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In this retrospective cohort study, we compared neonatal and maternal outcomes after exposure of different psychopharmacological classes of drugs. Both psychiatric diseases and pharmacological treatment of these are associated with lower birth weights, lower APGAR scores, and NICU admission. Therefore, we tried to rule out the role of psychotropics as if no differences were found between pharmacological classes, the lower birthweights might not be attributable to these. We divided our groups in exposed to atypical antipsychotic drugs, Selective Serotonin Reuptake Inhibitors (SSRI), Tricyclic Antidepressants (TCA), benzodiazepines, and different combinations of psychotropic drugs. The last group included SSRIs combined with benzodiazepines, methylphenidate, lithium, and classic antipsychotic drugs. We used univariate regression analysis to see which factors from our rich dataset including pharmacological class, are associated with birth weight, APGAR scores, gestational age, and NICU admission. The significant associations from univariate analyses were further analyzed using ancova analysis or logistic regression where applicable. We found no clinically relevant differences in neonatal and maternal outcomes between the different exposed pharmacological classes. However, our dataset may have been too small to draw firm conclusions. [ABSTRACT FROM AUTHOR]

Introduction : This study presents a comprehensive analysis of wrong-way driving (WWD) fatal crashes on divided highways in the United States over a 17-year period, from 2004 to 2020. The study aims to uncover trends, distribution patterns, and factors contributing to these fatal crashes. Data were extracted from the National Highway Traffic Safety Administration (NHTSA) Fatality Analysis Reporting System (FARS) database. Methods : Descriptive statistical analysis was used to reveal general crash characteristics, while trends were updated through an examination of the annual occurrence of WWD fatal crashes. The study further employed binomial logistic regression to compute odds ratios, identifying significant contributing factors. These factors encompassed temporal variables, crash characteristics, and driver characteristics. The odds ratios shed light on the relationship between WWD fatal crashes and other fatal crashes, allowing for the identification of key elements that drive WWD incidents. Results : On average, 302 WWD fatal crashes occurred annually, resulting in 6,953 fatalities during the study period. The frequency of WWD fatal crashes remained relatively stable, with a slight increase over time. According to the model, variables include day of week, time of day, month, lighting conditions, weather conditions, roadway profile, collision type, passenger presence, driver age, gender, license status, and driver injury severity were found to significantly impact the occurrence of WWD fatal crashes. One significant finding is that road profiles like sag curves or hillcrests can increase the likelihood of WWD fatal crashes. Practical Application : The findings of this study contribute to an improved understanding of WWD fatal crashes on divided highways, thereby aiding in the development of strategies for prevention and mitigation. [ABSTRACT FROM AUTHOR]

The list of standard abbreviations for JDS is available at adsa.org/jds-abbreviations-24. Nonstandard abbreviations are available in the Notes. This study aimed to verify the effect of milking permission (MPE) and concentrate supplementation (CS) on milking frequency (milkings per cow per day) and milk yield (kilograms per cow per day) in a farm using a pasture-based automatic milking system (AMS). Sixty-eight cows milked using this AMS unit were randomly assigned to 1 of 4 groups homogeneous for parity, DIM, and milk yield. Treatments used were frequent or restricted MPE, that granted cows permission to milk after 6 to 8 h or 9.6 to 14 h of the previous milking, respectively; and low (LC) or high (HC) CS of 0.5 kg or 3.5 kg/cow per day, respectively. The combination of the 2 levels of MPE and the 2 levels of CS resulted in the 4 treatment combinations (frequent HC [FHC], restricted HC [RHC], frequent LC [FLC], and restricted LC [RLC]). This study was designed as a 2 × 2 factorial arrangement with treatment crossover: each of the 4 cow groups was randomly assigned to 1 of the 4 treatment combinations for a 5-wk experimental period (1 pretreatment week and 4 treatment weeks), and after each 5-wk period groups crossed over to another treatment combination until they experienced all. Statistical analysis assessed the effect of MPE, CS, and their interaction on milk yield, milking frequency, box time, milking time, and average milk-flow rate. This was done using a mixed model analysis with repeated measures to account for repeated observations on the experimental unit (cow). Milk yield per cow per day and milkings per cow per day were significantly higher with the frequent compared with the restricted MPE (1.5 kg and 0.65 milkings, respectively). Milk yield per cow per day and milkings per cow per day were significantly higher with the HC compared with the LC CS (3.1 kg and 0.25 milkings, respectively). Additionally, milk yield per cow per day was affected by the interaction of MPE and CS and it was highest with the FHC (20.1 kg) treatment combination, followed by RHC (18.2 kg) treatment combination. The number of milkings per cow per day were also affected by the interaction of MPE and CS. The highest estimated number of milkings per cow per day was recorded for the FHC (2.12) and the FLC (1.77) treatment combinations, followed by the RHC (1.38) and RLC (1.23) treatment combinations. Similarly, milking interval was 2.5 h longer for the RLC treatment combination compared with RHC. The shortest milking interval was observed for the FHC (11 h) and FLC (12.8 h) treatment combinations. In conclusion, the study showed that allowing access to the robot between 6 to 8 h after the previous milking was sufficient (even with a minimal level of CS) to achieve acceptable milk production and milking performance in a pasture-based AMS. [ABSTRACT FROM AUTHOR]

Planetary defense scenarios require an assessment of the possible effects of an impact and of the efficacy of different mitigation options in order to provide decision makers with actionable information. Essential inputs to these assessments are the orbital parameters, the likelihood of impact, the possible locations of impact, and the physical properties of the potential impactor. There is a robust framework in place to determine the orbital parameters, the likelihood of impact, and the possible locations of impact (e.g. Milani et al. [1] , Sciarra et al. [2] , Losacco et al. [3]). While there is a robust suite of potential methods to determine properties of a potential impactor, most of these methods depend critically on the details of the objects observability (e.g. brightness, distance from Earth, ...). As a result, in practice it is rare that all the physical properties of interest are measurable. In order to fill this gap, we have developed a property inference network that can be used to generate a set of potential impactors whose properties in aggregate are consistent with the distributions from the available measurements, the distributions derived from population-wide statistics, and the combination of physical properties for each individual impactor is physically plausible. We will describe this Asteroid Property Inference Network (APIN), apply it to the PDC23 scenario, and demonstrate how even limited asteroid characterization can be leveraged to improve impact risk assessment. • We have developed a hybrid inference network to estimate asteroid physical parameters. • The inference network can leverage limited observational information about asteroids. • The use of the inference network in a planetary defense scenario is demonstrated. [ABSTRACT FROM AUTHOR]

Strong opioids are the cornerstone in the treatment of cancer-related pain. This study aims to compare analgesic effectiveness of different strong opioids for the treatment of cancer-related pain. PubMed and Embase were searched for RCTs that compared strong opioids for treatment of cancer-related pain against one another. A network meta-analysis was conducted and the related Surface Under the Cumulative RAnking (SUCRA)-based treatment ranks were calculated. Primary outcome was pain intensity (numerical rating scale (NRS)) and/or the percentage of patients with ≥50% pain reduction, after 1 and 2–4 weeks. Sixteen RCTs (1813 patients) were included. Methadone showed, with a high certainty of evidence, increased ORs for treatment success at 1 week, compared with morphine, buprenorphine, fentanyl, and oxycodone, range 3.230–36.833. Methadone had the highest likelihood to be the treatment of preference (ToP) (SUCRA 0.9720). For fentanyl, ORs were lower, however significant and with high certainty. After 2–4 weeks, methadone again showed the highest likelihood for ToP, however, with moderate certainty and nonsignificant ORs. The combination of morphine/methadone, compared with morphine, buprenorphine, fentanyl, hydromorphone, methadone, and oxycodone achieved a treatment effect of mean NRS difference after 2–4 weeks between −1.100 and −1.528 and had the highest likelihood for ToP. The results suggest that methadone possibly deserves further promotion as first-line treatment for the treatment of cancer-related pain. [ABSTRACT FROM AUTHOR]

A number of studies have reported that contrast-enhanced ultrasound (CEUS) imaging might be used for the early diagnosis of adnexal masses. A meta-analysis was performed to evaluate the diagnostic accuracy of CEUS combined with Ovarian−Adnexal Reporting and Data System (O-RADS) ultrasound risk stratification for adnexal masses. Related articles were retrieved from PubMed, Web of Science, Embase, and the Cochrane Library in strict accordance with established standards, and data (including true positive, false positive, false negative, and true negative values) was extracted from the original articles. The Quality Assessment of Diagnostic Accuracy Studies 2 was used to evaluate the quality of articles and the possibility of bias. STATA 12.0 software was used to perform statistical analysis. Five articles that included 598 patients were analyzed in this meta-analysis. The pooled sensitivity and specificity of CEUS combined with O-RADS for the diagnosis of adnexal masses were 0.95 (95% confidence interval [CI]: 0.91–0.98) and 0.86 (95% CI: 0.79–0.91). Moreover, the positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and area under the curve (AUC) were 6.81 (95% CI: 4.61–10.08), 0.05 (95% CI: 0.03–0.11), 111.30 (95% CI: 65.32–189.65), and 0.97 (95% CI: 0.95–0.98), respectively. The pooled AUC and DOR for the detection of CEUS combined with O-RADS were superior to O-RADS US. Our findings revealed that O-RADS combined with CEUS can improve the diagnostic accuracy of ovarian adnexal masses. • O-RADS and CEUS O-RADS have moderate or high diagnostic efficiency in adnexal masses. • Adding CEUS to O-RADS US has a higher diagnostic accuracy compared with O-RADS US. • The further clinical application of CEUS O-RADS may need a unified standard. [ABSTRACT FROM AUTHOR]

Laryngopharyngeal reflux disease (LPRD) is a common condition affecting patients reporting to an otolaryngologist. However, the diagnosis of this condition is usually hinged on the combination of largely non-specific symptoms, and clinical findings on laryngoscopy. This study aimed at evaluating the utility of digital image analysis to quantitatively evaluate the severity of signs as recorded with laryngoscopy in patients of LPRD. The study group included individuals who were aged between 18 and 65 years and reported to the ENT OPD. These were then divided into two groups depending on symptoms and laryngoscopic findings. The LPRD group had symptomatic patients with an Reflux finding score (RFS) score >7. Those with an RFS of <6 were designated as the 'Normal group'. The Laryngoscopic images were recorded and analyzed using Image J software as per the set protocol. The Red Green Blue (RGB) values of the laryngoscopic images of each group were obtained and subjected to statistical analysis. 200 participants were enrolled in the study with 100 participants in the LPRD group (mean age = 46.2, 40 males, 60 females) and 100 in the control group (mean age = 43.6, 55 males, 45 females). The measured RGB values were more in the LPRD group as compared to the control group and the results were statistically significant (P < 0.001). By providing an objective value to the degree of inflammation, RGB value measurement provides a quick, economical, adaptable tool for auxiliary and corroborative information for the diagnosis of LPRD. [ABSTRACT FROM AUTHOR]

Scapular orientation may play an important role in preoperative planning for shoulder arthroplasty; however, there is currently no defined method for producing standardized three-dimensional measurements. The purpose of this study is to develop a reproducible measurement system of scapular orientation and to evaluate differences between unaffected shoulders and those with diagnoses of primary glenohumeral osteoarthritis (GHOA) and rotator cuff tear arthropathy (CTA). Patients receiving computed tomography scans for preoperative shoulder arthroplasty planning were enrolled prospectively. Thin sliced axial images that included bilateral shoulders and the thorax were reformatted. The pathology of the bilateral glenohumeral joints was defined as GHOA, CTA, or unaffected. Scapular orientation was defined relative to the thorax using three-dimensional models to define the protraction, rotation, and tilt angles in the supine position. Univariate analysis was performed to compare demographics and scapular measurements between patients with GHOA, CTA, and unaffected shoulder pathology. Multivariate linear regression analysis was performed to identify independent predictors of scapular orientation. One hundred fifty-eight shoulders, comprising 79 patients were included. Twenty-seven percent (n = 21/79) of patients had an unaffected contralateral shoulder. Shoulders with GHOA had significantly greater downward scapular rotation (-14 ± 7 degrees) than both unaffected shoulders (-8 ± 7 degrees; P <.001) and those with CTA (-7 ± 8 degrees; P <.001). Increased downward scapular rotation was predicted by a shoulder pathology of GHOA in multivariate analysis (beta -7.09; P <.001). The magnitude of side-to-side difference was greatest in scapular rotation for patients with GHOA compared to CTA, with no significant differences in tilt or protraction. Scapular rotation in the supine position varies by shoulder pathology, with greater downward rotation seen in patients with primary GHOA. These findings underscore the need for awareness of scapular orientation in addition to glenoid morphology when evaluating and planning shoulder arthroplasty cases. [ABSTRACT FROM AUTHOR]

Social determinants of health (SDOH) refer to social and economic factors that influence a patient's health status. The purpose of this study was to investigate the impact of SDOH on preoperative and postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) scores and postoperative resource utilization following primary shoulder arthroplasty (SA). This retrospective chart review evaluated data from all patients who underwent primary SA (including anatomic, reverse, and hemiarthroplasty) at a single health system between May 2020 and May 2022. Patients without at least 6-month postoperative PROMIS questionnaires and those undergoing revision surgeries were excluded. The electronic medical record was used to identify SDOH for each patient, and PROMIS scores for Upper Extremity (PROMIS-UE), Pain Interference (PROMIS-PI), and Depression (PROMIS-D) were completed electronically at respective preoperative and postoperative visits. Univariate analysis using independent 2-group t -tests and Chi-squared tests were used to analyze the mean difference between patient groups based on SDOH. Multivariate linear regressions were performed with all predictors used in the univariate model using the least squares method. The study included 248 patients who underwent SA, with a mean age of 67.9 years. Caucasian patients were over-represented in the highest quartile of median household income (MHI) compared to Black patients (35.1% vs. 17.2%) who were over-represented in the lowest MHI quartile (37.9% vs. 8.3%). At 6-month postoperative, black patients had significantly lower UE (33.8 ± 6.2 vs. 38.1 ± 9.0; P =.03) and greater PI scores (59.1 ± 6.1 vs. 55.6 ± 8.6; P =.145) compared to Caucasian patients. Similarly, at 6-month follow-up, the lowest MHI quartile had lower UE (33.8 ± 7.7 vs. 39.6 ± 8.8; P =.01) and higher PI scores (58.7 ± 6.5 vs. 54.3 ± 8.2; P <.01) compared to the highest MHI quartile, and females demonstrated lower UE (36.3 ± 7.9 vs. 38.6 ± 9.8; P =.04) and higher D scores (46.2 ± 9.1 vs. 42.0 ± 8.6; P =.046) compared to males. Government/public insurance demonstrated lower UE (36.8 ± 8.0 vs. 39.8 ± 10.4; P =.03) and higher D scores (45.9 ± 9.2 vs. 40.6 ± 7.6; P =.03) compared to private insurance. At 12-month follow-up, females demonstrated lower UE scores compared to males (36.0 ± 10.2 vs. 40.1 ± 11.3; P =.03). Black patients harbored lower UE, PI, and D scores compared to Caucasian patients, although not statistically significant. Several socioeconomic factors such as race, gender, and insurance status are associated with differential outcomes after SA. Patients who are Black, female, current smokers, and from the lowest income quartile are associated with inferior PROMIS function, pain, and depression outcomes following SA. [ABSTRACT FROM AUTHOR]

Anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) are proven surgical treatment options for both traumatic and degenerative conditions of the shoulder. Our objective is to report both clinical and patient-reported outcomes (PROs) of patients over the age of 75 at the time of arthroplasty. We hypothesize no functional difference in outcomes between patient groups. Patients over the age of 75 at the time of surgery who received primary aTSA or rTSA between 2009 and 2020 with a minimum of two-year follow-up were selected. A retrospective chart review was performed. Patients 60-75 were included as a control group. 2:1 propensity matching using sex, Charlson Comorbidity Index, preoperative forward elevation (FE), and external rotation (ER) was used in selecting a comparison cohort of patients 60-75. Statistical analysis included the t -test, Wilcoxon signed-rank test, and chi-squared test. For aTSA, 25 patients older than 75 years fit the inclusion criteria. The mean follow-up time was 4.2 (2.0-12.0) years. aTSA patients over the age of 75 had significant improvements in FE 111 to 141 degrees (P =.007), ER 28 to 44 degrees (P <.001), and internal rotation (IR) sacrum to L4 (P =.003). There were also improvements in FE strength (FES) 4+/5 to 5/5 (P =.0303) and IR strength (IRS) but not ER strength (ERS) from 4+/5 to 5/5 (P =.098). There was no significant difference in range of motion (ROM), strength, or PROs between age groups (>75 years vs. 60-74 years). For rTSA, 47 patients older than 75 years fit the inclusion criteria. Average clinical follow-up was 3.5 (2.0-10.6) years. Patients demonstrated ROM improvements in ER (31 to 40 degrees, P =.0413), FE (96 to 138 degrees, P <.001) but not IR (L5 to L4, P =.3509). There were significant improvements in postoperative strength in FES (4-/5 to 4+/5, P <.001), ERS (4-/5 to 4+/5, P <.001), and IRS (4/5 to 5/5, P <.001). The only significant difference between propensity-matched age groups was postoperative IR (L4 to L5, P =.013). There were no significant differences in PROs between different age groups. aTSA and rTSA provide significant improvements in ER, FE, ROM, ERS, FES, and IRS in patients over the age of 75 with no significant difference in outcomes compared to a younger cohort. [ABSTRACT FROM AUTHOR]

Glenoid component loosening remains the most common reason for revision of anatomic total shoulder arthroplasty (aTSA). We assessed early clinical and radiographic outcomes following aTSA using a press-fit short stem and a peripherally enhanced fixation glenoid. 275 consecutive patients with end-stage glenohumeral arthritis and Walch A- or B-type glenoid morphology who underwent primary aTSA in 2017-2018 at two high-volume shoulder arthroplasty institutions were evaluated, and patient-reported outcomes (PROMs) and radiographic findings were studied in those with completed baseline and minimum 2-year follow-up, respectively. Patient demographics, glenoid morphology, body mass index (BMI), Charlson Comorbidity Index (CCI), range of motion, American Shoulder and Elbow Surgeons (ASES) score, and Simple Assessment Numeric Evaluation score were collected. Radiographic analysis of glenoid and humeral components was performed. Multivariable logistic, equal adjacent odds ordinal, and beta regression were respectively used to identify predictors of glenoid radiolucent lines, humeral calcar resorption, and total ASES score. Patients were 43% female, with a mean age of 66, a median BMI of 30, and median follow-up of 28.4 months. ASES and Simple Assessment Numeric Evaluation scores improved by respective medians of 54.4 and 55.0 points, forward elevation by median 35°, and external rotation by median 30° (all P <.001 for preoperative to postoperative change). Postoperative radiographs of 177 cases showed 10 (5.7%) glenoid osteolysis, 51 (28.8%) glenoid radiolucent lines, and 81 (45.8%) calcar resorptions. The follow-up duration (median 40.1 vs. 27.2 months; P <.001), BMI (median 27.5 vs. 30.7; P <.001), and Charlson Comorbidity Index (Q3 0 vs. 1; P =.02) were associated with glenoid osteolysis in bivariate analyses. In multiple logistic regression, surgeon (C vs. A/B) was the only statistically significant predictor of glenoid radiolucent lines [OR 0.27, 95% CI (0.1, 0.8)]. By descending importance, Surgeon C [OR 6.5 (2.0, 20.5)], humeral canal filling ratio [upper vs. lower quartile OR 2.3 (1.3, 4.0)], mediolateral humeral head deviation [upper vs. lower quartile OR 1.9 (1.0, 3.5)], and glenoid osteolysis [OR 13.5 (2.6, 71.6)] significantly predicted greater calcar resorption. Longer follow-up duration marginally statistically significantly predicted lower ASES score [upper vs. lower quartile OR 0.8 (0.6, 1.0)]. Following aTSA with a peripherally enhanced fixation glenoid, pain, range of motion, and patient-reported outcomes significantly improved at a minimum of 2 years with only 5.7% glenoid osteolysis despite heterogeneous preoperative glenoid pathologies. [ABSTRACT FROM AUTHOR]

Validate the Preschool Nutrition Education Practices Survey. Iterative approach combining design-based research and Standards for Educational and Psychological Testing. Los Angeles, CA and Philadelphia, PA Early Care and Education (ECE) classrooms. Expert panel members (n = 7); ECE teachers: interviews (n = 8), pilot survey (n = 31), and final survey (n = 136). Early care and education nutrition education practices used in the classroom either during class time or mealtime. Qualitative content analysis was implemented for content, response process, and consequences of testing validity evidence. Rasch rating scale analysis was conducted for the response process and internal structure validity and reliability evidence. Qualitative field-testing produced strong content, response process, and consequences of testing validity evidence to inform survey modifications. Quantitative field-testing generated a psychometrically sound, well-targeted 12-item survey on a 4-point frequency scale with excellent item and person reliability (0.97 and 0.93 respectively) and separation (5.36 and 3.77 respectively); good Rasch Principal Components Analysis findings (60.3%); and productive item fit statistics (0.50–1.50 logits). Robust validity (content, response process, consequences of testing, internal structure) and reliability evidence were demonstrated for using the Preschool Nutrition Education Practices Survey to assess ECE teachers' use of nutrition education practices. Future research is needed to examine its relationship to other variables, such as nutrition teaching efficacy, and to determine its ability to detect change in ECE nutrition education practices over time and across groups. [ABSTRACT FROM AUTHOR]

The first formal definition of randomness, seen as a property of sequences of events or experimental outcomes, dates back to Richard von Mises' work in the foundations of probability and statistics. The randomness notion introduced by von Mises is nowadays widely regarded as being too weak. This is, to a large extent, due to the work of Jean Ville, which is often described as having dealt the death blow to von Mises' approach, and which was integral to the development of algorithmic randomness—the now-standard theory of randomness for elements of a probability space. The main goal of this article is to trace the history and provide an in-depth appraisal of two lesser-known, yet historically and methodologically notable proposals for how to modify von Mises' definition so as to avoid Ville's objection. The first proposal is due to Abraham Wald, while the second one is due to Claus-Peter Schnorr. We show that, once made precise in a natural way using computability theory, Wald's proposal constitutes a much more radical departure from von Mises' framework than intended. Schnorr's proposal, on the other hand, does provide a partial vindication of von Mises' approach: it demonstrates that it is possible to obtain a satisfactory randomness notion—indeed, a canonical algorithmic randomness notion—by characterizing randomness in terms of the invariance of limiting relative frequencies. More generally, we argue that Schnorr's proposal, together with a number of little-known related results, reveals that there is more continuity than typically acknowledged between von Mises' approach and algorithmic randomness. Even though von Mises' exclusive focus on limiting relative frequencies did not survive the passage to the theory of algorithmic randomness, another crucial aspect of his conception of randomness did endure; namely, the idea that randomness amounts to a certain type of stability or invariance under an appropriate class of transformations. [ABSTRACT FROM AUTHOR]

Limited data exist examining whether timing and/or duration of eating behaviors throughout the day affect sleep health. The aim of this study was to identify the relationship between eating behaviors and sleep in young adults without chronic diseases or conditions. This was a cross-sectional study using 7 days of baseline data from a randomized crossover trial. Participants included 52 young adults. The study took place in West Lafayette, Indiana, between April 2017 and May 2018. Timing and duration of eating were assessed via 3 nonconsecutive, 24-hour dietary recalls. Bedtime, wake time, total sleep time, sleep latency, sleep efficiency, and wake after sleep onset were measured over 7 days via wrist actigraphy and sleep diaries. Two-way analyses of variance were applied to assess group differences based on timing of consumption (early vs late eating) and duration of eating (long: >13 hours, short: <11 hours, or standard: 11-13 hours) with post-hoc pairwise comparisons. Main effects of timing of consumption, but not duration of eating, were detected for wake time, bedtime, and sleep efficiency (all, P <.05). Specifically, participants with later eating patterns that included breakfast skipping had later wake times and later bedtimes than those with earlier eating patterns. In addition, those who had later eating patterns that included breakfast skipping and nighttime eating experienced lower sleep efficiency (mean [SE], 77.0% [2.3%]) vs those who consumed breakfast and no nighttime eating (mean [SE], 84.6% [1.4%]; P <.001) and those who skipped breakfast but had no nighttime eating (mean [SE], 84.2% [2.5]; P <.05). Those who consumed breakfast but also had nighttime eating had a mean (SE) sleep efficiency of 82.4% (1.4%) (P =.09). The timing of eating was associated with sleep–wake onset and sleep efficiency. This study provides the preliminary characterization of eating behaviors relative to sleep–wake cycles and highlights the need for experimental studies to understand whether manipulating the timing of eating occasions to better align with sleep–wake cycles could improve sleep health. [ABSTRACT FROM AUTHOR]

Nickel-titanium rotary endodontic files have been commercially available for decades, but more recent innovations have introduced heat-treated and surface-treated files. This study investigated the corrosion properties of various nickel-titanium files in normal saline and sodium hypochlorite (NaOCl). Ten different file brands of size 40 with a 0.04 taper were subjected to electrochemical testing in 0.9% NaCl (saline) and 5.25% NaOCl at room temperature. The Open Circuit Potential (OCP) was observed for 1 hour followed by a cyclic polarization test from −300 to 700 mV and back to −300 mV (vs OCP). Nonparametric ANOVA and a pairwise comparison (P <.05) were used for statistical analysis of the OCP at 1 hour and the corrosion current (Icorr) obtained via the cyclic polarization test. Significant differences (P <.05) were found between files with respect to OCP and Icorr in both solutions. Nine files exhibited significantly greater (P <.05) Icorrs in NaOCl than in saline. Conversely, pitting corrosion was observed in the saline solution but not NaOCl. Weak and/or moderate correlations existed between OCP and Icorr measures in the 2 solutions. Significant differences in electrochemical properties were observed among the 10 brands of files. Overall, there was not a clear trend between conventional, heat-treated, or surface-treated files among OCP or Icorr in either solution. [ABSTRACT FROM AUTHOR]

• Evaluated the performance of various dissimilarity criteria and distance metrics for meteor association with CAMS database, as well as computed their optimal thresholds. • The sEuclidean metric excels in meteor shower association and identifying sporadic meteors, with D SH and ϱ 2 closely behind, the latter showing the closest equivalence to Machine Learning metrics. • Machine Learning distance metrics demonstrate their potential to match or even surpass tailored orbital similarity criteria in meteor dynamical associations. Meteor showers, originating as a result of the activity of comets or the disruption of large objects, provide a unique window into the composition and dynamics of our Solar System. While modern meteor detection networks have amassed extensive data, distinguishing sporadic meteors from those belonging to specific meteor showers remains challenging. In this study, we statistically evaluate and compare four orbital similarity criteria within five-dimensional parameter space ( D SH , D D , D H , and ϱ 2 ) to study dynamical associations using the already classified meteors (manually by a human) in CAMS database as a benchmark. In addition, we assess various distance metrics typically used in Machine Learning with two different vectors: ORBIT, grounded in heliocentric orbital elements, and GEO, predicated on geocentric observational parameters. To estimate their degree of correlation and efficacy, the Kendall rank correlation coefficient and the Top-k accuracy are employed. The statistical equivalence of the Top-1 results is examined using the Kolmogorov–Smirnov test and the percentage of Top-1 agreement is calculated on an event-by-event basis. Additionally, we compute the optimal cut-offs for all methods for distinguishing sporadic background events. Our findings demonstrate the superior performance of the sEuclidean metric in conjunction with the GEO vector. Within the scope of D-criteria, D SH emerged as the preeminent metric, closely followed by ϱ 2 . The Bray-Curtis metric displayed an advantage compared to the other distance metrics when paired with the ORBIT vector for Top-k accuracy, however, the Cityblock metric is more effective when considering the sporadic background. ϱ 2 stands out as the most equivalence to the distance metrics when utilizing the GEO vector and the most compatible with GEO and ORBIT simultaneously, whereas D D aligns more closely when using the ORBIT vector. The stark contrast in D D 's behavior compared to other D-criteria highlights potential inequivalence. Our results suggest that geocentric features provide a more robust basis than orbital elements for meteor dynamical association. Most distance metrics associated with the GEO vector surpass the D-criteria when differentiating the meteoroid background. Accuracy displayed a dependence on solar longitude with a pronounced decrease around 180 ° matching an apparent increase in the meteoroid background activity, tentatively associated with the transition from the Perseids to the Orionids. Considering lately identified meteor showers, ∼ 27% of meteors in CAMS would have different associations. This work unveils that Machine Learning distance metrics can rival or even exceed the performance of tailored orbital similarity criteria for meteor dynamical association. [ABSTRACT FROM AUTHOR]

• The dietary intake of patients with type 2 diabetes mellitus (T2DM) is imbalanced. • The insufficient fruit intake was associated with a higher risk of T2DM. • Indicators of Dietary Balance Index-16 may predict the risk of T2DM. The association between dietary quality and type 2 diabetes mellitus (T2DM) based on the Chinese Dietary Balance Index (DBI-16) is seldom reported. We hypothesized that poor dietary quality might increase the risk of T2DM in the middle-aged and older populations. A total of 1816 individuals (≥50 years) were included in the study. Demographic characteristics and dietary intake data were collected. Logistic regression and restricted cubic spline (RCS) analyses were conducted to explore the association between DBI-16 indexes and the risk of T2DM. The insufficient intake of vegetables and dairy might decrease the risk of T2DM (OR Vegetable = 0.77, 95% CI = 0.60-0.97; OR Dairy = 0.58, 95% CI = 0.35-0.96), but the individuals with insufficient intake of fruit were more likely to have a higher risk of T2DM (OR fruit = 2.26, 95% CI = 1.69-3.06). Compared with the subjects with the lowest quartile of Low Bound Score (LBS) or Diet Quality Distance (DQD), the individuals with Q2 and Q3 level of LBS (OR Q2 = 1.40, 95% CI = 1.03-1.90, P =.033; OR Q3 = 1.52, 95% CI = 1.11-2.08, P <.01) or DQD (OR Q2 = 1.45, 95% CI = 1.06-1.99, P =.021; OR Q3 = 1.64, 95% CI = 1.20-2.24, P <.01) showed increased risk of T2DM with a nonlinear association observed by RCS analysis. We concluded that imbalanced dietary intake, especially insufficient daily fruit intake, might predict an increased risk of T2DM in the middle-aged and elderly Chinese. Dietary quality was assessed by DBI-16, based on the Chinese Food Guide Pagoda and Chinese dietary guidelines. Individuals with higher DQD, especially higher LBS, are at an increased risk of developing diabetes. Among this, fruit, vegetables, and dairy significantly contribute to the overall dietary insufficiency associated with the risk of T2DM, especially insufficient fruit intake. Abbreviations: Chinese Diet Balance Index 2016, DBI-16; Diet Quality Distance, DQD; Low Bound Score, LBS. [Display omitted] [ABSTRACT FROM AUTHOR]

Perform radiologic measurements and analysis of normal brain computed tomography (CT) scans; delineate a new ventricular entry point from cutaneous landmarks, highlighting the potential surgical implications of these findings. Six radiologic distances (AR; BR; AL; BL, C, and D) were measured in normal brain CT scans using Horos software. Statistical analysis of the measurements was performed with minitab18 software based on age, sex, and side. 132 brain CT scans were analyzed, yielding the following mean results: AR distance: 2.1 cm; BR distance: 7 cm; AL distance: 2.1 cm; BL distance: 7.1 cm; C distance: 12.4 cm; D distance: 7 cm; new ventricular entry point: 12.4 cm posterior to the nasion, and 2.1 cm lateral to the midline. The freehand technique for accessing the lateral ventricles is a common neurosurgical procedure but is often accompanied by complications. To address this, we suggest a novel entry point for ventricular access, determined by cutaneous reference points. This point is situated 12.4 cm posterior to the nasion along the midline and 2.1 cm lateral to the midline. Although our findings may play a role in presurgical planning for ventricular pathologies, future prospective studies are warranted. [ABSTRACT FROM AUTHOR]

Medication abortion is safe and effective, but restrictions still limit patients from accessing this method. Alternative models of medication abortion provision, namely advance provision, over-the-counter (OTC), and online, could help improve access to care for some, although there is limited evidence about abortion patients' interest in these models. Between 2017 and 2019, we administered a cross-sectional survey to abortion patients at 45 clinics across 15 U.S. states to explore their interest in and support for advance provision, OTC, and online abortion access. We assessed relationships between sociodemographic characteristics and interest in and support for each model using bivariate logistic regressions and present perceived advantages and disadvantages of each model, as described by a subset of participants. Among 1,965 people enrolled, 1,759 (90%) initiated the survey. Interest in and support for advance provision was highest (72% and 82%, respectively), followed by OTC (63% and 72%) and online access (57% and 70%). In bivariate analyses, non-Hispanic Black and Asian/Pacific Islander respondents expressed lower interest and support for the online model and Alaska Native/Native American respondents expressed higher interest in an OTC model, as compared with white respondents. Among 439 participants naming advantages and disadvantages of each model, the most common advantages included convenience and having the abortion earlier. The most common disadvantages were not seeing a provider first and possibly taking pills incorrectly. Although most abortion patients expressed interest in and support for alternative models of medication abortion provision, variation in support across race/ethnicity highlights a need to ensure that abortion care service models meet the needs and preferences of all patients, particularly people from historically underserved populations. [ABSTRACT FROM AUTHOR]

[Display omitted] Accurate and detailed spatial information on rice cultivation is essential to developing agricultural policy and reducing the negative impacts of agriculture. However, the dependence of most traditional methods on samples severely limits the feasibility of large-scale rice cultivation mapping. This study proposes a robust large-scale sample-free monitoring method for single-season rice in northern China. A new rice phenology index, quantifying dynamic phenological features of rice (i.e., the occurrence of flooding during transplanting and the growth of rice after transplanting), was generated to highlight rice. Subsequently, a constrained cyclic threshold classification strategy was designed to obtain plausible rice maps using statistical data. Innovatively combining rice mapping with statistical data, the most detailed (10 m) single-season rice map in northern China to date was created. Compared with three other high-precision rice map products, the resulting rice map has high accuracy and good local details. The results indicate that the rice phenology index has excellent and robust performance in identifying rice cultivation locations in northern China. Moreover, the proposed mapping method exhibits clear advantages in the tracking of large-scale and historical rice cultivation. As a whole, this study provides a paradigm of using statistical data instead of samples for crop mapping. [ABSTRACT FROM AUTHOR]

Epidemiological evidence on myoepithelial carcinoma is rare. This study aimed to investigate the effect of tumor primary site and treatment modality on survival in patients with head and neck myoepithelial carcinoma. Data on adult patients diagnosed with head and neck myoepithelial carcinoma between 2000 and 2019 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Uni- and multivariable Cox proportional hazard models were utilized to evaluate the effects of different tumor primary sites and treatment modalities on overall survival (OS) and cancer-specific survival (CSS), and expressed as hazard ratio (HR) and 95% confidence interval (CI). A total of 415 patients were enrolled. No significant differences in OS and CSS were found between different tumor primary sites (P > 0.05). Compared with partial excision, patients with total excision (HR = 1.65, 95%CI: 1.12–2.42) (partial or total removal of the organ in which the tumor is located and complete removal of the tumor) or no surgery (HR = 3.52, 95%CI: 2.05–6.03) had worse OS. Compared with surgery only, patients with radiotherapy only had poorer OS (HR = 4.69, 95%CI: 2.32–9.46) and CSS (HR = 6.72, 95%CI: 2.59–17.46), while no significant differences in OS (P = 0.120) and CSS (P = 0.847) were found among patients who received surgery combined with radiotherapy. In patients with AJCC III/IV, patients with radiotherapy only (HR = 4.51, 95%CI: 1.61–12.62) had poorer OS compared to those with surgery only, whereas patients who received surgery combined with radiotherapy had better OS (HR = 0.50, 95%CI: 0.29–0.89). The tumor primary site may not affect the prognosis of patients with myoepithelial carcinoma, while the effect of treatment modality on prognosis is related to the primary site and stage of the tumor. • Primary site may not affect the survival of patients with myoepithelial carcinoma. • Total organ excision may be related to worse OS/CSS compared to partial excision. • Surgery plus radiotherapy did not show better survival compared to surgery alone. [ABSTRACT FROM AUTHOR]

BK virus nephropathy (BKVN) is a significant complication in kidney transplant recipients, resulting in graft dysfunction and potentially leading to graft loss. This study aims to investigate the incidence and outcomes of BKVN in kidney transplant recipients receiving steroid-free maintenance immunosuppression in a Latin -American cohort. Case series study of BKVN among kidney transplant recipients who underwent transplantation between 2008 and 2023. The primary outcome was graft loss caused by BKVN, excluding death with function. Secondary outcomes included graft function and acute rejection episodes. The statistical analysis involved descriptive statistics and the Kaplan-Meier (K-M) method to plot the overall probabilities of not initiating dialysis. During the 15-year period, 2236 kidney transplants were performed, BKVN was histologically diagnosed in 38 kidney recipients and 33 cases were analyzed. Median age was 50 years and men were 48.5% of patients. A total of 45.4% of BKVN occurred within the first 12 months of transplant. The incidence of BKVN was 1.6% but it varied by era. The rate of graft loss was 75.7% (25 cases). The K-M graft survival probability at 6 months and 12 months after diagnosis of BKVN was 38.3% (95% CI 24.7–59.4) and 22.3% (95% CI 11.7–42.8), respectively. BKVN affected 1.6% of transplant recipients and it was associated with high-rate of graft loss. We observed that significant graft disfunction at the time of diagnosis resulted in worse outcomes with a reduced probability of graft survival. [ABSTRACT FROM AUTHOR]

Although the important roles of proprioception and neuromuscular control in carpal instabilities under laboratory conditions have been recognized, only a few studies have translated this knowledge into a routine clinical practice. This study aimed to evaluate the results of a personalized rehabilitation in patients with carpal instability on functionality and pain intensity. This was a case series study. This case series included 39 adults (mean age: 38.2 ± 14.0 years; 16/23 females/males) diagnosed with carpal instability (radial or ulnar) with indication for orthopedic treatment. The disabilities of the arm, shoulder, and hand questionnaire was used to assess upper limb functionality. Pain perception was assessed using a visual analog scale. Exercise-based physiotherapy interventions were performed according to the clinical needs of the patients for at least 6 weeks (2-3 sessions per week). For the treatment of radial instability (n = 13), strengthening exercises of the abductor pollicis longus, extensor carpi radialis longus, flexor carpi radialis, and pronator quadratus muscles were prescribed. For the treatment of ulnar instability (n = 24), extensor carpi ulnaris and pronator quadratus were trained. All patients underwent proprioceptive training in open kinetic chain and closed kinetic chain, as well as strengthening of the unaffected hand. Changes before and after treatment were compared using the nonparametric Wilcoxon signed rank test. A significant improvement with a large effect size in disabilities of the arm, shoulder, and hand (P <.001; d = 2.9) and visual analog scale (P <.001; d = 3.2) scores were obtained after treatment. Moreover, the changes were greater than the minimal clinically important difference of 10.8 and 1.4, respectively. Similar results were found when patients with radial instability and ulnar instability were analyzed separately. Personalized training with specific proprioception and strengthening exercises produces improvements in functionality and pain perception in our cohort of people with carpal instability. These results highlight the importance of multicomponent exercise in the treatment of wrist instability. Future randomized clinical trials should further investigate the effectiveness of this protocol. • The protocol included strength training exercises combined with proprioceptive and cross-education training. • The combined exercise program showed benefits for function and pain in patients with carpal instability. • This protocol could be a valid alternative as a nonsurgical treatment for carpal instabilities. [ABSTRACT FROM AUTHOR]

• Alirocumab improves cardiovascular outcomes after ACS irrespective of sex. • Reduction of total cardiovascular events was greater at higher baseline Lp(a). The ODYSSEY OUTCOMES trial (NCT01663402) compared the effects of the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab with placebo on major adverse cardiovascular events (MACE) in patients with recent acute coronary syndrome (ACS). We assessed efficacy and safety of alirocumab versus placebo according to sex and lipoprotein(a) level. This prespecified analysis compared the effects of alirocumab versus placebo on lipoproteins, MACE (coronary heart disease death, non-fatal myocardial infarction, fatal/non-fatal ischemic stroke, unstable angina requiring hospitalization), death, total cardiovascular events, and adverse events in 4762 women and 14,162 men followed for a median of 2.8 years. In post-hoc analysis, we evaluated total cardiovascular events according to sex, baseline lipoprotein(a), and treatment. Women were older, had higher baseline low-density lipoprotein cholesterol (LDL-C) levels (89.6 vs 85.3 mg/dL) and lipoprotein(a) (28.0 vs 19.3 mg/dL) and had more co-morbidities than men. At 4 months, alirocumab lowered LDL-C by 49.4 mg/dL in women and 54.0 mg/dL in men and lipoprotein(a) by 9.7 and 8.1 mg/dL, respectively (both p < 0.0001). Alirocumab reduced MACE, death, and total cardiovascular events similarly in both sexes. In the placebo group, lipoprotein(a) was a risk factor for total cardiovascular events in women and men. In both sexes, reduction of total cardiovascular events was greater at higher baseline lipoprotein(a), but this effect was more evident in women than men (p interaction =0.08). Medication adherence and adverse event rates were similar in both sexes. Alirocumab improves cardiovascular outcomes after ACS irrespective of sex. Reduction of total cardiovascular events was greater at higher baseline lipoprotein(a). [Display omitted] [ABSTRACT FROM AUTHOR]

Despite increasing adoption of the direct anterior (DA) approach in total hip arthroplasty (THA), uncertainty persists regarding its outcomes beyond the 1-year mark in comparison to other approaches. We used the reverse fragility index (RFI) to evaluate the robustness of reported findings in the literature. We conducted a systematic review of randomized controlled trials (RCTs) comparing implant revision rates between DA and other approaches in THA, defined as all those different from DA. Our primary outcome was the RFI, which gauges the number of events needed for a nonsignificant result to become significant, in the revision rate between DA and other approaches. We also calculated the reverse fragility quotient by dividing the RFI by each study's sample size. Median values and interquartile ranges (IQRs) were displayed. A total of 10 RCTs with a total of 971 patients were included. The median RFI was 5 (IQR, 4 to 5), indicating the study's results would be statistically significant if the outcomes of 5 patients in 1 treatment arm were reversed. The median reverse fragility quotient was 0.049 (IQR, 0.04 to 0.057), indicating that a change of outcome in 4.9% of patients would render the revision rate significant. The median number of patients lost to follow-up was 4 (IQR, 0 to 7). Of the 10 RCTs, 6 had more patients lost to follow-up than their respective RFI values. Notable fragility was evidenced in most studies comparing DA to other approaches for THA. Surgeons should not solely rely on the P value to determine clinical significance and instead use multiple metrics. II. [ABSTRACT FROM AUTHOR]

We derive functional equations for distributions of six classical statistics (ascents, descents, left-to-right maxima, right-to-left maxima, left-to-right minima, and right-to-left minima) on separable and irreducible separable permutations. The equations are used to find a third degree equation for joint distribution of ascents and descents on separable permutations that generalizes the respective known result for the descent distribution. Moreover, our general functional equations allow us to derive explicitly (joint) distribution of any subset of maxima and minima statistics on irreducible, reducible and all separable permutations. In particular, there are two equivalence classes of distributions of a pair of maxima or minima statistics. Finally, we present three unimodality conjectures about distributions of statistics on separable permutations. [ABSTRACT FROM AUTHOR]

The public health burden of gambling remains difficult to estimate, given the lack of relevant, available data. Death by suicide, represents a substantial and quantifiable public health cost. The current study reviews data from the National Violent Death Reporting System to detect cases where gambling was identified as a meaningful contextual factor to a death by suicide. This study is an exploratory content analysis. We analysed narrative data from cases of death by suicide, collected from 2003 to 2020 recorded in the Restricted Access Data of the National Violent Death Reporting System. Gambling-related cases identified in our analysis were compared against all other cases on demographic characteristics, case characteristics, US state, and incident year. Chi-square tests of independence and the Wilcoxon ranked sum tests were used in bivariate comparisons. Overall, 1306 of 296 317 cases were classified as gambling-related. This represented 0.44% of total cases. Gambling-related classification was over-represented among those identified as Asian (7.0% vs 2.2%) and under-represented among those identified as Black or African American (4.0% vs 6.4%) compared with all other deaths by suicide. Gambling-related cases were also over-represented in cases where alcohol use was suspected (28.0% vs 21.2%), where there were significant financial problems (50.3% vs 8.6%), where there were intimate partner problems (31.5% vs 25.6%), and under-represented in cases where there was a previous mental health diagnosis (35.1% vs 38.8%). The rate of gambling-related cases in Nevada was approximately nine times greater than the rate in the overall sample (4.0% vs 0.44%). Administrative data can be used to study the impacts of gambling on public health in the absence of quality representative survey data. However, these sources are still likely to underestimate the public health burden of gambling with current structures and procedures. Requiring intentional collection of gambling-related information in cases of suicide would be a significant step towards better quantifying the public health burden of gambling in the United States. [ABSTRACT FROM AUTHOR]

In this piece of research, cubic and quartic Hyperbolic B-splines based Differential quadrature methods are implemented for numerical approximation of coupled 2 D and 3 D Navier-Stokes equations. The validity of the proposed regimes is tested by the means of different variety of errors such as; L 2 error, L ∞ error, RMS error, and R e l a t i v e error. It is noticed that most of the time, errors generated by cubic Hyperbolic B-spline are far better than those of quartic Hyperbolic B-spline. Numerical convergence of the Method I is also validated in this research. The main key aspect of this research is the fusion of numerical simulation and statistical analysis. The data generated vis the considered error. Thereafter, on the basis of fetched errors, correlation matrix heatmaps are provided claiming the types of correlation occurred between mentioned parameters and errors. This research work is not only important from Mathematical aspect but also it will be a major breakthrough in the field of Statistics. This study's primary contribution is the assertion that numerical methods based on cubic hyperbolic B-spline are more efficient than quartic order methods. Furthermore, another distinguishing feature of this work is the incorporation of statistical concepts as correlation in such studies. [ABSTRACT FROM AUTHOR]

Trying to better define Bipolar Disorder (BD) progression, different staging models have been conceptualized, each one emphasizing different aspects of illness. In a previous article we retrospectively applied the main staging models to a sample of 100 bipolar patients at four time points over a ten-year observation. In the present study, focusing on Kupka & Hillegers's model, we aimed to assess the transition of the same sample through the different stages of illness and to explore the potential role of clinical variables on the risk of progression. Multistate Model using the mstate package in R and Markov model with stratified hazards were used for statistical analysis. A high hazard of transition from stage 2 to 3 emerged, with a probability of staying in stage 2 decreasing to 14 % after 3 years. BD II was significantly associated with transition from stage 1 to 2, whereas the number of lifetime episodes >3 and the elevated predominant polarity with transition from stage 3 to 4. Our results corroborated the evidence on BD progression and contributed to outline its trajectory over time. Further effort may help to define a standardized staging approach towards ever increasing tailored interventions. • We retrospectively applied Kupka & Hillegers's model to a sample of 100 bipolar patients at 4 time-points over 10 years • We assessed the transition across stages and the role of clinical variables on the risk of progression • A high hazard of transition 2→3 emerged, with a probability of staying in stage 2 decreasing to 14% after 3 years • BD II was associated with transition 1→2; > 3 lifetime episodes and elevated predominant polarity with transition 3→4 [ABSTRACT FROM AUTHOR]

The objective of this study is to evaluate the epidemiological characteristics of Japanese Spotted Fever (JSF) cases reported through the National Epidemiological Surveillance of Infectious Disease (NESID) system in Shimane Prefecture, Japan, from 2000 to 2022, encompassing the periods before and during the COVID-19 pandemic period. A retrospective analysis was conducted on JSF cases reported to the NESID system in Shimane Prefecture between 2000 and 2022. Population data were obtained from the Statistical Information of Shimane. Poisson regression analysis was employed to examine the relationship between the annual prevalence rate of JSF and the COVID-19 pandemic. A total of 301 JSF cases were analyzed during the study period. Even the pre-COVID-19 pandemic period, a gradual and significant increase in the prevalence rate was observed (prevalence rate = 1.03, 95% CI: 1.01–1.05; p = 0.01), and a rapid increase was noted since 2020 (prevalence rate = 1.57, 95% CI: 1.39–1.78; p < 0.01). The slope during the pre-COVID-19 pandemic period was estimated to have significantly increased (p < 0.01). Our findings suggest that while the prevalence rate of JSF had exhibited a slight increase in the years preceding the COVID-19 pandemic, it demonstrated a more significant increase following the pandemic in Shimane Prefecture. JSF has increased since 2020 and may be linked to COVID-19 pandemic. The COVID-19 pandemic has had a substantial impact on global health, underscoring the importance of investigating the prevalence of specific infectious diseases and other health-related indicators to accurately assess the pandemic's impact. [ABSTRACT FROM AUTHOR]

The paper builds on the framework proposed by Pattison and Snijders (2012) for specifying exponential random graph models (ERGMs) for social networks. We briefly review the two-dimensional hierarchy of potential dependence structures for network tie variables that they outlined and provide proofs of the relationships among the model forms and of the nature of their sufficient statistics, noting that models in the hierarchy have the potential to reflect the outcome of processes of cohesion, closure, boundary and bridge formation and path creation over short or longer network distances. We then focus on the so-called partial inclusion dependence assumptions among network tie variables and the pendant-triangle , or paw , statistics to which they give rise, and illustrate their application in an empirical setting. We argue that the partial inclusion assumption leads to models that can reflect processes of boundary and bridge formation and that the model hierarchy provides a broad and useful framework for the statistical analysis of network data. We demonstrate in the chosen setting that pendant-triangle (or paw) effects, in particular, lead to a marked improvement in goodness-of-fit and hence add a potentially valuable capacity for modelling social networks. • The paper provides a principled basis for some new effects for exponential random graph models for social networks • We describe how these new terms can be used to understand processes of boundary and bridge formation in networks • We demonstrate that these new terms improve goodness-of-fit in an illustrative application [ABSTRACT FROM AUTHOR]

• In this study, we conducted a statistical analysis of foF2 and TEC data under both ionospheric quiet and disturbed conditions, employing the ionospheric slab thickness model. • The utilization of Kriging with external drift (KED) in generating maps has enhanced their realism. • The inclusion of foF2 data from the map's periphery has resulted in the overall stabilization of the map. • Based on our findings, we can conclude that the correlation distance between ionospheric characteristics should not exceed the range of 120–300 km. The importance of this study lies in its contribution to the field of ionospheric science, particularly in the monitoring and prediction of ionospheric parameters. This study focuses on comparing two techniques for spatio-temporal kriging of critical ionospheric parameters, namely the F2 layer critical frequency (foF2) and Total Electron Content (TEC), under both quiet and disturbed ionospheric conditions. The first technique, Ordinary Kriging (OK), relies solely on foF2 data, while the second technique, Kriging with External Drift (KED), incorporates the dynamic relationship between foF2 and TEC data to improve the interpolation process. This study demonstrates how KED, which utilizes dynamic secondary information, offers advantages over OK. By simultaneously monitoring the ionosphere from a single ionosonde station and collecting data from visible GPS satellites, KED enhances the accuracy of spatial structural analysis, enabling more precise estimations of ionospheric characteristics across interpolation grid nodes. The research highlights that the non-uniform distribution of ionosonde stations, especially in regions with limited foF2 data, can benefit from KED's incorporation of TEC data. Additionally, the study reveals the potential for improving TEC maps by assimilating foF2 data located at the periphery of the observation area. Furthermore, the paper discusses the determination of semivariogram structures for both foF2 and TEC data, emphasizing the spatial correlations between data points. These findings contribute to a better understanding of ionospheric behavior and the potential for enhanced ionospheric modeling. [ABSTRACT FROM AUTHOR]

Due to the hasty growth of digital technology, securing medical images for transmission and storage is a significant issue. Information on the texture of medical images is essential for diagnosis. Hence, protecting these content has become a great challenge in the e-Healthcare system. So, we propose a novel dynamic circular bit shifting and bit-flipping process in the diffusion phase of the image cryptosystem to provide high level protection for the medical image. In the developed framework, at first, the hyperbolic chaotic map is executed for generating three hyper chaotic series and these chaotic series are utilized for encryption process. In encryption process, primarily the secret image is confused by utilizing any two chaotic series, then the confused image is divided into blocks and each block is diffused by executing the proposed dynamic circular bit shifting and bit-flipping process which greatly increases the probability and complexity level of the developed cryptosystem. Evaluation using different medical images represents that the proposed model has robustness, high efficiency, key sensitivity and also has the ability to withstand different attacks. This has been represented using the results of security measures and statistical analysis, such as Shannon entropy (7.997), CC (< 0), NPCR (99.63 %), UACI (37.14 %), SSIM (< 0), FSIM (< 0.5), PSNR (6.88). These results prove that the developed medical crypt can efficiently provide better security for medical images utilized in real time medical application like e-Healthcare and telemedicine. [ABSTRACT FROM AUTHOR]

Pedigrees used in genetic evaluations contain errors. Because of such errors, assumptions regarding the relatedness among individuals in genetic evaluation models are wrong. Consequences of that have been investigated in earlier studies focusing on models that did not account for genomic information yet. The objective of this work was to investigate the effects of pedigree errors on the results from genetic evaluations using the single-step model, and the effect of such effects on results from validation studies with forward prediction. We used a real pedigree (n = 361,980) and real genotypes (n = 25,950) of Fleckvieh cattle, sampled in a way to provide a good consistency between pedigree and genomic relationships. Given the real pedigree and genotypes, true breeding values (TBV) were simulated to have a covariance structure equal to the matrix H assumed in a single-step model. Based on TBV, phenotypes were simulated with a heritability of 0.25. Genetic evaluations were conducted with a conventional animal model (i.e., without genomic information) and a single-step animal model under scenarios using either the correct pedigree or a pedigree containing 5%, 10%, or 20% of wrong records. Wrong records were simulated by randomly assigning wrong sires to nongenotyped females. The increasing rates of pedigree errors led to decreasing correlations between TBV and EBV and lower standard deviations of predictions. Less variation was observed because pedigree errors operate actually as a random exchange of daughters among bulls, making them look more similar to each other than they actually are. This occurs of course only when animals have progeny. Therefore, this decreased variation was more pronounced for progeny tested bulls than for young selection candidates. In a forward prediction validation scenario, the stronger decrease in variation when animals get progeny caused an apparent inflation of early predictions. This phenomenon may contribute to the usually observed problem of inflation of early predictions observed in validation studies. [ABSTRACT FROM AUTHOR]

Hallux valgus is a common condition where the subluxation of the first metatarsophalangeal joint and lateral deviation of the hallux at the interphalangeal joint creates difficulty with footwear fit. Footwear and foot orthoses are commonly prescribed nonsurgical treatments for hallux valgus. Do extra-width footwear and foot orthoses influence peak pressure at the medial aspect of the metatarsophalangeal and interphalangeal joints in women with hallux valgus? Community-dwelling women with symptomatic hallux valgus underwent gait testing when wearing their own shoes and when wearing extra-width footwear fitted with three-quarter length, arch-contouring prefabricated foot orthoses. Peak pressure (kPa) on the medial aspect of the metatarsophalangeal and medial interphalangeal joints and on the plantar surface of the foot (hallux, lesser toes, metatarsophalangeal joint 1, metatarsophalangeal joints 2–5, midfoot and heel) were measured using the novel pedar®-X system with the pedar® pad and pedar® insole, respectively (Novel, GmbH, Munich, Germany). Paired samples t -tests were used to calculate the differences between the two conditions, and the magnitude of observed differences was calculated using Cohen's d. We tested 28 participants (aged 44–80 years, mean 60.7, standard deviation 10.7). Compared to their own footwear, wearing the intervention footwear and orthoses was associated with a statistically significant decrease in pressure on the medial aspect of the metatarsophalangeal joint (58.3 ± 32.8 versus 42.6 ± 32.8, p =0.026, d =0.49), increased pressure under the midfoot (70.7 ± 25.7 versus 78.7 ± 23.6, p =0.029, d =0.33) and decreased pressure underneath the heel (137.3 ± 39.0 versus 121.3 ± 34.8, p =0.019, d =0.45). The intervention footwear and orthoses significantly decreased peak pressure on the medial aspect of the first metatarsophalangeal joint but had no significant effect on the interphalangeal joint. Further studies are required to determine whether these changes are associated with improvements in symptoms associated with hallux valgus. • We investigated peak medial and plantar pressure in women with hallux valgus. • The intervention decreased medial pressure at the first metarsophalangeal joint. • The intervention increased midfoot and decreased heel plantar pressure. • Women with hallux valgus may benefit from extra-width footwear and orthoses. [ABSTRACT FROM AUTHOR]

The development of normal tissue radiation dose-response models for children with cancer has been challenged by many factors, including small sample sizes; the long length of follow-up needed to observe some toxicities; the continuing occurrence of events beyond the time of assessment; the often complex relationship between age at treatment, normal tissue developmental dynamics, and age at assessment; and the need to use retrospective dosimetry. Meta-analyses of published pediatric outcome studies face additional obstacles of incomplete reporting of critical dosimetric, clinical, and statistical information. This report describes general methods used to address some of the pediatric modeling issues. It highlights previous single- and multi-institutional pediatric dose-response studies and summarizes how each PENTEC taskforce addressed the challenges and limitations of the reviewed publications in constructing, when possible, organ-specific dose-effect models. [ABSTRACT FROM AUTHOR]

This study comprehensively analyzed the temporal and spatial dynamics of COVID-19 cases and deaths within the obstetric population in Brazil, comparing the periods before and during mass COVID-19 vaccination. We explored the trends and geographical patterns of COVID-19 cases and maternal deaths over time. We also examined their correlation with the SARS-CoV-2 variant circulating and the social determinants of health. This is a nationwide population-based ecological study. We obtained data on COVID-19 cases, deaths, socioeconomic status, and vulnerability information for Brazil's 5570 municipalities for both the pre-COVID-19 vaccination and COVID-19 vaccination periods. A Bayesian model was used to mitigate indicator fluctuations. The spatial correlation of maternal cases and fatalities with socioeconomic and vulnerability indicators was assessed using bivariate Moran. From March 2020 to June 2023, a total of 23,823 cases and 1991 maternal fatalities were recorded among pregnant and postpartum women. The temporal trends in maternal incidence and mortality rates fluctuated over the study period, largely influenced by widespread COVID-19 vaccination and the dominant SARS-CoV-2 variant. There was a significant reduction in maternal mortality due to COVID-19 following the introduction of vaccination. The geographical distribution of COVID-19 cases and maternal deaths exhibited marked heterogeneity in both periods, with distinct spatial clusters predominantly observed in the North, Northeast, and Central West regions. Municipalities with the highest Human Development Index reported the highest incidence rates, while those with the highest levels of social vulnerability exhibited elevated mortality and fatality rates. Despite the circulation of highly transmissible variants of concern, maternal mortality due to COVID-19 was significantly reduced following the mass vaccination. There was a heterogeneous distribution of cases and fatalities in both periods (before and during mass vaccination). Smaller municipalities and those grappling with social vulnerability issues experienced the highest rates of maternal mortality and fatalities. [ABSTRACT FROM AUTHOR]

Evidence shows stereotactic ablative body radiotherapy (SABR) is used as a non-invasive ablative therapy in the treatment of multisite oligometastatic (OM) and oligoprogressive (OP) diseases originating from metastatic breast cancer. This study aims to report the treatment outcomes and to investigate what factors that are prognostic in terms of local control, progression-free survival (PFS) and overall survival (OS) in patients receiving SABR for extracranial OM and OP diseases originating from metastatic breast cancer. A retrospective review on treatment records of patients with OM and OP from metastatic breast cancer who underwent SABR at a single was carried out. SABR was performed with daily image-guided radiotherapy (IGRT) using a dedicated robotic SABR machine. Local control, PFS and OS were calculated using Kaplan-Meier statistics and the post-treatment toxicity data was scored following the CTCAE v4.0 protocol. Univariate and multivariate Cox regression tests were used in the subgroup analysis of prognostic factors on PFS and OS including patients' age, types of follow-up imaging (staging CT only vs whole-body MR/PET), metastases status (OM vs OP), primary breast cancer tumour grade, hormone receptors (ER/PR/HER2) status, change of systemic treatments at SABR, number of metastases, SABR treatment sites and doses. 56 metastatic breast cancer patients (38 patients with OM and 18 patients with OP) were involved in this retrospective review. The median follow-up was 35.6 months (range 4.0–132.9 months). The estimated local control at 1 , 2 and 5 years were 90.9%, 88.7% and 88.7%, respectively. The estimated median PFS was 19.2 months (95%CI 10.3–28.1 months); the PFS at 1, 2 and 5 years were 63.3%, 44.4% and 33.2%. The estimated OS at 1, 2 and 5 years were 98.0%, 91.9% and 74.3%, respectively with the estimated median OS of 105.1 months (95%CI 51.5–158.7 months). The vast majority of patients tolerated the treatment well with the commonest acute side effects as grade 1 fatigue. There were no statistically significant factors found in OS regression analysis. The types of follow-up imaging, metastases status, oestrogen receptor status, and number of metastases for SABR were statistically significant factors (p < 0.05) in the multivariate Cox regression analysis on PFS. There are limited studies published on the efficacy and post-treatment toxicities of metastatic breast cancer OM and OP SABR with adequate length of follow-up. This study confirmed that SABR was a safe, non-invasive treatment option for patients with extracranial OM and OP diseases originated from primary breast cancer in terms of the acceptable post-treatment toxicities. • This study reported SABR treatment outcomes for multisite OM and OP diseases originating from metastatic breast cancer • It showed modest local control and post-treatment toxicities on the SABR of extracranial OM and OP from metastatic breast cancer. • The types of follow-up imaging, OM vs OP, oestrogen receptor status, and number of metastases for SABR can be used as PFS prognostic factors. [ABSTRACT FROM AUTHOR]

This letter introduces a Discriminant Analysis-based unimodality Test (DAT) for automatically identifying whether a dataset is unimodal or multimodal, detecting deviations in time series datasets, estimating statistical parameters, and identifying the skewness of the data. DAT is effective in classifying datasets under both unimodal and multimodal conditions and is suitable for bi-classification applications. The performance of DAT was compared to two well-known unimodality tests, namely the dip and folding tests, and is shown to perform better. We then extended DAT to the development of a fault detection technique, which was tested against five different machine learning classifiers using data from the Case Western Reserve University (CWRU) ball bearing database. The results obtained show that the proposed approach is effective, achieving 99.999% accuracy for detecting small ball bearing fault sizes (0.007 inches). Our conclusion indicates a significant potential of the proposed test for improving anomaly detection in industrial and other related fields. • Introduces the Discriminant Analysis-Based Unimodality Test (DAT). • Compares DAT with Dip and Folding tests and proves superiority. • Extension and application of DAT for fault detection with 99.999% accuracy. • Shows immense potential for enhancing anomaly detection. [ABSTRACT FROM AUTHOR]

As reverse total shoulder arthroplasty (rTSA) has evolved, the use of augmented glenoid baseplates has increased. While there are benefits of metal augmentation, literature concerning the mid- to long-term follow-up of these implants is emerging. The purpose of this study is to report early to short-term radiographic follow-up of patients with glenoid deformity treated with a metal-augmented glenoid baseplate. Our hypothesis is that we will see a low incidence of osteolysis, loosening, complications, and revision of these implants regardless of diagnosis, augment type, or patient demographics. We performed a single-center retrospective review of all patients undergoing primary reverse shoulder arthroplasty with an augmented metallic baseplate for rotator cuff arthropathy and glenohumeral arthritis. Patients undergoing revision procedures or reverse arthroplasty for fractures were excluded. All patients had a minimum of 1-year radiographic follow-up. Preoperative imaging was reviewed to confirm the diagnosis and glenoid deformity classification. Postoperative radiographs were reviewed for evidence of complications, revisions, osteolysis, baseplate loosening, and failure. Clinical data were reviewed for complications. Primary rTSA with a metal-augmented baseplate (38 full wedge and 22 half wedge augments) was performed on 60 patients who met inclusion criteria (mean age 74 ± 7). The average radiographic follow-up of all patients was 17 months. In our cohort, there was one patient with aseptic loosening of a full wedge implant that was not revised. There were no other complications, revision surgeries, baseplate failures, or acromial stress fractures. Six patients developed scapular notching, and five patients were found to have asymptomatic glenoid osteolysis. Two patients with full wedge implants developed aseptic humeral loosening. Pearson chi-square post hoc analysis found no correlation between augment type, gender, or glenoid deformity classification and radiographic changes such as glenoid or humeral osteolysis, loosening, or scapular notching. We did find a statistically significant correlation (P =.018) between patients with body mass index > 35 and glenoid osteolysis. Primary rTSA for patients with rotator cuff arthropathy or glenohumeral arthritis with glenoid deformity corrected with metal-augmented glenoid baseplates results in a low complication rate and an acceptable outcome at a minimum 1-year follow-up. Compared to other similar cohorts, our patients did not experience any acromial stress fractures, and only one patient had loosening of the glenoid component that was not ultimately revised. Further studies with longer follow-up will be needed, but early outcomes are promising and support the increase in the use of these implants. [ABSTRACT FROM AUTHOR]

Total shoulder arthroplasty (TSA) is increasingly recognized as a therapeutic solution for various shoulder disorders. However, the correlation between preoperative determinants of health and postoperative TSA revisions remains underexplored. These correlations are scientifically important as they may be used to design higher-level clinical studies to confirm if they are in-fact predictive of revision. As such, this investigation aims to identify possible health and demographic disparities between primary TSA and revision TSA cohorts. Data for this research was sourced from the American College of Surgeons National Surgical Quality Improvement Program database from 2013 to 2021. Patients were classified based on Current Procedural Terminology (CPT) codes into 2 groups: primary TSA (CPT: 23472) and revision TSA (CPT: 23473 or 23474). Nineteen demographic and preoperative variables were compared between the cohorts using multivariate logistic regression. Odds ratios (ORs) along with their 95% confidence intervals (CIs) were calculated and graphically displayed. To account for multiple exploratory comparisons, Bonferroni correction was utilized with an adjusted significance threshold of 0.0026. TSA revision patients were more likely to arrive from a nursing home (OR 1.87, 95% CI [1.50, 2.32], P <.001), have diabetes (OR 1.09, 95% CI [1.05, 1.14], P <.001), be diagnosed with Systemic inflammatory response syndrome prior to surgery (1.38, 95% CI [1.13, 1.69], P =.002) and less likely to have independent functional status prior to surgery (OR 0.69, 95% CI [0.63, 0.76], P <.001). Moreover, those in the revision group were predominantly younger, male, receiving immunosuppressive therapy, exhibited baseline dyspnea, and had elevated American Society of Anesthesiologists class. Notably, factors such as smoking, racial background, and hypertension showed no significant differences (P >.0026). Contrary to contemporary literature, our findings suggest that, when demographic factors are controlled for, smoking is not correlated with revisions in TSA when compared to primary TSA. Furthermore, patients undergoing primary TSA are more likely to be functionally independent than patients undergoing revision TSA. While at the same time, a patient's arrival at surgery from a nursing home gave the greatest likelihood of a revision. [ABSTRACT FROM AUTHOR]

This study aims to compare short-term functional outcomes and conversion rates to reverse shoulder arthroplasty between patients who underwent total shoulder arthroplasty (TSA) using a modular metal-backed glenoid component, a hybrid glenoid component, and an all-polyethylene component. A retrospective review of individuals undergoing TSA between October 2014 and December 2020 was performed. Inclusion criteria included patients undergoing primary TSA for osteoarthritis during this time frame by 1 surgeon. Preoperative and postoperative variables included demographic information, American Shoulder and Elbow Surgeons score (ASES), and range of motion. Revision rates were also documented. Summary statistics were performed, using a 1-way analysis of variance with Tukey post hoc pairwise comparisons when the outcome reached significance. Fifty-two patients were included with age averaging 68 ± 8.1 years, with body mass index of 31 ± 5.8. 54% of patients were female with 12% having diabetes and only 2% were smokers. Follow-up averaged 42 months with patients undergoing metal-backed glenoid having longer follow-up at 56.5 months (P <.001). ASES, forward elevation, and external rotation (ER) for every implant type improved significantly postoperatively (P <.001) besides internal rotation and ER within the poly group (P =.072). No difference was found between the 3 groups for preoperative and postoperative ASES scores, forward elevation, internal rotation, and ER (P >.05). Two patients within the poly group required revision due to rotator cuff tear (P =.225). At 2 years, functional outcomes and patient-reported outcomes are similar in all 3 glenoid groups. There were slightly higher revision rates within the all-polyethylene group. If outcomes are similar among all groups, modular implant systems may be favorable to make conversion to revision TSA easier. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) is associated with negative outcomes after hip and knee arthroplasty due to higher rates of infection, aseptic loosening, and transfusion. The purpose of this study was to compare clinical outcome scores and complication rate after shoulder arthroplasty (SA) for patients with and without CKD. We conducted a retrospective cohort study of prospectively collected data and reviewed all patients who underwent primary SA from January 2015 to December 2019 by one surgeon at one institution. Revision arthroplasty patients were excluded. We evaluated results from patients with CKD (glomerular filtration rate [GFR] ≤ 59) and without CKD (GFR ≥ 60). Outcome measures including visual analog scale for pain, American Shoulder and Elbow Surgeons (ASES) score, the Simple Shoulder Test (SST), and Single Assessment Numeric Evaluation (SANE) scores were compared between cohorts. Minimum clinically important difference (MCID) and substantial clinical benefit also were determined for this cohort. Univariate and multivariable regression was performed to assess the influence of CKD on outcome measures and risk of complications. 518 patients met inclusion criteria; 4 patients did not have recorded GFR, leaving 514 patients for analysis. 389 patients had normal GFR; 125 had CKD. Patients with CKD had lower overall preoperative and postoperative ASES, SST, and SANE scores but demonstrated similar levels of clinical improvement from preoperative to postoperative time points (Δ ASES 41.4 ± 21.8 vs. 42.9 ± 21.4, P =.55), (Δ SST 4.8 ± 3.4 vs. 4.9 ± 3.3, P =.08), (Δ SANE 40.7 ± 29.1 vs. 42.4 ± 26.5, P =.77). Both cohorts achieved MCID for ASES, SST, and SANE scores. Univariately, patients with CKD were at high risk to require transfusion (OR 16.2 (1.9, 139.7), P =.01) despite similar intraoperative estimated blood loss (156.9 ± 132.5mL vs. 153.8 ± 89.7mL, P =.77). CKD patients also were at higher risk for intraoperative fracture (OR 5.4 (1.3, 23.0), P =.02). CKD patients were not at higher risk for prosthetic joint infection (OR 3.2 (0.2, 50.8), P =.42), medical complications (OR 0.9 (0.2, 4.4), P =.89), or revision (OR 1.9 (0.7, 4.9), P =.19) in this cohort. Multivariable analysis of any complication after SA demonstrated that renal disease was not an independent risk factor for overall complication risk in this cohort (OR 1.1 (0.7, 1.8) P =.650). Surgeons can be assured that patients who have CKD achieve similar gains in clinical outcomes as other patients. Despite experiencing a higher risk for transfusion and intraoperative fracture, renal disease was not an independent risk factor for complications after SA in this small cohort. [ABSTRACT FROM AUTHOR]

The purpose of this study is to retrospectively analyze all primary anatomic total shoulder arthroplasty (aTSA) patients within a multicenter international database of a single prosthesis to identify risk factors for patients with rotator cuff tear (RCT) and aseptic glenoid loosening. To investigate the risk factors for RCT and aseptic glenoid loosening, we retrospectively analyzed all aTSA patients with 2-year minimum follow-up from a multicenter international database of a single platform shoulder system, only excluding patients with a history of revision arthroplasty, infections, and humeral fractures. A univariate/multivariate analysis was conducted to compare primary aTSA patients who had report of: 1) a RCT and/or subscapularis failure and 2) aseptic glenoid loosening/cage glenoid dissociations, to identify the differences in (i) intrinsic patient demographics and comorbidities and (ii) implant and operative parameters. Finally, to adapt our statistical analysis for prospective identification of patients most at-risk for RCT and aseptic glenoid loosening, we stratified the dataset by multiple risk factor combinations and calculated the odds ratio (OR) to determine the impact of accumulating risk factors on the incidence rate of each complication. 122 aTSA shoulders had a RCT for a rate of 3.2% and 123 aTSA shoulders had aseptic glenoid loosening for a rate of 3.3%. The multivariate analysis identified that aTSA patients with RCT were more likely to have previous shoulder surgery (P <.001) and small size glenoids (P =.002). Additionally, the multivariate analysis identified that aTSA patients with aseptic glenoid loosening were more likely to be younger (≤62 years at the time of surgery, P =.001), have small size glenoids (P =.033) and have a nonhybrid glenoids (P <.001). Stratifying patients with multiple risk factors identified multiple aTSA cohorts with ORs >2 for RCT or aseptic glenoid loosening. This analysis of 2699 primary aTSA identified risk factors for the two most common postoperative complications: RCTs and aseptic glenoid loosening. Using these risk factors, we calculated ORs for patient cohorts with multiple risk factors to identify the patients with the greatest risk for each complication. This information is useful to guide the surgeon in their preoperative counseling and potentially mitigate the occurrence of these complications, by indicating patients with these risk-factors for alternative treatment strategies, like rTSA, instead of aTSA. [ABSTRACT FROM AUTHOR]

Psoriasis, a chronic, immune-mediated disease, is a known risk factor for infectious complications following certain surgical procedures such as lower extremity arthroplasty. However, there is a paucity in the literature that observes the association of psoriasis and infectious complications following total shoulder arthroplasty (TSA). The primary research question was whether a diagnosis of psoriasis is associated with increased odds of short-term infectious complications and long-term surgical complications. A retrospective cohort analysis was performed using the PearlDiver all-payers' claims database. Patients who underwent primary TSA were identified using Current Procedural Terminology and International Classification of Diseases procedure codes. Patients were then stratified into two groups: (1) patients with psoriasis who underwent TSA, and (2) patients without psoriasis who underwent TSA. Primary outcomes included the incidence of 90-day infectious complications including periprosthetic joint infection, deep surgical site infection, and sepsis. Secondary outcomes included the incidence of 5-year surgical complications including all-cause revision, aseptic revision, and septic revision. Univariate and multivariable regression analyses were conducted to compare complications between the cohorts. In total, 89,321 patients were included in this study, with 3311 (3.71%) having psoriasis. Patients with psoriasis had significantly higher odds of 90-day infectious complications following TSA including periprosthetic joint infection (1.63; P =.014) and deep surgical site infection (1.79; P =.003), when compared to those without psoriasis. There were no significant differences in odds of 5-year all-cause revisions, septic revisions, and aseptic revisions between the two cohorts. Psoriasis is associated with significantly higher 90-day infectious complications but not long-term implant complications. Orthopedic surgeons should be aware of the increased acute infectious complications in this population, promote preoperative counseling and extensive infectious precautions, and consider the use of alternative prophylaxis against infection. These findings also have implications for risk adjustments in increasingly common bundled payments or shared risk payment models. [ABSTRACT FROM AUTHOR]

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Following a national multicentre study, two emergency department (ED) screening tools were developed to determine risk of medication-related problems; one for use at ED presentation and another at ED discharge to the community. This study aimed to determine the inter-rater reliability amongst ED health professionals when applying these screening tools to a series of case scenarios. A prospective, cross-sectional study was undertaken in the ED of a major metropolitan hospital. Twelve case scenarios were developed following ED observation of a range of patients, which were incorporated into a questionnaire and distributed to 50 health professionals. Inter-rater reliabilities of each explanatory variable of the screening tools and overall assessment were calculated using Fleiss' multi-rater kappa. The questionnaire was completed by 15 doctors, 19 nurses and 16 pharmacists. Fleiss' kappa showed an overall inter-rater reliability for the ED presentation tool of 0.83 (95% CI 0.83–0.84), indicating near perfect agreement. Fleiss' kappa for the ED discharge tool was 0.83 (95% CI 0.83–0.85), which also showed near perfect agreement. The screening tools produced favourable inter-rater reliability amongst ED health professionals. These results have important implications for ensuring consistency of ED decision-making in screening patients at risk of developing medication-related problems. [ABSTRACT FROM AUTHOR]

The purpose of our study was to assess the multiscalar changes in leprosy burden and its associated risk factors over the last three decades. We conducted an in-depth examination of leprosy's spatial–temporal trends at multiple geographical scale (global, regional, and national), utilizing information from Global Burden of Disease, Injuries, and Risk Factors Study (GBD 2019). Incidence and the estimated annual percentage change (EAPC) in age-standardized incidence rate (ASIR) of leprosy were determined, with countries categorized based on leprosy incidence changes. We examined socioeconomic and physical geography influences on leprosy incidence via Spearman correlation analysis, using ternary phase diagrams to reveal the synergetic effects on leprosy occurrence. Globally, incident cases of leprosy decreased by 27.86% from 1990 to 2019, with a reduction in ASIR (EAPC = −2.53), yet trends were not homogeneous across regions. ASIR and EAPC correlated positively with sociodemographic index (SDI), and an ASIR growth appeared in high SDI region (EAPC = 3.07). Leprosy burden was chiefly distributed in Tropical Latin America, Oceania, Central Sub-Saharan Africa, and South Asia. Negative correlations were detected between the incidence of leprosy and factors of SDI, GDP per capita, urban population to total population, and precipitation, whereas the number of refugee population, temperature, and elevation showed opposite positive results. Despite a global decline in leprosy over the past three decades, the disparities of disease occurrence at regional and national scales still persisted. Socioeconomic and physical geographic factors posed an obvious influence on the transmission risk of leprosy. The persistence and regional fluctuations of leprosy incidence necessitate the ongoing dynamic and multilayered control strategies worldwide in combating this ancient disease. [ABSTRACT FROM AUTHOR]

To evaluate the incidence and pattern of contralateral nodal relapse (CLNR), contralateral nodal relapse-free survival (CLNRFS) and risk factors predicting CLNR in well-lateralised oral cavity cancers (OCC) treated with unilateral surgery and adjuvant ipsilateral radiotherapy with or without concurrent chemotherapy. Consecutive patients of well-lateralised OCC treated between 2012 and 2017 were included. The primary endpoint was incidence of CLNR and CLNRFS. Univariable and multivariable analyses were carried out to identify potential factors predicting CLNR. Of the 208 eligible patients, 21 (10%) developed isolated CLNR at a median follow-up of 45 months. The incidence of CLNR was 21.3% in node-positive patients. CLNR was most common at level IB (61.9%) followed by level II. The 5-year CLNRFS and overall survival were 82.5% and 57.7%, respectively. Any positive ipsilateral lymph node (P = 0.001), two or more positive lymph nodes (P < 0.001), involvement of ipsilateral level IB (P = 0.002) or level II lymph node (P < 0.001), presence of extranodal extension (P < 0.001), lymphatic invasion (P = 0.015) and perineural invasion (P = 0.021) were significant factors for CLNR on univariable analysis. The presence of two or more positive lymph nodes (P < 0.001) was an independent prognostic factor for CLNR on multivariable analysis. CLNR increased significantly with each increasing lymph node number beyond two compared with node-negative patients. The overall incidence of isolated CLNR is low in well-lateralised OCC. Patients with two or more positive lymph nodes have a higher risk of CLNR and may be considered for elective treatment of contralateral neck. • Incidence of contralateral nodal relapse (CLNR) is low in lateralised oral cancers. • ≥2 ipsilateral positive lymph nodes are associated with higher risk of CLNR. • Nodal levels IB and II are the most common stations of contralateral relapse. • Contralateral relapse increases with increasing number of positive lymph nodes. • Elective contralateral neck treatment may be considered in case of ≥2 ipsilateral positive lymph nodes. [ABSTRACT FROM AUTHOR]