal guideline was considered in terms of the precision of supportive care medications regarding the reduction of ADRs in cancer patients.ResultWe enrolled 302 patients,166 (55%) female and 136 (45%) male (SD 14.378) (mean 49.97), patients with one comorbidity 59(19.6%) and multimorbidity (two or more) 45(14.9%), the DRPs identified were found to be 153 (50.6%); only P2 (safeties of drug therapy PCNE) were considered in this study. ADRs which are identified 175(57.9%) contributed/caused by the supportive care medications. WHO probability scale: 97 (32.1%) possible and 60 (19.9%) unlikely; Naranjo’s algorithm: 97 (32.1%) unlikely and 69 (22.8%) possible; ADR severity assessment scale (Modified Hartwig and Siegel): 95 (31.5%) mild and 63 (20.9%) moderates; Rawlins and Thompson for determining predictability of an ADR: 33 (10.9%) predictable and 137 (45.5%) non-predictable; and Modified Shumock and Thornton for determining preventability of an ADR: 81 (26.8%) probably preventable and 90 (29.8%) non-preventable. The statistical comparison through preforming t-test and measuring Chi-Square between group with ADRs and without ADRs shows in some variables, significantly (Alcohol consumption status, P = .019) and Easter Cooperative Oncology Group (ECOG) performance status P < 0.001.ConclusionComprehensive assessment of supportive medications in cancer patients would enhance the patient management and therapeutic outcome. The potential adverse drug reactions (ADRs) caused by supportive care medications can contribute to longer hospital stays and interact with the systemic anti-cancer treatment. The health care professionals should be informed to monitor the patients clinically administered with supportive medications.

Music listening for improvement of sleep in post-acute rehabilitation of adults with acquired brain injury: A feasibility study

ABSTRACT Introduction Acquired brain injury (ABI) often leads to sleep disturbances impacting recovery. Previous research has shown that listening to music at bedtime can have a beneficial effect on sleep quality in various populations, but the impact of bedtime music on sleep problems related to ABI has not been studied. This feasibility study investigates the acceptability and effectiveness of music listening for sleep improvement in ABI patients. Methods In a within-subjects crossover design with repeated measures for 28 days, ABI patients with sleep disturbance were allocated to a control or music condition, switching conditions after 14 days. Acceptability was assessed with questionnaires on compliance and attrition. The effect was evaluated with the Pittsburgh Sleep Quality Index (PSQI) at baseline, day 14 and 28, daily sleep ratings, and actigraphy. Results The intervention was well-liked, and participants listened to the music most of the intervention nights. A descriptive statistical comparison of outcome data on PSQI and daily sleep ratings regarding how well participants slept indicated that participants (n = 4) experienced better sleep with the music intervention. The objective sleep measures reflected a slightly longer time to fall asleep with the music intervention. Discussion The results suggest good acceptability and a potential beneficial effect of the intervention. Music listening may be a safe and effective tool, and a full RCT is recommended to evaluate the efficacy of music listening for sleep improvement in ABI patients. https://www.clinicaltrials.gov, Identification number: NCT05620069.

Comparison between twin block appliance and mandibular advancement on clear aligners in the improvement of airway dimension: incremental versus maximum bite advancement.

The aim of the present retrospective study was to compare the changes resulting from treatment using the MA and the TB with special regard to the oro-and naso-pharyngeal sagittal airway dimensions in subjects with dentoskeletal Class II malocclusions and positive history of Sleep Disorder Breathing (SDB) diagnosed through the Pediatric Sleep Questionnaire (PSQ). This retrospective study involved 2 groups of subjects: patients treated with Twin Block (TB group: n = 22, 10 males, 12 females; mean age 12.0 ± 1.3 years) and patients treated with Mandibular Advancement (MA group: n = 23, 11 males, 12 females; mean age 12.2 ± 1.1 years). Pretreatment (T1) and posttreatment (T2) lateral cephalograms were analyzed. All patients underwent the PSQ to diagnose SDB. In both treated groups there was an increase in the airways dimensions and an improvement in symptoms related SDB. The statistical comparison of the changes between T1 and T2 in the TB group showed a significant increment in upper airway size (PNS-AD2, +1.50 mm + -3.30; McNamara's upper pharynx dimension, +2.21 + -4.21) after active treatment. The MA group showed similar results during active treatment with a significant increase in both upper (PNS-AD2, +2.72 + -2.65; McNamara's upper pharynx dimension, +2.97 + -3.07) and lower (PNS-AD1, +2.17 mm + -3.54) airway size. Despite the different structure of these two devices and the different advancement protocols, both appliances were valuable as a suitable treatment option for Class II patients with respiratory disorders, inducing an increase of upper and lower airway size and a significant reduction in diurnal symptoms.

The impact of coupling a dynamic ocean in the Hurricane Analysis and Forecast System

Coupling a three-dimensional ocean circulation model to an atmospheric model can significantly improve forecasting of tropical cyclones (TCs). This is particularly true of forecasts for TC intensity (maximum sustained surface wind and minimum central pressure), but also for structure (e.g., surface wind-field sizes). This study seeks to explore the physical mechanisms by which a dynamic ocean influences TC evolution, using an operational TC model. The authors evaluated impacts of ocean-coupling on TC intensity and structure forecasts from NOAA’s Hurricane Analysis and Forecast System v1.0 B (HFSB), which became operational at the NOAA National Weather Service in 2023. The study compared existing HFSB coupled simulations with simulations using an identical model configuration in which the dynamic ocean coupling was replaced by a simple diurnally varying sea surface temperature model. The authors analyzed TCs of interest from the 2020–2022 Atlantic hurricane seasons, selecting forecast cycles with small coupled track-forecast errors for detailed analysis. The results show the link between the dynamic, coupled ocean response to TCs and coincident TC structural changes directly related to changing intensity and surface wind-field size. These results show the importance of coupling in forecasting slower-moving TCs and those with larger surface wind fields. However, there are unexpected instances where coupling impacts the near-TC atmospheric environment (e.g., mid-level moisture intrusion), ultimately affecting intensity forecasts. These results suggest that, even for more rapidly moving and smaller TCs, the influence of the ocean response to the wind field in the near-TC atmospheric environment is important for TC forecasting. The authors also examined cases where coupling degrades forecast performance. Statistical comparisons of coupled versus uncoupled HFSB further show an interesting tendency: high biases in peak surface winds for the uncoupled forecasts contrast with corresponding low biases, contrary to expectations, in coupled forecasts; the coupled forecasts also show a significant negative bias in the radii of 34 kt winds relative to National Hurricane Center best track estimates. By contrast, coupled forecasts show very small bias in minimum central pressure compared with a strong negative bias in uncoupled. Possible explanations for these discrepancies are discussed. The ultimate goal of this work will be to enable better evaluation and forecast improvement of TC models in future work.

The Impact of Scroll Ligament Preservation on Nasal Airway Patency in Rhinoplasty: An Objective Study with Rhinomanometry and Acoustic Rhinometry.

Rhinoplasty is a critical surgical intervention aimed at enhancing nasal form and function. However, traditional approaches often compromise the integrity of nasal scroll ligaments, vital for the functionality of the internal nasal valve, leading to potential postoperative nasal dysfunction. Despite the importance of scroll ligaments in maintaining nasal structure and function, the literature lacks objective, quantifiable evidence of their role. This study sought to objectively compare nasal functionality and anatomy between patients undergoing rhinoplasty with bilateral preservation of scroll ligaments and those with bilateral sacrifice of these ligaments, employing computerized rhinomanometric and acoustic rhinometric measurements as evaluative tools. This retrospective, double-blind study was conducted at Tekirdağ Namık Kemal University's Plastic Reconstructive and Aesthetic Surgery and Ear, Nose, and Throat Clinics. The study population comprised patients who underwent rhinoplasty between May 1, 2018, and October 1, 2019. Patients were rigorously selected based on their medical history, including previous nasal surgeries, aesthetic dissatisfaction, and minimal nasal septum deviation. They were then categorized into two distinct groups: one undergoing rhinoplasty with an emphasis on preserving the scroll ligaments (n = 31) and the other where these ligaments were intentionally sacrificed (n = 30). A comprehensive analysis involving preoperative and six-month postoperative computerized rhinomanometry and acoustic rhinometry measurements was conducted to assess the surgical impact on nasal functionality and structure. The statistical comparison focused on evaluating the changes in air pressure and airflow rates, aiming to delineate the functional outcomes attributable to the differing surgical techniques. Our findings reveal a stark contrast in postoperative nasal functionality between the two groups. In the group with preserved scroll ligaments, there was a significant improvement in postoperative computerized rhinomanometric measurements, indicating enhanced nasal airflow and reduced airway resistance. Conversely, the group with sacrificed scroll ligaments exhibited deteriorated postoperative outcomes, with increased nasal airway resistance and decreased airflow. These differences underscore the pivotal role of scroll ligaments in maintaining nasal airway patency and functionality. The study unequivocally demonstrates that the preservation of scroll ligaments during rhinoplasty significantly benefits nasal airway function, as evidenced by improved postoperative rhinomanometry and acoustic rhinometry measurements. This objective data provide a compelling argument for the functional importance of scroll ligaments, advocating for surgical techniques that prioritize their preservation. By highlighting the positive correlation between ligament preservation and enhanced nasal functionality, this research contributes valuable insights into rhinoplasty practices, suggesting a paradigm shift towards approaches that safeguard nasal structural integrity for optimal functional outcomes. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Investigating early and late-time epochs in f(Q) gravity

In the following work, a new hybrid model of the form f(Q)=Q(1+a)+bQ02Q\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ f(Q)=Q(1+a)+b\\frac{Q_0^2}{Q} $$\\end{document} has been proposed and confronted using both early as well as late-time constraints. We first use conditions from the era of Big Bang Nucleosynthesis (BBN) in order to constrain the models which are further used to study the evolution of the Universe through the deceleration parameter. This methodology is employed for the hybrid model as well as a simple model of the form α1Q+α2Q0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ \\alpha _1 Q+\\alpha _2 Q_0 $$\\end{document} which is found to reduce to Λ\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\Lambda $$\\end{document}CDM. The error bar plot for the Cosmic Chronometer (CC) and Pantheon+SH0ES datasets which includes the comparison with Λ\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\Lambda $$\\end{document}CDM, has been studied for the constrained hybrid model. Additionally, we perform a Monte Carlo Markov Chain (MCMC) sampling of the model against three datasets – CC, Pantheon+SH0ES, and Baryon Acoustic Oscillations (BAO) to find the best-fit ranges of the free parameters. It is found that the constraint range of the model parameter (a) from the BBN study has a region of overlap with the ranges obtained from the MCMC analysis. Finally, we perform a statistical comparison between our model and the Λ\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\Lambda $$\\end{document}CDM model using AIC and BIC method.

Abstract 16: A Novel H2 Relaxin B-Chain-Only Peptide Variant B7-33 Improves The Pathophysiology Of Placental Ischemia In The Reduced Uterine Perfusion Pressure Rat Model Of Preeclampsia

Background: Preeclampsia (PE) is a hypertensive pregnancy disorder, which occurs in approximately 10% of all gestations. The literature suggests the potential therapeutic role of H2 relaxin in PE. A novel H2 relaxin B-chain-only peptide variant B7-33 (27 amino acids without any disulfide bonds) has recently been developed. Objective: The goal of this study was to test the hypothesis that a novel H2 relaxin B-chain-only peptide variant B7-33 could improve the pathophysiology of placental ischemia in the Reduced Uterine Perfusion Pressure (RUPP) rat model of PE. Methods: The efficacy of B7-33 was evaluated in the RUPP model as described previously. RUPP rats are randomly assigned to 4 groups (N=8/group): 1) vehicle, 2) B733; 3) B733-Fc; and 4) B733-HSA. Rats are dosed twice weekly (i.v.) from GD10 to GD 20. On GD 18, rats are anesthetized with isoflurane, and carotid arterial catheters are inserted into the carotid artery, tunneled under the skin, and externalized at the back of the neck. On the following day, mean arterial pressure (MAP) is monitored with a pressure transducer (Cobe III Tranducer CDX Sema) and recorded continuously for 30 min. On GD18, uterine artery resistance index (UARI) of rats is measured by Doppler sonography. The nitric oxide bioavailability, soluble fms-like tyrosine kinase-1 (sFlt-1), and TNF-α) were measured by commercially available kits. Statistical comparisons were performed using analysis of variance with Duncan’s post hoc test. Results: The RUPP rats have increased MAP (122.2 ± 8.1 mm Hg), plasma TNF-α (223 ±11.4 pg/mL), and plasma sFlt-1(863 ±18.2 pg/mL) along with decreased NO index (14±2 µM) compared to normal pregnancy: MAP (102 ± 5.2 mm Hg); plasma TNF-α (28 ± 4.1 pg/mL); plasma sFlt-1(244 ± 9.4 pg/mL) and NO index (26 ±4.1 µM). Treatment with B733 and B7-33 fusion proteins significantly (*p&lt;0.05) lowers MAP, plasma TNF-α, and plasma sFlt-1 and increased NO index back to that of normal pregnancy. The B7-33 data are consistent with earlier data with serelaxin in the RUPP model. All fusions tested ameliorate hypertension in the RUPP animals. B7-33 normalizes BP and proteinuria in the DOCA rat model of preE. Conclusion: The conclusion of the study is that both B7-33 and B7-33 fusion proteins demonstrate efficacy in attenuating the symptoms of PE including hypertension and inflammation in RUPP model. We conclude that B7-33 is an ideal candidate for development as a novel therapeutic in preE.

Total Magnetic Field Perturbations at Martian Low Altitudes (≤500 km): MAVEN Observations in 2014–2023

AbstractMagnetic perturbations in the Martian ionosphere are often considered as representing plasma irregularities, but thorough statistical comparisons between the two independent phenomena have been rarely conducted. In this study, we investigate the statistical relationship between total magnetic field perturbations and those of O2+ density as observed by the Mars Atmosphere and Volatile EvolutioN (MAVEN) spacecraft at altitudes below 500 km in 2014–2023. From the 1 Hz time series of magnetic field strength, perturbation intensity is estimated by subtracting a signal smoothed with a Savitzky‐Golay filter (window size ∼36 km). Statistically, the magnetic perturbations are stronger on the dayside than at night, in the local summer hemisphere than in winter, and away from crustal magnetic anomalies than nearby. Also, day‐to‐day variability of the magnetic perturbations exhibits a weak but significant correlation with that of solar wind electron density. The statistical behavior of total magnetic field perturbations is not the same as that of O2+ density perturbations: that is, the former is not a perfect proxy for the latter. The seemingly counter‐intuitive discrepancy can be explained by effects of inhomogeneous background magnetic field strength (participating in total pressure balance across plasma perturbations) and localized ionospheric currents at altitudes unreachable by MAVEN.

Can a large language model create acceptable dental board-style examination questions? A cross-sectional prospective study

Background/purposeNumerous studies have shown that large language models (LLMs) can score above the passing grade on various board examinations. Therefore, this study aimed to evaluate national dental board-style examination questions created by an LLM versus those created by human experts using item analysis. Materials and methodsThis study was conducted in June 2024 and included senior dental students (n = 30) who participated voluntarily. An LLM, ChatGPT 4o, was used to generate 44 national dental board-style examination questions based on textbook content. Twenty questions for the LLM set were randomly selected after removing false questions. Two experts created another set of 20 questions based on the same content and in the same style as the LLM. Participating students simultaneously answered a total of 40 questions divided into two sets using Google Forms in the classroom. The responses were analyzed to assess difficulty, discrimination index, and distractor efficiency. Statistical comparisons were performed using the Wilcoxon signed rank test or linear-by-linear association test, with a confidence level of 95%. ResultsThe response rate was 100%. The median difficulty indices of the LLM and human set were 55.00% and 50.00%, both within the range of “excellent” range. The median discrimination indices were 0.29 for the LLM set and 0.14 for the human set. Both sets had a median distractor efficiency of 80.00%. The differences in all criteria were not statistically significant (P > 0.050). ConclusionThe LLM can create national board-style examination questions of equivalent quality to those created by human experts.

Conversion of Tibial Plateau Fractures to Total Knee Arthroplasty is Associated With Worse Patient-Reported Outcomes, Increased Operative Times, and Increased Complications

BackgroundPrior open reduction and internal fixation (ORIF) of tibial plateau fracture (TPF) adds complexity to subsequent total knee arthroplasty (TKA). The purpose of this study was to compare the outcomes of patients undergoing a TKA following prior ORIF of TPF to patients undergoing a primary TKA for osteoarthritis and an aseptic revision TKA. MethodsThere were 52 patients who underwent primary TKA following prior ORIF of TPF between January 2009 and June 2021, who were included and matched in a 1:4 ratio to 208 patients undergoing primary TKA. A second 1:1 matched comparison to 52 aseptic revision TKA patients was also included. The Knee injury and Osteoarthritis Outcome Score for Joint Replacement scores were obtained preoperatively and at two years postoperatively. Independent t-tests and Chi-square tests were used for statistical comparisons. ResultsThe TPF patients were significantly younger than both primary and revision cohorts (55 ± 14.0 versus 63 ± 16.3 versus 64 ± 9.5, P < 0.001). Compared to primary TKA patients, the TPF group had worse Knee injury and Osteoarthritis Outcome Score for Joint Replacement scores at two years (46.9 ± 18.5 versus 66.2 ± 17.8, P = 0.0152), higher rates of wound complications (15.4 versus 3.9%, P = 0.0020), and increased operative times (140.2 ± 45.3 versus 95.2 ± 25.7, P < 0.0001). Additionally, TPF patients were more likely to require a manipulation under anesthesia than both primary and revision patients (21.2 versus 5.8 versus 5.8%, P = 0.001). ConclusionsThe TKAs following ORIF of TPF are more like revision TKAs than primary TKAs in terms of patient-reported outcomes, operative times, and wound complications. The rate of manipulation under anesthesia was higher than in both matched groups. These findings provide valuable information that can affect preoperative patient education and postoperative management regimens. They also emphasize the need for a conversion TKA code due to increased complexity and complications seen in this more difficult subset of TKAs.

Effects of Local Anesthetics on Tissue Penetration Using Diode Lasers in Intraoral Tissues.

Objective: The purpose of this study was to demonstrate heat transfer within oral soft tissues using different lasers under the effect of local anesthetics (LA). Methods: Bovine tongue slices were placed in between two glass slides and at a distance from a thermographic camera. In total, 2-cm-long 240 incisions were made along the surface of the tissue parallel to glass slides and the camera capture field. Incisions were performed using 445-nm and infrared (IR) lasers (970 nm and 980 nm on a continuous wave at 2 W) with 320 µm-initiated (concentrated energy at the tip provided by a blue articulated paper and laser irradiation) and noninitiated (defused energy) fiber (30-sec irradiation period). LA was injected into the specimens before irradiation. The temperature changes in °C (ΔT) and vertical and lateral heat transfer (in mm) were recorded at 10-sec intervals for 30 sec, using thermographic images. The amount of lateral and vertical heat transfer was measured. A repeated analysis of variance statistical comparison test was used to analyze differences between the lateral (width) and the vertical (height) heat transfer for initiated and noninitiated lasers and different lasers. Results: The maximum ΔT in °C utilizing initiated tips of 970, 980, or 445 nm were 11.82 ± 3.46, 7.66 ± 3.24, and 18.94 ± 7.01 and using noninitiated tips were 8.27 ± 1.69, 8.87 ± 2.40, and 12.31 ± 8.65, respectively. Heat transfers (height/width) for initiated were 40.65 ± 10.40/90.65 ± 10.77 mm, 41.50 ± 11.83/83.95 ± 11.20 mm, and 33.70 ± 9.10/95.10 ± 11.17 mm and for noninitiated lasers were 52.95 ± 6.89/96.10 ± 11.17 mm, 47.75 ± 7.41/93.75 ± 14.96 mm, and 31.35 ± 11.40/75.20 ± 19.68 mm, respectively. A statistically significant difference was found between all lasers (p < 0.05) for initiated and noninitiated lasers (except for 970/980 nm for noninitiated lasers). Lower penetration depth (p < 0.05) at 445-nm diode and greater lateral heat spreading (p < 0.05) were identified under LA especially utilizing noninitiated tips without significant difference in IR lasers. Conclusions: LA might negatively influence soft tissues creating scattering when noninitiated tips are used and IR diode laser technology.