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Background. Anti-vascular endothelial growth factor (anti-VEGF) therapy via intravitreal injection is an effective treatment for patients with abnormal ocular neovascularization, such as age-related macular degeneration (AMD) and diabetic macular edema (DME). However, prolonged and frequent anti-VEGF treatment is associated with a risk of local and systemic adverse events, including geographic atrophy, cerebrovascular disease, and death. Furthermore, some patients do not adequately respond to anti-VEGF therapy. Hypoxia-inducible factor (HIF) is a transcription factor that controls the expression of hypoxia-responsive genes involved in angiogenesis, inflammation, and metabolism. The HIF/VEGF pathway plays an important role in neovascularization, and the inhibition of HIF activation could be an effective biomolecular target for neovascular diseases. The demand for disease prevention or treatment using functional foods such as superfoods has increased in recent years. Few reports to date have focused on the antineovascular effects of superfoods in the retinal pigment epithelium (RPE). In light of the growing demand for functional foods, we aimed to find novel HIF inhibitors from superfoods worked in RPE cells, which could be an adjuvant for anti-VEGF therapy. Methods. Seven superfoods were examined to identify novel HIF inhibitor candidates using luciferase assay screening. We used the human RPE cell line ARPE-19 and fetal human RPE (fhRPE) to investigate the biomolecular actions of novel HIF inhibitors using quantitative PCR and western blotting. Results. Under CoCl2-induced pseudohypoxic condition and 1% oxygen hypoxic incubation, camu-camu (Myrciaria dubia) showed HIF inhibitory effects determined by luciferase assays. Camu-camu downregulated HIF-1α and VEGFA mRNA expressions in a concentration-dependent manner. Camu-camu also inhibited HIF-1α protein expressions, and its inhibitory effect was greater than that of vitamin C, which is present at high levels in camu-camu. Conclusion. The camu-camu extract suppressed the activation of HIF and VEGF in RPE cells. This could assist anti-VEGF therapy in patients with abnormal ocular neovascularization. [ABSTRACT FROM AUTHOR]

Hikers and hillwalkers typically use the gradient in the direction of travel (walking slope) as the main variable in established methods for predicting walking time (via the walking speed) along a route. Research into fell-running has suggested further variables which may improve speed algorithms in this context; the gradient of the terrain (hill slope) and the level of terrain obstruction. Recent improvements in data availability, as well as widespread use of GPS tracking now make it possible to explore these variables in a walking speed model at a sufficient scale to test statistical significance. We tested various established models used to predict walking speed against public GPS data from almost 88,000 km of UK walking / hiking tracks. Tracks were filtered to remove breaks and non-walking sections. A new generalised linear model (GLM) was then used to predict walking speeds. Key differences between the GLM and established rules were that the GLM considered the gradient of the terrain (hill slope) irrespective of walking slope, as well as the terrain type and level of terrain obstruction in off-road travel. All of these factors were shown to be highly significant, and this is supported by a lower root-mean-square-error compared to existing functions. We also observed an increase in RMSE between the GLM and established methods as hill slope increases, further supporting the importance of this variable. [ABSTRACT FROM AUTHOR]

Background: To demonstrate bioequivalence between two drug formulations, a pilot trial is often conducted prior to a pivotal trial to assess feasibility and gain preliminary information about the treatment effect. Due to the limited sample size, it is not recommended to perform significance tests at the conventional 5% level using pilot data to determine if a pivotal trial should take place. Whilst some authors suggest to relax the significance level, a Bayesian framework provides an alternative for informing the decision-making. Moreover, a Bayesian approach also readily permits possible incorporation of pilot data in priors for the parameters that underpin the pivotal trial. Methods: We consider two-sequence, two-period crossover designs that compare test (T) and reference (R) treatments. We propose a robust Bayesian hierarchical model, embedded with a scaling factor, to elicit a Go/No-Go decision using predictive probabilities. Following a Go decision, the final analysis to formally establish bioequivalence can leverage both the pilot and pivotal trial data jointly. A simulation study is performed to evaluate trial operating characteristics. Results: Compared with conventional procedures, our proposed method improves the decision-making to correctly allocate a Go decision in scenarios of bioequivalence. By choosing an appropriate threshold, the probability of correctly (incorrectly) making a No-Go (Go) decision can be ensured at a desired target level. Using both pilot and pivotal trial data in the final analysis can result in a higher chance of declaring bioequivalence. The false positive rate can be maintained in situations when T and R are not bioequivalent. Conclusions: The proposed methodology is novel and effective in different stages of bioequivalence assessment. It can greatly enhance the decision-making process in bioequivalence trials, particularly in situations with a small sample size. [ABSTRACT FROM AUTHOR]

Background: Alexithymia is the inability to identify and describe one's own emotions. Adolescents who suffer from Restrictive Eating Disorders (REDs) show a higher prevalence of alexithymia than the general population. Methods: The study explored the correlation between levels of alexithymia in mothers, fathers, and adolescents affected by REDs and patients' ability to recognize their emotions. The study also aimed to evaluate if patients' emotional distress can significantly impact the severity of their disorder and functioning measured by the Clinical Global Impression Scale - Severity (CGI-S) and the Children's Global Assessment Scale (CGAS). We enrolled 67 families of adolescents affected by REDs. Parents and patients' levels of alexithymia were assessed through the Toronto Alexithymia Scale (TAS-20). Spearman's correlation shows a statistically significant correlation between mothers and patients' levels of alexithymia. Results: Our findings also suggest that fathers and mothers' TAS scores correlate with each other. However, there is no statistically significant relationship between the influence of the TAS scores of fathers and sons/daughters. Conclusions: In conclusion, mothers' level of alexithymia could influence both fathers and patients' difficulty in identifying and describing their own emotions. This relationship can be investigated further when considering externally oriented thinking. However, the severity of the disease and overall functioning do not appear to be affected by patients' levels of alexithymia. [ABSTRACT FROM AUTHOR]

(1) Background: The aim of this prospective study was to evaluate measurement software in comparison with manual measurements using inter-observer and intra-observer variability on radiographs in the preoperative planning of total knee arthroplasty. (2) Methods: Two independent observers retrospectively measured the mechanical lateral proximal femoral angle (mLPFA), the mechanical lateral distal femoral angle (mLDFA), the joint line convergence angle (JLCA), the mechanical medial proximal tibial angle (mMPTA), the mechanical lateral distal tibial angle (mLDTA), the hip–knee angle or mechanical tibial–femoral axis angle (HKA), and the anatomical–mechanical angle (AMA) on 55 long-leg anteroposterior radiographs manually twice, followed by measurements using dedicated software. Variability between manual and computer-aided planning was assessed, and all measurements were performed a second time after 14 days in order to assess intra-observer variability. (3) Results: Concerning intra-observer variability, no statistically significant difference was observed regarding the software-based measurements. However, significant differences were noted concerning intra-observer variability when measuring the mLDFA and AMA manually. Testing for statistical significance regarding variability between manual and software-based measurements showed that the values varied strongly between manual and computer-aided measurements. Statistically significant differences were detected for mLPFA, mLDFA, mMPTA, and mLPTA on day 1, and mLPFA, mMPTA, and mLPTA on day 15, respectively. (4) Conclusions: Preoperative planning of leg axis angles and alignment using planning software showed less inter- and intra-observer variability in contrast to manual measurements, and results differed with respect to manual planning. We believe that the planning software is more reliable and faster, and we would recommend its use in clinical settings. [ABSTRACT FROM AUTHOR]

The Kaplan–Meier (KM) estimator is widely used in medical research to estimate the survival function from lifetime data. KM estimation is a powerful tool to evaluate clinical trials due to simple computational requirements, its use of a logrank hypothesis test, and the ability to censor patients. However, KM estimation has several constraints and fails to generalize to ordinal variables of clinical interest, such as toxicity and ECOG performance. We devised weighted trajectory analysis (WTA) to combine the advantages of KM estimation with the ability to visualize and compare treatment groups for ordinal variables and fluctuating outcomes. To assess statistical significance, we developed a new hypothesis test analogous to the logrank test. We demonstrated the functionality of WTA through 1000-fold clinical trial simulations of unique stochastic models of chemotherapy toxicity and schizophrenia disease course. With increments in sample size and hazard ratio, we compared the performance of WTA to KM estimation and the generalized estimating equation (GEE). WTA generally required half the sample size to achieve comparable power to KM estimation; advantages over the GEE included its robust nonparametric approach and summary plot. We also applied WTA to real clinical data: the toxicity outcomes of melanoma patients receiving immunotherapy and the disease progression of patients with metastatic breast cancer receiving ramucirumab. The application of WTA demonstrated that using traditional methods such as KM estimation can lead to both type I and II errors by failing to model illness trajectory. This article outlines a novel method for clinical outcome assessment that extends the advantages of Kaplan–Meier estimates to ordinal outcome variables. [ABSTRACT FROM AUTHOR]

The detrending-moving-average-based multivariate linear regression has been recently introduced as a new tool to probe into multiscale dependent behavior between multivariate data. It well solves the dependence among the nonstationary variates while classic multivariate linear regression dose not. The real-world applications demonstrate its versatility and robustness. However, the statistical significance of this new model needs to be further improved mathematically not just empirically. Hence, the main motivation of this paper is to provide a solid theoretical basis for the latest regression framework. Specifically, four propositions and three theorems are deduced theoretically to support the statistical significance test of detrending-moving-average-based multivariate linear regression model. These propositions and theorems revolve around hypothesis testing of each partial regression coefficients and regression model. They can examine the statistical significance at every given scales. Moreover, we also resort to synthetic time series to verify the performances of the proposed statistical test procedure. By using those statistical tests, we investigate the multiscale interdependence between the crude oil price and the exchange rates among oil-importing and oil-exporting countries. Some interesting findings show that the dependent behavior between the oil price and exchange rates varies at various scales, which cannot be achieved from classical multivariate regression model. • Statistical properties are derived mathematically for the model of DMA-based MLR. • Artificial experiments are also conducted around the statistical test of new model. • The scale-dependent co-movement behavior is investigated between crude oil price and exchange rate by the proposed methods. • The co-movement behavior is compared before and during the oil bust. [ABSTRACT FROM AUTHOR]

The meaning of randomization tests has become obscure in statistics education and practice over the last century. This article makes a fresh attempt at rectifying this core concept of statistics. A new term—"quasi-randomization test"—is introduced to define significance tests based on theoretical models and distinguish these tests from the "randomization tests" based on the physical act of randomization. The practical importance of this distinction is illustrated through a real stepped-wedge cluster-randomized trial. Building on the recent literature on randomization inference, a general framework of conditional randomization tests is developed and some practical methods to construct conditioning events are given. The proposed terminology and framework are then applied to understand several widely used (quasi-)randomization tests, including Fisher's exact test, permutation tests for treatment effect, quasi-randomization tests for independence and conditional independence, adaptive randomization, and conformal prediction. for this article are available online. [ABSTRACT FROM AUTHOR]

Simple Summary: In Sri Lanka, the authors are encouraging a cost-effective way to reduce the number of people developing oral cancer, which is a common cancer among men. The authors wanted to find out how well dentists can find signs of oral cancer and potential problems in their patients, and they did this by asking dentists questions in an online survey. Surprisingly, most of the dentists thought it would be better to only check people who are at a higher risk for oral cancer instead of checking everyone. Only about two thirds of the dentists regularly look for signs of oral cancer when people come for dental check-ups. The authors found that these dentists, on average, had noticed about 34 patients with concerning signs in the past year. Almost all the dentists believed that they needed more training to spot these problems. So, while opportunistic screening at the dentist's office is good, dental professionals also need to focus on other ways to prevent oral cancer, like checking high-risk groups and giving dentists more confidence to spot potential issues. In Sri Lanka, opportunistic screening is encouraged as a cost-effective tool to bring down the prevalence of oral cancer, which is the most common cancer among males. The objectives of the study were to determine the practices, attitudes, and level of competency of dental surgeons regarding the early detection of oral cancer and oral potentially malignant disorders (OPMDs) through opportunistic screening. A prospective study was conducted online via a Google form using a pretested, self-administered questionnaire of 22 close-ended questions and 3 open-ended questions. Out of the 137 dental surgeons who responded, 88% (121/137) of the participants believed that screening high-risk target groups would be more effective in the early detection of oral cancer rather than opportunistic screening. Only 64% (88/137) of the participants frequently check for oral cancer and OPMDs when patients visit for dental treatment. Participants recalled an average of 34 patients (4628/137) with clinically suspicious lesions being diagnosed during examination at general dental practice during the past year, and 98% (134/137) of the participants believed that they should receive additional training in order to identify and diagnose clinically suspicious OPMDs and oral cancer. Opportunistic screening in general dental practice as an oral-cancer prevention strategy is appreciable, but due emphasis should be given to other prevention strategies such as population screening and screening high-risk target groups. The level of confidence of general dental practitioners in the early detection of oral cancer has to be raised in order to achieve higher standards in oral cancer prevention through opportunistic screening. [ABSTRACT FROM AUTHOR]

BACKGROUND: Climate change scenarios illustrate various pathways in terms of global warming ranging from “sustainable development” (Shared Socioeconomic Pathway SSP1-1.9), the best-case scenario, to ‘fossil-fueled development’ (SSP5-8.5), the worst-case scenario. OBJECTIVES: We examined the extent to which increase in daily average urban summer temperature is associated with future cause-specific mortality and projected heat-related mortality burden for the current warming trend and these two scenarios. METHODS: We did an observational cohort study of 363,754 participants living in six cities in Finland. Using residential addresses, participants were linked to daily temperature records and electronic death records from national registries during summers (1 May to 30 September) 2000 to 2018. For each day of observation, heat index (average daily air temperature weighted by humidity) for the preceding 7 d was calculated for participants’ residential area using a geographic grid at a spatial resolution of 1 km × 1 km. We examined associations of the summer heat index with risk of death by cause for all participants adjusting for a wide range of individual-level covariates and in subsidiary analyses using case-crossover design, computed the related period population attributable fraction (PAF), and projected change in PAF from summers 2000–2018 compared with those in 2030–2050. RESULTS: During a cohort total exposure period of 582,111,979 summer days (3,880,746 person-summers), we recorded 4,094 deaths, including 949 from cardiovascular disease. The multivariable-adjusted rate ratio (RR) for high (≥21°C) vs. reference (14-15°C) heat index was 1.70 (95% CI: 1.28, 2.27) for cardiovascular mortality, but it did not reach statistical significance for noncardiovascular deaths, RR=1.14 (95% CI: 0.96, 1.36), a finding replicated in case-crossover analysis. According to projections for 2030-2050, PAF of summertime cardiovascular mortality attributable to high heat will be 4.4% (1.8%-7.3%) under the sustainable development scenario, but 7.6% (3.2%-12.3%) under the fossil-fueled development scenario. In the six cities, the estimated annual number of summertime heat-related cardiovascular deaths under the two scenarios will be 174 and 298 for a total population of 1,759,468 people. DISCUSSION: The increase in average urban summer temperature will raise heat-related cardiovascular mortality burden. The estimated magnitude of this burden is >1.5 times greater if future climate change is driven by fossil fuels rather than sustainable development. [ABSTRACT FROM AUTHOR]

Single‐cell Hi‐C (scHi‐C) has made it possible to analyze chromatin organization at the single‐cell level. However, scHi‐C experiments generate inherently sparse data, which poses a challenge for loop calling methods. The existing approach performs significance tests across the imputed dense contact maps, leading to substantial computational overhead and loss of information at the single‐cell level. To overcome this limitation, a lightweight framework called scGSLoop is proposed, which sets a new paradigm for scHi‐C loop calling by adapting the training and inferencing strategies of graph‐based deep learning to leverage the sequence features and 1D positional information of genomic loci. With this framework, sparsity is no longer a challenge, but rather an advantage that the model leverages to achieve unprecedented computational efficiency. Compared to existing methods, scGSLoop makes more accurate predictions and is able to identify more loops that have the potential to play regulatory roles in genome functioning. Moreover, scGSLoop preserves single‐cell information by identifying a distinct group of loops for each individual cell, which not only enables an understanding of the variability of chromatin looping states between cells, but also allows scGSLoop to be extended for the investigation of multi‐connected hubs and their underlying mechanisms. [ABSTRACT FROM AUTHOR]

Simple Summary: LCMR1 is a subunit of the mediator complex, also known as MED19, which is involved in various life activities and is closely related to the occurrence and development of tumors. In this study, we knocked down LCMR1 in large cell lung cancer cells and found that high expression of LCMR1 in LCLC indicates a poor prognosis. Meanwhile, blocking LCMR1 in the 95D LCLC cell line reduced proliferation and metastasis in vitro and in living organisms. LCMR1 inhibits the transcription of HLAs, a gating factor of cancer-specific antigen-presenting. Lung cancer is notorious for its high global morbidity and mortality. Here, we examined whether the LCMR1 gene, which we previously cloned from a human large-cell lung carcinoma cell line, contributes to the proliferation and metastasis of large-cell lung carcinoma. To this end, we performed pan-cancer and non-small cell lung cancer (NSCLC) cell line-based LCMR1 expression profiling. Results revealed that LCMR1 was expressed at high levels in most solid tumors, including NSCLC. LCMR1 expression was the highest in the 95D large cell lung cancer cell line. Functional studies using lentivirus-based knockdown revealed that LCMR1 was critical for the proliferation, migration, and invasion of cultured large cell lung cancer cells. Moreover, blocking this gene significantly reduced tumor growth in a 95D cell xenograft mouse model. A multiple sequence-based assay revealed a mechanism by which LCMR1 diminished the RNA Pol II occupancy at the promoter of human leukocyte antigen (HLA)-encoding genes to prevent their transcription. The HLA genes play vital roles in cancer-specific antigen presentation and anticancer immunity. A correlation assay using TCGA database identified a negative relationship between the expression levels of LCMR1 and HLA coding genes. Taken together, our findings demonstrate that LCMR1 is required for large cell lung cancer cell growth and invasion and suggest its potential as a valid target in clinical treatment. [ABSTRACT FROM AUTHOR]

Polymeric materials show great promise for use in a variety of dental applications. Manufacturers generally provide flexural strength information based on standardized (ISO and ASTM) specimen dimensions and loading conditions. It is not clear, however, if flexural strength data are predictive of the clinical performance of dental crowns. The objectives of this study were, therefore, to determine whether flexural strengths, as measured via three-point bending (3PB), would be predictive of failure loads assessed via crunch-the-crown (CTC) tests. Three brands of polymers (Trilor, Juvora, and Pekkton) were fabricated into rectangular bars and fully contoured crowns (10 specimens of each polymer brand, 30 specimens of each shape). Differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), and burn off tests were used to characterize/confirm the materials. Bars were tested blindly in 3PB to determine flexural strength, and crowns were CTC-tested to determine failure load after luting to resin abutments. The statistical significance of the test results was evaluated via one-way ANOVA (α = 0.05) and Pearson's correlation coefficient, while regression analysis was used to test for a correlation between 3PB and CTC results. The fracture mechanisms and failure surface characteristics were characterized using scanning electron microscopy (SEM). There were significant differences (p < 0.05) in the mean crown failure loads (Trilor (7033 N) > Juvora (5217 N) > Pekkton (3023 N)) and mean flexural strengths of the bars (Trilor (468 MPa) > Juvora (197 MPa) = Pekkton (192 MPa)). The mode of crown fracture was different between the materials and included deformation (Juvora), ductile-to-brittle fracture (Pekkton), and a combination of cracks and deformation (Trilor). Flexural strengths did not correlate with the corresponding crown failure loads for any of the materials tested. These results suggest that dental practitioners should not rely on the flexural strengths reported from three-point bending tests, as advertised by the manufacturer, to predict the performance of polymeric crowns. [ABSTRACT FROM AUTHOR]

Particle swarm optimization (PSO) is a population-based heuristic algorithm that is widely used for optimization problems. Phasor PSO (PPSO), an extension of PSO, uses the phase angle θ to create a more balanced PSO due to its increased ability to adjust the environment without parameters like the inertia weight w. The PPSO algorithm performs well for small-sized populations but needs improvements for large populations in the case of rapidly growing complex problems and dimensions. This study introduces a competitive coevolution process to enhance the capability of PPSO for global optimization problems. Competitive coevolution disintegrates the problem into multiple sub-problems, and these sub-swarms coevolve for a better solution. The best solution is selected and replaced with the current sub-swarm for the next competition. This process increases population diversity, reduces premature convergence, and increases the memory efficiency of PPSO. Simulation results using PPSO, fuzzy-dominance-based many-objective particle swarm optimization (FMPSO), and improved competitive multi-swarm PPSO (ICPPSO) are generated to assess the convergence power of the proposed algorithm. The experimental results show that ICPPSO achieves a dominating performance. The ICPPSO results for the average fitness show average improvements of 15%, 20%, 30%, and 35% over PPSO and FMPSO. The Wilcoxon statistical significance test also confirms a significant difference in the performance of the ICPPSO, PPSO, and FMPSO algorithms at a 0.05 significance level. [ABSTRACT FROM AUTHOR]

• Innovative phenotype-genotype association analysis for categorical genomic data having non-ignorable missing values. • Statistical learning method of random forest is used for variable selection in the analysis. • Weighted logistic ridge regression with EM algorithm is used for missing data imputation in the analysis. • Linear statistical hypothesis testing is used for determining the missingness mechanism in the analysis. • An application to analyzing real data from Australia breast cancer genome-wide association study (GWAS). Genomic data arising from a genome-wide association study (GWAS) are often not only of large-scale, but also incomplete. A specific form of their incompleteness is missing values with non-ignorable missingness mechanism. The intrinsic complications of genomic data present significant challenges in developing an effective and efficient procedure of phenotype-genotype association analysis by a statistical variable selection approach. In this paper we develop a coherent procedure of categorical phenotype-genotype association analysis, in the presence of missing values with non-ignorable missingness mechanism in genomic data. It is developed by integrating the statistical learning methods of random forest for variable selection, joint weighted logistic ridge regression with EM algorithm for missing data imputation, and linear statistical hypothesis testing for determining the missingness mechanism. Two simulated genomic datasets are used to undertake the phenotype-genotype association analysis by the proposed procedure, with the performance validated. The proposed procedure is then applied to analyze a real data set from breast cancer GWAS. [ABSTRACT FROM AUTHOR]

(1) Background: Fire department cadets preparing to become firefighters and paramedics experience high levels of stress when participating in incidents like traffic accidents and fires. Stress adversely affects health, and coping with it proves difficult. Unfortunately, there is no single method that reduces stress completely in humans. One non-invasive method for lowering stress hormone levels is craniosacral therapy. (2) Methods: Fifty-seven firefighting cadets aged 18–24 years (21.63 ± 1.41) participated in the study. They were randomly assigned to either a test group or a control group. Participants' blood levels of cortisol and CRH (corticotropin-releasing hormone) were assessed before and after the study. The study group underwent 5-week craniosacral therapy (1× per week). (3) Results: The Kruskal–Wallis test showed that the therapy group's results were statistically significant for CRH values (p-value = 0.00067) and for cortisol values (p-value ≤ 0.0001). Wilxocon and Dunn tests showed statistical significance for cortisol after CS therapy between the control and study groups (p = 0.0377), and for CRH between the control and study groups before (p = 0.00634) and after the study (p = 0.000887), and in the study group before and after the study (p = 0.0101). (4) Conclusions: The application of craniosacral therapy reduced stress hormone levels in male firefighter cadets. The results indicate that craniosacral therapy (five sessions, one per week) has an effect on the reduction of stress hormones. [ABSTRACT FROM AUTHOR]

Whether a compound prolongs cardiac repolarization independent of changes in beat rate is a critical question in drug research and development. Current practice is to resolve this in two steps. First, the QT interval is corrected for the influence of rate and then statistical significance is tested. There is renewed interest in improving the sensitivity of nonclinical corrected QT interval (QTc) assessment with modern studies having greater data density than previously utilized. The current analyses examine the effects of moxifloxacin or vehicle on the QT interval in nonhuman primates (NHPs) using a previously described one‐step method. The primary end point is the statistical sensitivity of the assessment. Publications suggest that for a four animal crossover (4 × 4) in NHPs the minimal detectable difference (MDD) is greater than or equal to 10 ms, whereas in an eight animal crossover the MDD is ~6.5 ms. Using the one‐step method, the MDD for the four animal NHP assessments was 3 ms. In addition, the one‐step model accounted for day‐to‐day differences in the heart rate and QT‐rate slope as well as drug‐induced changes in these parameters. This method provides an increase in the sensitivity and reduces the number of animals necessary for detecting potential QT change and represents "best practice" in nonclinical QTc assessment in safety pharmacology studies. [ABSTRACT FROM AUTHOR]

In order to develop a statistical model for complex interactions among factors affecting early childhood caries development (ECC), 234 children from the "XXXX oral growth longitudinal study" were analysed at ages 3, 4 and 5. A questionnaire for children's parents (clinical history, nutritional and oral hygiene habits) and clinical oral examinations were recorded each year. The probabilistic dependence structure on the most significant factors was modelled with an Undirected Graphical Model (UGM or Markov random fields) which provides a probabilistic reasoning approach for the establishment of multi-way associations. The best fitting UGM was estimated through the maximum likelihood principle and two-way factor associations were verified through Fisher's exact statistical hypothesis tests for count data. The effect of sugar intake on caries incidence is mediated by oral hygiene; for caries incidence, oral hygiene quality is more relevant than toothbrushing time; the effect of pacifier on caries incidence is statistically significant only when considered in combination with breastfeeding time. Among behavioural ECC risk factors, the quality of oral hygiene, and not the toothbrushing frequency, is a primary factor that modulates the sugar intake in his primary role of the ECC developer. School-based oral health programs for ECC prevention should be improved with supervised toothbrushing program. UGM analysis could improve the school-based oral health programs with more effective and efficient prevention strategies based on the hierarchical interactions among the ECC risk factors. Oral hygiene plays a pivotal role in early childhood caries and can modulate positively or negatively their development. Supervised toothbrushing is a crucial intervention to be included in the daily educational and clinical practice and in the school-based oral health promotion programs. Trial registration: Clinical trial registration number: NCT02798809. [ABSTRACT FROM AUTHOR]

Background: Diabetic neovascular glaucoma is a secondary glaucoma that may require immediate correction of elevated intraocular pressure to control pain and protect the optic nerve. While there is a seasonal trend to glucose levels, it is unknown if a seasonal trend exists for diabetic neovascular glaucoma. Objective: This study evaluates the incidence of urgent glaucoma tube shunt implantation in diabetic neovascular glaucoma in a tertiary academic referral center in Southern California. Methods: Electronic medical records were queried for urgent glaucoma tube shunt surgery from 2014 to 2021. The number of cases were separated by month of occurrence, and average hemoglobin A1c values were calculated per month. Data were analyzed via ANOVA tests and one-tailed t-tests. Results: A total of 127 cases were identified. The months of March and April contained the most cases averaging 3 and 2.75 cases, respectively. April had statistically significant higher case numbers than that of other months (P =.041). ANOVA tests excluding April showed no statistically significant difference between the remaining months (P =.901). Average hemoglobin A1c values were highest in the months of April and March at 9.8 and 9.6%, respectively. Conclusion: Emergency glaucoma tube shunt surgery for diabetic neovascular glaucoma occurs most frequently in April. This observation may provide insight into disease prevention through diabetes management and help improve surgical operations such that staffing and resources are allocated accordingly. [ABSTRACT FROM AUTHOR]

Quickly intensifying tropical cyclones (TCs) are exceptionally hazardous for Atlantic coastlines. An analysis of observed maximum changes in wind speed for Atlantic TCs from 1971 to 2020 indicates that TC intensification rates have already changed as anthropogenic greenhouse gas emissions have warmed the planet and oceans. Mean maximum TC intensification rates are up to 28.7% greater in a modern era (2001–2020) compared to a historical era (1971–1990). In the modern era, it is about as likely for TCs to intensify by at least 50 kts in 24 h, and more likely for TCs to intensify by at least 20 kts within 24 h than it was for TCs to intensify by these amounts in 36 h in the historical era. Finally, the number of TCs that intensify from a Category 1 hurricane (or weaker) into a major hurricane within 36 h has more than doubled in the modern era relative to the historical era. Significance tests suggest that it would have been statistically impossible to observe the number of TCs that intensified in this way during the modern era if rates of intensification had not changed from the historical era. [ABSTRACT FROM AUTHOR]

Background: Our aim was to determine whether child attachment to parents, parent attachment style, and morning cortisol levels were related to diabetes outcomes measured by average glycated hemoglobin (HbA1c), HbA1c variability over 4 years and time in range (TIR) in children with type 1 diabetes (T1D). Research design and methods: 101 children with T1D and one of their parents were assessed at baseline for child attachment (Child Attachment Interview; CAI) and parent attachment (Relationship Structures Questionnaire; ECR-RS). Serum samples were collected for cortisol measurements before the interviews. HbA1c levels were measured during a 4-year follow-up period at regular 3-monthly visits, and data for TIR were exported from blood glucose measuring devices. Multivariate linear regression models were constructed to identify independent predictors of glycemic outcomes. Results: More girls than boys exhibited secure attachment to their mothers. The results of the regression models showed that securely attached girls (CAI) had higher average HbA1c than did insecurely attached girls (B = −0.64, p = 0.03). In boys, the more insecure the parent's attachment style, the worse the child's glycemic outcome: the higher the average Hb1Ac (B = 0.51, p = 0.005), the higher the HbA1c variability (B = 0.017, p = 0.011), and the lower the TIR (B = −8.543, p = 0.002). Conclusions: Attachment in close relationships is associated with glycemic outcomes in children with T1D, and we observed significant differences between sexes. A sex- and attachment-specific approach is recommended when treating children with less favorable glycemic outcomes. Special attention and tailored support should be offered to securely attached girls in transferring responsibility for diabetes care and at least to male children of insecurely attached parents to prevent suboptimal glycemic control. Further studies in larger samples and more daily cortisol measurements may help us better understand the links between stress response, attachment and T1D. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is the most common time-dependent pathology that pre-hospital emergency medical services (EMS) are confronted with. Prioritisation of ambulance dispatch, initial actions and early pre-notification have a major impact on mortality and disability. The COVID-19 pandemic has led to disruptions in the operation of EMS due to the implementation of self-protection measures and increased demand for care. It is crucial to evaluate what has happened to draw the necessary conclusions and propose changes to improve the system's strength for the future. The study aims to compare prehospital time and neuroprotective care metrics for acute stroke patients during the first wave of COVID-19 and the same periods in the years before and after. Methods: Analytical, observational, multicentre study conducted in the autonomous communities of Andalusia, Catalonia, Galicia, and Madrid in the pre-COVID-19 (2019), "first wave" of COVID-19 (2020) and post-COVID-19 (2021) periods. Consecutive non-randomized sampling. Descriptive statistical analysis and hypothesis testing to compare the three time periods, with two by two post-hoc comparisons, and multivariate analysis. Results: A total of 1,709 patients were analysed. During 2020 there was a significant increase in attendance time of 1.8 min compared to 2019, which was not recovered in 2021. The time of symptom onset was recorded in 82.8% of cases, and 83.3% of patients were referred to specialized stroke centres. Neuroprotective measures (airway, blood glucose, temperature, and blood pressure) were performed in 43.6% of patients. Conclusion: During the first wave of COVID-19, the on-scene times of pre-hospital emergency teams increased while keeping the same levels of neuroprotection measures as in the previous and subsequent years. It shows the resilience of EMS under challenging circumstances such as those experienced during the pandemic. [ABSTRACT FROM AUTHOR]

One highly sought-after vegetable is Kalian (Brassica oleraceae L.), valued for its exceptional nutritional content. The cultivation of kalian demands specialized attention. Hydroponic cultivation utilizing Calcium Chloride plays a pivotal role in fostering robust plant growth and resilience, particularly in urban settings. Calcium serves a multifaceted role: safeguarding against pests, enhancing fruit quality, and functioning as an antioxidant during storage. This research was conducted between October 2022 and February 2023, employing a single-factor Randomized Block Design (RBD) that was replicated three times. The study encompassed the following treatments: (i) Control with 0 ppm CaCl2, (ii) 550 ppm CaCl2 (P1), (iii) 650 ppm CaCl2 (P2), and (iv) 750 ppm CaCl2 (P3). The observed parameters encompassed plant height, leaf count, leaf area, fresh weight, and dry weight. The data underwent analysis via analysis of variance (ANOVA), followed by the Honest Significant Difference (HSD) test at the 5% significance level. The outcomes of the study unveiled substantial and statistically significant responses at the 7th, 14th, 21st, and 28th days after planting (HST) concerning the leaf count and wet weight variables. However, no statistically significant response was observed in relation to root length and leaf area measurements. [ABSTRACT FROM AUTHOR]

In the context of climate warming, flash drought has become increasingly frequent, posing significant threats to agriculture, ecosystems, and the environment. Xinjiang, located in an arid and semi-arid region, necessitates a thorough investigation into the distinctions between flash drought and traditional drought, as well as an exploration of the driving forces behind both types of drought. In this study, soil moisture data from ERA5-Land were utilized to construct a framework for the identification of flash drought and traditional drought based on historical events. The Geodetector was employed to explore the factors that influence the spatial heterogeneity of these two drought forms. The findings illuminate that (1) in terms of spatial distribution, traditional drought predominated in southern Xinjiang, while flash drought exhibited greater prominence in northern Xinjiang. (2) Regarding changes in trends, both flash drought and traditional drought exhibited an increasing trend in frequency since the 1990s, with the frequency trend of flash drought passing the significance test (α ≤ 0.05). Additionally, the severity of both flash drought and traditional drought displayed a noteworthy and statistically significant increase within sliding windows ranging from 46 to 62 years. (3) Concerning the driving forces, precipitation emerged as the principal driving force behind both flash drought and traditional drought. Furthermore, human activities exerted a more substantial influence on traditional drought, and the interactions involving human activities had the potential to significantly amplify the explanatory power of the spatial heterogeneity for both drought types. (4) In terms of the drought risk, a notable variation in the risk of flash drought was observed across various ecological zones, with the highest risk occurring in mildly fragile ecological zones. Furthermore, when comparing the results from 1995 to 2019, the flash drought risk exhibited a marked increase in severely fragile ecological zones. This study enriches the understanding of the dynamics of flash drought and traditional drought in Xinjiang and carries important implications for enhancing the precision of drought monitoring and early warning systems. [ABSTRACT FROM AUTHOR]

Background: The first 1,000 days of a child’s life is a critical window for growth faltering, deficiencies, and common childhood illnesses. Even with optimum breastfeeding, children 6-23 months are at higher risk of being undernourished if they do not receive adequate and appropriate complementary feeding. Therefore, this study was carried out to assess the nutritional status of children 6-23 months and find the association between sociodemographic profile and nutritional status. Materials and Methods: Mothers of 411 children of age 6-23 months in an urban area of Raipur were interviewed using a pretested questionnaire based on the WHO indicators to record their complementary feeding practices. Weight, height, and mid-upper arm circumference (MUAC) was taken to assess the nutritional status. Overall and specific (sex-wise and severity-wise) prevalence rate of stunting, wasting, and underweight were calculated. The distribution of these according to various factors like infant and young child feeding practices, and details of study subject and family were calculated. Chi-square test of significance was applied to find the association between nutritional status and independent variables and their strength of association. Results: The prevalence of wasting was 25%, underweight 30%, and stunting 15%. Statistically significant association of underweight with age of the parents, both mother and father, was observed (P < 0.05). Minimum dietary diversity was achieved by only 4.1% and minimum acceptable diet by 2.4% children. Conclusions: The prevalence of wasting and undernutrition was assessed. Complementary feeding indicators were unsatisfactory among children. Ending all forms of malnutrition is the global goal. The Sustainable Development Goals (SDGs) that directly affect or indirectly influence nutrition have to be recalled at this stage and addressing malnutrition is a key element required to achieving them. [ABSTRACT FROM AUTHOR]

Symmetry in a differential evolution (DE) transforms a solution without impacting the family of solutions. For symmetrical problems in differential equations, DE is a strong evolutionary algorithm that provides a powerful solution to resolve global optimization problems. DE/best/1 and DE/rand/1 are the two most commonly used mutation strategies in DE. The former provides better exploitation while the latter ensures better exploration. DE/Neighbor/1 is an improved form of DE/rand/1 to maintain a balance between exploration and exploitation which was used with a random neighbor-based differential evolution (RNDE) algorithm. However, this mutation strategy slows down convergence. It should achieve a global minimum by using 1000 × D, where D is the dimension, but due to exploration and exploitation balancing trade-offs, it can not achieve a global minimum within the range of 1000 × D in some of the objective functions. To overcome this issue, a new and enhanced mutation strategy and algorithm have been introduced in this paper, called DE/Neighbor/2, as well as an improved random neighbor-based differential evolution algorithm. The new DE/Neighbor/2 mutation strategy also uses neighbor information such as DE/Neighbor/1; however, in addition, we add weighted differences after various tests. The DE/Neighbor/2 and IRNDE algorithm has also been tested on the same 27 commonly used benchmark functions on which the DE/Neighbor/1 mutation strategy and RNDE were tested. Experimental results demonstrate that the DE/Neighbor/2 mutation strategy and IRNDE algorithm show overall better and faster convergence than the DE/Neighbor/1 mutation strategy and RNDE algorithm. The parametric significance test shows that there is a significance difference in the performance of RNDE and IRNDE algorithms at the 0.05 level of significance. [ABSTRACT FROM AUTHOR]

Differential evolution (DE) stands out as a straightforward yet remarkably powerful evolutionary algorithm employed for real-world problem-solving purposes. In the DE algorithm, few parameters are used, and the population is evolved by applying various operations. It is difficult in evolutionary computation algorithms to maintain population diversity. The main issue is the sub-population of the DE algorithm that helps improve convergence speed and escape from the local optimum. Evolving sub-populations by maintaining diversity is an important issue in the literature that is considered in this research. A solution is proposed that uses sub-populations to promote greater diversity within the population and improve the algorithm performance. DE, heterogeneous distributed differential evolution (HDDE), multi-population ensemble differential evolution (MPEDE), and the proposed improved multi-population ensemble differential evolution (IMPEDE) are implemented using parameter settings; population sizes of 100 NP, 150 NP, and 200 NP; and dimensions of 10D, 30D, and 50D for performance comparison. Different combinations of mutations are used to generate the simulated results. The simulation results are generated using 1000, 3000, and 5000 iterations. Experimental outcomes show the superior results of the proposed IMPEDE over existing algorithms. The non-parametric significance Friedman test confirms that there is a significant difference in the performance of the proposed algorithm and other algorithms used in this study by considering a 0.05 level of significance using six benchmark functions. [ABSTRACT FROM AUTHOR]

Patellofemoral pain (PFP) is a common source of knee pain in active individuals, accounting for a large number of knee injuries examined in sports medicine clinics. As a chronic condition, PFP can affect mental health. However, this effect has not yet been studied in individuals with PFP. To determine how subjective physical and mental health measures in individuals with PFP differed from those measures in pain-free individuals. Case-control study. Laboratory. Volunteers for the study were 30 people with PFP (19 women, 11 men; age = 20.23 ± 3.32 years, height = 166.69 ± 6.41 cm, mass = 69.55 ± 13.15 kg) and 30 matched pain-free individuals (19 women, 11 men; age = 20.33 ± 3.37 years, height = 169.31 ± 9.30 cm, mass = 64.02 ± 11.00 kg). Current and worst pain levels in the past 24 hours were determined using a visual analog scale (VAS). The Anterior Knee Pain Scale, Fear Avoidance Belief Questionnaire, and Lower Extremity Functional Scale were administered. Physical and mental health measures were obtained using a modified 12-item Short Form Health Survey. Scores for 2 subscales on the modified Short Form-12 were weighted and calculated: physical component and mental component. Independent t tests were calculated to compare variables between groups. Coefficient correlations were used to measure the associations between the variables. Individuals with PFP reported lower levels of physical (pain free: 56.13 ± 1.63, PFP: 50.54 ± 7.10, P <.001) and mental (pain-free: 53.32 ± 4.71, PFP: 48.64 ± 10.53, P =.03) health. In the PFP group, we found moderate negative correlations between the VAS score for current pain and mental health (r = −0.52, P <.01) and between the VAS score for worst pain in the past 24 hours and mental health (r = −0.46, P =.01) and between activity limitations in individuals with PFP and fear avoidance beliefs (r = −0.61, P <.01). Our results should encourage clinicians, especially musculoskeletal rehabilitation professionals, to acknowledge the importance of a whole-person approach when treating or planning rehabilitation programs for individuals with PFP. [ABSTRACT FROM AUTHOR]

The current research explored the antecedents and consequences of the memorable experiences of Chinese tourists in duty-free shopping. Utilitarian (i.e., savings, quality, and convenience) and hedonic (i.e., value expression, exploration, and entertainment) benefits were proposed to enhance the memorable experiences of these tourists. Unlike previous studies, this study examined the antecedents and consequences of memorable experiences in the field of duty-free shopping for the first time. Based on these theoretical relationships, a research model with 11 hypotheses was developed and the hypotheses tested with data collected from 523 Chinese tourists with shopping experiences at duty-free shops in Korea. The results of structural equation modeling analysis indicated that savings, quality, exploration, and entertainment benefits play important roles in the formation of memorable experiences. Additionally, memorable experiences were found to be an important predictor of brand attitude and brand preference. Moreover, brand preference had a positive influence on WOM. [ABSTRACT FROM AUTHOR]

As the most commonly established and attested language contact phenomenon, loanwords, also known as lexical borrowings, may undergo transformations when borrowed from the source language (SL) to the borrowing language (BL). Previous studies have separately illustrated the role of perception and phonology in the borrowing process. However, the speech perception or phonology contributes more to the adaptation pattern in some cases than others. Few studies attempt to explain this phenomenon. To fill in the gap, the present study hypothesizes that differences in borrowers' L2 proficiency level of the SL are the potential source. To examine this hypothesis, an online adaptation experiment was designed and conducted. The experiment examines how Mandarin Chinese native speakers adapt the English non-words ended in the combination of low vowel and nasal coda. The results suggest that BL monolinguals and less proficient L2 learners of the SL tend to use a phonetic mapping strategy guided by the backness of vowels, while advanced learners of the SL are more likely to adopt a phonological mapping strategy based on coda nasal place. This paper concludes by proposing that borrowers' L2 proficiency level has an effect on the certain randomized variations in the process of loanword adaptation. [ABSTRACT FROM AUTHOR]

Studies illustrate progress in financial technology in Pakistan; nevertheless, the uncertain obstacle that prevents clients from adopting financial technology remains unclear. The research on the perceived risk, particularly in using financial technology in Pakistan, is limited. Therefore, this research bridges this gap. Two hundred ten members partook in this exploration. We have used the structural equation modeling approach to probe the acquired information and hypothesis. Empirical results show that three of eight perceived risk factors: performance risk, financial risk, and overall risk, have a substantial adverse effect on the intention to utilize financial technology. The highest impact was performance risk, followed by financial risk and overall risk. Whereas the other five risks: social risk, time risk, security risk, legal risk, and psychological risk, statistically have no substantial adverse effect on intent to utilize financial technology. The outcomes help experts better conceptualize and diminish hazard boundaries in planning for the disturbance of financial technology (fintech). Experts are likewise encouraged to focus on fintech's operational aptitudes and utilitarian framework execution in fintech administrations. [ABSTRACT FROM AUTHOR]

Introduction: Researchers must concentrate their focus on whether patients understand various treatment options available among removable complete and partial denture patients and whether they are aware of the maintenance protocol of the prosthesis. Materials and Methods: All the patients who completed removable partial or complete denture treatment in a period of 6 months were included in the study. Collected data were statistically analyzed using Chi-square test at a significance level of P < 0.05. Results: Awareness needs to be increased regarding the treatment options available for removable complete and partial denture treatment causes because many subjects in this study were only aware of the removable partial denture and complete denture treatment for missing teeth and not the other options, especially among individuals in the lower socioeconomic group. Conclusion: The findings indicate that awareness needs to be increased regarding the functions of prostheses such as esthetics and phonetics because many subjects in this study were only aware of the masticatory function performed by prosthesis. [ABSTRACT FROM AUTHOR]

Sense of belongingness in the academic environment has been associated with positive student outcomes and increased student success. To cultivate belongingness, graduate nursing students were invited to participate in a virtual fitness challenge. Sense of belongingness was measured through pre-(n = 103) and post-intervention (n = 64) surveys with three subscales: other students, faculty, and the university. Students reported improved sense of belongingness following the intervention for all subscales, with statistically significant improvements related to other students (p = .007) and the university (p = .023). A virtual fitness challenge may improve sense of belongingness among graduate nursing students. [ABSTRACT FROM AUTHOR]

Acta Obstetricia et Gynecologica Scandinavica (AOGS) has updated its guidelines for authors to report methods and statistical analyses. The guidelines reflect recent advancements in research methodology and address concerns about the misuse of statistical hypothesis testing. The guidelines aim to promote transparency and best practices in scholarly publishing by encouraging consistent and standardized reporting. They also emphasize the interpretation of effect sizes and confidence intervals, rather than relying solely on statistical significance. The guidelines cover various aspects of experimental and observational studies and are aligned with the EQUATOR network's guidelines for health research. AOGS encourages authors to adhere to these guidelines to enhance the credibility and understanding of their research. [Extracted from the article]

Health systems worldwide are implementing lung cancer screening programmes to identify early-stage lung cancer and maximise patient survival. Volumetry is recommended for follow-up of pulmonary nodules and outperforms other measurement methods. However, volumetry is known to be influenced by multiple factors. The objectives of this systematic review (PROSPERO CRD42022370233) are to summarise the current knowledge regarding factors that influence volumetry tools used in the analysis of pulmonary nodules, assess for significant clinical impact, identify gaps in current knowledge and suggest future research. Five databases (Medline, Scopus, Journals@Ovid, Embase and Emcare) were searched on the 21st of September, 2022, and 137 original research studies were included, explicitly testing the potential impact of influencing factors on the outcome of volumetry tools. The summary of these studies is tabulated, and a narrative review is provided. A subset of studies (n = 16) reporting clinical significance were selected, and their results were combined, if appropriate, using meta-analysis. Factors with clinical significance include the segmentation algorithm, quality of the segmentation, slice thickness, the level of inspiration for solid nodules, and the reconstruction algorithm and kernel in subsolid nodules. Although there is a large body of evidence in this field, it is unclear how to apply the results from these studies in clinical practice as most studies do not test for clinical relevance. The meta-analysis did not improve our understanding due to the small number and heterogeneity of studies testing for clinical significance. Critical relevance statement: Many studies have investigated the influencing factors of pulmonary nodule volumetry, but only 11% of these questioned their clinical relevance in their management. The heterogeneity among these studies presents a challenge in consolidating results and clinical application of the evidence. Key points: • Factors influencing the volumetry of pulmonary nodules have been extensively investigated. • Just 11% of studies test clinical significance (wrongly diagnosing growth). • Nodule size interacts with most other influencing factors (especially for smaller nodules). • Heterogeneity among studies makes comparison and consolidation of results challenging. • Future research should focus on clinical applicability, screening, and updated technology. [ABSTRACT FROM AUTHOR]

The main objective of this study is to assess the impact of unobserved heterogeneity on microfinance social efficiency analysis. Based on recent nonparametric techniques and directional distances, we identify a latent heterogeneity factor related to the microfinance institute (MFI) manager's ability to promote women, independent of MFI size. We test for the significance of this unobserved factor and analyze the impact of MFI social inefficiency measures. Using a cross-country sample of 501 MFIs in 2011 from six main regions of the world, our findings reveal a significant effect of unobserved heterogeneity on the frontier and hence stress the importance of subjective factors in defining the set of production possibilities. We assess the robustness of our findings with the considered profit-oriented status and analyze the link between our unobserved heterogeneity factor and institutional and socioeconomic indicators. [ABSTRACT FROM AUTHOR]

When the in/consistency in Pairwise Comparisons (PCs) is taken into consideration as the subarea of the Multi Attribute Decision Making (MADM) scientific field, it has many repercussions in various types of research areas including different modelling scenarios e.g. reduction of inconsistency during PCs, deriving appropriate consistency thresholds for inconsistent Pairwise Comparison Matrices (PCMs), completing of incomplete PCMs, aggregating of individual PCMs in relation to Group Decision Making (GDM) aspects, and PCMs in/consistency relation to credibility of Priority Vectors (PV) derived from PCMs with the application of various Priorities Deriving Methods (PDMs). The examination objective in the latter area of research is the uncertainty related to the inexactitude of prioritization based on derived PVs. However, only few research studies examine this problem from the perspective of PCM applicability for credible designation of decision maker's (DM) priorities in the way that leads to minimization of the prioritization uncertainty related to possible, and sometimes very probable, ranking fluctuations. This problem constitutes the primary area of interest for this research paper as no research study was thus far identified that examines this problem from the perspective of consistent PCMs. Hence, a research gap was identified. Thus, the objective of this research paper is to fill in this scientific gap. The research findings have serious repercussions in relation to prioritization quality with the application of PCs methodology, mostly in relation to the interpretation and reliability evaluation of prioritization results. Firstly, the research study outcome changes the perspective of the rank reversal phenomenon, which shed new light on many research studies that have been presented in the subject's literature for many decades. Secondly, the research study results throw new light on the discussion concerning the fuzziness of AHP's results. Last but not least, the effect of the research opens the unique opportunity to evaluate the prioritization outcome obtained within the process of consistent PCs from the well-known perspective of statistical hypothesis testing i.e. the probability designation of the chance that accepted ranking results which were considered as correct due to low probability of change may be incorrect, hence they should be rejected, and the probability designation of the chance that rejected ranking results which were considered as incorrect due to high probability of change may be correct and should be accepted. The paramount finding of the research is the fact that consistent PCMs provide PVs, which elements cannot be considered as established, but only approximated within certain confidence intervals estimated with a certain level of probability. As problems related to heuristics can be analyzed only via a computer simulation process, because they cannot be mathematically determined, the problem examined in this research paper is examined via Monte Carlo simulations, appropriately coded and executed with the application of Wolfram's Mathematica Software. It is believed that this research findings should be very important and useful for all decision makers and researchers during their problems' examinations that relate to prioritization processes with the application of PCs methodology. [ABSTRACT FROM AUTHOR]

Preoperative homeostasis of sex hormones in testicular germ cell tumor (TGCT) patients is scarcely characterized. We aimed to explore regulation of sex hormones and their implications for histopathological parameters and prognosis in TGCT using a data-driven explorative approach. Pre-surgery serum concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), estradiol (E2) and prolactin were measured in a retrospective multicenter TGCT cohort (n = 518). Clusters of patients were defined by latent class analysis. Clinical, pathologic and survival parameters were compared between the clusters by statistical hypothesis testing, Random Forest modeling and Peto-Peto test. Cancer tissue expression of sex hormone-related genes was explored in the publicly available TCGA cohort (n = 149). We included 354 patients with pure seminoma and 164 patients with non-seminomatous germ cell tumors (NSGCT), with a median age of 36 years. Three hormonal clusters were defined: 'neutral' (n = 228) with normal sex hormone homeostasis, 'testicle' (n = 91) with elevated T and E2, low pituitary hormones, and finally 'pituitary' subset (n = 103) with increased FSH and LH paralleled by low-to-normal levels of the gonadal hormones. Relapse-free survival in the hormonal subsets was comparable (p = 0.64). Cancer tissue expression of luteinizing hormone- and follicle-stimulating hormone-coding genes was significantly higher in seminomas, while genes of T and E2 biosynthesis enzymes were strongly upregulated in NSGCT. Substantial percentages of TGCT patients are at increased risk of sex hormone dysfunction at primary diagnosis before orchiectomy. TGCT may directly influence systemic hormonal homeostasis by in-situ synthesis of sex hormones. [ABSTRACT FROM AUTHOR]

Beatrix Frangepán (* c. 1480, +(27 March) 1510) from the Counts of Veglia (Krk), Modrus and Zengg was a descendant from one of the leading families of the Hungarian–CroatianHungarian–Croatian late Medieval Kingdom. She became wife of Crown Prince János Corvinus-Hunyadi and later of Margrave Georg Hohenzollern-Brandenburg. From her first marriage, she had three children. One of these, Kristóf, who died young, was buried together with his father in Lepoglava (Croatia). Recently, successful archaeogenetic analyses have been performed on the remains of János and Kristóf Corvinus-Hunyadi; and in the course of these studies, the family background of Kristóf's mother, Beatrix Frangepán, became an important factor. The present study provides a nine-generation family tree of Beatrix Frangepan as a complementary data pool for an eventual expansion of the archaeogenetic studies. Preliminary results of archaeological study of the supposed grave of Beatrix Frangepán are also reported. [ABSTRACT FROM AUTHOR]

In most Western European societies, surnames pass from generation to generation and in cases where surnames are shared by fathers to children, the Y chromosome passes down from fathers to male offspring in the same way as surnames do. The aim of this study was to ascertain the patrilineal relationship between individuals with the surname "Castilla" and their respective Y-chromosome haplotypes. The toponymic surname "Castilla" is part of the Spanish royal family. Genealogical studies of this surname have allowed the formulation of different hypotheses about its origin, most of which were centered in Burgos. To shed some light on the origin of the surname Castilla and to investigate the possible co-ancestry behind the living carriers of this surname, markers located in the Y chromosome-specific region were analyzed in a sample of 102 men whose paternal surname was Castilla. The study aimed to establish the minimum number of founders and the expansion time of the lineages from our sample. Two major haplogroups were identified: R1b and E1b1b-M81. The high frequency of the E1b1b-M81 haplogroup in comparison to that of the general Spanish population, its low haplotype diversity, and its young TMRCA (323+/− 255 years CE) are compatible with the historical timing of the obligation to use surnames. However, the coincidence of the most common haplogroup in the Castilla sample and the most frequent haplogroup in the Spanish general population, R1b, makes it difficult to identify founder haplotypes/haplogroups in the history of the Castilla surname. [ABSTRACT FROM AUTHOR]

The timely detection of special nuclear material (SNM) transfers between nuclear facilities is an important monitoring objective in nuclear nonproliferation. Persistent monitoring enabled by successful detection and characterization of radiological material movements could greatly enhance the nuclear nonproliferation mission in a range of applications. Supervised machine learning can be used to signal detections when material is present if a model is trained on sufficient volumes of labeled measurements. However, the nuclear monitoring data needed to train robust machine learning models can be costly to label since radiation spectra may require strict scrutiny for characterization. Therefore, this work investigates the application of semi-supervised learning to utilize both labeled and unlabeled data. As a demonstration experiment, radiation measurements from sodium iodide (NaI) detectors are provided by the Multi-Informatics for Nuclear Operating Scenarios (MINOS) venture at Oak Ridge National Laboratory (ORNL) as sample data. Anomalous measurements are identified using a method of statistical hypothesis testing. After background estimation, an energy-dependent spectroscopic analysis is used to characterize an anomaly based on its radiation signatures. In the absence of ground-truth information, a labeling heuristic provides data necessary for training and testing machine learning models. Supervised logistic regression serves as a baseline to compare three semi-supervised machine learning models: co-training, label propagation, and a convolutional neural network (CNN). In each case, the semi-supervised models outperform logistic regression, suggesting that unlabeled data can be valuable when training and demonstrating value in semi-supervised nonproliferation implementations. [ABSTRACT FROM AUTHOR]

The Qilian Mountains (QMs) act as the "water tower" of the Hexi Corridors, playing an important role in the regional ecosystem security and economic development. Therefore, it is of great significance to understand the spatiotemporal characteristics of precipitation in the QMs. This study evaluated the performance of 21 models of phase 6 of the Coupled Model Intercomparison Project (CMIP6) from 1959 to 1988 based on ERA5 and in situ datasets. In addition, the precipitation changing trend from 2015 to 2100 was projected according to four shared socioeconomic pathways (SSPs): namely, SSP126, SSP245, SSP370, and SSP585. The results have shown the following: (1) all CMIP6 models could reflect the same precipitation changing trend, based on the observed datasets (−2.01 mm·10a−1), which was slightly lower than that of ERA5 (2.82 mm·10a−1). Multi-mode ensemble averaging (MME) showed that the projected precipitation-change trend of the four scenarios was 5.73, 9.15, 12.23, and 16.14 mm·10a−1, respectively. (2) The MME and ERA5 showed the same precipitation spatial pattern. Also, during the period 1959–1988, the MME in spring, summer, autumn and winter was 130.07, 224.62, 95.96, and 29.07 mm, respectively, and that of ERA5 was 98.57, 280.77, 96.85, and 22.64 mm, respectively. The largest precipitation difference in summer was because of strong convection and variable circulation. (3) From 2015 to 2100, the snow-to-rain ratio was between 0.1 and 1.1, and the snow-to-rain ratio climate tendency rate was concentrated in the range of −10~0.1 mm·10a−1. Both of these passed the significance test (p < 0.05). The projected rainfall of all four SSPs all showed an increasing trend with values of 6.20, 11.31, 5.64, and 20.41 mm·10a−1, respectively. The snowfall of the four SSPs all showed a decreasing trend with values of 0.42, 2.18, 3.34, and 4.17 mm·10a−1, respectively. [ABSTRACT FROM AUTHOR]

Local structural equation models (LSEM) are structural equation models that study model parameters as a function of a moderator. This article reviews and extends LSEM estimation methods and discusses the implementation in the R package sirt. In previous studies, LSEM was fitted as a sequence of models separately evaluated as each value of the moderator variables. In this article, a joint estimation approach is proposed that is a simultaneous estimation method across all moderator values and also allows some model parameters to be invariant with respect to the moderator. Moreover, sufficient details on the main estimation functions in the R package sirt are provided. The practical implementation of LSEM is demonstrated using illustrative datasets and an empirical example. Moreover, two simulation studies investigate the statistical properties of parameter estimation and significance testing in LSEM. [ABSTRACT FROM AUTHOR]

INTRODUCTION The use of e-cigarettes has steadily increased, and vocational students are one primary target of e-cigarette marketing. This cross-sectional survey research aimed to explore e-cigarette use and examine the factors associated with it. METHODS Multistage cluster random sampling was employed to select 1536 students in vocational education institutions. A self-administered questionnaire was used to collect the data from September to December 2019. Multinomial logistic regression analysis was used to obtain the adjusted odds ratio (AOR) to determine the associated factors of e-cigarette use. RESULTS Altogether, 28.7% of the subjects were currently e-cigarette users, 7.4% used e-cigarettes only, and 21.3% were dual users. Various factors were found to be significantly associated with e-cigarette use by 43.7%. Those consisted of sex (male) (AOR=2.183; 95% CI: 1.510-3.157), grade point average (GPA) of <2.5 (AOR=2.363; 95% CI: 1.502-3.717), having neutral attitudes toward e-cigarette use (AOR=2.676; 95% CI: 1.499-4.779) and positive attitudes toward e-cigarette use (AOR=4.171; 95% CI: 2.250-7.734), moderate level of perceived behavioral control on e-cigarette use (AOR=3.520; 95% CI: 2.287-5.418) and low level of perceived behavioral control on e-cigarettes use (AOR=4.959; 95% CI: 3.274-7.511), moderate price of e-cigarettes (AOR=1.436; 95% CI: 1.009-2.044), and e-cigarette use of their parents (AOR=1.827; 95% CI: 1.137-2.938), close friends (AOR=4.327; 95% CI: 2.954-6.338) and idols (AOR=4.604; 95% CI: 1.844-11.497). CONCLUSIONS Students should be encouraged to develop negative attitudes toward e-cigarette use and increase their self-confidence to control the use of e-cigarettes. This can be achieved by regularly distributing information on the product's risks. Moreover, students can find inspiration and guidance from peers, close friends, or their idols, who will act as positive role models and inspire them not to initiate e-cigarette use. [ABSTRACT FROM AUTHOR]

BACKGROUND: Newborns can be exposed to inorganic arsenic (iAs) through contaminated drinking water, formula, and other infant foods. Epidemiological studies have demonstrated a positive association between urinary iAs levels and the risk of developing nonalcoholic fatty liver disease (NAFLD) among U.S. adolescents and adults. OBJECTIVES: The present study examined how oral iAs administration to neonatal mice impacts the intestinal tract, which acts as an early mediator for NAFLD. METHODS: Neonatal mice were treated with a single dose of iAs via oral gavage. Effects on the small intestine were determined by histological examination, RNA sequencing, and biochemical analysis. Serum lipid profiling was analyzed by fast protein liquid chromatography (FPLC), and hepatosteatosis was characterized histologically and biochemically. Liver X receptor-alpha (LXRα) knockout (퐿푥푟α-/-) mice and liver-specific activating transcription factor 4 (ATF4)-deficient (퐴푡푓 4Δ퐻푒푝) mice were used to define their roles in iAs-induced effects during the neonatal stage. RESULTS: Neonatal mice exposed to iAs via oral gavage exhibited accumulation of dietary fat in enterocytes, with higher levels of enterocyte triglycerides and free fatty acids. These mice also showed accelerated enterocyte maturation and a longer small intestine. This was accompanied by higher levels of liver-derived very low-density lipoprotein and low-density lipoprotein triglycerides, and a lower level of high-density lipoprotein cholesterol in the serum. Mice exposed during the neonatal period to oral iAs also developed hepatosteatosis. Compared with the control group, iAs-induced fat accumulation in enterocytes became more significant in neonatal 퐿푥푟α-/- mice, accompanied by accelerated intestinal growth, hypertriglyceridemia, and hepatosteatosis. In contrast, regardless of enterocyte fat accumulation, hepatosteatosis was largely reduced in iAs-treated neonatal 퐴푡푓 4Δ퐻푒푝 mice. CONCLUSION: Exposure to iAs in neonatal mice resulted in excessive accumulation of fat in enterocytes, disrupting lipid homeostasis in the serum and liver, revealing the importance of the gut–liver axis and endoplasmic reticulum stress in mediating iAs-induced NAFLD at an early age. [ABSTRACT FROM AUTHOR]

With the proliferation of the Industry 4.0 paradigm, the inadequacy of conventional quality management tools has become increasingly apparent. The preliminary investigation presented in this paper focuses on the identification of the Quality 4.0 readiness level of organizations operating in the Czech Republic, Poland, and Slovakia, as well as affecting factors. The study is based on the review of relevant literature. The web-based questionnaire enabling organizations' representatives through Computer-Assisted Web Interviewing (CAWI) to take part in the study was used. Data from 298 completed responses were subjected to comprehensive analysis. Descriptive statistics and hypothesis testing were applied to analyse the data. Small and medium-sized organizations achieve low levels of Quality 4.0 readiness. Large organizations are better prepared. The study confirmed the dependence between the Quality 4.0 readiness level and whether the organization operates in automotive, while automotive organizations achieved a higher level of Quality 4.0 readiness than other organizations. The significant relationship between the Quality 4.0 readiness level and whether the organization has a certified management system was also confirmed. Received data also enabled the identification of the main barriers and benefits of Quality 4.0 implementation perceived by the organizations. The research findings identify the challenges that enterprises face regarding the Quality 4.0 implementation and the necessary support that organizations require. These findings can be a foundation for developing novel research initiatives and implementation programs. The research results contribute to the existing body of knowledge and bring new information and insights into the field of quality digitalization. [ABSTRACT FROM AUTHOR]

Background: In research designs that rely on observational ratings provided by two raters, assessing inter-rater reliability (IRR) is a frequently required task. However, some studies fall short in properly utilizing statistical procedures, omitting essential information necessary for interpreting their findings, or inadequately addressing the impact of IRR on subsequent analyses' statistical power for hypothesis testing. Methods: This article delves into the recent publication by Liu et al. in BMC Cancer, analyzing the controversy surrounding the Kappa statistic and methodological issues concerning the assessment of IRR. The primary focus is on the appropriate selection of Kappa statistics, as well as the computation, interpretation, and reporting of two frequently used IRR statistics when there are two raters involved. Results: The Cohen's Kappa statistic is typically utilized to assess the level of agreement between two raters when there are two categories or for unordered categorical variables with three or more categories. On the other hand, when it comes to evaluating the degree of agreement between two raters for ordered categorical variables comprising three or more categories, the weighted Kappa is a widely used measure. Conclusion: Despite not substantially affecting the findings of Liu et al.?s study, the statistical dispute underscores the significance of employing suitable statistical methods. Rigorous and accurate statistical results are crucial for producing trustworthy research. [ABSTRACT FROM AUTHOR]

Background: Primary headache disorders are a group of highly prevalent and disabling neurological diseases that mainly consist of migraine and tension-type headache (TTH). A previous study showed that the burden of headaches peaked at a working age that ranged from 15 to 49, particularly among females, affecting their productivity and severely damaging their social interactions. Methods: The latest dataset was retrieved from the Global Burden of Disease (GBD) Study 2019. Three indicators, including prevalence, incidence, and years lived with disability (YLDs), were adopted for evaluation. The overall and specific headache burdens were fully compared and analysed at global, regional, and national levels. The ratio of female YLD rates to male YLD rates due to headaches was calculated to estimate the sex pattern. Finally, we utilized the two-tailed Spearman test to explore the potential association between socioeconomic background and headaches among young people. Results: Globally, for overall headache disorders, a total of 2,049,979,883 prevalent cases (95% uncertainty interval (UI): 1,864,148,110 to 2,239,388,034), 601,229,802 incident cases (95% UI: 530,329,914 to 681,007,934), and 38,355,993 YLDs (95% UI: 7,259,286 to 83,634,503) were observed for those aged 10 to 54 in 2019. Sex differences were widely found for all headache types among adolescents and young adults, especially migraine. However, the most interesting finding was that the associations we tested between the socioeconomic environment and young headache patients were positive, regardless of region or specific country or territory. Conclusions: Overall, the global burden of headaches in adolescents and young adults largely increased from 1990 to 2019. Although slight declines were observed in sex differences, they remained significant and challenging. The positive correlations between headache and socioeconomic background among young people were relatively inconsistent with previous investigations, and several related hypotheses were proposed for explanation. Interdisciplinary actions involving education, policy- and law-making, and basic medical practice are desperately needed to further fight against the headache burden, promote gender equality in headache care, and eliminate the stigmatization of headache patients in student and working groups. [ABSTRACT FROM AUTHOR]

Background: Composite multidimensional indices are broadly used to measure child poverty and social exclusion. Many of such indices are based on EU-SILC data or similar large scale complex sampling surveys, with the household as unit of analysis. Indicators related to households with or without children may quantify the intended attribute differently depending on the household structure and characteristics of individuals, potentially compromising the assessment. Methods: We conducted statistical modelling and hypotheses tests using a two-parameter logistic item response model (IRM) and the likelihood-ratio test for DIF verification. Methods were applied to 2020 EU-SILC Portuguese data comprising 11,367 households representing a population of 4,099,052. Statistical analysis have allowed for the survey sampling design. Conclusion: Our findings demonstrate differential item functioning in the assessment material deprivation in households with or without children. [ABSTRACT FROM AUTHOR]

This paper aims to develop a machine-learning model based on a gradient-boosting algorithm to predict the energy-saving awareness of households using a questionnaire survey and 11-month energy data collected from more than 200 smart houses in Kitakyushu, Japan. We utilize the LightGBM (light gradient boosting machine) classifier to perform feature selection for the prediction. By using this approach, we demonstrate that the key features are the standard deviations of electricity purchased between 8 a.m. and 9 a.m. and electricity consumed between 7 p.m. and 9 p.m. Next, by using k-means clustering we split the households based on the obtained features into three groups. Finally, by using statistical hypothesis testing, we prove that these three groups have statistically distinct levels of energy-saving awareness. This model enables us to detect eco-friendly households from their energy data, which may support energy policymaking. [ABSTRACT FROM AUTHOR]