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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]

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]

Background: MRI T2 mapping has been proven to be sensitive to the level of blood oxygenation. We hypothesized that impaired exercise capacity in chronic heart failure is associated with a greater difference between right (RV) to left ventricular (LV) blood pool T2 relaxation times due to a higher level of peripheral blood desaturation, compared to patients with preserved exercise capacity and to healthy controls. Methods: Patients with chronic heart failure (n = 70) who had undergone both cardiac MRI (CMR) and a 6-min walk test (6MWT) were retrospectively identified. Propensity score matched healthy individuals (n = 35) served as control group. CMR analyses included cine acquisitions and T2 mapping to obtain blood pool T2 relaxation times of the RV and LV. Following common practice, age- and gender-adjusted nominal distances and respective percentiles were calculated for the 6MWT. The relationship between the RV/LV T2 blood pool ratio and the results from 6MWT were evaluated by Spearman's correlation coefficients and regression analyses. Inter-group differences were assessed by independent t-tests and univariate analysis of variance. Results: The RV/LV T2 ratio moderately correlated with the percentiles of nominal distances in the 6MWT (r = 0.66) while ejection fraction, end-diastolic and end-systolic volumes showed no correlation (r = 0.09, 0.07 and − 0.01, respectively). In addition, there were significant differences in the RV/LV T2 ratio between patients with and without significant post-exercise dyspnea (p = 0.001). Regression analyses showed that RV/LV T2 ratio was an independent predictor of the distance walked and the presence of post-exercise dyspnea (p < 0.001). Conclusion: The proposed RV/LV T2 ratio, obtained by two simple measurements on a routinely acquired four-chamber T2 map, was superior to established parameters of cardiac function to predict exercise capacity and the presence of post-exercise dyspnea in patients with chronic heart failure. [ABSTRACT FROM AUTHOR]

Typical statistical methods of data analysis only handle determinate uncertainty, the type of uncertainty that can be modeled under the Bayesian or confidence theories of inference. An example of indeterminate uncertainty is uncertainty about whether the Bayesian theory or the frequentist theory is better suited to the problem at hand. Another example is uncertainty about how to modify a Bayesian model upon learning that its prior is inadequate. Both problems of indeterminate uncertainty have solutions under the proposed framework. The framework is based on an information-theoretic definition of an incoherence function to be minimized. It generalizes the principle of choosing an estimate that minimizes the reverse relative entropy between it and a previous posterior distribution such as a confidence distribution. The simplest form of the incoherence function, called the incoherence distribution, is a min-plus probability distribution, which is equivalent to a possibility distribution rather than a measure-theoretic probability distribution. A simple case of minimizing the incoherence leads to a generalization of minimizing relative entropy and thus of maximizing entropy. The framework of minimum incoherence is applied to problems of Bayesian-confidence uncertainty and to parallel problems of indeterminate uncertainty about model revision. [ABSTRACT FROM AUTHOR]

We examined differences in rates of severe maternal morbidity and mortality (SMMM) among Medicaid-funded compared with privately insured hospital births through specific additive and intersectional risk by rural or urban geography, race and ethnicity, and clinical factors. We used maternal discharge records from childbirth hospitalizations in the Healthcare Cost and Utilization Project's National Inpatient Sample from 2007 to 2015. We calculated predicted probabilities using weighted multivariable logistic regressions to estimate adjusted rates of SMMM, examining differences in rates by payer, rurality, race and ethnicity, and clinical factors. To assess the presence and extent of additive risk by payer, with other risk factors, on rates of SMMM, we estimated the proportion of the combined effect that was due to the interaction. In this analysis of 6,357,796 hospitalizations for childbirth, 2,932,234 were Medicaid funded and 3,425,562 were privately insured. Controlling for sociodemographic and clinical factors, the highest rate of SMMM (224.9 per 10,000 births) occurred among rural Indigenous Medicaid-funded births. Medicaid-funded births among Black rural and urban residents, and among Hispanic urban residents, also experienced elevated rates and significant additive interaction. Thirty-two percent (Bonferroni-adjusted 95% confidence interval, 19%–45%) of SMMM cases among patients with chronic heart disease were due to payer interaction, and 19% (Bonferroni-adjusted 95% confidence interval, 17%–22%) among those with cesarean birth were due to the interaction. Heightened rates of SMMM among Medicaid-funded births indicate an opportunity for tailored state and federal policy responses to address the particular maternal health challenges faced by Medicaid beneficiaries, including Black, Indigenous, and rural residents. [ABSTRACT FROM AUTHOR]

Quantum state discrimination depicts the general progress of extracting classical information from quantum systems. We show that quantum state discrimination can be realized in a measurement device-independent scenario using tools of self-testing results. That is, the states can be discriminated credibly with the untrusted experiment devices by the correspondence between quantum correlations and states. In detail, we show that two states that are not conjugate with each other can be discriminated without additional trusted input states, and the discrimination of others require a kind of trusted inputs. Further we show the guessing probability analysis of this protocol for minimum error discrimination, which is acceptable based on numerical results. • Quantum state discrimination can be realized measurement device-independently. • The devices are treated as black boxes and the quantum state discrimination is realized without knowing precise form of measurements. • The trust of devices can be removed to improve security and experimental errors can be treated at the level of observed statistics. [ABSTRACT FROM AUTHOR]

Subsyndromal delirium is a dynamic, recognizable condition commonly observed in intensive care unit (ICU) patients that can lead to poor patient prognosis, and its prompt recognition and management can prevent disease progression. However, no evidence-based predictive tool has been developed specifically to assess the occurrence of subsyndromal delirium in the ICU. To develop and validate a novel, simple and effective tool for estimating the risk of subsyndromal delirium among ICU patients. A prospective, nested case-controlled study. A total of 731 patients were recruited from the central ICU of a tertiary hospital in southwestern China from August 2021 to November 2022. The least absolute shrinkage and selection operator was applied to screen potential features for univariate and multivariate logistic regression. A nomogram was constructed using the selected variables. The performance of the nomogram was evaluated by combining the area under the receiver operating characteristic curve (AUC), calibration curves and decision curve analysis (DCA). The prevalence of subsyndromal delirium among ICU patients was 23.06 %. Multiple logistic regression analysis revealed that the independent predictive factors for subsyndromal delirium among ICU patients were vision impairment, a history of falls, the use of restraint, blood transfusion, the use of antibiotics, surgery, the Caprini score, and the Braden score, all of which were used to construct the nomogram. The AUCs for the model were 0.710 (95 % CI, 0.654–0.766, P < 0.001) and 0.825 (95 % CI, 0.732–0.917, P < 0.001) in the training and validation cohorts, respectively, indicating that the model had high accuracy in distinguishing patients with and without subsyndromal delirium. The calibration curve of the nomogram showed good consistency between the predicted and actual probabilities. The DCA indicated that the nomogram has clinical application for patients in the ICU. We developed an easy-to-use nomogram for identifying subsyndromal delirium in ICU patients with satisfactory predictive ability based on simple and easily accessible clinical features. The nomogram can identify ICU patients at high-risk for subsyndromal delirium and may be a useful subsyndromal delirium tool for current ICU physicians. [ABSTRACT FROM AUTHOR]

We retrospectively investigated the role of (neo)adjuvant chemotherapy in patients with primary, localized angiosarcoma. We selected all patients with primary, localized angiosarcoma, who had received radical surgery between January 2005 and December 2019 at 33 European sarcoma reference centers. The primary objective was to compare the outcome of patients who received (neo)adjuvant chemotherapy versus those who did not, in terms of overall survival (OS), disease-free survival (DFS) and distant metastasis-free survival (DMFS). To reduce the risk of confounding due to imbalance, a propensity-score matching(PSM) was performed. Finally, subgroups analysis was performed according to tumor site, tumor size (< 50 mm or ≥ 50 mm) and patients predicted 10-years OS according to the nomogram sarculator (two different cutoff-values were applied: ≤ 33% or > 33% and < 60% or ≥ 60%). 362 patients were analyzed: 149 (41.2%; treated group) received (neo) adjuvant chemotherapy and 213 (58.6%; control group) did not. The median follow-up for the OS endpoint was 5.1 years (95% CI: 4.0–5.5). The OS-HR was 0.58 (95%CI: 0.40–0.83; p-value = 0.003) in the univariate analysis and 0.74 (95% CI: 0.38–1.43; p = 0.367) in the PSM analysis. The DFS-HR was 0.75 (95% CI: 0.57–0.98; p-value = 0.036) in the univariate analysis, and 0.91 (95% CI:0.56–1.48; p-value = 0.7) in the PSM analysis. The DMFS-HR was 0.75 (95% CI: 0.55–1.02; p-value = 0.065) in univariate analysis and 0.92 (95% CI: 0.53–1.61; p-value = 0.769) in the PSM analysis. Subgroup analysis revealed no heterogeneity of results in strata of tumor site. On the contrary, there was a trend for heterogeneity according to tumor size and patient's risk of death. For all the endpoints analyzed, patients with tumors smaller than 50 mm or at lower risk of death seem to have no benefit from chemotherapy, while patients with larger tumors or at higher risk of death at 10 years seem to derive substantial benefit. This large, retrospective study suggests that patients affected by > 50 mm and/or high-risk primary, localized angiosarcoma could benefit from (neo)adjuvant chemotherapy. • Localized angiosarcoma of any site. • Effectiveness of (neo)adjuvant chemotherapy. • High risk angiosarcoma. [ABSTRACT FROM AUTHOR]

Advance care planning (ACP) is a process that helps people prepare to make decisions about their future medical care. We sought to understand who was received billed ACP visits and measure the association with health care utilization, cost, and mortality. We used a randomly sampled 20 % cohort of Medicare fee-for-service (FFS) beneficiaries' files to conduct a retrospective cohort study. Beneficiaries with a billed ACP visit were matched to controls using a 2-stage propensity score matching process that included assigning a pseudo-ACP visit date for controls. Outcomes included healthcare utilization, mortality, and total medical cost per month. We used descriptive statistics for univariate analysis and fit multilevel logistic regression, multilevel linear regression, or Cox regression models. We identified 183,513 beneficiaries who received any billed ACP visit and 550,539 matched controls. Of those who had a ACP visit, the mean age was 76.5 years and high-risk comorbidities were common: 16 % dementia, 10 % congestive heart failure, 10 % cancer. Beneficiaries who had an ACP visit had slightly more health care utilization than controls. Beneficiaries who had an ACP visit were more likely to die (3.1% vs. 1.0 %, p < 0.01, OR=3.0, 95 %CI 2.9–3.2) in the unadjusted and adjusted analyses compared to matched controls. Total monthly medical costs were 33 % higher among beneficiaries who had an ACP visit. Our results suggest that ACP visits may be preferentially utilized amongst individuals with higher risk of mortality. There may be an opportunity to increase ACP visits among older adults at lower risk for mortality. This article suggests that ACP visits are likely targeted to older adults with a higher risk of mortality than those at lower risk of mortality suggesting an opportunity to reach people before they are facing end-of-life decisions. [ABSTRACT FROM AUTHOR]

This paper presents two data-driven virtual sensors to estimate the time-series of the probability of high-concentration occurrence of naturally occurring radioactive materials (NORMs; 238U and 222Rn) in groundwater based on the in-situ groundwater quality monitoring data and geological information. The random forest was applied to estimate the NORM concentration based on the actual in-situ groundwater quality data, rock type, and the aquifer depth. Additionally, this study proposes three data sampling techniques (i.e., under-sampling, synthetic minority over-sampling, and a complex sampling) to improve the model applicability and accuracy. The developed models were validated using the actual data acquired from 201 locations in South Korea. The models for 238U and 222Rn showed estimation accuracies of 85% and 80%, respectively; the models with over-sampling showed better performance. All the results verified the usefulness of the developed models as virtual sensors for providing immediate information on the in-situ presence of NORMs in groundwater. [Display omitted] • Naturally occurring radioactive material (NORMs) in groundwater can be problematic. • Virtual sensor for in-situ estimating the probability of high-concentration of NORMs. • Major geochemical factors for NORMs were evaluated using statistical analyses. • Methods for solving data imbalance problem in training virtual sensor were proposed. • Major factors for the estimation were consistent with the statistical analysis result. [ABSTRACT FROM AUTHOR]

1) To show the validation criteria of the product of probabilities (PPs). Bayes' theorem (BT) is widely used in the ionizing radiation field; and 2) To demonstrate that terms P(B|A) and P (A|B) in the BT are not new probabilistic metrics, but the own respective probabilities of B and An events. Mathematical derivations based on strong probabilistic foundations, and with their respective illustrations. a) Determination of the validationcriteria of the PPs; and b) There is demonstration of incoherencies of the BT. 1) The tumor control probability (TCP) of independent radiation oncology treatments to patients with more than one target, calculated as the product of individual TCPs is an incoherent determination; 2) Given previously explained about BT terms, the use of this theorem should be re-considered; and 3). P (A∩B) P(A)*P(B) only when N × P(A) and N × P(B) are a subset of a population N, and if A and B are independent and simultaneous events. • It provides validation criteria of the product of probabilities (PPs). • The use of the Bayes' theorem should be re-considered. • UTCP = TCP × NTCP0 is an excellent example using PPs. • It provides a new proposal for the composite TCP expression. [ABSTRACT FROM AUTHOR]

We investigated whether nurse home visiting (NHV) affects the uptake and quality of formal early childhood education and care (ECEC) at child ages 2 and 3 years, and reasons for using ECEC at 3 years. Design: Secondary analysis of the "right@home" randomized trial of NHV. Participants: 722 pregnant Australian, English-speaking women experiencing adversity recruited from antenatal clinics across 2 states. Intervention: 25 nurse home visits to 2 years; Control: universal well-child nursing service. Measures: Parents reported formal ECEC use (government approved and subsidized), comprising long or family day care (LDC), and reasons for use. ECEC quality was classified using the Australian government's national ratings. Eighty-three percent of parents provided data at 2 years (306 intervention/290 control); and 69% at 3 years (255 intervention/240 control). Analysis: Intention-to-treat analyses were conducted using adjusted regression models, addressing missing data using multiple imputation and inverse probability weighting. There was no evidence of group differences in ECEC uptake or quality, although control families may have used more LDC at 3 years (mean difference 2.8 hours, 95% confidence interval, -0.2 to 5.8 hours). Intervention parents reported using ECEC to support their children's social development more frequently than controls (48% vs 33%) but less for work/study (39% vs 46%). The right@home NHV program did not impact ECEC uptake or quality, although it may influence parents' reasons for using ECEC. If supported by policy and provision, there is an opportunity for NHV programs to promote the transition to high-quality ECEC and evaluate the synergistic benefit on children's development. [ABSTRACT FROM AUTHOR]

In Siotani and Fujikoshi (1984), a precise local limit theorem for the multinomial distribution is derived by inverting the Fourier transform, where the error terms are explicit up to order N − 1. In this paper, we give an alternative (conceptually simpler) proof based on Stirling's formula and a careful handling of Taylor expansions, and we show how the result can be used to approximate multinomial probabilities on most subsets of R d. Furthermore, we discuss a recent application of the result to obtain asymptotic properties of Bernstein estimators on the simplex, we improve the main result in Carter (2002) on the Le Cam distance bound between multinomial and multivariate normal experiments while simultaneously simplifying the proof, and we mention another potential application related to finely tuned continuity corrections. • Local limit theorem for the multinomial distribution up to an N − 3 ∕ 2 error. • Simple proof using Stirling's formula and Taylor expansions. • Application to obtain asymptotic properties of Bernstein estimators. • Improves Le Cam distance between multinomial and multivariate normal experiments. • Potential applications to continuity corrections and power divergence statistics. [ABSTRACT FROM AUTHOR]

Objectif.- On constate une préoccupation croissante concernant la véracité des publications scientifiques. La probabilité qu'un résultat publié soit vrai peut dépendre de la puissance de l'étude et d'éventuels biais ; du nombre d'autres études sur le même sujet ; et, de manière cruciale, du taux de résultats positifs par rapport à celui de résultats nuls parmi les rapports étudiés par chaque domaine scientifique. Des simulations sont effectuées pour évaluer la probabilité qu'un résultat publié soit faux. Dans ce contexte, un résultat a une moindre probabilité de véracité quand le nombre d'études similaires effectuées dans un domaine donné est petit ; quand les tailles d'effet sont plus petites ; quand le nombre de relations étudiées est plus important et leur présélection plus petite ; quand il y a une plus grande flexibilité dans le protocole, les définitions, les mesures et la modalité d'analyse ; quand il y a un plus grand intérêt financier (avec le biais qui peut l'accompagner) ; et quand plusieurs équipes dans un domaine sont engagées dans une course aux résultats qui soient statistiquement significatifs. Pour de nombreux champs de recherche actuels, des résultats publiés ne sont ni plus ni moins qu'un reflet fidèle des biais régnants. Dans cet essai, j'explore les implications de ces problèmes par rapport à la conduite et l'interprétation de la recherche. There is increasing concern that most current published research findings are false. The probability that a research claim is true may depend on study power and bias, the number of other studies on the same question, and, importantly, the ratio of true to no relationships among the relationships probed in each scientific field. Simulations are performed to assess the likelihood that a published result is false. In this framework, a research finding is less likely to be true when the studies conducted in a field are smaller; when effect sizes are smaller; when there is a greater number and lesser preselection of tested relationships; where there is greater flexibility in designs, definitions, outcomes, and analytical modes; when there is greater financial and other interest and prejudice; and when more teams are involved in a scientific field in chase of statistical significance. For many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias. In this essay, I discuss the implications of these problems for the conduct and interpretation of research. [ABSTRACT FROM AUTHOR]

Background: Multicentre RCTs are widely used by critical care researchers to answer important clinical questions. However, few trials evaluating mortality outcomes report statistically significant results. We hypothesised that the low proportion of trials reporting statistically significant differences for mortality outcomes is plausibly explained by lower-than-expected effect sizes combined with a low proportion of participants who could realistically benefit from studied interventions.Methods: We reviewed multicentre trials in critical care published over a 10-yr period in the New England Journal of Medicine, the Journal of the American Medical Association, and the Lancet. To test our hypothesis, we analysed the results using a Bayesian model to investigate the relationship between the proportion of effective interventions and the proportion of statistically significant results for prior distributions of effect size and trial participant susceptibility.Results: Five of 54 trials (9.3%) reported a significant difference in mortality between the control and the intervention groups. The median expected and observed differences in absolute mortality were 8.0% and 2.0%, respectively. Our modelling shows that, across trials, a lower-than-expected effect size combined with a low proportion of potentially susceptible participants is consistent with the observed proportion of trials reporting significant differences even when most interventions are effective.Conclusions: When designing clinical trials, researchers most likely overestimate true population effect sizes for critical care interventions. Bayesian modelling demonstrates that that it is not necessarily the case that most studied interventions lack efficacy. In fact, it is plausible that many studied interventions have clinically important effects that are missed. [ABSTRACT FROM AUTHOR]

We construct a class of generalized q -deformed coherent states (G q -CS) and we introduce a generalization of the Euler probability distribution for which we write down the probability generating function. As application, we discuss the statistics of a q -deformed number operator in these G q -CS with respect to many parameters. [ABSTRACT FROM AUTHOR]

Background: To assess the incremental long-term prognostic value of vasodilator stress perfusion cardiovascular magnetic resonance (CMR) in patients without known coronary artery disease (CAD). Methods: Between 2010 and 2011, consecutive patients with cardiovascular risk factors without known CAD referred for stress CMR were followed for the occurrence of major adverse cardiac events (MACE), defined by cardiovascular mortality or recurrent non-fatal myocardial infarction (MI). Uni- and multivariable Cox regressions were performed to determine the prognostic value of ischemia and unrecognized MI defined by sub-endocardial or transmural late gadolinium enhancement (LGE). Results: Among 2,295 patients without known CAD, 2058 (89.7%) (71.2 ± 12.5 years; 37.5% males) completed the follow-up (median [IQR]: 8.3 [7.3–8.7] years), and 203 had MACE (9.9%). Using Kaplan–Meier analysis, ischemia and unrecognized MI were associated with MACE (hazard ratio, HR: 4.64 95% CI: 3.69–6.17 and HR: 2.88; 95% CI: 2.08–3.99, respectively; both p < 0.001). In multivariable stepwise Cox regression, ischemia and unrecognized MI were independent predictors of MACE (HR = 3.71; 95% CI 2.73–5.05, p < 0.001 and HR = 1.73; 95% CI 1.22–2.45, p = 0.002; respectively) and cardiovascular mortality (HR: 3.13; 95% CI: 2.17–4.51, p < 0.001 and HR = 1.73; 95% CI 1.15–2.62, p = 0.009; respectively). The addition of ischemia and unrecognized MI led to an improved model discrimination for MACE (change in C statistic from 0.61 to 0.72; NRI = 0.431; IDI = 0.053). Conclusions: Inducible ischemia and unrecognized MI identified by stress CMR have incremental long term prognostic value for the incidence of MACE in patients without known CAD over traditional risk factors and left ventricular ejection fraction. [ABSTRACT FROM AUTHOR]

Background: Bayesian methods, with the predictive probability (PredP), allow multiple interim analyses with interim posterior probability (PostP) computation, without the need to correct for multiple looks at the data. The objective of this paper was to illustrate the use of PredP by simulating a sequential analysis of a clinical trial.Methods: We used data from the Laryngobloc trial that planned to include 480 patients to demonstrate the equivalence of success between a laryngoscopy performed with the Laryngobloc® device and a control device. A crossover Bayesian design was used. The success rates of the two laryngoscopy devices were compared. Interim analyses, computed from random numbers of subjects, were simulated.Results: The PostP of equivalence rapidly reached the predefined bound of 0.95. The PredP computed with an equivalence margin of 10% reached the efficacy bound between 352 and 409 of the 480 included patients. If a frequentist analysis had been made on the basis of 217 out of 480 subjects, the study would have been prematurely stopped for equivalence. The PredP indicated that this result was nonetheless unstable and that the equivalence was, thus far, not guaranteed.Conclusions: Based on these interim analyses, we can conclude with a sufficiently high probability that the equivalence would have been met on the primary outcome before the predetermined end of this particular trial. If a Bayesian approach using PredP had been used, it would have allowed an early termination of the trial by reducing the calculated sample size by 15-20%. [ABSTRACT FROM AUTHOR]

In this paper, we show how a possibilistic description of uncertainty arises very naturally in statistical data analysis. In combination with recent results in inverse uncertainty propagation and the consistent aggregation of marginal possibility distributions, this estimation procedure enables a very general approach to possibilistic identification problems in the framework of imprecise probabilities, i.e. the non-parametric estimation of possibility distributions of uncertain variables from data with a clear interpretation. [ABSTRACT FROM AUTHOR]

Our aim was to analyze whether shoulder pain is related to scapular upward rotation (SUR) or to the lengths of the pectoralis minor and levator scapulae muscles. This cross-sectional, observational study was carried out in 3 primary-care centers; 54 individuals with chronic shoulder pain participated. Scapular upward rotation and the lengths of the pectoralis minor and levator scapulae muscles were assessed. The level of association was small between shoulder pain and function and (1) the lengths of the pectoralis minor (r = 0.08, P =.93) and levator scapulae (r = −0.01, P =.57) muscles and (2) SUR at 45° (r = 0.17, P =.21), 90° (r = 0.08, P =.57), and 135° (r = 0.10, P = 0.45) of shoulder elevation. The relationship was small between shoulder pain and function and (1) SUR (45°, 90°, and 135° of shoulder elevation) and (2) the lengths of the pectoralis minor and levator scapulae muscles. Thus, the use of SUR and pectoralis minor and levator scapulae lengths in shoulder assessment should be undertaken with caution. Other factors such as psychological factors, central/peripheral sensitization, and intrinsic properties of the tissue have to be taken into account. [ABSTRACT FROM AUTHOR]

• Forensic evidence reporting shows a high degree of adherence to prevailing disciplinary standards. • Probabilistic reporting of forensic results remains rare. • Probabilistic reports were mostly subjective verbal assignments of posterior probabilities. [ABSTRACT FROM AUTHOR]

Objectives: To develop efficient approaches for fitting network meta-analysis (NMA) models with time-varying hazard ratios (such as fractional polynomials and piecewise constant models) to allow practitioners to investigate a broad range of models rapidly and to achieve a more robust and comprehensive model selection strategy.Methods: We reformulated the fractional polynomial and piecewise constant NMA models using analysis of variance-like parameterization. With this approach, both models are expressed as generalized linear models (GLMs) with time-varying covariates. Such models can be fitted efficiently with standard frequentist techniques. We applied our approach to the example data from the study by Jansen et al, in which fractional polynomial NMA models were introduced.Results: Fitting frequentist fixed-effect NMAs for a large initial set of candidate models took less than 1 second with standard GLM routines. This allowed for model selection from a large range of hazard ratio structures by comparing a set of criteria including Akaike information criterion/Bayesian information criterion, visual inspection of goodness-of-fit, and long-term extrapolations. The "best" models were then refitted in a Bayesian framework. Estimates agreed very closely.Conclusions: NMA models with time-varying hazard ratios can be explored efficiently with a stepwise approach. A frequentist fixed-effect framework enables rapid exploration of different models. The best model can then be assessed further in a Bayesian framework to capture and propagate uncertainty for decision-making. [ABSTRACT FROM AUTHOR]

To compare the outcomes and cost effectiveness of two alternate policy strategies for prenatal care among low-income, immigrant women: coverage for delivery only (the federal standard) and prenatal care with delivery coverage (state option under the Children's Health Insurance Program). A decision-analytic model was developed to determine the cost effectiveness of two alternate policies for pregnancy coverage. All states currently provide coverage for delivery, and 19 states also provide coverage for prenatal care. An estimated 84,000 unauthorized immigrant women have pregnancies where no prenatal care is covered. Our outcomes were costs, quality-adjusted life-years, and cases of cerebral palsy and infant death before age 1. Model inputs were obtained from a database of Oregon Medicaid claims and the literature. Univariate and bivariate sensitivity analyses, as well as a Monte Carlo simulation, were performed. Extending prenatal coverage is a cost-effective strategy. Providing prenatal care for the 84,000 women annually who are currently uninsured could prevent 117 infant deaths and 34 cases of cerebral palsy. Prenatal care coverage costs $380 more per woman than covering the delivery only. For every 865 additional women receiving prenatal care, one infant death would be averted, at an average cost of $328,700. Cost-effectiveness acceptability curve analyses suggest a 99% probability that providing prenatal care is more cost effective at a willingness-to-pay threshold of $100,000 per quality-adjusted life-year. Extending prenatal care to low-income, immigrant women, regardless of citizenship status, is a cost-effective strategy. [ABSTRACT FROM AUTHOR]

The theoretical investigation of Evolutionary Algorithms (EAs) has increased our understanding of the computational mechanism of algorithms. OneMax is a test function most frequently and deeply studied in the field of EAs. In this work, a method is presented for describing the runtime properties of (1 + 1) EA on OneMax. This method is motivated by the work of Erdös and Rényi treating the coupon collector's problem. They showed that the success probability of the coupon collector's problem is given by a function of double exponential form, and that the number of uncollected coupons follows the Poisson distribution. Today, the double exponential function is called Gumbel function, which is one of three fundamental functions in extreme value statistics. We introduce an algorithm that is a variant of the (1 + 1) EA, First Order Evolutionary Algorithm (FO-EA). FO-EA takes into account only the effect of single-bit mutations in the (1 + 1) EA, which in general includes multiple-bit mutations. We modified the method of Erdös and Rényi to apply FO-EA. We apply the Gumbel distribution for calculating the success probability of the (1 + 1) EA on OneMax. This method turns out to give a sufficiently reliable estimation for success probabilities, even in the tail region. [ABSTRACT FROM AUTHOR]

• Decoupling of the bearing composite failure mechanism has been avoided. • The amount of statistical information rich in the raw signal has been utilized. • The sampling uncertainty caused by the average multi-segment signal and the fluctuation of the signal with time have been solved. • Subjective cognitive uncertainty and objective experimental uncertainty of experimental data have been considered. Feature extraction leads to the loss of statistical information of raw data and ignores the sampling uncertainty and the fluctuations in the signal over time in mechanical fault diagnosis. In this paper, novel modeling methods for mechanical signals based on probability box theory were proposed to solve the above problem. First, the type of random distribution of the bearing signals were analyzed. Then, a Dempster-Shafer structure was obtained to establish a probability box model. To address the identification difficulty of the type of random distribution for the bearing signals, a second probability box model was established based on a vector consisting of features from the bearing signals. If the data are not found to follow a random distribution, a third modeling method based on the definition of probability boxes was proposed. The effectiveness and applicability of the three proposed models were compared with experimental data from rolling element bearings. The combination of probability box theory and mechanical fault diagnosis theory can open up a new research direction for mechanical fault diagnosis. [ABSTRACT FROM AUTHOR]

Keywords: Statistics; Clinical trial; Bayesian; Resuscitation EN Statistics Clinical trial Bayesian Resuscitation 60 64 5 03/31/20 20200401 NES 200401 Bayesian methods for clinical trials Statistical methods are fundamental to clinical trials, because they provide formal ways of reaching conclusions from data that are subject to uncertainty and random variation. Doing this for every possible treatment effect produces a probability distribution (the "posterior probability distribution"), which is the main result of a Bayesian analysis. Bayesian analysis is therefore often seen as a process of updating our information about the treatment effect with new data. Even with these numbers, non-significant results are likely if the treatment effect is smaller than assumed, or the incidence of the outcome is lower, which may lead to an incorrect conclusion that a therapy is ineffective. [Extracted from the article]

Background: Little is known about COVID-19 outside Hubei. The aim of this paper was to describe the clinical characteristics and imaging manifestations of hospitalized patients with confirmed COVID-19 infection in Wenzhou, Zhejiang, China.Methods: In this retrospective cohort study, 149 RT-PCR confirmed positive patients were consecutively enrolled from January 17th to February 10th, 2020 in three tertiary hospitals of Wenzhou. Outcomes were followed up until Feb 15th, 2020.Findings: A total of 85 patients had Hubei travel/residence history, while another 49 had contact with people from Hubei and 15 had no traceable exposure history to Hubei. Fever, cough and expectoration were the most common symptoms, 14 patients had decreased oxygen saturation, 33 had leukopenia, 53 had lymphopenia, and 82 had elevated C-reactive protein. On chest computed tomography (CT), lung segments 6 and 10 were mostly involved. A total of 287 segments presented ground glass opacity, 637 presented mixed opacity and 170 presented consolidation. Lesions were more localized in the peripheral lung with a patchy form. No significant difference was found between patients with or without Hubei exposure history. Seventeen patients had normal CT on admission of these, 12 had negative findings even10 days later.Interpretation: Most patients presented with a mild infection in our study. The imaging pattern of multifocal peripheral ground glass or mixed opacity with predominance in the lower lung is highly suspicious of COVID-19 in the first week of disease onset. Nevetheless, some patients can present with a normal chest finding despite testing positive for COVID-19.Funding: We did not receive any fundings. [ABSTRACT FROM AUTHOR]

This paper outlines the common statistical methods used to analyze four types of observational study: ecological studies, cross-sectional studies, case–control studies and cohort studies. Three statistical methods are considered in detail: correlation coefficients, t-tests for the difference between two means from independent samples and odds ratios. For each method, the need for the same four key outputs is highlighted: the measure of effect, its precision (95% confidence interval), its statistical significance (p-value) and its clinical significance (comparison to the minimum important difference). Where possible, this paper explains the derivation of measures of effect and statistical significance to help readers understand where the numbers come from. The paper also highlights other important aspects of analyzing the quantitative data collected in an observational study, potential biases to consider, and good practice in reporting. Examples from relevant pediatric studies are used where appropriate. [ABSTRACT FROM AUTHOR]

In recent years several authors have documented common problems in the use of statistics in nursing research, including failure to consider the effects of multiple testing, inattention to clinical significance, and under-reporting of effect sizes and confidence intervals. More subtle forms of multiple testing are not as widely recognized, and abuse of researcher degrees of freedom has received little attention in the nursing research literature. These and other unsound practices in applying and interpreting statistics are problematic in themselves, and they arguably reflect an insufficiently clear understanding of statistical inference as a method for dealing with randomness among many researchers. The goal of this educational paper is to improve the understanding and practice of inferential statistics among nursing researchers. An accessible explanation of hypothesis testing is provided, including discussion of the crucial concept of repeated sampling. Several pervasive mistakes and misconceptions in statistical inference are examined in detail, including misinterpretation of "non-significant" p -values as evidence for the null hypothesis, failure to account for forms of multiple testing that arise in model selection, abuse of researcher degrees of freedom, and hypothesis testing for baseline differences between arms in randomized trials. Recommendations for better statistical practice are offered. For the foreseeable future classical methods of statistical inference based on the idea of repeated sampling will be the primary tools for quantifying randomness in nursing research. The hypothesis testing framework, despite its limitations, can be helpful in ruling out chance as an explanation for observed effects. Nursing researchers who use quantitative methods, as well as journal reviewers and editors, should understand this framework well. Those involved in educating nursing researchers and those who teach statistics would do well to ask what changes need to be made to raise the level of statistical practice in nursing research. [ABSTRACT FROM AUTHOR]

Two new terrein derivatives asperterreinones A-B (1–2), one new octahydrocoumarin derivative (±)-asperterreinin A (6), along with seventeen known compounds, were isolated from Aspergillus terreus F6–3, a marine fungus associated with Johnius belengerii. The structures of 1, 2, and 6 were established on the basis of 1D and 2D NMR, mass spectroscopy, comparative electronic circular dichroism (ECD) spectra analysis, density functional theory calculation of 13C NMR, and DP4+ probability analysis. Among all the isolates, eurylene (7), a constituent of the Malaysian medicinal plant Eurycoma longifolia , was obtained from a microbial source for first time. In the in vitro bioassay, 11 and 13 showed potent inhibitory activity against the Escherichia coli β -glucuronidase (EcGUS) with IC 50 values of 27.75 ± 0.73 and 17.73 ± 0.81 μM, respectively. It was the first time that questinol (11) and (±)-aspertertone B (13) were reported as potent EcGUS inhibitors. [Display omitted] [ABSTRACT FROM AUTHOR]

Active warming reduces risk of surgical complications. Implementation of a perioperative thermal care bundle increased use of active warming for surgical patients. This study aimed to determine if implementing a thermal care bundle to prevent inadvertent perioperative hypothermia is cost-effective. A model-based cost-effectiveness analysis was undertaken using Monte Carlo simulations from input distributions to estimate costs and effects. Hospitals undertaking between 5,000 and 40,000 surgeries per year, which either implemented or did not implement the thermal care bundle, were modelled. The decision tree guiding the structure of the model was populated with clinical outcomes (surgical site infection, blood transfusion requirement and morbid cardiac events) of a hypothetical cohort of surgical patients. Implementation or non-implementation of the thermal care bundle. Net monetary benefit was calculated by multiplying the health benefits (quality-adjusted life years) by the willingness-to-pay threshold minus the cost. We tested a range of values for willingness to pay per quality-adjusted life year thresholds and plotted results for expected incremental benefits and probability of cost-effectiveness. The incremental cost-effectiveness ratio was also calculated. Thermal care bundle implementation simultaneously reduced costs and increased quality-adjusted life years in the majority of simulations (88.1%). The average cost reduction was $689,659 (95% credible intervals spanned from a $2,718,364 decrease in costs to $379,826 increase in costs) and average difference in quality-adjusted life years was 54 (95% CI = 0.4 less to 176 more). This equated to an incremental cost-effectiveness ratio of $12747 saved per quality-adjusted life year gained. It is likely that increasing use of active warming by implementing the thermal care bundle would generate cost-savings and improve the quality of life for surgical patients. It would be good value for hospitals with similar characteristics to those included in our model to allocate the extra resources required for implementation. [ABSTRACT FROM AUTHOR]

A framework for quantitative assessment of different mission architectures is described using historical data and formal (Bayesian) information value measures. The science value of the result is argued for binary questions (e.g. 'is there life on Europa?) to be proportional to the logarithm of the posterior likelihood ratio of the answers, and can be derived from estimates of the false positive rates of instrumentation and of the presence (P D) of biosignatures at a given site. The expectation payoff is the product of the sought result with Markovian success probabilities of the required steps of launch, landing, sample acquisition etc., and historical planetary mission data are reviewed to derive (sometimes dismaying) estimates of these probabilities, e.g. historical landing successes rates are of the order of 66% and when landing is successful, the conditional rates of individual sample acquisition/analysis/return have similar values. The history of seafloor exploration on Earth is used as an analog, and indicates that in the absence of close reconnaissance data, P D may have rather low values of the order of 1% or less. The data acquisition success framework is demonstrated on the value of single versus multiple landers, on the choice of flyby altitudes for multiple plume fly-through missions, and on the value of surface mobility, which for small values of P D multiplies the science return by the number of sites visited. Bayesian reasoning requires encapsulation of prior information: while such estimates (of biosignature presence, false alarm rates, etc.) are inevitably subjective, the decomposition of that information onto specific factors affords transparency into their contribution to the final result and provides a basis for rational mission evaluation. [ABSTRACT FROM AUTHOR]

The predictive coding account of psychosis postulates the abnormal formation of prior beliefs in schizophrenia, resulting in psychotic symptoms. One domain in which priors play a crucial role is visual perception. For instance, our perception of brightness, line length, and motion direction are not merely based on a veridical extraction of sensory input but are also determined by expectation (or prior) of the stimulus. Formation of such priors is thought to be governed by the statistical regularities within natural scenes. Recently, the use of such priors has been attributed to a specific set of well-documented visual illusions, supporting the idea that perception is biased toward what is statistically more probable within the environment. The Predictive Coding account of psychosis proposes that patients form abnormal representations of statistical regularities in natural scenes, leading to altered perceptual experiences. Here we use classical vision experiments involving a specific set of visual illusions to directly test this hypothesis. We find that perceptual judgments for both patients and control participants are biased in accordance with reported probability distributions of natural scenes. Thus, despite there being a suggested link between visual abnormalities and psychotic symptoms in schizophrenia, our results provide no support for the notion that altered formation of priors is a general feature of the disorder. These data call for a refinement in the predictions of quantitative models of psychosis. [ABSTRACT FROM AUTHOR]

• Confidence intervals (CI) measure the uncertainty around effect estimates. • Frequentist 95% CI: we can be 95% confident that the true estimate would lie within the interval. • Bayesian 95% CI: there is a 95% probability that the true estimate would lie within the interval. • Decision-making should not be made considering only the dichotomized interpretation of CIs. • Training and education may enhance knowledge related to understanding and interpreting CIs. Reporting confidence intervals in scientific articles is important and relevant for evidence-based practice. Clinicians should understand confidence intervals in order to determine if they can realistically expect results similar to those presented in research studies when they implement the scientific evidence in clinical practice. The aims of this masterclass are: (1) to discuss confidence intervals around effect estimates; (2) to understand confidence intervals estimation (frequentist and Bayesian approaches); and (3) to interpret such uncertainty measures. Confidence intervals are measures of uncertainty around effect estimates. Interpretation of the frequentist 95% confidence interval: we can be 95% confident that the true (unknown) estimate would lie within the lower and upper limits of the interval, based on hypothesized repeats of the experiment. Many researchers and health professionals oversimplify the interpretation of the frequentist 95% confidence interval by dichotomizing it in statistically significant or non-statistically significant, hampering a proper discussion on the values, the width (precision) and the practical implications of such interval. Interpretation of the Bayesian 95% confidence interval (which is known as credible interval): there is a 95% probability that the true (unknown) estimate would lie within the interval, given the evidence provided by the observed data. The use and reporting of confidence intervals should be encouraged in all scientific articles. Clinicians should consider using the interpretation, relevance and applicability of confidence intervals in real-world decision-making. Training and education may enhance knowledge and skills related to estimating, understanding and interpreting uncertainty measures, reducing the barriers for their use under either frequentist or Bayesian approaches. [ABSTRACT FROM AUTHOR]

In this study, a general methodology that is based on numerical models and statistical analysis is developed to assist in the definition of marine litter cleanup and mitigation strategies at an estuarine scale. The methodology includes four main steps: k-means clustering to identify representative metocean scenarios; dynamic downscaling to obtain high-resolution drivers with which to force a transport model; numerical transport modelling to generate a database of potential litter trajectories; and a statistical analysis of this database to obtain probabilities of litter accumulation. The efficacy of this methodology is demonstrated by its application to an estuary along the northern coast of Spain by comparing the numerical results with field data. The necessary criteria to ensure its applicability to any other estuary were provided. As the main conclusion, the developed methodology successfully assesses the litter distribution in estuaries with minimum computational effort. • Clustering and numerical models enable the study of litter distribution in estuaries. • K-means successfully describe biweekly multivariable ocean states. • Estuarine physical features implemented in transport models influence accumulations. • Marine litter tends to accumulate near litter sources and on beaches. [ABSTRACT FROM AUTHOR]

This paper proposes a stochastic shortest path approach to find an optimal sequence of tests to confirm or discard a disease, for any prescribed optimality criterion. The idea is to select the best sequence in which to apply a series of available tests, with a view at reaching a diagnosis with minimum expenditure of resources. The proposed approach derives an optimal policy whereby the decision maker is provided with a test strategy for each a priori probability of disease, aiming to reach posterior probabilities that warrant either immediate treatment or a not-ill diagnosis. [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorder (ASD) have a high prevalence of co-occurring medical conditions, including speech, sleep, and gastrointestinal disorders (constipation and feeding difficulties); developmental delay; attention deficit/hyperactivity disorder; hypotonia; epilepsy; anxiety; disruptive behavior; pica; and eczema. Less is known about whether these commonly coexist in the same children. We sought to determine clinically meaningful, statistically significant associations among co-occurring medical conditions in children with ASD that could lead to better understanding, identification, and treatment of these disorders. We studied 2114 children with ASD aged 17 months to 5years and 1221 children aged 6 to 17years at 15 Autism Speaks Autism Treatment Network Registry sites. Clinician-reported diagnoses and problems were grouped into 12 core conditions. We determined the observed prevalence (O) of co-occurring conditions and the estimated expected prevalence (E) across the network, adjusting for sitevariability in the prevalence of individual conditions. P values were calculated using a Cochran–Mantel–Haenszel test stratified by site. We identified pairs of conditions co-occurring more frequently than expected (O/E >1) and less frequently than expected (O/E <1) and highlighted statisticallysignificant differences. Among the 66 condition pairs for each age group, we confirmed previously identified associations, such as sleep disorders and anxiety symptoms, in older children. We found some associations not previously described, including feeding with sleep disorders (younger children only), constipation with sleep disorders, feeding with speech disorders, and constipation with speech disorders. We have identified new associations among co-occurring medical conditions in children with ASD, offering the potential to examine common pathways. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the validity and reliability of standing posture assessments in asymptomatic men using the PostureScreen Mobile (PSM) iOS application. The standing posture of 50 asymptomatic male participants (24.04 ± 1.81 years) was measured during 3 trials on the same day. The following 10 measurements using the PSM app were compared to the criterion VICON 3-dimensional analysis: from the frontal plane, shift and tilt of the head, shoulders, and hips; and from the sagittal plane, shift of the head, shoulders, hips, and knees. We used Bayesian methods to analyze the data. Compared with the VICON measurements, PSM assessments of head tilt, shoulder tilt and shift, and hip tilt and shift in the frontal plane were biased. In the sagittal plane, PSM measurements of shoulder, hip, and knee shift were biased. Only head shift in the frontal and sagittal planes were comparable between the VICON and the PSM. The VICON and PSM had similar intraclass correlations in 6 of 10 measurements. The PSM assessments of head shift and tilt and shoulder tilt in the sagittal plane were significantly less reliable than with VICON. The use of the PSM app introduced significant bias in postural measurements in the frontal and sagittal plane. Until further research reports additional validity and reliability data of the PSM app, we suggest caution in the use of PSM app when highly accurate postural assessments are necessary. [ABSTRACT FROM AUTHOR]

Abstract Objective Identify differences in teacher perceptions of benefits, challenges, and preferences to different School Breakfast Program (SBP) service models. Design A cross-sectional study design was used and an electronic survey was distributed to teachers throughout the state of Utah. Setting Kindergarten through 12th-grade schools throughout Utah. Participants A convenience sample of 369 kindergarten through 12th-grade teachers in Utah. Variables Measured Demographics, benefits and challenges, and teacher preference for SBP models in Utah. Analysis Frequencies and multiple comparison analysis tests were performed. A level of significance of <.001 was chosen to protect for multiple comparisons. Results Traditional breakfast was the most preferred model, with a mean score of 2.8; Breakfast in the Classroom was the least preferred model by teachers, with a mean of −1.3 (scale used = −5 to 0 to 5). Children not going hungry was the greatest benefit (95.4%; n = 352) to SBP and food waste was the greatest challenge (45.8%; n = 168). Conclusions and Implications Teachers prefer traditional SBP model over BIC and other nontraditional models. Increased awareness and education regarding benefits and challenges of SBP models may increase teacher preference for nontraditional SBP models, especially BIC. [ABSTRACT FROM AUTHOR]

Abstract Objective To evaluate the impact of a vegetable-focused cooking skills and nutrition program on parent and child psychosocial measures, vegetable liking, variety, and home availability. Design Baseline and postcourse surveys collected 1-week after the course. Setting Low-income communities in Minneapolis–St Paul. Participants Parent–child dyads (n = 89; one third each Hispanic, African American, and white) with complete pre-post course data; flyer and e-mail recruitment. Intervention(s) Six 2-hour-weekly sessions including demonstration, food preparation, nutrition education lessons, and a meal. Main Outcome Measures Parental cooking confidence and barriers, food preparation/resource management, child self-efficacy and cooking attitudes, vegetable liking, vegetable variety, and vegetable home availability. Analysis Pre-post changes analyzed with paired t test or Wilcoxon signed-rank tests. Results were significant at P <.05. Results Increased parental cooking confidence (4.0 to 4.4/5.0), healthy food preparation (3.6 to 3.9/5.0), child self-efficacy (14.8 to 12.4; lower score = greater self-efficacy), vegetable variety (30 to 32/37 for parent, 22 to 24/37 for child), and home vegetable availability (16 to 18/35) (all P <.05). Conclusions and Implications A short-term evaluation of a vegetable-focused cooking and nutrition program for parents and children showed improvements in psychosocial factors, variety, and home availability. [ABSTRACT FROM AUTHOR]

Abstract Objective To examine factors related to attendance of Mexican-heritage parents at community-based nutrition classes to prevent childhood obesity. Methods Starting in 2011, interviewers collected baseline data from Niños Sanos Familia Sana ( Healthy Children, Healthy Families ) participants in rural California. Educators maintained attendance logs from 2012 to 2014. Informed by the Theory of Planned Behavior, interviewers administered an exit survey in 2015 to collect data on attitudes, subjective norms, health motivations, and perceived control related to attendance. Multivariable ordinal logistic regression analysis examined the correlates of attendance (n = 194, intervention group only). Results Controlling for mother's age, marital status, acculturation, and employment, attitudes and subjective norms were significantly related to attendance (odds ratio = 1.27; 95% confidence interval [CI], 1.18–1.37; P <.001). Conclusions and Implications In these Mexican-heritage participants, attitudes and subjective norms were significant correlates of attendance. The Theory of Planned Behavior may shed light on attendance of high-risk groups but further testing of instruments is needed. [ABSTRACT FROM AUTHOR]

Aims There are limited data on dosimetric correlates of toxicity in stereotactic body radiotherapy (SBRT) for prostate cancer. We aimed to identify potential relationships between dose and toxicity using conventional dose–volume histograms (DVHs) and dose–surface maps (DSMs). Materials and methods Urinary bladder trigone and rectum DSMs were produced for a single-institution service evaluation cohort of 50 patients receiving SBRT for localised prostate cancer, together with conventional DVHs for bladder and rectum. Patients had been prospectively recruited to this cohort and treated according to a pre-defined protocol to a dose of 36.25 Gy in five fractions. Radiation Therapy Oncology Group (RTOG) and International Prostate Symptom Score (IPSS) toxicity data were recorded prospectively. Logistic regression was used to identify dosimetric predictors of acute IPSS+10 (rise of 10 points or more above baseline) and grade 2+ RTOG toxicity. Results On univariate analysis, trigone area receiving 40 Gy and trigone D max were associated with IPSS+10 (odds ratio 1.06 [1.02–1.11], P = 0.007 and odds ratio 1.54 [1.06–2.25], P = 0.024, respectively). These two variables were highly correlated. In a multivariate model, including all baseline variables, trigone D max remained associated with IPSS+10 (odds ratio 1.91 [1.13–3.22], P = 0.016). These findings were not significant with Holm–Bonferroni correction for multiple testing (corrected P value threshold 0.006). No associations were seen between rectal toxicity and DVH or DSM parameters. Conclusions Our study suggests a potential relationship between high doses to the urinary bladder trigone and patient-reported urinary toxicity in prostate SBRT, and is consistent with previous studies in conventionally fractionated radiotherapy, justifying further evaluation in larger cohorts. [ABSTRACT FROM AUTHOR]

Highlights • 95% confidence interval identified more doubtful points than other studied methods. • Correction techniques do not influence the final set of RR intervals. • Selection methods may interfere with the quantity–quality of RR intervals. • The 256-point selection appears to be more sensitive to changes in autonomic function. Abstract Background Oscillation between successive sinus beats or RR intervals, termed heart rate variability, is an important marker of autonomic function of the heart. However, its analysis may be influenced by the database recorded based on the occurrence of interference. Objective To evaluate if the techniques of identification and editing of artifacts, as well as the selection methods of RR intervals, can interfere with heart rate variability analysis. Methods The RR intervals of 56 subjects (30 aortic stenosis patients, 14 physically active individuals, 12 amateur athletes) were recorded for 10 min using a heart rate monitor. Values with differences greater than 20%, higher than three standard deviations or outside of the normal curve (95% confidence interval) were considered artifacts. These points were corrected through data replacement, adjacent, linear and polynomial interpolation, or excluded. Then, the 256 highest stability points and the last 5 min of recordings were chosen. The software programs, Kubios HRV and GraphPAD , were used to calculate and to analyze the indices of heart rate variability, respectively. Results Strong agreement was observed among the identification algorithms; there was no difference between the correction techniques (p = 0.95); and the selection methods exhibited different sections (p < 0.01) with a direct influence on approximated entropy (p < 0.05). Conclusion With short-term recordings, selection methods may interfere with the non-linear heart rate variability analysis. The confidence interval, the replacement by the average of previous data and the selection of 256 of the highest stability points of the signal seem to be the most adequate procedures to treat the data with prior to analysis. [ABSTRACT FROM AUTHOR]

Highlights • This study examined the influence of glaucoma on gait, functional tests and fall risk. • Visual contrast sensitivity and proprioception were different between glaucoma and control groups. • Dynamic Gait Index-Brazil score was significantly different between glaucoma and control groups. • Glaucoma group spent more time to perform the Timed Up and Go test than control group. • Glaucoma group presented higher fall risk compared to the control group. Abstract Objective This study investigated the influence of early to moderate primary open angle glaucoma on gait, functional mobility and fall risk. Methods Thirty-three participants in the early and moderate stages of primary open angle glaucoma and 34 asymptomatic controls participated in the study. Spatiotemporal gait data were obtained with the GAITRite system and included: velocity, cadence, step length, base of support, swing, stance and double support times. Functional measures included the Timed Up and Go test, the Five-Repetition Sit-To-Stand test and the Dynamic Gait Index. Fall risk was measured using the Physiological Profile Assessment. Results The variables contrast sensitivity, proprioception and the Timed Up and Go and Dynamic Gait Index tests were significantly different between groups. In addition, the glaucoma group presented significantly higher risk of falling compared to the control group. Individuals in the early and moderate stages of primary open glaucoma presented mobility and sensory deficits that increase the risk of falling. Conclusions The results of this study suggest that adding the Timed Up and Go and Dynamic Gait Index tests to routine physical therapy assessment of individuals with early glaucoma could be useful. Rehabilitation programs should focus on maintaining and/or improving mobility and balance, and prevention of falls in this population. [ABSTRACT FROM AUTHOR]

Abstract Suicide prevention training recommended as part of national suicidal strategies across the UK has contributed to a reduction in suicide. Previous studies have found suicide prevention training changes attitude and increases confidence in ability to utilise suicide prevention strategies. There is limited evidence relating to the different responses to suicide prevention training by females and males. As the majority of nurses are female it is important to know if they report the same increases in confidence after suicide prevention training. An exploratory study utilising a survey design and repeated measures was used to investigate the effect of SafeTALK training on the level of general perceived self-efficacy (GPSE) in student nurses and to observe for any gender-related differences. A sample (N = 128) of first year student nurses were asked to complete a GPSE assessment pre and post SafeTALK training. Males reported higher scores on both total pre and post-training scores of GPSE and on mean scores per question compared to females. An effect of time (F (1, 118) = 20.07, p =.001) but no effect of gender (F (1, 118) = 3.53, p =.06) was found. A post-hoc sample size calculation revealed that a replication of the current investigation with a sample size of N = 15 (males), N = 155 (females), would be likely to find a statistically significant difference between genders in GPSE scores. It may be prudent to consider joint facilitation, with both male and female facilitators of SafeTALK training sessions. Specific pedagogical strategies can also be used to promote an increase in self-efficacy in those people undertaking SafeTALK training. Highlights • Suicide prevention training has contributed to the reduction in suicides. • Suicide prevention training increases confidence in utilising suicide prevention strategies. • There was a significant increase in self-efficacy over time. • A sample of 15 = males, 155 = females would have found a significant gender difference. • There are implications for the way in which SafeTALK training is delivered. [ABSTRACT FROM AUTHOR]

Many real-world systems are classified as phased-mission systems (PMSs). These systems involve multiple, consecutive, non-overlapping phases of operations, where system configuration and component behavior can vary from phase to phase due to changing tasks and environmental conditions. In addition, statistical dependencies exist across phases for a given component. These dynamic, dependent behaviors make reliability analysis of PMSs more challenging than single-phase systems. Further complicating the PMS analysis is the probabilistic functional dependence behavior where operations of some system components (referred to as probabilistic-dependent components) rely on functions of other components (referred to as trigger components) with certain probabilities. Time-domain competitions exist between a trigger component failure and propagated failures of related probabilistic-dependent components; different occurrence sequences can cause distinct system statuses. This paper models effects of phase-dependent, probabilistic competing failures, and suggests a multiple-valued decision diagram-based combinatorial procedure for reliability analysis of non-repairable PMSs. The method is applicable to arbitrary types of time-to-failure distributions for system components and probabilistic isolation factors, as well as different statistical relationships between local and propagated failures of the same component. A case study is presented to illustrate applications and advantages of the proposed method. Correctness of the method is verified using Monte Carlo simulations. [ABSTRACT FROM AUTHOR]

Background: The relative importance of individual and country-level factors influencing access to diagnosis and treatment for depression across the world is fairly unknown.Methods: We analysed cross-national data from the WHO World Health Surveys. Depression diagnosis and access to health care were ascertained using a structured interview. Logistic Bayesian Multilevel analyses were performed to establish individual and country level factors associated with: (1) receiving a diagnosis and (2) accessing treatment for depression if a diagnosis was ascertained.Results: The sample included 7870 individuals from 49 countries who met ICD-10 criteria for depressive episode in the past 12 months. A third (32%) of these individuals had ever been diagnosed with depression in their lifetime. Among those diagnosed with depression, 66% reported to have ever received treatment for depression. Although individual factors were more important determinants of access to treatment for depression, country-level factors explained 27.6% of the variance in access to diagnosis and 24.1% in access to treatment. Access to treatment for depression improved with increasing country income. Female gender, better education, the presence of physical co-morbidity, more material assets, and living in urban areas were individual level determinants of better access.Limitations: Data on other contextual factors was not available. Unmet need was likely underestimated, since only lifetime treatment data was available.Conclusion: This study highlights major inequalities in access to a diagnosis and treatment of depression. Unlike the prevalence of depression, where contextual factors have shown to have less importance, a significant proportion of the variance in access to depression care was explained by country-level income. [ABSTRACT FROM AUTHOR]

Abstract Objective The purpose of this study was to determine the prevalence of musculoskeletal disorders among Iranian physical therapists. Methods A cross-sectional study was carried out. An online survey was completed by Iranian physiotherapists from June 2017 to August 2017. A total of 333 online questionnaires were sent, and 319 questionnaires were fully completed and used for data analysis. The Persian version of the Nordic Questionnaire was the main outcome measurement. This questionnaire identified work-related pain or discomfort in 9 parts of the body, including: (1) neck, (2) shoulder, (3) elbow, (4) wrists, (5) upper back, (6) lumbar, (7) thighs, (8) knee, and (9) ankle. Results The findings of this study showed the prevalence of musculoskeletal disorders was 94% in Iranian physiotherapists. Lumbar (65%), neck (57.4%), shoulder (50.2%), upper back (49%), and knee (45.5%) were the most prevalent regions of these disorders. While ankle (19.7%) and elbow (21.6%) disorders showed the lowest prevalence. Conclusion The prevalence of work-related musculoskeletal disorders was high in Iranian physiotherapists, especially in the lumbar, neck, shoulder, and upper back regions. [ABSTRACT FROM AUTHOR]