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Purpose: To compare (1) fluid, food and nutrient intake obtained with a paper versus an online version of a 7-day food record and (2) user's acceptability of both versions of the food record. Methods: A cross-over study was carried out in 2010 in France. A total of 246 participants aged 18-60 years reported their food and fluid intake using both versions of the 7-day food record, separated by a 7- to 14-day washout period. To help participants in estimating consumed portions, both versions of the food record were supported by a photographic booklet of standard portions and containers. At the end of the study protocol, participants completed a questionnaire designed to assess the acceptability of the two questionnaires. Results: The reported water intake of fluids was significantly higher with the online version compared with the paper version (respectively 1348 ± 36 and 1219 ± 34 mL/day, p < 0.0001). No difference was found between methods in terms of energy intake and the consumption of most food categories, macro- and micronutrients. Furthermore, 77 % of the participants preferred the online method to the paper version. Conclusions: Fluid intake, but not food intake, reported with the online 7-day food record was higher in comparison with the paper version. In addition, the online version was preferred by users. In population surveys, the online record is therefore a relevant alternative, and even a preferred alternative in the case of fluid intake, to the paper record. [ABSTRACT FROM AUTHOR]

Purpose: To give an overview of the multicenter Prostate Cancer Outcomes (PCO) study, involving paper-based and web-based collection of patient-reported outcome measures (PROM) in patients undergoing local treatment for prostate cancer in certified centers in Germany. The PCO study is part of the larger Movember-funded TrueNTH Global Registry. The article reports on the study's design and provides a brief progress report after the first 2 years of data collection. Methods: Prostate cancer centers (PCCs) certified according to German Cancer Society requirements were invited to participate in collecting patient-reported information on symptoms and function before and at least once (at 12 months) after treatment. The data were matched with disease and treatment information. This report describes progress in patient inclusion, response rate, and variations between centers relative to online/paper use, and also data quality, including recruitment variations relative to treatment in the first participating PCCs. Results: PCC participation increased over time; 44 centers had transferred data for 3094 patients at the time of this report. Patient recruitment varied widely across centers. Recruitment was highest among patients undergoing radical prostatectomy. The completeness of the data was good, except for comorbidity information. Conclusions: The PCO study benefits from a quality improvement system first established over 10 years ago, requiring collection and harmonization of a predefined clinical dataset across centers. Nevertheless, establishing a PROM routine requires substantial effort on the part of providers and constant monitoring in order to achieve high-quality data. The findings reported here may be useful for guiding implementation in similar initiatives. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the development of the paper-based Hajji Health Record (PHHR) instrument. Topics covered include the conduct of a survey among physicians in Alnoor Specialist Hospital in Saudi Arabia, the supportive effects of electronic health record system on health care and the need for standard-based health information technology to get quality of care.

In the present school-based study, a convenience sample of 477 students in grades 6-9 and second year in high school from a city and a smaller town recorded daily occurrence and intensity of headaches in a standard paper diary during a 3-week period. Total headache activity (headache sum), number of headache days, intensity level and duration for weekly headaches were estimated. Approximately 85% of the adolescents had experienced headache of any intensity level during the 3-week recording period. On the average, they reported 2.5 headache days per week and a mean intensity level for headache episodes of 1.7. Our estimates for headache of any intensity level (1-5) occurring at least once a week was surprisingly high (73.8%). For the highest intensity level across the whole 3-week period, almost identical proportions of mild and moderate headaches were reported by students (22.3-22.5%), while about twice as many (40.7%) had experienced severe headaches. Girls consistently reported more headaches than boys, in particular of the moderate and severe intensity types. Students in the city also reported more frequent and intense headaches than those in the town. Peak headache activity was observed at noon and in the afternoon and in the days from the middle of the week until weekend. The use of prospective recordings in diaries will further advance our knowledge on the prevalence and characteristics of recurrent headaches among children and adolescents in community samples. [ABSTRACT FROM AUTHOR]

Purpose: To extend knowledge about measurement equivalence of depression measures assessed by tablet and paper-pencil administration, the present study evaluated the effect of mode of administration (MoA) on scale and item level for the Patient Health Questionnaire (PHQ-9) and the Aachen Depression Item Bank (ADIB) in elderly patients.Methods: Primary care patients (N = 193, ≥60 years) were assessed following a crossover design in Leipzig, Germany. All participants filled out the PHQ-9 and the ADIB in both MoAs under study. Effects of MoA were analyzed by intra-class correlation, mixed-effects regression, and differential item functioning (DIF). Additionally, detection rates between both MoAs were compared using receiver operating characteristics analysis compared to a diagnostic interview (SCID-I, N = 163).Results: No effect of MoA was found in the PHQ-9 on scale score or item level. Two ADIB items showed DIF according to MoA. In terms of discriminatory power, MoA did not influence detection rates of both instruments.Conclusions: In summary, our findings suggest that no severe effect of mode of administration on self-report assessments of depression should be expected. It can be concluded that tablets provide a valid way to electronically assess depressive symptoms in elderly patients. Yet changes in item presentation can influence the psychometric properties and require equivalence testing using sophisticated analyses on item level such as DIF. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present cross-sectional study was to compare the interocclusal contact records obtained by three different digital methods (intra- and extraoral digital scanners and T-Scan III system) with the conventional method (articulating paper). Materials and methods: Twenty-five healthy volunteers were selected. As a control group, maximum intercuspation occlusal contacts were registered and photographed from the patients with an 8 µm articulating paper. Then, intraoral conventional elastomer impressions were taken and after obtaining the corresponding plaster models of every patient they were scanned with an extraoral scanner (Zfx Evolution, Zimmer Biomet Dental) (group 1). Moreover, digital impressions were made with an intraoral scanner (Trios Color POD, Phibo, 3Shape) and contacts were also registered (group 2). Finally, T-Scan III records were made and stored for further analysis (group 3). Two previously calibrated examiners independently evaluated the interocclusal contacts from every group. Data was analyzed by using Kappa index test and Pearson's chi-square test. Diagnostic tests and ROC curve were also performed. Results: Kappa interoperator index was 70.6% (better agreement). In Kappa intraoperator index, the best value was obtained in the intraoral scanner group (moderate agreement) and the worst with T-Scan III group (low agreement). ROC curve showed highest values in the intraoral scanner group (0.817) and lowest values in the T-Scan III group (0.613). Conclusion: Results suggest greater reliability to record occlusal contacts with the intraoral scanner. Clinical relevance: Intraoral scanners seem to be reliable in registering intermaxillary occlusal contacts when compared with the current gold standard. [ABSTRACT FROM AUTHOR]

This systematic review aims to give an overview of the diversity of research areas related to human biometeorology in Brazil. The main focus of this paper addresses research trends, represented by published papers with national and international authorship, main contributions and shortcomings, as well as challenges and prospects of research in this area of study. An extensive literature search was conducted in the Scopus, Web of Science, and Science Direct databases so as to identify relevant publication output up to July 2021 related to the research area. The screening resulted in 96 studies chosen for full-text reading. Overall, results indicated a reduced amount of articles on the subject matter published internationally, with noticeable gaps in research in some regions of the country, such as the Amazon region and in the Brazilian Midwest region. Research gaps in relevant areas have been identified with limited output in the climate dimensions of tourism, vector-borne diseases, mortality and morbidity in urban centers. Such gaps should further encourage researchers to engage in research focused on those areas. [ABSTRACT FROM AUTHOR]

Introduction: With shifting demographics and declining response rates, state and national health surveys are considering mixed mode approaches. Most states field the Pregnancy Risk Assessment Monitoring System (PRAMS) surveillance project, but few have studied the effect of encouraging online responses. Methods: Like PRAMS, the 2016 Ohio Pregnancy Assessment Survey interviewed new mothers 2–4 months after delivery (n = 3382). Fielding included a traditional mailed paper questionnaire with telephone follow-up protocol and two experiments: a rotating web invitation added a web survey link at different points during the mail protocol, and a push-to-web protocol asked women to complete the survey online before mailing a questionnaire. This analysis examined the responses rates and tested for unweighted demographic differences using Pearson's chi-square. Results: The unweighted response rate was highest with the traditional contact protocol (30.0%) and slightly lower among the rotating web invite (27.4%) and the push-to-web (25.5%) groups. Nearly two-thirds (64%) of push-to-web protocol respondents completed the survey online, with 70% of those web surveys submitted before the first paper questionnaire was mailed. Women who responded to the web versus mail surveys were similar on most characteristics, although in both experimental groups, women who completed the web version were more likely to be college educated. Among the push-to-web group, 60% of web and 36% of mail respondents had a 4-year college degree (p <.001). Discussion: Given the potential for push-to-web to shift respondents to an online survey without greatly impacting response rates, researchers should continue to examine the utility of incorporating a web mode in surveys of new mothers. [ABSTRACT FROM AUTHOR]

Introduction: Smartphone applications (apps) for pharmacovigilance present an opportunity for integration as cost-effective healthcare service intervention into basic healthcare services in low-resource settings. This study aimed to (i) evaluate the implementation of the Med Safety app in Burkina Faso, and (ii) compare the characteristics of the reports sent by the Med Safety app with those sent on paper form. Methods: The study had two components: (i) a cross-sectional online survey assessing the Med Safety app, and (ii) a retrospective analysis comparing the characteristics of the Med Safety reports with those of the paper form, received by the National Pharmacovigilance Centre of Burkina Faso (CNVPS), from January 1, 2021 to December 31, 2022. We evaluated the success of the implementation of the Med Safety intervention using measures of acceptability, usefulness and feasibility. This assessment involved a set of 14 items rated on a 4-point Likert scale. Acceptability, feasibility, and usefulness were determined based on achieving a total score higher than the mean. Subsequently, we computed the proportion of participants whose overall score for all items exceeded the mean. Continuous and categorical variables were compared using the Wilcoxon rank-sum test and the Chi2 test, respectively. The significance level of the statistical test was set at 5%. Results: The survey participation rate was 51.9% (160/308). Half of the respondents were in the 35-44 age group (50.6%), and participants were predominantly male (71.9%). The Med Safety app was acceptable, feasible, and useful to 58.1% of respondents. The most useful features of the app were "reporting" (53.1%), "news" (13.6%) and "watch list" (12.4%). During the period, a total of 1,472 reports were received, including 357 (24.3%) through Med Safety and 1,115 (75.7%) through the paper form. The reports of adverse events following immunization received at the CNVPS numbered 974 (66.2%), these were related to COVID-19 vaccines, with 256 (26.3%) through the Med Safety and 718 (73.7%) through the paper form. The median time to submit the reports to the CNVPS was 159 (IQR 59–187) days for the Med Safety and 166 (IQR 107–281) days for the paper form (p < 0.001). Conclusion: In Burkina Faso, the Med Safety was found to be acceptable, useful, and feasible by users surveyed. In addition, and compared to the paper form, the app reduces the time to submit a report, and with increase in use, the reporting timeframe could be further improved. [ABSTRACT FROM AUTHOR]

This is the second in a series of studies assessing the usability and reliability of a novel voice-based delivery system of mental health screening assessments. The previous study demonstrated the reliability and patient preference of a voice-based format of the Patient Health Questionnaire 9 (PHQ 9) for measuring major depression compared to a traditional paper format. Through this study, we further examined the Amazon Alexa tool in the administration of the General Anxiety Disorder 7 (GAD 7). With a replicated methodology to the first study, 40 newly administered patients completed the GAD 7 in one format at their first session and the alternate format at their follow up. Results from the new in clinic population replicated the findings observed in the first PHQ 9 study: GAD 7 assessment scores for the Alexa and paper version showed a high degree of reliability (α = 0.77), patients showed higher overall positive attitudes for the voice-based GAD 7 format, and subscales for attractiveness, stimulation, and novelty were significantly higher for the voiced-based format. Results also demonstrated 42 (84%) of the 50 patients who completed the voice-based format responded as being willing to use the device from home. With new recommendations of universal screening of anxiety disorders for patients below the age of 65 and rapid changes in virtual mental healthcare, convenient screenings are more important than ever. We believe this novel clinical assessment tool has the potential to improve patient behavioral healthcare while mitigating the workload of healthcare professionals. [ABSTRACT FROM AUTHOR]

Security of medical images over an unsecured channel is a challenging task, and for this, several methods have been designed recently. The present paper is also in the same direction, and is an attempt to improve the security of the existing methods. In this paper, a cryptosystem is proposed, which performs encryption and decryption in the CBC (Cipher Block Chaining) mode of operation, and attains the confusion-diffusion properties using the PSN (Permutation-Substitution Network) of cryptography. The permutation is performed by a composite operation, consisting of rotation (via special orthogonal group), reflection, flipping, and pixel-wise shuffling, while substitution is performed by a composite operation of multiplication and multiplicative inverse over Galois field. The Archimedes' constant is utilized for constructing Initialization Vector (IV) to be used in the CBC mode of encryption (and decryption). The proposed approach is able to encrypt monochrome (8-bit, 10-bit, 12-bit, and 16-bit), palette color, and 24-bit color medical images, simultaneously into noisy-like images from the human visual as well as the statistical point of view. The designed approach is empirically assessed via several statistical and security evaluation metrics, such as key sensitivity, chi-squared test, number of pixel change rate, avalanche effect, poker test, peak signal-to-noise ratio, etc. The results of these metrics support the objectives of our proposed approach. Moreover, a thorough comparison is also made with the recent state-of-the-art existing methods. [ABSTRACT FROM AUTHOR]

The growth of Internet and the services provided by it has been growing exponentially in the past few decades. With such growth, there is also an ever-increasing threat to the security of networks. Several efficient countermeasures have been placed to deal with these threats in the network, such as the intrusion detection system (IDS). This paper proposes an ensemble learning-based method for building an intrusion detection model. The model proposed in this paper has relatively better overall performance than its individual classifiers. This ensemble model is constructed using lightweight machine learning models, i.e., Gaussian naive Bayes, logistic regression and decision tree as the base classifier and stochastic gradient descent as the meta-classifier. The performance of this proposed model and the individual classifiers used to build the ensemble model is trained and evaluated using three datasets, namely, KDD Cup 1999, UNSW-NB15 and CIC-IDS2017. The performance is evaluated for binary class as well as multiclass classifications. The proposed method also incorporates the usage of a feature selection method called Chi-square test to select only the most relevant features. The empirical results definitively prove that using an ensemble classifier can be immensely helpful in the field of intrusion detection system with unbalanced datasets where misclassifications can be costly. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Moments of the Product and Ratio of Two Correlated Chi-Square Variables," by A. H. Joarder in a 2007 issue.

The lives of caregivers can be deeply impacted by having a child with a developmental disability (DD). To offset those impacts, caregivers may engage in accommodations, or strategies to bolster everyday functioning. The nature and extent of these accommodations can provide insight into how the family is doing and what supports are needed from a family-centered perspective. This paper presents the development and preliminary validation of the Accommodations & Impact Scale for Developmental Disabilities (AISDD). The AISDD is a rating scale that measures day-to-day accommodations and impacts of raising a child with a DD. A sample of 407 caregivers of youth with DDs (Mage = 11.7 years; 63% males) completed the AISDD, along with measures of caregiver strain, daily challenges, child adaptive behavior, and behavior and emotional regulation. The AISDD is a unidimensional, 19-item scale with excellent internal consistency (ordinal alpha =.93) and test–retest (ICC =.95) reliability. Scores were normally distributed and sensitive to age (r = −.19), diagnosis (ASD + ID > ASD > ID), adaptive functioning (r = −.35), and challenging behaviors (r =.57). Finally, the AISDD showed excellent convergent validity with similar measures of accommodations and impacts. These findings support the use of the AISDD as a valid and reliable tool for measuring accommodations among caregivers of individuals with DDs. This measure shows promise in its ability to identify which families may need additional support for their children. [ABSTRACT FROM AUTHOR]

Time series forecasting is an important application of many statistical methods. When it is appropriate to assume that the data may be projected towards the future based on the past history of the dataset, a preliminary examination is usually required to ensure that the data sequence is autocorrelated. This is a quite obvious assumption that has to be made and can be the object of a formal test of hypotheses. The most widely used test is the portmanteau test, i.e., a sum of the squared standardized autocorrelations up to an appropriate maximum lag (the truncation point). The choice of the truncation point is not obvious and may be data-driven exploiting supplementary information, e.g. the largest autocorrelation and the lag where such maximum is found. In this paper, we propose a portmanteau test with a truncation point equal to the lag of the largest (absolute value) estimated autocorrelation. Theoretical and simulation-based comparisons based on size and power are performed with competing portmanteau tests, and encouraging results are obtained. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the therapeutic effects of TNF-α blockers on ulcerative colitis (UC) and their safety. Methods: Randomized controlled trials (RCTs) of TNF-α blockers for treatment of UC were retrieved from databases. Heterogeneity test was performed on all data to select effects models. Finally, sensitivity analysis was carried out, and a funnel plot was drawn to evaluate publication bias. Results: A total of nine RCTs conformed to the inclusion criteria. Of 1,226 patients with UC, 806 were given a TNF-α blocker, and 420 were given placebo or other drugs as control. Infliximab was used in eight papers and adalimumab in one paper. Placebo was used in seven papers and hormones in two papers. Short-term response, short-term relief, long-term response, and long-term relief were better in the TNF-α blocker group than in the control group ( P < 0.05). TNF-α blockers decreased the colectomy rate ( P < 0.05). There were no significant differences in mucosal healing and quality of life between the two groups ( P > 0.05). The rates of adverse reactions were similar in the two groups ( P > 0.05), but the rate of severe adverse reactions was significantly lower in the TNF-α blocker group than in the control group ( P < 0.05). The funnel plot of each parameter was symmetrical with the lower part broader than the upper. Conclusions: TNF-α blockers have better therapeutic effects on moderate or severe UC, which shows little response to conventional therapy. TNF-α blockers can induce short-term response, maintain long-term clinical response and clinical relief, and decrease the colectomy rate and the severe adverse reaction rate, but they fail to improve quality of life and mucosal healing. [ABSTRACT FROM AUTHOR]

Common strategies employed in preventing STI/AIDS transmission among young adults in America include abstinence, monogamy and safer sex. These strategies require a high level of vigilance and responsibility and, according to inner city participants in Project PHRESH.comm, neither option is always desirable, available, or rational in the context of their lived experiences. This article reports findings from Project PHRESH.comm, a mixed-method, ethnographic study incorporating data from focus group discussions, semi-structured interviews, coital diaries, systematic cultural assessments and a structured survey designed to explore concepts of risk and decision making about condom use among at risk African American and Puerto Rican young adults aged 18-25 years in Hartford, CT. We found that many young adults from our study population rely on a strategy of using clinic-sponsored STI/AIDS screening when wanting to discontinue condom use with a partner. While our data suggest that screening is a common strategy used by many couples to transition to having sex without a condom, the data also show that most youth do not maintain monogamy even in long-term, serious relationships. Thus, sharing test results may provide a false sense of security in the sexual culture of inner city, minority youth. [ABSTRACT FROM AUTHOR]

The aim of the study is to assess the feasibility of Drugs Rational Usage Guideline System (DRUGS)-supported clinical pathway (CP) for breast carcinoma, cataract, inguinal hernia and 2-diabetes mellitus whether the application of such a system could improve work efficiency, medical safety, and decrease hospital cost. Four kinds of diseases which included 1773 cases (where 901 cases using paper-based clinical pathways and 872 cases using DRUGS-supported clinical pathways) were selected and their demographic and clinical data were collected. The evaluation criteria were length of stay, preoperative length of stay, hospital cost, antibiotics prescribed during hospitalization, unscheduled surgery, complications and prognosis. The median total LOS was 1 to 3 days shorter in the DRUGS-supported CP group as compared to the Paper-based CP group for all types ( p < 0.05). Totel hospital cost decreased significantly in the DRUGS-supported CP group than that in Paper-based CP group. About antibiotics prescribed during hospitalization, there were no statistically differences in the time of initial dose of antibiotic and the duration of administration except the choice of antibiotic categories. The proportion of DRUGS-supported clinical pathway conditions where a broad-spectrum antibiotic was prescribed decreased from 63.6 to 34.5 % ( p < 0.01) in the Paper-based group. While after the intervention, the differences were statistically not significant in unscheduled surgery, complications and prognosis. In this study, DRUGS-supported clinical pathway for breast carcinoma, cataract, inguinal hernia, 2-diabetes mellitus was smoothly shifted from a paper-based to an electronic system, and confer benefits at the hospital level. [ABSTRACT FROM AUTHOR]

The paper is a study of risk assessment posed by trees in selected urban woodlands (urban forests) of Warsaw. Two groups of trees were analysed and compared: exhibiting signs of maturity and ageing (hollow-bearing trees with open or hidden cavities and/or caries) and with no signs of decay. 373 individual trees growing near routes frequently or continuously used for recreational purposes were examined using Roloff's vitality classification, and tree risk assessment method, complemented by instrumental studies: a resistance resistograph, pulling tests, and sonic tomography (SoT). The collected data was analysed using the Chi-square test. The results indicate that it is not possible to conclude unequivocally that the presence of hollows in aged trees significantly increases the risk of falling. According to the safety factor results from the SoT and pulling tests, no correlation was demonstrated between the presence of hollow trees and an increase in risk class. The highest proportion of hollow trees (89.42%) was in the low risk group for trunk fracture and uprooting. The results also indicate the coherence of the diagnostic methods to be necessary for providing sufficient information to assess the statics and, ultimately, as our study showed, the protection of hollow trees. [ABSTRACT FROM AUTHOR]

At present, there are no brief, freely-available, informant-report measures that evaluate key challenging behaviors relevant to youth with autism spectrum disorder (ASD) or other developmental disabilities (DD). This paper describes the development, refinement, and initial psychometric evaluation of a new 18-item measure, the Open-Source Challenging Behavior Scale (OS-CBS). In a large sample (n = 2004, 169 with ASD, ages 2–17), results of psychometric analyses indicated a clear factor structure (property destruction, aggression, elopement, conduct problems, and self-injury and a general factor with high loadings from all items) based on exploratory structural equation modeling, good scale reliability (α =.66–.83 for subscales, α =.91 total scale), measurement invariance across demographics, and good construct validity. The OS-CBS is a psychometrically-sound instrument for screening and monitoring intervention progress. [ABSTRACT FROM AUTHOR]

Background: To assess quality of life and unmet needs after stroke, patient-reported outcome measures (PROMs) have gained increasing attention. However, patients' perspectives on assessing PROMs remain unclear, potentially hindering implementation into clinical practice. Therefore, this study explored patients' preferences on assessing PROMs after ischemic stroke. Methods: A paper-based questionnaire was sent to stroke survivors treated at the Department of Neurology, University of Leipzig, Germany. Health-related quality of life (HRQoL, EQ-5D-5L) and preferences regarding different aspects of data collection to assess PROMs were investigated and linked to socio-demographic and medical characteristics. Results: 158 persons were contacted and 80 replies were subsequently analyzed. Mean age was 70.16 years and mean HRQoL was 68.79 (visual analogue scale with a theoretical maximum of 100). Participants showed positive attitudes towards PROMs as they saw potential to improve care of other patients (n = 66/79; 83.54%) or to improve their own situation (n = 53/74; 71.62%). Participants preferred an annual interview after stroke (n = 39/80; 48.75%) and would preferably spend 15–30 min (n = 41/79; 51.90%) to answer a written survey (n = 69/80; 86.25%). The initially treating clinic was preferred as initiator of such surveys (n = 43/79; 54.43%). Stratification revealed that participants with more than 1 h of daily digital media usage preferred email as way of communication. Conclusions: For the first time, this study showed individual preferences on assessing PROMs after ischemic stroke, focusing on the way, time interval, duration, and initiation site of surveys. These insights might help to successfully implement PROMs after stroke and subsequently detect unmet needs and deficits in stroke care. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to have youth participate in the design and implementation of a research project set within a child rights framework to better understand high schoolers' perceptions of safety in their school and community. Results: Between June 2020 and March 2021, a team of East Harlem, New York high school students, participated as co-researchers to modify the United Nations Children's Fund Child Friendly Cities Initiative Survey to suit their needs. Due to the COVID-19 pandemic, the final survey was conducted through an online remote classes system during advisory school classes, accompanied by brief focused group discussions. The novel process of conducting an interactive qualitative and quantitative virtual survey during a pandemic via youth participatory action research is outlined in this paper. Conclusions: Our results demonstrate that youth participatory action research can be utilized as part of a child rights framework approach to assess the views of youth regarding community safety and violence prevention. [ABSTRACT FROM AUTHOR]

Purpose: Identify aspects of quality of life (QoL) important to Australian informal carers and explore how well the Adult Social Care Outcomes Toolkit for Carers, Care-related Quality of Life instrument and Carer Experience Scale capture these aspects in the Australian context. Methods: Online questionnaires were completed by Australian informal carers. Socio-demographics, open-ended questions: positive/negative aspects of caring and QoL aspects missing from the instruments, and ranking of the instrument domains was used to explore the content of the instruments. Instruments were scored using preference-weighted value sets (reported in another paper). Content analysis was used to analyse the open-ended responses. Chi-squared test looked at differences in domain importance. Descriptive analyses summarised all other information. Results: Eight themes were identified: Behaviour-mood of the care recipient, Caring responsibilities, Finances, Health, Own life, Perception of carers, Relationship with care recipient and Support. Many aspects of carer QoL mentioned as missing in the instruments appeared covered by the domains, of which all were reported as important. The highest ranked domain was relationship with the care recipient. The influence of the care recipient specific support, behaviour/mood and health on carer QoL appear absent in all instruments. Conclusion: The content of the three instruments appears relevant in an Australian setting. The influence of care recipient's health and well-being on carer QoL should be considered, along with spillover effects. A content and/or face validity analysis is required to confirm differences in item interpretation in Australian informal carers. [ABSTRACT FROM AUTHOR]

Tobacco use is the leading cause of death in the United States and youth prevention is key to reducing tobacco use. American Indian/Alaska Native (AI/AN) individuals have a higher prevalence of tobacco use compared to other populations. This paper aims to evaluate the prevalence of tobacco products among youth within the Cherokee Nation reservation. Data from the 2019 Cherokee Nation Youth Risk Behavior Survey (YRBS) was used to analyze the prevalence of tobacco use (cigarettes, smokeless tobacco, electronic cigarettes, cigars, and ≥ 2 products) among students within Cherokee Nation. Weighted frequency and percentages were obtained for variables and 95% confidence intervals were computed using Taylor linearization variance estimators. Binary associations between variables were examined using the Rao-Scott Chi-square test. There were 1475 high students who participated in the 2019 Cherokee Nation YRBS. Males were more likely to report the use of smokeless tobacco and ≥ 2 products than females. Twelfth graders had a higher prevalence of reported e-cigarette use compared to lower grades. AI/AN students had a higher prevalence of current use of cigarettes and ≥ 2 products compared to other groups. The use of marijuana and alcohol was positively associated with the use of all tobacco products. Depression was also positively associated with the use of all products excluding smokeless tobacco. Grade, age, depression, and current use of other tobacco products, marijuana, and alcohol were associated with greater electronic cigarette intensity levels. Using the results, tribal and local organizations can promote evidence-based interventions that focus on reducing tobacco use among youth. [ABSTRACT FROM AUTHOR]

Research to date has shown that HIV infection is a highly stressful experience for individuals, and one of the key adaptive resources after such painful experiences may be forgiveness. The aim of the present study was to examine the associations between dispositional forgiveness (assessed using Mullet's Forgivingness Questionnaire and Toussaint's Forgiveness Scale), perceived stress (single-item measure of stress symptoms), health perception (EuroQol visual analogue version of the scale) and life satisfaction (Satisfaction With Life Scale) in people living with HIV (PLWH) in France. Paper surveys were completed by 222 PLWH aged 18–78 (57% male). Multiple regression analysis revealed that sensitivity to circumstances, unconditional forgiveness, self-forgiveness, and forgiveness of others were significant predictors of health and happiness. Mediation analysis showed that these relationships are completely mediated by perceived stress. The present findings suggest that forgiveness and perceived stress may be important variables for healing in PLWH. Interventions designed to improve forgiveness and self-forgiveness may result in improved health and life satisfaction in PLWH. [ABSTRACT FROM AUTHOR]

Dating apps are now used by the majority of MSM to meet sexual and romantic partners. While research has demonstrated an association between app use and greater number of sex partners and STIs, dating apps also pose an opportunity for intervention. By advocating for new and improved sexual health features on dating apps, Building Healthy Online Communities (BHOC) aims to increase communication about sexual health on the apps. As a follow-up to our previous paper assessing the uptake of sexual health-related profile options on dating apps through Emory's annual survey of 10,000 MSM in the US, BHOC and Emory partnered to explore the change in uptake over time, again through their annual survey. Among survey participants in 2021, 85% reported using dating apps to meet a partner in the past year, and among this group, 93% reported awareness of sexual health features, up from 77% in 2018 (p < 0.0001). 71% of app users who were aware of features in 2021 reported using one or more sexual health feature, up from 61% in 2018 (p < 0.0001). BHOC will continue to advocate for increased uptake of these features, especially among subgroups with lower levels of uptake. [ABSTRACT FROM AUTHOR]

Promoting Farmer Managed Natural Regeneration (FMNR) aims to increase the productive capacities of farmer households. Under FMNR, farmers select and manage natural regeneration on farmlands and keep them under production. While FMNR contributes to the wealth of farming communities, its contribution to household food security has rarely been researched. We, therefore, used a mixed-methods approach to address the research gap by measuring FMNR's contribution to food security among farmer households in the Talensi district of Ghana. We adopted the Household Dietary Diversity Score (HDDS) and Food Consumption Score (FCS) to estimate food security status among 243 FMNR farmer households and 243 non-FMNR farmer households. Also, we performed a Chi-square test of independence to compare the frequency of each food group (present vs not present) between FMNR adopters and non-FMNR adopters to establish the relationship between adopting FMNR and consuming the FCS and HDDS food groups. Our results reveal that FMNR farmer households are more food secure than non-FMNR farmer households. The HHDS of the FMNR farmer households was 9.6, which is higher than the target value of 9.1. Conversely, the HHDS of the non-FMNR farmer households was 4.3, which is lower than the target value of 9.1. Up to 86% and 37% of the FMNR farmer households and non-FMNR farmer households fell within acceptable FCS; 15% and 17% of FMNR farmer households and non-FMNR farmer households fell within borderline FCS. While none of the FMNR farmer households fell within poor FCS, 46% of non-FMNR farmer households fell within poor FCS. Adopting FMNR is significantly related to consuming all food groups promoted and benefiting from FMNR practices. The paper recommends enabling farmers in semi-arid environments to practice and invest in FMNR for long-term returns to food security. [ABSTRACT FROM AUTHOR]

Introduction: This research paper investigates whether robotic total knee replacement (TKR) reduces bone resection compared to conventional TKR. While TKR is a successful procedure, revision surgery remains a challenge with up to 8.3% of all knee replacement procedures requiring revisions. Materials and methods: The study retrospectively analyzed the tibial polyethylene inserts used and bone cuts made in 157 primary TKRs performed by a single surgeon. The results show that 93.3% of robotic TKRs used the base size tibial polyethylene of 9 mm, and the average distal femoral cut was 7.4 mm and the average tibial cut was 6.4 mm, with the minimum being 3 mm. Conclusion: The study suggests that robotic TKR reduces bone resection compared to conventional TKR. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate disparities in urine drug testing (UDT) during perinatal care at a single academic medical center. This retrospective cohort study included patients who had a live birth and received prenatal care at our institution between 10/1/2015 and 9/30/2020. The primary outcomes were maternal UDT during pregnancy (UDTPN) and UDT only at delivery (UDTDEL). Secondary outcomes included the number of UDTs (UDTNUM) and the association between a positive UDT test result and race/ethnicity. Mixed model logistic regression and negative binomial regression with clustering based on prenatal care locations were used to control for confounders. Of 6,240 live births, 2,265 (36.3%) and 167 (2.7%) received UDTPN and UDTDEL, respectively. Black (OR 2.09, 95% CI 1.54–2.84) and individuals of Other races (OR 1.64, 95% CI 1.03–2.64) had greater odds of UDTPN compared to non-Hispanic White individuals. Black (beta = 1.12, p < 0.001) and Hispanic individuals (beta = 0.78, p < 0.001) also had a positive relationship with UDTNUM. Compared to individuals with non-Medicaid insurance, those insured by Medicaid had greater odds of UDTPN (OR 1.66, 95% CI 1.11–2.49) and had a positive relationship with UDTNUM (beta = 0.89, p < 0.001). No significant associations were found for UDTDEL and race/ethnicity. Despite receiving more UDT, Black individuals were not more likely to have a positive test result compared to non-Hispanic White individuals (OR 0.95, 95% CI 0.72–1.25). Our findings demonstrate persistent disparities in substance use testing during the perinatal period. Significance: What is already known on this subject?: Prior literature has shown evidence of racial disparities in urine drug testing during pregnancy-related hospital admissions and at delivery. What this study adds?: This paper found that disparities in urine drug testing also exist during the prenatal care period at an urban academic institution. We also found a positive relationship between the number of tests received and being of Black or Hispanic race/ethnicity. Future research should investigate health care system-related interventions to mitigate disparities in urine drug testing. [ABSTRACT FROM AUTHOR]

Caregiver-adolescent sexual health communication can reduce sexual risk attitudes and behaviors, but less is known about caregiver-adolescent sexual health communication in Uganda. Using a risk-focused approach, this paper seeks to characterize caregiver-adolescent sexual health communication and associated individual and family-based attributes, and associations with adolescents' sexual risk attitudes. We used latent class analyses to derive typologies (classes) of sexual health communication and assess their relationships with respondents' socio-demographic characteristics and sexual risk-taking attitudes. We derived three latent classes of sexual risk communication characterized as avoidant (class 1; 48%), functional (class 2; 22.2%) and comprehensive (class 3; 29.8%), each representing varying levels of frequency and type of content covered in the caregiver-adolescent sexual health communication. Primary caregiver's sex and respondents' comfort talking to their caregiver were significantly associated with membership in the functional class (RRR = 1.52; 95% CI: 1.05–2.19; p < 0.05) and comprehensive class (RRR = 1.68; 95% CI: 1.13–2.49; p < 0.05). Caregivers and their adolescents are attempting to engage in conversations related to sexual health, but many caregivers tend to shy away from potentially embarrassing topics such as sex. The wide variations in type and content of covered in caregiver-adolescent sexual health communications may compromise adolescents' sexual health knowledge, putting them at risk for poor sexual health outcomes. Given the cultural taboos around caregiver-adolescent communications on sex related topics, family interventions to address to strengthen caregiver-adolescent communication on sexual health are required. Highlights: Study findings revealed three latent caregiver-adolescent sexual health classes, dominated by avoidant communication. Caregiver gender and adolescents' comfort enhanced caregiver-adolescent sexual health communication. Interventions must tackle cultural norms and taboos for better caregiver-adolescent sexual health communication. [ABSTRACT FROM AUTHOR]

Background: Frailty has been associated with increased postoperative mortality and morbidity; however, the use of the modified frailty index (mFI-11) to assess patients undergoing surgery for diverticular disease has not been widely assessed. This paper aims to examine frailty, evaluated by mFI-11, to assess postoperative morbidity and mortality among patients undergoing operative intervention for colonic diverticular disease. Methods: We used data from the Healthcare Cost and Utilization Project National Inpatient Sample (October 1, 2015–December 31, 2019). ICD-10-CM codes were utilized to identify a cohort of adult patients with a primary admission diagnosis of diverticulitis. mFI-11 items were adapted to correspond with ICD-10-CM codes. Patients were stratified into robust (mFI < 0.27) and frail (mFI ≥ 0.27) groups. Primary outcomes were in-hospital postoperative morbidity and mortality. Secondary outcomes included system-specific postoperative complications, length of stay (LOS), total admission cost, and discharge disposition. Multivariable regression models were fit. Results: Of the 26,826 patients, there were 24,194 patients with mFI-11 < 0.27 (i.e., robust) and 2,632 patients with mFI-11 ≥ 0.27 (i.e., frail). Adjusted analysis showed significant increases in postoperative mortality (aOR 2.16, 95% CI 1.38–3.38, p = 0.001) and overall postoperative morbidity (aOR 1.84, 95% CI 1.65–2.06, p < 0.001). LOS was higher in the frail group (MD 1.78 days, 95% CI 1.46–2.11, p < 0.001) as well as total cost (MD $25,495.19, 95% CI $19,851.63-$31,138.75, p < 0.001). Conclusion: In the elective setting, a high mFI-11 (i.e., presence of the variables comprising the index) could alert clinicians to the possibility of implementing preoperative optimization strategies. In the emergent setting, a high mFI-11 may help guide prognostication for these vulnerable patients. [ABSTRACT FROM AUTHOR]

A great deal of economic problems are related to detecting the stability of time series data, where the main interest is in the unit root test. In this paper, we consider the unit root testing problem with errors being long-memory processes with the GARCH structure. A new test statistic is developed by using the random weighted bootstrap method. It turns out that the proposed statistic has a chi-squared distribution asymptotically regardless of the process being stationary or nonstationary, and with or without an intercept term. The simulation results show that the statistic has a desired finite sample performance in terms of both size and power. A real data application is also given relying on the inflation rate data of 17 countries. [ABSTRACT FROM AUTHOR]

Female genital mutilation (FGM) involves the cutting of the external female genital organs for non-medical purposes. It is a widespread public health problem in Nigeria as it affects the health of women and girls. The views of women about FGM are widely researched and known; however, very little empirical research has been conducted to understand the views of men. Aim: This study therefore sought to examine men's views with regard to the continuation of FGM and its associated factors in a rural Igbo community in Nigeria. Subject and Method: This paper reports the results of a survey of 215 men aged 18 and above living in Isuikwuato Local Government Area, Uturu in Nigeria. Bivariate and binary logistic regression were performed on 215 completed and returned questionnaires (86% response rate) using the Statistical Package for Social Science. This is the first study to investigate Nigerian Igbo men's views of FGM. Results: Descriptive statistics revealed that almost two-thirds of the sample (63.7%) thought FGM should be discontinued. Logistic regression found that owning a television and/or a radio and holding a Christian faith significantly predicted favouring the discontinuation of FGM. Conclusion: This study provides evidence to suggest that some Nigerian Igbo men's attitudes about FGM appear to be generally less than favourable. The major implication of these findings is that policy makers must place greater emphasis on addressing the economic and social development of rural areas in Nigeria if the harmful practice of FGM is to be reduced. [ABSTRACT FROM AUTHOR]

In order to improve the computational efficiency of testing the hypothesis about the distributions of random variables, the paper proposes a modified testing procedure. This procedure is based on determining the maximum estimation discrepancy for the distribution functions of the compared random variables, followed by the calculation and analysis of confidence intervals for the determined distribution function values. The hypothesis about the identity of distributions is confirmed if obtained confidence intervals overlap at a given level of significance. According to the results of computational experiments, the Kolmogorov–Smirnov and Pearson's chi-squared tests were compared using the following formulas for sampling the intervals of random variables: Sturgess' rule, Heinhold–Gaede formula, and that of the modified method. Pairwise combinations of the following distributions of random variables are considered: uniform, normal, lognormal, and power- law. It is shown that the modified procedure can be generalized to the case of testing hypotheses about the distributions of multidimensional random variables. In contrast to Pearson's chi-squared test, the proposed modified procedure helps to bypass the problem associated with converting the range of random variables into multidimensional intervals. [ABSTRACT FROM AUTHOR]

Structural equation models are used to model the relationships between latent constructs and observable behaviors such as survey responses. Researchers are often interested in testing nested models to determine whether additional constraints that create a more parsimonious model are also supported by the data. A popular statistical tool for nested model comparison is the chi-square difference test. However, there is some evidence that this test performs suboptimally when the unrestricted model is misspecified. In this paper, we examine the type I error rate of the difference test within the context of single-group confirmatory factor analyses when the less restricted model is misspecified but the constraints imposed by the restricted model are correct. Using empirical simulations and analytic approximations, we find that the chi-square difference test is robust to many but not all forms of realistically sized misspecification in the unrestricted model. [ABSTRACT FROM AUTHOR]

Purpose: Since the 1960s, federal and state governments and private-sector companies have used supplier diversity initiatives to ensure their supply chains include businesses owned by traditionally economically disadvantaged or underrepresented groups. Originally concentrated on racial and ethnic minority groups, programs have expanded to include businesses owned by women, veterans, LGBTQ+ individuals, and, in some cases, people with disabilities. This study investigates the extent to which disability is included in supplier diversity initiatives of Fortune 500 companies. Methods: This paper uses a novel data set created by the authors with information on supplier diversity initiatives and Disability, Equity, and Inclusion (DEI) statements in Fortune 500 companies extracted from public sources. This information is combined with data from Compustat, a corporate financial database published by Standard and Poor's and additional variables from other sources. Results: 75% of the Fortune 500 companies have supplier diversity programs that express a commitment to diversity yet only 49% of those with such programs include disability-owned businesses (38% of all Fortune 500 companies). Among the largest 100 companies, 89% had supplier diversity programs that included disability, almost 6 times the rate Ball et al. reported in 2005. This study finds disability inclusion varies significantly by company size, industry, and whether the company is a government contractor. Conclusion: Despite the growth in disability inclusion, the absence of disability as a diversity category in regulations mandating supplier diversity initiatives for government contractors impacts disability inclusion. If we want to align our supplier diversity programs with the Americans with Disabilities Act, the first step is to address the issue in the Small Business Administration and federal contracting requirements. [ABSTRACT FROM AUTHOR]

There were 9.7 million Native Americans (American Indian, Alaska Native-AI/AN- these acronyms will be used interchangeably with Native Americans throughout the paper) in 2019 comprising 2.9% of the U.S. population. Native American populations have disproportionately higher rates of mental illnesses compared to other racial groups in the U.S. Mental health is a significant public health concern for this population, impacting different areas of their lives including employment. Additionally, Native Americans continue to experience significant disparities in access to Vocational Rehabilitation (VR) services and have poor employment outcomes. However, little is known about the relationships among demographic factors, vocational rehabilitation services, and employment outcomes of Native Americans with mental illness. Consequently, the current study examined how demographic factors and VR services are related to successful employment outcomes for Native American VR clients with mental illnesses using data from the Rehabilitation Services Administration (RSA) program year (2019) Case Service Report (9–11). Both descriptive analysis and data mining approaches were used to answer the research questions. Chi-square Automatic Interaction Detector (CHAID) analysis was used to determine which of the VR services could best predict the successful employment outcome of Native Americans with mental illness. The findings of the data mining approach revealed that among all the vocational rehabilitation services, job placement assistance was the strongest predictor of successful employment among Native American clients with mental illnesses. The second most important service predicting successful employment for those who received job placement assistance was shown to be maintenance. Implications for rehabilitation counselors and future research are discussed. [ABSTRACT FROM AUTHOR]

Violence, abuse and neglect constitute major threats to children's health and wellbeing globally. However, until recently, relatively little systematic attention has been paid to the role of faith communities in shaping the protective environment for children. This paper describes the development of a measure to capture child-protective disposition amongst faith communities through field studies with faith leaders and their spouses in Senegal, Uganda and Guatemala. Identifying common factors related to child care and protection practices, orientation to child rights and approaches to discipline, the measure potentially serves to both inform and evaluate interventions seeking to engage with the beliefs and behaviours of faith communities to support children's health and wellbeing. [ABSTRACT FROM AUTHOR]

Software Defined Networking (SDN) is a network paradigm with the separation of the control plane from the data plane. Centralized management of the network and dynamic programming ability are the advantages of this separation. However, SDN suffers from security threats like DDoS attacks. In this paper, we propose an early detection and mitigation model to detect the DDoS attacks caused by the TCP SYN flood. This model uses the programming ability of SDN to collect features from network traffic at the centralized controller. For that, we implement the proposed model as a module in the POX controller. Our model extracts the header features: MAC addresses and TCP flags to construct the list of number of half-open connections per each host in the network within a given time period. The extended chi-square goodness of fit test serves as a basis for the detection method in our model. We calculate the χ 2 value for the list of half-open connections and from this p _ value is derived. When p _ value drops below the threshold value, the attack is detected. We also mitigate the attack by blocking the attack traffic from the attackers' within the network using source MAC addresses. The experiments results show that the model is successful in TCP SYN flood detection and mitigation at the source end, i.e. attack-originating network. We compare our model with existing literature and show improvement over attack detection and discuss the advantages of the proposed model over the existing schemes in the literature. [ABSTRACT FROM AUTHOR]

Protection of information (data/images) is crucial in the colossal and ever-expanding domain of digital transfer. Cryptography is one of the well-known admired solutions to preserve images' confidentiality over highly unreliable and unrestricted public media. Researchers propose numerous techniques to accomplish the ever-growing need for security. In continuation, this paper aims to develop a robust image encryption scheme that accomplishes the task of protection by employing a series of specially designed substitution box, permutation box and diffusion box by taking encryption keys as input which is consequently generated from a Generative Adversarial Network (GAN), an unsupervised deep learning algorithm trained on the Logistic Maps. The substitution box performs byte-level substitution using two different schemes, and the other two perform encryption at both bit-level and byte-level, which helps it withstand a wide range of attacks. A dataset with 789 standard images is taken for experimentation, partitioned into three sets according to size (128, 256, and 512). The projected scheme outperforms state-of-the-art methods with better performance since the trained generator passed the comprehensive tests; it also withstands most of the probable attacks available in the literature. GAN was subjected to the chi-square test, runs test, and NIST test suite to check the randomness of the Pseudo-Random Number Generator. The projected algorithm offers promising visual, statistical, robustness, and quantitative analysis results. [ABSTRACT FROM AUTHOR]

Background: Previous studies have demonstrated that the trauma population has needs for rehabilitation services that are best provided in a continuous and coordinated way. The discharge destination after acute care is the second step to ensuring quality of care. There is a lack of knowledge regarding the factors associated with the discharge destination for the overall trauma population. This paper aims to identify sociodemographic, geographical, and injury-related factors associated with discharge destination following acute care at trauma centers for patients with moderate-to-severe traumatic injuries. Methods: A multicenter, population-based, prospective study was conducted with patients of all ages with traumatic injury [New Injury Severity Score (NISS) > 9] admitted within 72 h after the injury to regional trauma centers in southeastern and northern Norway over a 1-year period (2020). Results: In total, 601 patients were included; a majority (76%) sustained severe injuries, and 22% were discharged directly to specialized rehabilitation. Children were primarily discharged home, and most of the patients ≥ 65 years to their local hospital. Depending on the centrality of their residence [Norwegian Centrality Index (NCI) 1–6, where 1 is most central], we found that patients residing in NCI 3–4 and 5–6 areas sustained more severe injuries than patients residing in NCI 1–2 areas. An increase in the NISS, number of injuries, or a spinal injury with an Abbreviated Injury Scale (AIS) ≥ 3 was associated with discharge to local hospitals and specialized rehabilitation than to home. Patients with an AIS ≥ 3 head injury (RRR 6.1, 95% Confidence interval 2.80–13.38) were significantly more likely to be discharged to specialized rehabilitation than patients with a less severe head injury. Age < 18 years was negatively associated with discharge to a local hospital, while NCI 3–4, preinjury comorbidity, and increased severity of injuries in the lower extremities were positively associated. Conclusions: Two-thirds of the patients sustained severe traumatic injury, and 22% were discharged directly to specialized rehabilitation. Age, centrality of the residence, preinjury comorbidity, injury severity, length of hospital stay, and the number and specific types of injuries were factors that had the greatest influence on discharge destination. [ABSTRACT FROM AUTHOR]

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The changes in pro-environmental behaviour, whether people become more environmentally friendly or not, have been analysed very scarcely. Therefore, the aim of this paper was to analyse the changes in pro-environmental behaviour and its determinants in Lithuania as a transition European Union country comparing years 2011 and 2020. Applying Chi-Square and t test statistics, the results showed a significant increase in performance of pro-environmental behaviour in 2020. Waste sorting and purchase of environmentally friendly goods increased the most, meanwhile water and energy saving behaviour increased the least. Applying the value-belief-norm theory and leaner regression analysis, we analysed whether the same determinants influenced pro-environmental behaviour in 2011 and 2020. The results revealed that the impact of determinants differed. In 2020, the main factor of pro-environmental behaviour was the perception of environmental problems but not self-transcendence values dimension. Furthermore, self-enhancement values and awareness of behavioural consequences negatively influenced pro-environmental behaviour in 2020. Analysing the changes in these factors, an insignificant difference was observed in self-enhancement values. The changes in other factors were significant, particularly the changes in the level of environmental responsibility was the biggest. Therefore, implementation of environmental education and information programmes and various environmentally friendly public initiatives positively contributed to the enhancement of environmental awareness and pro-environmental behaviour. [ABSTRACT FROM AUTHOR]

Several documents have investigated the area of Quran study and medicine from different points of view; the present study has been assessing all the documents about Quran study and medicine, published in Iranian scientific-research journals, to create an opportunity of revising the interventions executed in this areas and targeting the decisions in order to draw a clear and more realistic vision. In this simple review study, scientific-research and general informative websites in the period of 1992-2013 were explored by taking advantage of critical keywords such as Islamic medicine and Islamic lifestyle. After the initial retrieval, 348 articles were finally ready for the evaluation process. Chi-square test was used to assess the significance of patterns differences between years of study. Minimum and maximum numbers of articles were published in 1992 (0.28 %) and 2011 (12.35 %), respectively. The level of execution of studies by using different methods was as follows: about 3.44 % qualitative, 29.59 % cross-sectional descriptive-analytical, 30.45 % review, 1.14 % case-control, 17.52 % experimental, 3.73 % cohort methods and 12.93 % were performed by other methods. The most common subject study was 'The effects of fasting and Ramadan on health' (21.83 %). The most important journals hosting this field articles were the journals of medicine and refinement (27.01 %), as well as the Quran and medicine (12.64 %), respectively. Chi-square test showed significant thematic differences during the 21 years of study. Based on the available evidences, the number of descriptive papers was yet more than the analytical, interventional and scientific-comparative articles. Also, the most studies had been reviewing the medical-Islamic documents. This reflects the need for revising the search strategies of Quran study and medicine. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this paper is to describe the curriculum and self-reported outcomes on measures of interdisciplinary leadership skills for work within the field of developmental disabilities from trainees in one interprofessional training program. Methods: The paper highlights one program's curriculum and strategy for capturing self-report survey measures from trainees in cohorts from 2014–2018 (n = 86) on two surveys (Interdisciplinary Attitudes and Skills and Leadership Self-Evaluation Form) and three time points across the training year: before training (T1), mid-year (T2), and after training (T3). Results: Data from 86 trainees are reported including demographics (nearly 80% white, 92% female), non-descriptive statistics due to non-normative samples, and tertiles demonstrating changes between time points. Significant differences between medians are reported between T1-T3 specifically related to utilizing interdisciplinary skills and gains in leadership competencies. Specific utilization of skills was reported to be 'Greatly' attributable to the LEND program related to sharing ideas and asking for help across disciplines. Discussion: Trainees' self-report from before training to after training indicates an increase in competence and utilization of interdisciplinary skills to be expected from participation in the curriculum. Self-report measures are [ABSTRACT FROM AUTHOR]

Despite the abundance of literature highlighting poor sleep quality among medical students and its detrimental impact on their mental well-being and academic performance, no study has been conducted to investigate the sleep quality of undergraduate medical students in Rwanda to date. Therefore, this study sought to determine the magnitude of sleep quality of undergraduate medical students in Rwanda and to compare the scores of seven components of sleep quality across classes. This cross-sectional study was conducted among 290 undergraduate medical students aged 18–35 years (mean = 24, SD = 2.9) randomly recruited countrywide from 1st November 2021 to 1st March 2022. The questionnaire was self-administered with 2 sections: characteristics of medical students, and Pittsburgh Sleep Quality Index (PSQI). The Pearson Chi-square test was used to test whether the categories of seven components of sleep quality differ between classes, then ANOVA followed by the post hoc test was used to test if the seven components and global score of Pittsburgh Sleep Quality Index differ between classes. The results revealed that the global PSQI mean score was 7.73 (SD = 2.83), with fifth-year medical students reporting the highest PSQI mean score (M = 8.44, SD = 2.77), followed by first-year (M = 8.15, SD = 3.31). One-way ANOVA showed that the global PSQI score (F = 2.76, p = 0.028), subjective sleep quality (F = 3.35, p = 0.011), habitual sleep efficiency (F = 10.20, p < 0.001), and daytime dysfunction (F = 3.60, p = 0.007) were significantly different across classes. Notably, the post hoc test revealed significant scores differences in the global PSQI score between class II and V (p = 0.026), in subjective sleep quality between class I and II (p = 0.043), and between class I and IV (p = 0.016); habitual sleep efficiency between class V and all other classes (p < 0.001); and daytime dysfunction between class III and IV (p = 0.023). This paper concludes by arguing that poor sleep quality is highly prevalent among medical students in Rwanda, with final and first-year students reporting the poorest sleep quality. There were significant differences across classes in the global PSQI, subjective sleep quality, habitual sleep efficiency, and daytime dysfunction. Intervention approaches such as sleep education, behavioral changes, and relaxing techniques are recommended to address contributing factors and ultimately maximize the academic goals of Rwandan medical students. [ABSTRACT FROM AUTHOR]

Conflict of interests is a situation when someone is in need of other people's trust on one the hand and has personal or general interests on the other hand, resulting in conflict with the given responsibility. In this research work, an attempt was made to find the relation between declarations of conflict of interests and reporting positive outcomes in the dental journals in Iran (2000–2016). In this analytical/cross-sectional study, first Health and Biomedical Information was searched and all the Persian and English dental journals published in Iran were collected. Then, all the papers published in the journals from December 2000 to December 2016 were collected and categorized in terms of the year of publication, author or authors' affiliations, Persian and English journal, type of the substance or the drug used (including the manufacturing company), declarations of conflict of interests and the positive or negative conclusion of the report. Data were analyzed with the Fisher's exact test and Chi squared test, using the program SPSS 18. In numerical analysis, the significance was set at P < 0.05. Seventeen dental journals in Persian and English were analyzed: 10 in English and 7 in Persian. Reviewing these studies showed that of 1021 articles in Persian, in 128 cases there was no mention of a declaration of conflict of interests and in 11 cases, the COI had been stated. In addition, from 1220 articles in English, in 825 cases there was no mention of declarations of conflict of interests and in 45 cases, the declarations of COI had been mentioned. There was no significant relation between the COI and 'no' COI and the reporting of positive outcomes in papers in Iranian dental journals in terms of the journal type, year of publication and the journals' guarantee form (P = 0.25, P = 0.41 and P = 0.09). A total of 83% of studies with declarations of COI had one positive outcome, with a significant relationship in this field; however, in 73% of studies with no COI, there was one positive outcome, too. In general, the society expects that doctors would not consider any incentives except the health of the patients in the efforts made by them. The severity of the consequences of COI is of higher value when the patients' health is endangered due to it. In addition, COI might change the attitude and approach of other doctors and peers. [ABSTRACT FROM AUTHOR]

Msplit(q) estimation is a development of M-estimation which is based on the assumption that a functional model of observations can be split into q competitive ones. The main idea behind such an assumption is that the observation set might be a mixture of realizations of different random variables which differ from each other in location parameters that are estimated. The paper is focused on the robustness of Msplit(q) estimates against outlying observations. The paper presents derivatives of the general expressions of the respective influence functions and weight functions which are the main basis for theoretical analysis. To recognize the properties of Msplit(q) estimates in a better way, we propose considering robustness from two points of view, namely local and global ones. Such an approach is a new one, but it reflects the nature of the estimation method in question very well. Thus, we consider the local breakdown point (LBdP) and the global one (GBdP) that are both based on the maximum sensitivities of the estimates. LBdP describes the mutual relationship between the "neighboring" Msplit(q) estimates, whereas GBdP concerns the whole set of the estimates and describes the robustness of the method itself (in more traditional sense). The paper also presents GBdP with an extension, which shows how an outlier might influence Msplit(q) estimates. The general theory proposed in the paper is applied to investigate the squared Msplit(q) estimation, the variant which is used in some practical problems in geodesy, surveying, remote sensing or geostatistics, and which can also be applied in other geosciences. [ABSTRACT FROM AUTHOR]

With the development of industry, air pollution has become a serious problem. It is very important to create an air quality prediction model with high accuracy and good performance. Therefore, a new method of CT-LSTM is proposed in this paper, in which the prediction model is established by combining chi-square test (CT) and long short-term memory (LSTM) network model. CT is used to determine the influencing factors of air quality. The hourly air quality data and meteorological data from Jan. 1, 2017 to Dec. 31, 2018 are used to train the LSTM network model. The data from Jan. 1, 2019 to Dec. 31, 2019 are used to evaluate the LSTM network model. The AQI level of Shijiazhuang of Hebei Province of China from Jan. 1, 2019 to Dec. 31, 2019 is predicted with five methods (SVR, MLP, BP neural network, Simple RNN and this paper's new method). Then, a contrastive analysis of the five prediction results is made. The experimental results show that the accuracy of this new method reaches 93.7%, which is the highest in the five methods and the maximum error of this new method is 1. The correct number of days predicted by this new method is also the highest among the five methods, which is 342 days. The new method also shows good characteristics in MAE, MSE and RMSE, which makes it more accurate for people to predict the AQI level. [ABSTRACT FROM AUTHOR]

Worldwide, biogas programs fail to achieve broad acceptability because of failure to account for socio-economic constraints during program design and implementation. This paper attempts to revisit the relationship between socio-economic characteristics of rural households and adoption of biogas technology at the household level in Pakistan by using a predicted willingness-to-adopt approach in addition to considering energy-related variables which have been rarely accounted for in previous literature. The study is based on primary data collected from 200 households across eight villages in Khyber Pakhtunkhwa (KP) Province. A chi-square test of association is applied to determine the relationship between farmers' socio-economic characteristics and their willingness-to-adopt domestic biogas technology. Results confirm that socio-economic factors such as education, total landholdings, cost of energy consumption, duration of electric shortfalls, occurrence of smoke-related diseases, and possession of livestock had a significant relationship with farmers' willingness-to-adopt biogas technology. The study concludes that for the successful deployment of biogas technology in rural areas, it is imperative to account for the socio-economic conditions of the population. [ABSTRACT FROM AUTHOR]