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Context: Ankle sprains are a common injury in sports, for which use of external ankle support during rehabilitation has been suggested to improve clinical outcomes. Design: Cohort study. Methods: Thirteen soccer players experiencing acute lateral ankle sprain injury were provided a novel adaptive ankle brace or conventional ankle taping (control) as external ankle support throughout the injury rehabilitation process. All other clinical procedures were identical, and rehabilitation was supervised by the same team staff member. Time from injury to clearance to return to sport was tracked. Player experience with the ankle brace also was queried via electronic surveys. Results: The median time to return to sport was less for the Brace group (52.5 d) compared to the Control group (79.5 d), but the distributions of the 2 groups were not found to differ significantly (P =.109). Player surveys indicated they felt the brace to be comfortable or very comfortable, with better freedom of movement than other braces and the same freedom of movement as wearing no brace. All players reported wearing the brace to be the same or better experience as ankle taping. Discussion: These preliminary results indicate that the adaptive ankle brace is at least as effective as ankle taping for providing external support during the rehabilitation phase following acute lateral ankle sprain and suggest it may be a more effective ankle support solution in terms of patient compliance than conventional bracing or taping. [ABSTRACT FROM AUTHOR]

An editorial is presented in which the authors emphasize the importance of integrating theory, methods, and data to enhance management research. They critique the overreliance on null hypothesis significance testing (NHST) and suggest using Bayesian techniques, observed power, and longitudinal data to improve causal inference and theoretical development. The editorial also advocates for employing computational models and latent mixture models to better handle theoretical precision and heterogeneity, and it encourages exploring diverse approaches to strengthen research outcomes.

Null hypothesis significance testing (NHST) is the default approach to statistical analysis and reporting in marketing and the biomedical and social sciences more broadly. Despite its default role, NHST has long been criticized by both statisticians and applied researchers, including those within marketing. Therefore, the authors propose a major transition in statistical analysis and reporting. Specifically, they propose moving beyond binary: abandoning NHST as the default approach to statistical analysis and reporting. To facilitate this, they briefly review some of the principal problems associated with NHST. They next discuss some principles that they believe should underlie statistical analysis and reporting. They then use these principles to motivate some guidelines for statistical analysis and reporting. They next provide some examples that illustrate statistical analysis and reporting that adheres to their principles and guidelines. They conclude with a brief discussion. [ABSTRACT FROM AUTHOR]

The primary objective of this study is to determine the effect of parental migration on students' behavior and cognitive skills. This study sought to answer the following questions: (1) How do the respondents describe the migration of parents abroad in terms of education, work, and Income? (2) What is the perception of the respondents on students' behavior? (3) How do the respondents perceive students' cognitive skills? (4) Does Parental Migration significantly affect behavior and cognitive skills of the students? A survey questionnaire was used in collecting data and information. The survey was conducted on a face-to-face modality in St. Mary's Academy of Nagcarlan during the class in Araling Panlipunan. The descriptive correlational study method was used in order to gather data together with related sources of information for an accurate interpretation of findings. The main data obtained were treated statistically with the use of the percentage and frequency distribution, weighted mean, standard deviation and Pearson for inferential questions with a .05 level of significance to determine if there is a significant effect. The test of significance within the variables reveals that there are variables that do not have a significant effect on students' behavior and cognitive skills, thus, partially accepting the null hypothesis. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to investigate the validity and reliability of the Selective Control of Upper Extremity Scale (SCUES) in patients with stroke. Materials and Methods: Forty-two patients with stroke aged 18–75 years, were included in the study. Patients were video-recorded while SCUES was administered. The videos were scored to determine the intrarater and inter-rater reliability. Fugl Meyer Assessment of Upper Extremity (FMA-UE), Box and Block test (BBT) and Brunnstrom Stages of Motor Recovery were measured to evaluate validity of SCUES. Spearman correlation analysis was used to assess the validity of SCUES. Intraclass correlation coefficient (ICC), Kappa (κ) and weighted Kappa (κw) were calculated to determine intrarater and inter-rater reliability. Results: There were significant positive high correlations between SCUES and FMA-UE and BBT and Brunnstrom upper extremity proximal and distal values (rho = 0.944, p = 0.01; rho = 0,875, p = 0.01; rho = 0.84, p = 0.01, rho = 0.82, p = 0.01; respectively) showing validity of SCUES. The ICC value of inter-rater reliability of SCUES was 0,99 (%95 CI: 0,989-0,997, p = 0,001) showing excellent reliability. κ and κ w values for inter-rater and intrarater reliability of individual SCUES items were above 0.7 indicating excellent reliability. ICC of SCUES and FMA-UE indicated excellent intrarater reliability (ICC = 0,99; %95 CI: 0,989–0,997, p = 0,001; ICC = 0.943; %95 CI: 0.9–0.97, p = 0,0001, consecutively). Conclusions: SCUES showed similar validity and reliability with FMA-UE and SCUES can be used in the evaluation of upper extremity selective motor control in patients with stroke. IMPLICATIONS FOR REHABILITATION: The Selective Control of Upper Extremity Scale (SCUES) stands out from existing outcome assessment tools for upper extremity motor control in stroke patients by enabling the evaluation of various quantifiers of selective motor function. SCUES assesses not only the accompanying movements of the trunk or additional joints beyond the targeted joint but also the presence of mirror movements, along with assessing the limited dynamic range of motion. SCUES appears valid and reliable in patients with stroke, indicating its potential use in evaluating upper extremity selective motor control and assessing the outcomes of interventions aimed at enhancing selective motor control. [ABSTRACT FROM AUTHOR]

Security and privacy have become major issues. Although no one seriously claims that privacy and security are identical, most sources treat them as if they are. Differentiating between privacy and security is essential, for example, in those situations where there is a trade-off between the two concepts, or when a regulator imposes rules concerning privacy or security or both. Moreover, differentiation can support the selection of proper means of defence. Therefore, there is a gap between the need to differentiate and the availability of an appropriate methodology to do so. This article introduces a robust methodology for differentiating between privacy and security, based on four basic components: the target of the attack, the nature of the cost, the presence of a trade-off, and the existence of consent. Since many situations involve both privacy and security, the methodology ranks their level independently. The research addresses several goals: alignment with the prevalent definitions and concepts in the literature; achieving objectivity; and a non-dichotomous classification. The application of this methodology was demonstrated in an empirical study with $n = 155$ n = 155 valid participants. The empirical study indicated significant differences between intuitive classification and methodology-based classification, thereby emphasising the need for this methodology. [ABSTRACT FROM AUTHOR]

Purpose: This study explores the feasibility, acceptability, and treatment outcomes of Empower@Home, a digital cognitive behavioral therapy intervention for geriatric depression. Method: Participants with depressive symptoms (PHQ-9 ≥ 5) underwent a nine-session remote intervention supported by a lay coach (N = 103). Results: Most participants (91%) completed all nine sessions (mean = 8.5). According to the Treatment Evaluation Inventory, participant attitudes toward the program were largely positive. A medium effect in depression reduction was observed following the intervention (Cohen's d = 0.75) and at a 10-week follow-up (Cohen's d = 0.60). This reduction was large (Cohen's d = 1.31 at posttest and Cohen's d = 1.18 at 10-week follow-up) among those who presented with moderate depression at baseline (PHQ-9 ≥ 10). Significant improvements were also reported in anxiety, social isolation, loneliness, and behavioral activation. Discussion: Empower@Home is a promising, acceptable digital mental health intervention for treating depression in older adults. [ABSTRACT FROM AUTHOR]

This article employs dynamic recognition of acceleration points to determine velocity thresholds for different deformation stages of landslides. It proposes a dimensionless time parameter, tw, and analyzes over 60 slope cases using probability statistical methods to establish landslide threshold levels. Finally, based on various threshold determination methods and the dimensionless time threshold method, it establishes multiple early warning threshold indicators for rocky slopes along National Highway G312. The study validates the applicability of the dimensionless time threshold method by using landslide cases outside the statistical slope dataset. The research indicates the following: (1) The "two-sample t-test" method determines tw = 0.24 and tw = 0.39 as the first-level and second-level early warning thresholds for slopes, respectively. (2) The "ROC curve" method calculates an AUC of 0.85, confirming the high reliability and accuracy of the dimensionless time threshold method. (3) Using the dimensionless time threshold method, the analysis determines the first-level and second-level landslide thresholds for a landslide in Zhenggeer Banner, Ordos City, Inner Mongolia, as 84.03 h and 91.53 h, respectively. The second-level threshold provides an early warning time only 2.7 h ahead of the actual landslide time, demonstrating timely and accurate landslide prediction. [ABSTRACT FROM AUTHOR]

Accurate software development effort estimation (SDEE) is vital for effective project planning. Due to the complex nature of software projects, estimating development effort has become a challenging task that requires careful consideration, especially in the early project phases, to prevent overestimation and underestimation. Accurate effort estimation helps to estimate the cost of a developing project through effective resource management and project budgeting for manpower. Despite numerous effort estimation models introduced over the past two decades, achieving a satisfactory level of accuracy remains elusive. The adaptive neuro-fuzzy inference system (ANFIS) model gains more popularity for estimation tasks due to its rapid learning capacity, ability to represent complex nonlinear structures, and adaptability to improperly specified data. This study presents a model called the Two-Stage optimization technique for Software Development Effort Estimation (TSoptEE). Initially, it performs feature selection through a multi-objective improved binary social network search (SNS) algorithm and then optimizes the ANFIS tunable parameters through an improved SNS algorithm to enhance the accuracy of SDEE. The proposed TSoptEE model is compared against existing estimation models and evaluated using seven performance measures over nine software datasets. The obtained results are promising in terms of accuracy and statistical significance tests. This implies that the proposed model can significantly enhance the accuracy of effort estimation. [ABSTRACT FROM AUTHOR]

To unravel how within-person psychological processes fluctuate in daily life, and how these processes differ between persons, intensive longitudinal (IL) designs in which participants are repeatedly measured, have become popular. Commonly used statistical models for those designs are multilevel models with autocorrelated errors. Substantive hypotheses of interest are then typically investigated via statistical hypotheses tests for model parameters of interest. An important question in the design of such IL studies concerns the determination of the number of participants and the number of measurements per person needed to achieve sufficient statistical power for those statistical tests. Recent advances in computational methods and software have enabled the computation of statistical power using Monte Carlo simulations. However, this approach is computationally intensive and therefore quite restrictive. To ease power computations, we derive simple-to-use analytical formulas for multilevel models with AR(1) within-person errors. Analytic expressions for a model family are obtained via asymptotic approximations of all sample statistics in the precision matrix of the fixed effects. To validate this analytical approach to power computation, we compare it to the simulation-based approach via a series of Monte Carlo simulations. We find comparable performances making the analytic approach a useful tool for researchers that can drastically save them time and resources. [ABSTRACT FROM AUTHOR]

Recently, Asparouhov and Muthén Structural Equation Modeling: A Multidisciplinary Journal, 28, 1–14, (2021a, 2021b) proposed a variant of the Wald test that uses Markov chain Monte Carlo machinery to generate a chi-square test statistic for frequentist inference. Because the test's composition does not rely on analytic expressions for sampling variation and covariation, it potentially provides a way to get honest significance tests in cases where the likelihood-based test statistic's assumptions break down (e.g., in small samples). The goal of this study is to use simulation to compare the new MCM Wald test to its maximum likelihood counterparts, with respect to both their type I error rate and power. Our simulation examined the test statistics across different levels of sample size, effect size, and degrees of freedom (test complexity). An additional goal was to assess the robustness of the MCMC Wald test with nonnormal data. The simulation results uniformly demonstrated that the MCMC Wald test was superior to the maximum likelihood test statistic, especially with small samples (e.g., sample sizes less than 150) and complex models (e.g., models with five or more predictors). This conclusion held for nonnormal data as well. Lastly, we provide a brief application to a real data example. [ABSTRACT FROM AUTHOR]

We consider a regression model with autoregressive terms and propose significance tests for the detection of change points in this model. Our tests are applicable to both low- or moderate dimension and to high-dimension with sparse regressors. The dimension may be high from the practical point of view of economic and business applications, but in our theoretical framework it is fixed. To accommodate practically high dimension, variable selection is incorporated as an integral part of our approach. The regressors and the errors can exhibit general nonlinear dependence and the model incorporates autoregressive dependence. We develop asymptotic justification and evaluate the performance of the tests both on simulated and real economic data. We test for and estimate changes in responses to risk factors of a U.S. energy stocks portfolio and the Industrial Production index. We relate our findings to macroeconomic policy changes and global impact events. [ABSTRACT FROM AUTHOR]

Evidence-based medicine (EBM) is helpful for laypersons' decision-making. This study aimed to evaluate the effectiveness of e-learning materials on the essential components of EBM for laypersons. We conducted a web-based, open-label, randomized controlled trial with laypersons in Japan aged ≥20 years who used the internet. Participants were randomly assigned to the intervention group with the e-learning material and the control group with only the 'Introduction' section of the same material. The primary and secondary outcomes were the self-created acquirement test scores (responding correctly with confidence) immediately after using the material and after 4 weeks. A multiple linear regression analysis was conducted. Of the 122 participants, 62 were randomly assigned to the intervention group and 59 to the control group; finally, 59 and 58, respectively, were included in the full analysis set. The mean (standard deviation) of the acquirement test score immediately after learning was 14.11 and (3.11) and 11.07 (3.88) in the intervention and control groups, respectively, indicating statistical significance (multivariable P  < 0.001). The secondary long-term outcome was also statistically significant. The results showed that the e-learning material was effective for laypersons in acquiring the essential components of EBM. The material may increase laypersons' confidence in appraising health information, which can be used in decision-making. [ABSTRACT FROM AUTHOR]

This article addresses a portfolio selection problem with trading costs on stock market. More precisely, we develop a simple generalized method of moments (GMM)-based test procedure to test the significance of trading costs effect in the economy with a flexible form of transaction costs. We also propose a two-step procedure to test overidentifying restrictions in our GMM estimation. In an empirical analysis, we apply our test procedures to the class of anomalies used in Novy-Marx and Velikov (2016). We show that transaction costs have a significant effect on investors' behavior for many anomalies. In that case, investors significantly improve the out-of-sample performance of their portfolios by accounting for trading costs. [ABSTRACT FROM AUTHOR]

In the wake of the greatest mass extinction in Earth's history, the End-Permian Mass Extinction, the Triassic was a time of recovery and innovation. Aided by warm climatic conditions and favorable ecological circumstances, many reptilian clades originated and rapidly diversified during this time. This set the stage for numerous independent invasions of the marine realm by several reptilian clades, such as Ichthyosauriformes and Sauropterygia, shaping the oceanic ecosystems for the entire Mesozoic. Although comparatively less speciose, and temporally and latitudinally more restricted, another marine reptile clade, the Thalattosauriformes, stands out because of their unusual and highly disparate cranial, dental and skeletal morphology. Research on Thalattosauriformes has been hampered by a historic dearth of material, with the exception of rare material from Lagerstätten and highly fossiliferous localities, such as that from the UNESCO world heritage site of Monte San Giorgio. Consequently, their evolutionary origins and paleobiology remain poorly understood. The recent influx of new material from southwestern China and North America has renewed interest in this enigmatic group prompting the need for a detailed review of historic work and current views. The earliest representatives of the group may have been present from the late Early Triassic onwards in British Columbia. By the Ladinian the group had achieved a wide distribution across the northern hemisphere, spanning the eastern Panthalassic as well as the eastern and western Tethyan provinces. Distinct morphological and likely ecological differences exist between the two major clades of Thalattosauriformes, the Askeptosauroidea and the Thalattosauroidea, with the latter showing a higher degree of cranial and skeletal morphological disparity. In-group relationships remain poorly resolved beyond this bipartition. Overall, thalattosaurs may be closely related to other marine reptile groups such as ichthyopterygians and sauropterygians. However, their exact position within Diapsida remains elusive. Future focal points should utilize modern digital paleontological approaches to explore the many fragmentary specimens of otherwise poorly sampled localities. [ABSTRACT FROM AUTHOR]

Dynamic Virtual Reality (VR) has revolutionized gaming and entertainment industries by providing immersive experiences that take users to new locations. This study presents a novel and exciting idea called virtual reality horror sports, which combines aspects of horror with sports in the VR medium. We provide a novel approach to developing adaptive VR horror games by combining player modeling approaches with an adaptive means-based system that learn about each player's individual fears and adjust the game's content accordingly. This work presents two significant advances: a unique method for determining a player's specific fears via game data and machine learning methods and an adaptive game system that employs agents to monitor players' terror experiences and restrict exposure to components that they find upsetting. Additional evidence from user studies and statistical significance testing suggests that our method may boost the stress and anxiety felt by gamers, resulting in rewarding gaming experience. When VR, horror and sports are all brought together, the outcome may compel and absorbing entertainment experience. Players will be immersed in a virtual environment that is both realistic and exciting. A dynamic virtual reality horror sports experience improved by Artificial Intelligence (AI) and player modeling provide a novel and comprehensive form of entertainment by fusing physical activity, customization and immersion in a single package. An endeavor of this kind has the potential to advance state of VR and artificial intelligence in gaming while also offering exciting and memorable adventures for gamers. [ABSTRACT FROM AUTHOR]

A standard practice in statistical hypothesis testing is to mention the P-value alongside the accept/reject decision. We show the advantages of mentioning an e-value instead. With P-values, it is not clear how to use an extreme observation (e.g. P << α) for getting better frequentist decisions. With e-values it is straightforward, since they provide Type-I risk control in a generalized Neyman-Pearson setting with the decision task (a general loss function) determined post hoc, after observation of the data--thereby providing a handle on "roving α's." When Type-II risks are taken into consideration, the only admissible decision rules in the post hoc setting turn out to be e-value-based. Similarly, if the loss incurred when specifying a faulty confidence interval is not fixed in advance, standard confidence intervals and distributions may fail, whereas e-confidence sets and e-posteriors still provide valid risk guarantees. Sufficiently powerful e-values have by now been developed for a range of classical testing problems. We discuss the main challenges for wider development and deployment. [ABSTRACT FROM AUTHOR]

The ambiguous set theory has recently been introduced to characterize ambiguities inherent in information. Based on ambiguous set and ambiguous entropy (AE), this study presents a clustering algorithm called ambiguous-entropy clustering algorithm (AECA). The proposed AECA applies to analyze the resting-state fMRI signals (RSfMRISs). For the experimental purpose, this study considers RSfMRISs data obtained from resting-state of human brain. Three different data clusters related to RSfMRIS are identified and their statistical significance is analyzed using AECA. We perform the autocorrelation analysis for the clustered RSfMRISs. We test the statistical significance of the results using the Ljung-Box test. The results show that AECA is able to identify the activation of RSfMRISs despite the resting state of the brain. To discover the activation patterns of neurons in the resting state, functional connections in RSfMRISs are investigated. For this purpose, an algorithm called ambiguous-entropy functional connection algorithm (AEFCA) is presented in this study. Using this algorithm, a weighted graph is constructed to show the functional connections. Such a graph is called functional connection network graph (FCNG). [ABSTRACT FROM AUTHOR]

Introduction: Cardiac rehabilitation (CR) adherence and functional outcomes were measured after COVID-19 regulations reduced group sizes to one-onone, modeling a natural experiment. Methods: A retrospective analysis using a natural experiment model measured participants in 12 weeks of CR during the 17 months before and after a COVID-19-related closure was conducted. The age, sex, race, ethnicity, and referral diagnoses of the pre-COVID-19 closure and post-COVID-19 closure groups were analyzed using a student's unpaired T-test. Adherence (completion rate of CR) and functional outcomes [change in six-minute walk test (6MWT)] were assessed between the two groups using unpaired two-tailed student T tests in GraphPad Prism and confidence intervals were calculated with the Baptista-Pike method. Results: There were 204 patients in the pre-COVID-19 group and 51 patients in the post-COVID-19 group, due to the smaller group sizes in the post-COVID-19 group, with no significant differences in baseline characteristics between the groups. The pre-COVID-19 group had a higher patient-to-provider ratio [2.8 patients/provider (SD 0.74)] relative to the post-COVID-19 group [0.4 patients/provider (SD 0.12); p < 0.0001]. The post-COVID-19 group had a higher completion rate than pre-COVID-19 group [75% vs. 21%; OR 10.9 (95% CI, 5.3-21.3, p < 0.0001)]. Among those that completed CR, there was no significant difference between groups in 6MWT improvement [+377.9 ft. (n = 47; SD 275.67 ft.) vs. +346.9 ft. (n = 38; SD 196.27 ft.); p = 0.59]. Discussion: The reduction in group size to one-on-one was associated with 10 times higher odds of CR completion. Among those that completed CR, functional outcomes were not influenced by group size. Thus, pursuit of one-on-one sessions may improve CR adherence. [ABSTRACT FROM AUTHOR]

Background: Empathy is important in hospice nursing clinics and may influence nurses' professional quality of life (ProQOL). However, present studies ignoring each empathic dimension, and few researches have explored the correlation between empathy and ProQOL in hospice nurses in Asia. To better understand hospice nurses' empathy abilities in China and its relationship with ProQOL, the aim of this study was to identify the latent profiles and its influencing factors of hospice nurses' empathy ability, as well as differences in ProQOL across each latent profile. Methods: A cross-sectional study was conducted from October 2021 to September 2022, and a total of 725 hospice nurses were recruited from different geographic regions in China. Participants completed the Empathy Ability Scale for Hospice Nurses and the Brief Professional Quality of Life Scale. Latent profile analysis (LPA) was employed to identify latent profiles of empathy ability among hospice nurses in China. The predictors of hospice nurses' empathy ability in different latent profiles were assessed using multinomial logistic regression analysis. One-way ANOVA test and the Kruskal–Wallis test were used to compare the ProQOL scores in each latent profile of nurses' empathy ability. Results: This study identified three latent profiles of hospice nurses' empathy ability, and those profiles labelled "poor empathy ability-high surface empathy expression" (n = 216, 29.8%), "moderate empathy ability" (n = 359, 49.5%) and "high empathy ability-high deep empathy expression" (n = 150, 20.7%). Multinomial logistic regression analysis suggested that age, hospital level, whether income meets expectations, interests in hospice care work, hospice work experience, and receiving psychological counselling were predictors of hospice nurses' profile membership of empathy ability. The scores of compassion satisfaction (CS) and burnout (BO) in ProQOL were significantly different across each profile (P < 0.001), while scores of secondary traumatic stress (STS) in ProQOL were not different across each profile (P = 0.294). Conclusions: Hospice nurses' empathy ability was divided into three latent profiles, and enhancing empathy ability may be conducive to improving hospice nurses' CS, while reducing BO, thus fostering their overall quality of life. Nursing managers should identify hospice nurses at higher risk of BO and implement targeted interventions focused on enhancing nurse's empathy abilities. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate the efficacy of an oxygen scavenging mask device in reducing local oxygen concentrations from nasal cannula ventilation compared to a standard open facial surgical field. Methods: This is a controlled experiment using a custom-fabricated silicone midfacial oxygen scavenging device, SimMan airway management trainer manikin (Laerdal Medical, Stavanger, Norway), handheld oxygen detector (Forensics Detectors, Los Angeles, United States) and oxygen from a Datex Ohmeda Aisys Carestation anesthesia unit (GE HealthCare, Chicago, United States). Oxygen concentrations were measured at 18 facial landmarks (Fig. 1) with nasal cannula flow of 2, 4, and 6 L/min of 100% FiO2 in both masked and unmasked conditions (Fig. 2). Results: The mean oxygen concentration in the facial surgical field was 20.95% with the scavenger mask and 24.8% without (P < 0.001; two-tailed paired t-test). The unmasked condition was associated with suprathreshold oxygen concentration levels at 13 of 18 facial landmarks (Table 1). The device significantly reduced local oxygen concentration at 16 of 18 facial landmarks (Table 1). The device provided safe oxygen concentration levels at all three flow rates, and measured oxygen concentrations directly correlated with oxygen flow rate in the unmasked condition (Table 2). Conclusions: An oxygen scavenger mask device reduced local oxygen concentrations from nasal cannula ventilation to below the 23% fire threshold in the entire facial surgical field external to the mask in these experiments. The device may reduce intraoperative fire risk in patients that require supplementary oxygen during surgery. [ABSTRACT FROM AUTHOR]

Backgroud: The relationship between serum uric acid (SUA) and 25-hydroxyvitamin D (25(OH)D) has been variably characterized in existing literature, with inconsistent results regarding its nature and implications in the Chinese population. This study aims to clarify this association, considering the potential impact of vitamin D levels on SUA. Methods: This cross-sectional study involved 7,086 individuals from the Second Affiliated Hospital of Zhejiang University School of Medicine, screened throughout 2020. We collected data on 25(OH)D, SUA, and other metabolic markers. Logistic regression models adjusted for confounding factors were utilized to analyze the relationships. Results: Our findings illustrate a statistically significant inverted U-shaped relationship between 25(OH)D and SUA. The identified threshold effect at 28.82 ng/ml is pivotal; with 25(OH)D levels below this point associated with an increased risk of hyperuricemia (odds ratio: 1.0146, p = 0.0148), and levels above it offering protective benefits (odds ratio: 0.9616, p = 0.0164). Conclusions: Our findings confirm a nonlinear, inverted U-shaped correlation between 25(OH)D and SUA, emphasizing the importance of maintaining vitamin D levels within a specific range to effectively manage hyperuricemia. These results support the implementation of personalized vitamin D supplementation strategies to optimize metabolic health outcomes, highlighting the complex interplay between vitamin D status and uric acid levels. [ABSTRACT FROM AUTHOR]

Introduction: Increasing evidence suggests that air pollution has a significant impact on the development of synucleinopathies, but the potential neurobiological mechanisms are unknown. We aimed to explore the associations of air pollution (including ozone [O3], nitrogen dioxide [NO2], and particulate matter [PM2.5]) with CSF α-syn levels in urban older adults. Methods: We included 933 urban participants from the Chinese Alzheimer's Biomarker and LifestylE study. The 5-year average levels of air pollution exposure were estimated in the areas of residence. Multivariate linear regression was conducted to detect the correlation of air pollution with CSF α-syn levels. Subgroup analyses by age, gender, season, and history of coronary heart disease (CHD) were performed. Moreover, restricted cubic spline (RCS) models were applied to explore the potential nonlinear relationships. Results: We found a significant correlation of CSF α-syn level with PM2.5 in urban participants. Specifically, multiple linear regression showed a significant negative association between PM2.5 and CSF α-syn level (p = 0.029), which was more significant in female, midlife, non-CHD, and cold season subgroups. Besides, RCS models showed that O3 had an inverse J-shaped association with CSF α-syn levels in urban participants (p for nonlinearity = 0.040), and the harmful effect possibly appeared when O3 was above 37.9 ppb. Discussion: Long-term exposure to air pollution was associated with lower CSF α-syn levels, which may offer a new direction for exploring and preventing synucleinopathies. [ABSTRACT FROM AUTHOR]

AbstractIn spatial point data, a hotspot is defined as a group of points with a significantly higher density within an arbitrarily shaped area. Among existing hotspot identification methods, spatial scan statistic, known for its simple mechanism in locating hotspots, has been extensively studied and applied in various fields. However, existing methods rely on pre-defined scanning window shapes, e.g. generic geometries like circles or pre-divided regions, like administrative divisions, and thereby may not accurately capture the irregular shapes of hotspots. This study enhances the spatial scan statistic by introducing a tightened window, which is defined as the window tightened to align with the hotspot’s shape. In our method, without the necessity of outlining the exact geometry, the area of the tightened window, estimated using the nearest distance statistics, is used for calculating the objective function. Experiments with simulated data demonstrate that our method outperforms existing methods in terms of testing hotspots’ significance, identifying arbitrarily shaped hotspots, estimating hotspots’ spatial extent, and reducing subjectivity in parameter selection. An empirical study using taxi pick-up point data shows our method can identify regions with high taxi demand and potential traffic congestion, including subway exits and commercial streets. [ABSTRACT FROM AUTHOR]

Introduction Definitive management of non-compressible intra-abdominal hemorrhage (NCIAH) currently requires a surgeon and operating room capable of performing damage control surgery. In a wartime scenario or a geographically remote environment, these may not be readily available. In this study, we sought to test the safety of 2 emerging injectable hemostatic agents (CounterFlow and Fast Onset Abdominal Management, or FOAM, poloxamer component) versus normal saline control over a prolonged monitoring duration following administration by a non-surgical provider. Materials and Methods The Institutional Animal Care and Use Committee approved all research conducted in this study. We randomized male New Zealand white rabbits into 2 monitoring cohorts of 24 hours and 2 weeks. Each cohort contained 3 treatment groups (n  = 4 rabbits/group): CounterFlow, the testable poloxamer component of FOAM, and normal saline control. We injected each treatment intraperitoneally in the left lower abdominal quadrant. Doses were 15 mL/kg for CounterFlow, 6.3 mL/kg for the poloxamer component of FOAM, and 15 mL/kg for normal saline. We conducted all injections under isoflurane anesthesia monitored by trained veterinary staff. Animals were euthanized at each cohort end point, and a veterinary pathologist blinded to treatment type performed necropsy. The primary outcome was incidence of intra-abdominal adhesions at necropsy. Quantitatively, adhesions when present were graded by the veterinary pathologist on a 1 to 4 scale, where "1" represented adhesions involving from 1 to 25% of the examined abdomen, "2" represented from 26 to 50%, "3" represented from 51 to 75%, and "4" represented from 76 to 100%. Qualitatively, adhesions present were graded by degree ("1" = minimal, "2" = mild, "3" = moderate, and "4" = severe) and chronicity ("1" = acute, "2" = subacute, and "3" = chronic). We also drew d-dimer blood values and measured body weights for each animal. Statistical analysis included either repeated measures 2-way ANOVA or a mixed-effects model (in the case of missing data) with Geisser–Greenhouse correction. We adjusted multiple comparisons using Tukey statistical hypothesis tests. Results In the 2-week cohort, 3 CounterFlow animals showed adhesions judged to be "1" quantitatively. Qualitatively, 2 of these were assessed as "1" for degree of adhesions and the other demonstrated a "2." On the chronicity of adhesions scale, 1 animal demonstrated a "2" and 2 demonstrated a "3." No animals in other groups (FOAM and control) demonstrated adhesions. CounterFlow-treated animals showed a statistically significant rise in d-dimer values in the 24-hour cohort only. In the 2-week cohort, CounterFlow-treated animals showed a decrease in body weight at 24 hours after injection but returned to their baseline (normal) body weights at 7 days. Conclusions Findings from this study demonstrate that the tested ingredients of FOAM poloxamer component are safe for intraperitoneal injection and hold potential for further study directed toward prehospital non-compressible intra-abdominal hemorrhage management by non-surgical providers. Although CounterFlow produced abdominal adhesions in 3 of 4 rabbits in the 2-week cohort, these were determined to be "minimal" or "mild" in degree. [ABSTRACT FROM AUTHOR]

The supplementary motor area (SMA) is involved in the functional deficits of chronic ankle instability (CAI), but the structural basis of its abnormalities remains unclear. To determine the differences in volume- and surface-based morphologic features of the SMA between patients with CAI and healthy controls and the relationship between these features and the clinical features of CAI. Cross-sectional study. Sports medicine laboratory. A total of 32 patients with CAI (10 women, 22 men; age = 32.46 ± 7.51 years) and 31 healthy controls (12 women, 19 men; age = 29.70 ± 8.07 years) participated. We performed T1-weighted structural magnetic resonance imaging of participants and calculated volume- and surface-based morphologic features of SMA subregions. These subregions included anterior and posterior subdivisions of the medial portion of Brodmann area 6 (6 ma and 6 mp, respectively) and supplementary and cingulate eye fields. Between-group comparisons and correlation analysis with clinical features of CAI were performed. Moderately thinner 6 mp (motor-output site; Cohen d = −0.61; 95% CI = −1.11, −0.10; P =.02) and moderately plainer 6 ma (motor-planning site; Cohen d = −0.70; 95% CI = −1.20, −0.19; P =.01) were observed in the CAI than the control group. A thinner 6 mp was correlated with lower Foot and Ankle Ability Measure Activities of Daily Living subscale scores before (r = 0.400, P =.02) and after (r = 0.449, P =.01) controlling for covariates. Patients with CAI had a thinner 6 mp and a plainer 6 ma in the SMA compared with controls. The thin motor-output site of the SMA was associated with ankle dysfunction in patients. This morphologic evidence of maladaptive neuroplasticity in the SMA might promote more targeted rehabilitation of CAI. [ABSTRACT FROM AUTHOR]

Introduction: Chest X‐ray (CXR) remains one of the tools used in diagnosing tuberculosis (TB). However, few studies about such tools exist, specifically in children in Indonesia. We aim to investigate and compare the CXR findings of children with pulmonary drug‐resistant TB (DR‐TB) and drug‐sensitive TB (DS‐TB) that could help in the evaluation and management of TB cases in children. Methods: Retrospective analysis with cross‐sectional approach was conducted in children (<18 years old) diagnosed with pulmonary DR‐TB and DS‐TB from January 2018 to December 2021. Documented data were collected from the Paediatric Respirology Registry and Tuberculosis Information System at Dr. Hasan Sadikin General Hospital Bandung. Characteristics of children, CXR findings, and TB severity were assessed and compared using the chi‐square and Fisher's exact tests with significance levels set at p value <0.05. Results: Sixty‐nine children (DR‐TB 31 children vs. DS‐TB 38 children) were assessed. Of the 31 children with DR‐TB, 65% were classified as multidrug‐resistant TB (MDR‐TB), followed by rifampicin‐resistant TB (RR‐TB), pre‐extensively drug‐resistant TB (pre‐XDR‐TB), and extensively drug‐resistant TB (XDR‐TB). The most common CXR findings in DR‐TB are consolidation (68%), fibrosis (42%), and cavity (29%), whereas in DS‐TB, it is pleura effusion (37%). Severe TB accounts for 50% of DR‐TB (p = 0.008). Conclusions: Consolidation, fibrosis, cavities, and findings of severe TB are most common in DR‐TB. Pleural effusion is the most common in DS‐TB. These findings have the potential to be considered in further examination of children with pulmonary DR‐TB and DS‐TB; hence, more extensive studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Background: Diabetes complications are prevalent in people with diabetes, causing considerable individual suffering and increased health costs. However, the relationships of multidimensional, modifiable, and nonmodifiable factors to diabetes complications and the role of diabetes distress have been rarely examined. Objective: The aims of this study were to examine the associations of age, sex, knowledge, self-efficacy, self-compassion, resilience, self-esteem, depressive symptoms, diabetes distress, social support, and body mass index with diabetes complications and to investigate the mediating role of diabetes distress. Methods: In this cross-sectional, correlational study, data on all study variables were collected from 148 people with diabetes through REDCap in 2023. Multiple regression analysis and the PROCESS macro for SPSS were used to address the aims. Results: Older age and higher levels of diabetes distress were associated with more diabetes complications. Depressive symptoms were associated with diabetes distress; and diabetes distress, but not depressive symptoms, was associated with diabetes complications, controlling for all other variables. Conclusions: Depressive symptoms and diabetes distress were directly or indirectly associated with diabetes complications, and diabetes distress was a mediator in the relationship between depressive symptoms and diabetes complications. Health care providers can target reduction of depressive symptoms and diabetes distress to reduce diabetes complications. [ABSTRACT FROM AUTHOR]

The origins of the variable - s -marking patterns of present-tense verbs in earlier African American English (AAE) have been widely argued, with one of the most common arguments stating that the pattern is indicative of the Northern Subjects Rule (NSR), a variable - s -marking rule common in the northern British Isles. I explored verbal - s in the Federal Writers' Project ex-slave narratives to understand what patterns of - s -marking existed in earlier AAE and how these patterns differed across regions. Statistical analysis suggested no NSR influence in AAE as a whole or within any of the regions, but - s -marking still significantly differed between and within regions. I discuss other possible causes of this variation, including influence from other concord patterns, aspectual marking, and phonotactics, but highlight the difficulty of proposing concrete hypotheses due to change over time and a dearth of data. [ABSTRACT FROM AUTHOR]

Test of independence is of fundamental importance in modern data analysis, with broad applications in variable selection, graphical models, and causal inference. When the data is high dimensional and the potential dependence signal is sparse, independence testing becomes very challenging without distributional or structural assumptions. In this article, we propose a general framework for independence testing by first fitting a classifier that distinguishes the joint and product distributions, and then testing the significance of the fitted classifier. This framework allows us to borrow the strength of the most advanced classification algorithms developed from the modern machine learning community, making it applicable to high dimensional, complex data. By combining a sample split and a fixed permutation, our test statistic has a universal, fixed Gaussian null distribution that is independent of the underlying data distribution. Extensive simulations demonstrate the advantages of the newly proposed test compared with existing methods. We further apply the new test to a single cell dataset to test the independence between two types of single cell sequencing measurements, whose high dimensionality and sparsity make existing methods hard to apply. for this article are available online. [ABSTRACT FROM AUTHOR]

Background: The implementation of emerging technologies has resulted in an increase of data breaches in healthcare organisations, especially during the COVID-19 pandemic. Health information and cybersecurity managers need to understand if, and to what extent, breach types and locations are associated with their organisation's business type. Objective: To investigate if breach type and breach location are associated with business type, and if so, investigate how these factors affect information systems and protected health information in for-profit versus non-profit organisations. Method: The quantitative study was performed using chi-square tests for association and post-hoc comparison of column proportions analysis on an archival data set of reported healthcare data breaches from 2020 to 2022. Data from the Department of Health and Human Services website was retrieved and each organisation classified as for-profit or non-profit. Results: For-profit organisations experienced a significantly higher number of breaches due to theft, and non-profit organisations experienced a significantly higher number of breaches due to unauthorised access. Furthermore, the number of breaches that occurred on laptops and paper/films was significantly higher in for-profit organisations. Conclusion: While the threat level of hacking techniques is the same in for-profit and non-profit organisations, certain breach types are more likely to occur within specific breach locations based on the organisation's business type. To protect the privacy and security of medical information, health information and cybersecurity managers need to align with industry-leading frameworks and controls to prevent specific breach types that occur in specific locations within their environments. [ABSTRACT FROM AUTHOR]

The scale of Monopterus albus farming in Hubei Province is large, but there are few pre-treatment processing devices. The current Monopterus albus pretreatment device is mainly dissected and killed. Aiming at the problems of poor stability, low efficiency, and low meat yield of existing Monopterus albus deboning devices, an adaptive Monopterus albus deboning device was designed, which was mainly composed of laparotomy components, transitional components, and deboning components. The theoretical analysis of the process of fish laparotomy, transition transportation, and deboning was carried out, and the key factors affecting the performance of the deboning device were obtained. Taking the meat yield rate and sensory quality scores as evaluation indexes, the single-factor test of the distance between the pressure wheel and the V-block, the initial clearance of the transition wheel, the rotational speed of the transition wheel, the shape of the deboning blade disc and the rotational speed of deboning blade disc were carried out to determine the reasonable range of each parameter. The test results showed that when the distance between the pressure wheel and the V-block was 15.50-16.75 mm, the meat yield rate was higher; when the initial clearance of the transition wheel was 9 mm, the sensory quality scores of the fish body was the highest; the increase of the rotational speed of the transition wheel and the rotational speed of the deboning blade disc is beneficial to improve the meat yield rate and sensory quality scores; and the shape of the boning blade disc had little influence on the meat yield rate and the sensory quality scores. The orthogonal test of four factors and three levels was carried out with the distance between the pressure wheel and the V-block, the initial clearance of the transition wheel, the rotational speed of the transition wheel, and the rotational speed of the deboning blade disc as the test factors. The results showed that the order of significance of each test factor on the meat yield rate was the distance between the pressure wheel and the V-block, the initial clearance of the transition wheel, the rotational speed of the transition wheel, and the rotational speed of the deboning blade disc; and the order of significance on the sensory quality scores was the initial clearance of the transition wheel, the distance between the pressure wheel and the V-block, the rotational speed of the transition wheel and the rotational speed of the deboning blade disc. When the distance between the pressure wheel and the V-block was 16.75 mm, the initial clearance of the transition wheel was 9 mm, the rotational speed of the transition wheel was 648 r/min, and the rotational speed of the deboning blade disc was3200 r/min, the deboning effect was the best. The meat yield rate of the deboning device was 84%, and the total sensory quality scores of the fish after processing reached 17.3. The device can process Monopterus albus with a body mass of 75-150 g, and the production efficiency reaches 16.8 strips/min. Compared with the current commercially available deboning device, the feeding is more convenient and the production efficiency is higher. It can provide a reference for the research of Monopterus albus pretreatment device. [ABSTRACT FROM AUTHOR]

Phylogenetic association analysis plays a crucial role in investigating the correlation between microbial compositions and specific outcomes of interest in microbiome studies. However, existing methods for testing such associations have limitations related to the assumption of a linear association in high-dimensional settings and the handling of confounding effects. Hence, there is a need for methods capable of characterizing complex associations, including nonmonotonic relationships. This article introduces a novel phylogenetic association analysis framework and associated tests to address these challenges by employing conditional rank correlation as a measure of association. The proposed tests account for confounders in a fully nonparametric manner, ensuring robustness against outliers and the ability to detect diverse dependencies. The proposed framework aggregates conditional rank correlations for subtrees using weighted sum and maximum approaches to capture both dense and sparse signals. The significance level of the test statistics is determined by calibration through a nearest-neighbour bootstrapping method, which is straightforward to implement and can accommodate additional datasets when these are available. The practical advantages of the proposed framework are demonstrated through numerical experiments using both simulated and real microbiome datasets. [ABSTRACT FROM AUTHOR]

The article discusses the presence of mouse IgG antibodies in the widely used mouse IgE clone SPE-7, which is used to study IgE biology and function. The study found that SPE-7 contains IgG2a/b-IgE complexes, which can alter the functional profile of IgE. The presence of IgG in SPE-7 was confirmed through various assays, including enzyme-linked immunosorbent assays (ELISA) and liquid chromatography-mass spectrometry (LC-MS). These findings challenge the concept that IgE exerts antigen-independent effects on mast cell degranulation and survival. The study suggests that the presence of contaminating IgGs in therapeutic IgE antibodies should be considered, as they may alter the functional and pharmacological profile of these antibodies. [Extracted from the article]

À partir de ma clinique de sujets trans, et dans la continuité des travaux d'Esther Bick concernant la seconde peau psychique et de celle de Didier Anzieu avec le Moi-Peau et les enveloppes psychiques, je propose une nouvelle hypothèse : celle d'une seconde peau et d'un Moi-peau corsets. Ainsi, les corsets psychiques empêchent (seconde peau) ou déploient (Moi-peau) selon les réappropriations psychiques de chacun. Les perspectives psychanalytiques à propos de la peau, avec leurs constitutions développementales psycho-affectives et psychosomatiques tout le long de la vie, restent en effet contemporaines, et ce, plus particulièrement des personnes trans(genres). Ma pratique de psychologue clinicien-psychothérapeute, mes réseaux (RCP-trans) et mes recherches à partir des vécus des personnes trans(genres) m'ont amené à m'interroger à propos d'une métapsychologie du corset. J'expose ici deux situations cliniques de jeunes adultes FtoM (Female to Male) lesquels sont, entre autres situations cliniques rencontrées, particulièrement à la source de cette hypothèse. Deux situations cliniques m'ont particulièrement amené à réfléchir la qualité d'une capacité dépressive authentique, ou dépressivité, que je nomme ici tristesse fluide (sadness fluid) ou fluidité de la tristesse par analogie au gender fluid, la fluidité du genre (ce qui répond à la dysphorie de genre). Sur les plans transféro-contre-transférentiels, la transphobie et la transphilie sont à interroger comme des corsetages qui fluidifient plus ou moins la relation de soins psychiques, l'empêchent ou/et la déploient. Une armature opératoire, en lien aux travaux de l'École psychosomatique de Paris (IPSO), peut s'imposer intrapsychiquement avec un tel parcours, par la complexité et la diversité des vécus, des histoires et des ressources trouvées au sein des différents environnements du sujet. Envisager les besoins thérapeutiques des sujets trans dans leurs parcours et leurs réflexions, amène à considérer les besoins de desserrer, de dénouer certains liens psychiques avec leurs conséquences psychosomatiques. Ce décorsetage favorise une fluidité réflexive, afin que le sujet puisse évoluer avec et dans un authentique Moi-peau corset où il s'appartient. I develop my hypothesis of a two different corsets, the second skin and the ego-skin corset, which respectively prevent or deploy according to the psychic reappropriations of the subjects, specially transgender subjects. My practice as a clinical psychologist-psychotherapist and my research with transgender subjects led me to wonder about a metapsychology of the corset. I expose here two clinical cases. Two cases in particular led me to think about an authentic depressive capacity that I call here sadness-fluid or fluidity of sadness by analogy to gender-fluid, the fluidity of gender. Also, I reflect on the operative armature that can impose itself throughout the transition process, by the diversity of experiences, stories, and resources found in the subject's different environments. The therapeutic needs of trans subjects in their journeys and their reflections lead us to consider the needs to loosen, to untie certain ties. This uncorsetting favors a reflexive fluidity, so that the subject can evolve in an authentic ego-skin corset where it belongs to itself. [ABSTRACT FROM AUTHOR]

The validity of driving simulators is a topic that has been addressed ever since their first use. In practice, a comparison of field data and simulator data is often used for validation purposes. A systematic literature search was conducted which identified large heterogeneity in both study designs and statistical methods used in research on simulator validity. Most of the included studies concluded simulator validity (thus equivalence of field data and simulator data) from non-significant results in Null-Hypothesis Significance Testing (NHST), which is a well-known yet somewhat controversial practice. In this work, the consequences of both study design choice and the choice of the statistical method are outlined and alternatives such as using Bayes factor hypothesis testing and equivalence tests are discussed and applied to a real data example. The present paper is intended to shed light on the influence of the statistical method on conclusions drawn from experimental data. For research on driving simulator validity, we highly encourage the use of equivalence tests or Bayes factor hypothesis tests, in particular when evidence of the data suggests that an effect might be absent. [ABSTRACT FROM AUTHOR]

Background: Many patients critically ill with COVID-19 develop acute respiratory distress syndrome (ARDS) necessitating mechanical ventilation and proning. Although proning is lifesaving, it has been linked to the occurrence of facial pressure injuries (PIs). Objectives: To evaluate the incidence and use of prevention strategies and identify predictors of facial PIs in patients who received ventilator and proning treatments in COVID-designated intensive care units at 2 large quaternary medical centers in the Midwest. Method: This was a retrospective cohort study using data extracted from an electronic health record between October 2020 and February 2022. Demographics, clinical and care variables, and PI outcomes were analyzed to identify predictors of PI using logistic and Cox regression. Results: The cohort (N = 150) included patients from 2 units, unit a (n = 97) and unit b (n = 53) with a mean age of 60 years, with 68% identifying as male. Patients were vented for an average of 18 (SD, 16.2) days and proned for an average of 3 (SD, 2.5) days. Many (71%) died. Over half (56%) developed facial PI with a proning-exposure-adjusted incidence rate of 18.5%. Patients with PI were significantly different in several factors. Logistic regression showed predictors of PIs were duration of mechanical ventilation (in days; P = .02) and head turned (P = .01). Cox regression also identified head turn as predictive (P < .01), with Black/African American race as protective (P = .03) Discussion: Critically ill patients with COVID-19 receiving ventilator and proning therapy developed facial PIs despite the use of recommended prevention practices. Further research on effective PI prevention strategies is needed. [ABSTRACT FROM AUTHOR]

Background: Robotic suturing training is in increasing demand and can be done using suture-pads or robotic simulation training. Robotic simulation is less cumbersome, whereas a robotic suture-pad approach could be more effective but is more costly. A training curriculum with crossover between both approaches may be a practical solution. However, studies assessing the impact of starting with robotic simulation or suture-pads in robotic suturing training are lacking. Methods: This was a randomized controlled crossover trial conducted with 20 robotic novices from 3 countries who underwent robotic suturing training using an Intuitive Surgical® X and Xi system with the SimNow (robotic simulation) and suture-pads (dry-lab). Participants were randomized to start with robotic simulation (intervention group, n = 10) or suture-pads (control group, n = 10). After the first and second training, all participants completed a robotic hepaticojejunostomy (HJ) in biotissue. Primary endpoint was the objective structured assessment of technical skill (OSATS) score during HJ, scored by two blinded raters. Secondary endpoints were force measurements and a qualitative analysis. After training, participants were surveyed regarding their preferences. Results: Overall, 20 robotic novices completed both training sessions and performed 40 robotic HJs. After both trainings, OSATS was scored higher in the robotic simulation-first group (3.3 ± 0.9 vs 2.5 ± 0.8; p = 0.049), whereas the median maximum force (N) (5.0 [3.2–8.0] vs 3.8 [2.3–12.8]; p = 0.739) did not differ significantly between the groups. In the survey, 17/20 (85%) participants recommended to include robotic simulation training, 14/20 (70%) participants preferred to start with robotic simulation, and 20/20 (100%) to include suture-pad training. Conclusion: Surgical performance during robotic HJ in robotic novices was significantly better after robotic simulation-first training followed by suture-pad training. A robotic suturing curriculum including both robotic simulation and dry-lab suturing should ideally start with robotic simulation. [ABSTRACT FROM AUTHOR]

Students born in the days before the school-entry cutoff date are one year younger at school entry than their counterparts born in the days following the cutoff, which causes an achievement gap between the youngest and oldest students within each cohort. I assess this so-called relative age effect in the Spanish context, where the school-entry rule is strictly enforced. By means of a sharp Regression Discontinuity Design, I report a remarkable effect in fourth grade that is still visible in eighth grade. The heterogeneity of the effect by social origin and gender is explored. Following the compensatory advantage model, I reason that the relative age effect should be smaller among high-SES students when assessing academic outcomes that might endanger the probability of attaining higher education (such as repetition), but not for low-stakes external examinations. I confirm this expectation. As for gender, I argue that the relative age effect might be lower among girls either because younger girls are not ever affected by their birth month or because they are better able to catch up with their older peers than boys. I provide evidence supporting this second hypothesis. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To understand and describe attitudes toward general health checkups, breast health knowledge, cultural beliefs, and health-promoting behaviors among Myanmar American immigrant women in the United States. SAMPLE & SETTING: 267 women participated in the study. 10 women were excluded because of missing data, so the total sample size was 257 participants. METHODS & VARIABLES: A descriptive, crosssectional survey design was used to describe and investigate breast health perceptions and behaviors. RESULTS: Nearly 75% of the study sample reported having negative attitudes toward general health checkups and were found to have less accurate breast health knowledge and more fatalistic views about breast cancer. Only 29% of older women adhered to mammogram recommendations. Younger women reported more barriers to mammograms, and older women reported fewer barriers to mammograms. IMPLICATIONS FOR NURSING: This study demonstrated the need for additional research focusing on unique perspectives when investigating breast health practices among Myanmar American immigrant women. The findings highlight the essential need to build a strong partnership with stakeholders to combat breast health disparities and address the complex nature of acculturation. [ABSTRACT FROM AUTHOR]

Background: Preterm birth (PTB) is the main condition related to perinatal morbimortality worldwide. The aim of this study was to determine the indirect effects of neighbourhood socioeconomic status (NSES) on the risk of spontaneous PTB. Methods: We carried out a retrospective case-control study including sociodemographic and obstetric data of multigravid women who gave birth at a maternity hospital in Tucumán, Argentina, between 2005 and 2010: 949 women without previous PTB nor pregnancy loss who delivered at term and 552 who had spontaneous PTB. NSES was estimated from the Unsatisfied Basic Needs index of census data. Variables selected through penalised regressions were used to create a data-driven Bayesian network; then, pathways were identified and mediation analyses performed. Results: Maternal age less than 20 years mediated part of the protective effect of high NSES on spontaneous PTB [natural indirect effect (NIE) -0.0125, 95% confidence interval (CI) (-0.0208, -0.0041)] and on few prenatal visits (< 5) [NIE − 0.0095, 95% CI (-0.0166, -0.0025)]. These pathways showed greater sensitivity to unobserved confounders that affect the variables mediator-outcome in the same direction, and exposure-mediator in the opposite direction. They did not show sensitivity to observed potential confounders, nor to the parameterization used to define NSES. Meanwhile, urinary tract infections showed a trend in mediating the effect of low NSES on spontaneous PTB [NIE 0.0044, 95% CI (-0.0006, 0.0093), P 0.0834]. Conclusions: High NSES has protective indirect effects on spontaneous PTB risk, mainly associated with a lower frequency of teenage pregnancy. Significance: Few studies have empirically investigated pathways between neighbourhood socioeconomic status (NSES) and specific individual-level traits on spontaneous preterm birth, especially in Latin American populations. The findings of this study suggest that high NSES has protective indirect effects on spontaneous preterm birth, mainly associated with a lower frequency of teenage pregnancy. [ABSTRACT FROM AUTHOR]

To determine the relationship of dual-task-dynamic-balance with the risk-of-fall and gait-parameters in fallers and non-fallers elderly. After signing written informed consent, participants were assessed for dual-task-dynamic-balance [dual timed up and go (TUG) test (DTT)+ cognitive stops (CS) and DTT + CS + cognitive errors (CE)], risk-of-fall [berg balance scale], and gait-parameters [footprint method of gait analysis]. A significant difference was found between fallers and non-fallers for the variables falls in the previous 12 months, mini-mental state examination (MMSE), DTT + CS + CE, and walking speed. A significant moderate to strong negative correlation was found between dual task dynamic balance (DTT + CS and DTT + CS + CE), risk-of-fall and few gait-parameters in elderly fallers. The study emphasizes the importance of maintaining dynamic-balance and performing dual-tasks to prevent falls in elderly individuals, suggesting that interventions targeting both cognitive and motor aspects can be beneficial in reducing fall-risk. [ABSTRACT FROM AUTHOR]

In Canada, in the early 2000s, the decriminalization of cannabis for recreational use seemed imminent. Between 2003 and 2005, three government decriminalization bills were introduced in the Canadian House of Commons, but none were adopted, and decriminalization efforts were abandoned. Subsequently, Canada went beyond decriminalization and legalized recreational cannabis in 2018. This paper examines why the Canadian decriminalization efforts failed, using the Advocacy Coalition Framework (ACF) and ACF policy change theory. Three ACF-based hypotheses to explain the failed reform attempts are developed and investigated, but none are empirically supported. A fourth hypothesis is developed using information processing insights from Punctuated Equilibrium Theory (PET) but adapted to the ACF. This hypothesis is empirically supported showing that Canada's decriminalization efforts failed, despite a supportive advocacy coalition, favourable conditions in the cannabis policy subsystem and favourable conditions in the Canadian political system, because its systemic advocates did not give it priority relative to other issues from other subsystems. This finding has implications for ACF policy change theory, identifying a necessary condition for major policy change that has been potentially overlooked, and illustrates the potential for cross-fertilization between PET and ACF theories of policy change. [ABSTRACT FROM AUTHOR]

BACKGROUND: The balanced transfusion of blood components plays a leading role in traumatic hemostatic resuscitation. Yet, previous whole blood studies have only focused on urban trauma center settings. OBJECTIVE: To compare component vs whole blood therapy on wastage rates and mortality in the rural setting. METHODS: This study was a nonrandomized, retrospective, observational, single-center study on a cold-stored whole blood program implementation for adult massive transfusions from 2020 to 2022 at a Level II trauma center. Trauma registry data determined the facility's whole blood needs and facilitated sustainable blood supplies. Whole blood use protocols were established, and utilization and laboratory compliance for incompatible ABO antibody hemolysis was monitored and reviewed monthly at stakeholder and trauma services meetings. RESULTS: From 2018 to 2019, the facility initiated component therapy massive transfusions every 9 days (n = 41). Therefore, four units of low-titer, O-positive whole blood delivered fortnightly was determined to provide patient coverage and minimize wastage. Across the study time frame (2020–2022), there were n = 68 hemodynamically unstable patients, consisting of those receiving whole blood, n = 37, and patients receiving component therapy, n = 31. Mortality rates were significantly lower (p =.030) in the whole blood population (n = 3, 8%) compared to those solely receiving component therapy (n = 9, 29%). Wastage rates were constantly evaluated; in 2021, 43.4% was not utilized, and in 2022, this was reduced to 38.7%. Anecdotally, nurses appreciated the ease of administration and documentation of transfusing whole blood, as it negated ratio compliance. CONCLUSION: This evidence-based whole blood program provides vital care to severely injured trauma patients in a vast, rural region. [ABSTRACT FROM AUTHOR]

Curved mesial roots can be challenging for different stages of endodontic treatment. Preparation aims to enlarge, clean, and shape the root canal system, and hundreds of systems are available to carry it out. Aiming to maintain pericervical dentin, minimally invasive preparation was proposed, and with it, instruments with lower tapers emerged. This study aimed to evaluate the increase in canal volume, the centering ability of the instruments, and root canal transportation of two different rotary systems with lower tapers. Eighteen curved mesial roots of extracted mandibular molars were scanned by micro-CT at 3 moments: initial and after the 2 stages of endodontic preparation. The canals were prepared using TruNatomy (TN) and ProDesign Logic 2 (PDL2) instruments up to sizes 25.04 and 26.04, respectively, and after 36.03 and 35.05, respectively. The data were analyzed using parametric and nonparametric tests with a significance level of 5%. TN and PDL2 systems showed no difference regarding the increase in the volume of the canals with the first instruments, but after preparation with a diameter size of 35 or 36, there was a difference (P <.01) between the systems in the cervical and middle thirds. Both systems shaped the mesial canals of mandibular molars while keeping low transportation and good centering ability in enlargements up to diameter size 35 or 36 with tapers of 3 or 5%. [ABSTRACT FROM AUTHOR]

BACKGROUND: When treating acute respiratory failure, both hypoxemia and hyperoxemia should be avoided. ... should be monitored closely and O2 flows adjusted accordingly. Achieving this goal might be easier with automated O2 titration compared with manual titration of fixed-flow O2. We evaluated the feasibility of using an automated O2 titration device in subjects treated for acute hypoxemic respiratory failure in a tertiary care hospital. METHODS: Health-care workers received education and training about oxygen therapy, and were familiarized with an automated O2 titration device (FreeO2,). A coordinator was available from 8:00 AM to 5:00 PM during weekdays to provide technical assistance. The ability of the device to maintain ... within the prescribed therapeutic window was recorded. Basic clinical information was recorded. RESULTS: Subjects were enrolled from November 2020 to August 2022. We trained 508 health-care workers on the use of automated O2 titration, which was finally used on 872 occasions in 763 subjects, distributed on the respiratory, COVID-19, and thoracic surgery wards, and in the emergency department. Clinical information could be retrieved for 609 subjects (80%) who were on the system for a median (interquartile range) of 3 (2-6) d, which represented 2,567 subject-days of clinical experience with the device. In the 82 subjects (14%) for whom this information was available, the system maintained ... within the prescribed targets 89% of the time. Ninety-six subjects experienced clinical deterioration as defined by the need to be transferred to the ICU and/or requirement of high flow nasal oxygen but none of these events were judged to be related to the O2 device. CONCLUSIONS: Automated O2 titration could be successfully implemented in hospitalized subjects with hypoxemic respiratory failure from various causes. This experience should foster further improvement of the device and recommendations for an optimized utilization. [ABSTRACT FROM AUTHOR]

Background: Frailty is a multidimensional geriatric syndrome associated with physical, psychological and social changes. There is a paucity of research on frailty in Sub‐Saharan African (SSA) countries, especially Ethiopia. Objectives: To assess the initial correlations among frailty, nutritional status, depression and QOL (quality of life) in a group of older people in Ethiopia who are later enrolled in a study examining the effects of a nurse‐led community intervention on frailty and related health outcomes. Methods: Data from 68 community‐dwelling individuals 60 years of age, or over, were collected. Frailty was measured using the Amharic version of the Tilburg Frailty Indicator. The statistical analysis included Spearman's rank correlation coefficient for degrees of association, Mann–Whitney U‐test for variables with two categories and Kruskal–Wallis for variables with three or more categories. Results: The mean frailty score for participants was 7.3 (±1.9). Participants with higher frailty scores had lower nutritional status (rs = −0.46, p < 0.01). There was a statistically significant relationship (positive) between frailty scores and depression (rs = 0.39, p < 0.01). Depressed (Md = 9, n = 23) and non‐depressed frail older people (Md = 7, n = 45) showed a significant difference in their overall frailty score, U = 330.50, z = −2.49, p = 0.01, r = 0.30. There was an inverse significant association between the level of frailty across different domains in the QOL: physical (rs = −0.44, p < 0.01), psychological (rs = −0.45, p < 0.01), social relations (rs = −0.29, p < 0.05) and environmental (rs = −0.47, p < 0.01). Conclusion: The findings from this study were consistent with those from across middle‐income and high‐income countries. Implications for Practice: This research indicates that older people living in communities who are identified as frail often suffer from a poor nutritional status, depression and reduced QOL. It suggests that healthcare professionals in Sub‐Saharan countries would benefit from recognising the frailty in this population, and developing interventions aimed at enhancing nutrition, mental health and overall well‐being. [ABSTRACT FROM AUTHOR]

The authors explore the link between E, S, and G ratings of three well-known ESG data providers (LSEG, MSCI, and Sustainalytics) and equity performance, both on the single stock as well as on the portfolio level. Based on a universe of companies included in the Russell 3000 observed over the course of 2013 to 2022, they do not find a consistent link between E, S, and G ratings and stock price performance. On the portfolio level, however, they find that selecting stocks based on E, S, and G ratings tends to lead to a significant large-cap, profitability, investment tilt, as well as a momentum tilt—the tilts tend to be more pronounced the more E, S, and G focused the selection becomes. Once controlled for style factors, they find alphas to be largely statistically insignificant. As a result of their findings, investors should pay special attention to the potential presence of style factor tilts in ESG ratings-based products. [ABSTRACT FROM AUTHOR]

Introduction: The present study aimed to investigate the deformation behavior of three different clear aligner systems, CA® Pro+ Clear Aligner (Scheu Dental, Iserlohn, Germany), Taglus Premium (Taglus Company, Mumbai, India), and Spark Trugen (Ormco Corp., Orange, CA, USA), under compression testing, using the digital image correlation (DIC) technique. Materials and Methods: A total of 15 patients were treated with each of the three aligner systems, resulting in 45 sets of aligners. Each aligner set was fixed on the 3D-printed dental arches and then in an articulator. Then, the samples were subjected to occlusal forces using a purpose-built test stand to allow for controlled force application and precise displacement determination. The DIC technique was used for capturing the deformation behavior, providing detailed strain and displacement fields. Statistical analysis was performed using one-way ANOVA and Bonferroni post hoc tests with a significance of 0.05. Results: The results indicate that the Spark system exhibited the most substantial rigid displacement. Furthermore, the elastic deformation values of the Spark and Taglus systems were significantly higher than those of the CA Pro+ system (p > 0.05). Conclusions: The Spark Trugen clear aligner system demonstrated a lower stability to rigid displacement and elastic deformation under compression testing compared to the Scheu CA® Pro+ Clear Aligner and Taglus Premium. All three tested clear aligner systems showed an increased resistance to elastic displacement and rigid deformation in the mandibular arch. [ABSTRACT FROM AUTHOR]

Myxoid liposarcomas are malignant soft-tissue sarcomas whose treatment represents a challenge, even for the most experienced surgeon. In this study, we report on our experience with the treatment of myxoid liposarcomas of the thigh. Our retrospective analysis included myxoid liposarcomas of the thigh treated with surgical resection between 2016 and 2022. Resection margins, complications, local recurrences, and metastases were recorded. The oncological outcome of each case was evaluated at their latest follow-up. Adjuvant therapies were administered according to the ESMO guidelines. Functionality was assessed with the MSTS score before surgery and at the patients' latest follow-up. Thirty cases (ten high-grade and 20 low-grade) were included. The mean diameter was 11.8 cm. Twenty-four cases had wide margins (80%) and six (20%) were marginal. Five cases (60% marginal) had local recurrences (17%). Marginal resection was associated with a higher risk of local recurrence (p = 0.041). Three cases with high-grade tumors (10%) developed metastases. At the patients' latest follow-up, their mean MSTS score had risen from 22.9 to 27.3. While tumor grade influences the risk of metastases, the quality of resection margins can determine the local recurrence rate. An adequate surgery can lead to good post-operative functional outcomes. [ABSTRACT FROM AUTHOR]