Search

The Covid-19 pandemic affected the industrial sector by decreasing productivity, including in private companies. Some private companies have laid off their employees to achieve company efficiency. This situation drives a threat that is arising insecurity, anxiousness, and decreasing engagement among employees. This research aims to understand the role of calling and Perceived Organizational Support (POS) toward work engagement. The research participants are 144 employees from private companies working for at least six months, and they Work From Home (WFH). This study hypothesizes that POS and calling predict work engagement in a positive direction. Multiple regression analysis was utilized in this study. Results showed increased calling and POS followed by increased work engagement. The implication of this study has two directions; the first is for the organization to improve perceived organizational support, and the other hand, the employee needs to internalize the calling more. [ABSTRACT FROM AUTHOR]

Simple Summary: We assessed whether anti-VEGF therapy increases the risk of thromboembolic events or major adverse cardiovascular events (MACEs) in patients with colorectal cancer based on real-world evidence. Patients with advanced colorectal cancer who had previously received anti-VEGF therapy did not increase the risk of thromboembolic events and major cardiovascular events more than patients without anti-VEGF therapy in Taiwan. Antivascular endothelial growth factor (anti-VEGF) therapy has been a standard treatment for patients with metastatic colorectal cancer. However, the risk of thromboembolic events and cardiovascular events associated with this therapy remains controversial. We assessed whether anti-VEGF therapy increases the risk of thromboembolic events or major adverse cardiovascular events (MACEs) in patients with colorectal cancer based on real-world evidence. This retrospective cohort study was designed using linked 2009–2016 nationwide databases, including the Taiwan Cancer Registry, the National Health Insurance Research Database, and Taiwan's National Death Index. In total, 189,708 patients newly diagnosed as having advanced colorectal cancer from 2009 to 2016 were identified and categorized into the anti-VEGF and comparator groups through age, sex, clinical stage, and diagnosis date (within 180 days) matching. Propensity score matching was further performed to balance the baseline characteristics between the two groups. The Kaplan–Meier method was used to create the cumulative incidence curves of thromboembolic events and MACEs, and log-rank tests were used to compare the differences in Kaplan–Meier curves. Competing hazard ratios (HRs) for thromboembolic events and MACEs were estimated using the Fine–Gray method when considering the competing event of death. Statistical analysis was performed using two-tailed tests with a significance level of 0.05. In total, 4635 patients were included in both the anti-VEGF group and comparator group. The risk of thromboembolic events and MACEs did not differ significantly between the two groups. After propensity score matching, the adjusted HR for MACEs or thromboembolic events was 1.040, which for MACEs was 0.989, and that for thromboembolic events was 1.028. The competing HR for MACEs or thromboembolic events was 0.921, which for MACEs, was 0.862, and that for thromboembolic events was 0.908. In conclusion, patients with advanced colorectal cancer who received anti-VEGF therapy did not exhibit significantly higher risks of thromboembolic events and MACEs than those without anti-VEGF therapy. Our study provides real-world evidence regarding the safety of anti-VEGF therapy in Asian patients with advanced colorectal cancer. [ABSTRACT FROM AUTHOR]

The full Bayesian significance test (FBST) for precise hypotheses is a Bayesian alternative to the traditional significance tests based on p-values. The FBST is characterized by the e-value as an evidence index in favor of the null hypothesis (H). An important practical issue for the implementation of the FBST is to establish how small the evidence against H must be in order to decide for its rejection. In this work, we present a method to find a cutoff value for the e-value in the FBST by minimizing the linear combination of the averaged type-I and type-II error probabilities for a given sample size and also for a given dimensionality of the parameter space. Furthermore, we compare our methodology with the results obtained from the test with adaptive significance level, which presents the capital-P P-value as a decision-making evidence measure. For this purpose, the scenario of linear regression models with unknown variance under the Bayesian approach is considered. [ABSTRACT FROM AUTHOR]

Objective: to describe the effects of the new coronavirus pandemic carried out by the mobile emergency care service (SAMU) in Senador Canedo-Goiás in the period 2019-2020. Methods: This is a descriptive ecological study, using the SAMU service bulletins of the respective municipality as a source of information, referring to the period from January 2019 to December 2020. The absolute and relative frequencies of the selected variables were calculated and calculated the chi-square test with a significance level of 5% (p< 0.05). Results: In 2019, 1,078 occurrences were recorded, while in 2020, 1,705 were attended, showing an increase in the number of calls between years. Most attendances were male (2019-2020 - 59.4%) aged between 19 and 45 years (2019-2020 - 36.3%). The main place of occurrence was at home (2019-2020 - 45.9%), in the afternoon shift (2019-2020 - 34.1%) and the highest occurrences were carried out on weekends (2019-2020 - 32, 1%). The main type of occurrence was due to assistance in both years (2019-90.5%; 2020-79.6%), although removal/transport showed a significant demand in 2020 (2019-9.5%; 2020- 20.4% - p= <0.0001). The main reason for attendance was due to clinical causes (2019-19.5%; 2020-28.5% - p= 0.914), followed by external causes (2019-15.3%; 2020-26.6% - p=<0.0001). Conclusion: it was observed that the pandemic significantly influenced the increase in cases of occurrences in the year 2020, increasing the number of removals/ transportation, impacting the health service and it is expected that the unpublished data from the sample obtained can serve as a substrate for the planning and execution of measures aimed at improving health care. [ABSTRACT FROM AUTHOR]

Introduction: Understanding oral health and not merely dental health are becoming priorities as mouth often offers first sign and symptoms of many localised and systemic diseases. Like any other urban slums, Siliguri slum peoples were also prone for many illnesses and oral health was a different concern as because offering areca nut with betel to guests was a common practice in that particular area. Aim: To find out oral morbidity pattern among study subjects and to ascertain few behavioural determinants of oral morbidity. Materials and Methods: Community based cross-sectional study was performed in slums of Siliguri city, West Bengal, India, from January 2017 to January 2019. As Siliguri is a large city with more than 5 lac population and 154 slums, cluster sampling was adopted to choose samples from each cluster slum. Total 210 samples were studied derived from World Health Organisation (WHO) sample size formula and applying principles of 30 cluster sampling and data regarding socio-demographic profile, behaviour details and clinical history and examination was collected via self-structured, pretested schedule. Results were analysed in Statistical Package for the Social Sciences (SPSS) version 20.0 software and was presented in frequency tables, Chi-square test was applied for testing statistical significance. Results: Out of 210 study subjects, 154 of them (73.3%) had any form of oral morbidities, 136 study subjects (64.8%) had dental morbidities. Bleeding was commonest symptom for 96 study subjects (62.3%). A total of 59 study subjects (28.1%) had irregular brushing habit and 132 subjects (62.9%) did not wash their mouth after each major meal. A total of 94 subjects (44.8%) had the habit of any form addiction. Conclusion: Adult slum dwellers of Siliguri reported a huge proportion of oral morbidities, majority of which was dental morbidities, irregular brushing habit, lack of mouth wash after meal and addiction were associated with oral morbidities. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to identify the changes in the share of large public interest entities (PIEs) in European Union (EU) Member States providing Sustainable Development Goal (SDG) reporting prior to (2017) and after (2019) the implementation of Directive 2014/95/EU and the factors that influence their decisions to provide SDG reporting in 2019. Design/methodology/approach: The authors use the multilevel theory of social change in organizations as the theoretical background. The sample consists of 341 PIEs based in the EU Member States, for which reports published in 2017 and 2019 are available in the global reporting initiative sustainability disclosure database. The authors analyzed the data using the statistical significance test of equal proportions and the logistic regression model. Findings: The study findings allow to identify a significant positive change in the share of companies providing a reference to SDGs in 2019 compared with 2017. The research confirms that companies' engagement in United Nations Global Compact and previous experience in sustainability reporting positively influences the decision to report on SDGs in 2019. Contrary to the expectations, industry, size, SDG implementation score, future orientation of government and corporate governance score do not seem to be relevant factors influencing PIEs' disclosures. Originality/value: The paper adds to the understanding of the differences in SDG reporting within the EU, which is seen as a frontrunner in implementing the 2030 Agenda and the SDGs. [ABSTRACT FROM AUTHOR]

Objective. This study aims to assess the impact of re-establishing apical patency on the quantity of debris extruded through the apex after three supplementary retreatment files (TruNatomy (TRN), WaveOne Gold (WOG), and XP endo Finisher R (XPFR)). Materials and Methods. Eighty single-rooted mandibular premolars were prepared with ProTaper Universal rotary systems (PTU) up to F3 and obturated. The samples were divided into two main groups according to the presence or absence of the apical patency (n = 40), GI with apical patency and GII without apical patency. Based on the file system, which was adopted to eliminate the previous filling, each group had four subgroups (n = 10). In GI PTUR and GII PTUR, ProTaper Universal retreatment files (PTUR) were utilized only to remove the most primary filling material (control groups). In the other groups (PTUR) used, it was first followed by supplementary files. The quantity of debris extruded by different retreatment file systems was determined and compared to the corresponding control group with or without apical patency. Data were analyzed using a two-way ANOVA with a post hoc Tukey's multiple comparison test at a 5% significance level. Results. There was a statistically significant difference among the control and experimental groups. XPFR had the least quantity of extruded debris. Apical patency did not affect the debris extrusion. Conclusion. All tested files led to a significant apical debris extrusion regardless of apical patency. [ABSTRACT FROM AUTHOR]

Background: Although regulatory changes towards correcting the underrepresentation of women in randomized controlled trials (RCTs) occurred (National Institutes of Health 1994), concerns exist about whether an improvement is taking place. In this systematic review and meta-analysis, we aimed to assess the inclusion rates of women in recent RCTs and to explore the potential barriers for the enrollment of women. Methods: RCTs published in 2017 examining any type of intervention in adults were searched in PubMed and Cochrane Library. The following predefined medical fields were included: cardiovascular diseases, neoplasms, endocrine system diseases, respiratory tract diseases, bacterial and fungal infections, viral diseases, digestive system diseases, and immune system diseases. Studies were screened independently by two reviewers, and an equal number of studies was randomly selected per calendric month. The primary outcome was the enrollment rate of women, calculated as the number of randomized women patients divided by the total number of randomized patients. Rates were weighted by their inverse variance; statistical significance was tested using general linear models (GLM). Results: Out of 398 RCTs assessed for eligibility, 300 RCTs were included. The enrollment rate of women in all the examined fields was lower than 50%, except for immune system diseases [median enrollment rate of 68% (IQR 46 to 81)]. The overall median enrollment rate of women was 41% (IQR 27 to 54). The median enrollment rate of women decreased with older age of the trials' participants [mean age of trials' participants ≤ 45 years: 47% (IQR 30–64), 46–55 years: 46% (IQR 33–58), 56–62 years: 38% (IQR 27–50), ≥ 63 years: 33% (IQR 20–46), p < 0.001]. Methodological quality characteristics showed no significant association with the enrollment rates of women. Out of the 300 included RCTs, eleven did not report on the number of included women. There was no significant difference between these studies and the studies included in the analysis. Conclusions: Women are being inadequately represented, in the selected medical fields analyzed in our study, in recent RCTs. Older age is a potential barrier for the enrollment of women in clinical trials. Low inclusion rates of elderly women might create a lack of crucial knowledge in the adverse effects and the benefit/risk profile of any given treatment. Factors that might hinder the participation of women should be sought and addressed in the design of the study. [ABSTRACT FROM AUTHOR]

INTRODUCTION Ureteropelvic junction (UPJ) obstruction is by far the most common cause of pediatric hydronephrosis, occurring in 1 per 1000-2000 newborns. Widespread use of antenatal ultrasonography and the advent of modern imaging techniques have resulted in earlier and more common diagnosis of hydronephrosis. Before the advent of ultrasonography, congenital hydronephrosis presented throughout childhood and even adulthood with various symptoms such as abdominal or flank pain, recurrent urinary tract infections (UTIs), abdominal mass, renal stones, and hematuria. AIMS AND OBJECTIVES the safety and efficacy of lateral flank pycloplasty in comparison with the dorsal lumbotomypycloplasty in management of pelviureteric junction obstruction, good operative procedure in respect of post-operative complication. post-operative complications and its management. Know which procedure is suitable for which group of patient. MATERIALS AND METHODS It was a prospective randomized study performed to patients, presenting with pelviureteric junction obstruction. IPGME& R, SSKM HOSPITAL KOLKATA-700020. In the present study, 100 cases were included. Analysis was made on the basis of percentages, mean values, standard deviation, t-test and proportion/chisquare test of significance. The study comprises of 100 patients of pelviureteric junction obstruction admitted to indoors, OPD and casualty of IPGME& R, SSKM HOSPITAL, and KOLKATA. Preoperative History, investigations, operative data and postoperative course were recorded prospectively in a computerized database and in standardized data format. RESULT In our study showed that association between Post-op abdominal Distension in two groups was statistically significant. (P-value: 0.02699). Difference between Hospital Stay in two groups was statistically significant. (P-value: <0.0001). Association between Wound Infection in two groups was statistically significant. (P-value: 0.00268). Association between Seroma formation in two groups was statistically significant. (P-value: 0.0117). Association between Persistance of Abdominal lump in two groups was not statistically significant. (P-value: 0.09212). CONCLUSION Post-operative morbidity, wound infection and seroma formation all are low in dorsal lumbotomy approach. Overall, the complication rates were not significantly different for the 2 approaches .Further evaluation of cosmesis and pain control, and future studies with larger numbers of patients and longer follow up may show more divergent outcomes. [ABSTRACT FROM AUTHOR]

Diagnostic screening models for the interpretation of null hypothesis significance test (NHST) results have been influential in highlighting the effect of selective publication on the reproducibility of the published literature, leading to John Ioannidis' much-cited claim that most published research findings are false. These models, however, are typically based on the assumption that hypotheses are dichotomously true or false, without considering that effect sizes for different hypotheses are not the same. To address this limitation, we develop a simulation model that overcomes this by modeling effect sizes explicitly using different continuous distributions, while retaining other aspects of previous models such as publication bias and the pursuit of statistical significance. Our results show that the combination of selective publication, bias, low statistical power and unlikely hypotheses consistently leads to high proportions of false positives, irrespective of the effect size distribution assumed. Using continuous effect sizes also allows us to evaluate the degree of effect size overestimation and prevalence of estimates with the wrong sign in the literature, showing that the same factors that drive false-positive results also lead to errors in estimating effect size direction and magnitude. Nevertheless, the relative influence of these factors on different metrics varies depending on the distribution assumed for effect sizes. The model is made available as an R ShinyApp interface, allowing one to explore features of the literature in various scenarios. [ABSTRACT FROM AUTHOR]

Acne vulgaris is a common chronic inflammatory skin disease, which is considered one of the diseases of civilization due to the significant influence of environmental factors on the severity and frequency of these lesions. The aim of this study was to evaluate the hormonal profile of patients before treatment and to assess selected hormonal parameters after treatment. Our first objective was to examine the correlation between the selected hormonal parameters and the severity of acne before treatment. Our second objective was to evaluate the impact of treatment with three therapies, as measured by the selected hormonal parameters and acne severity. Statistical calculations were performed using the R v.4.1.1 statistical calculation environment (IDE RStudio v. 1.4.1717) with a significance level for the statistical tests set at α = 0.05. The results showed that the women in the pre-treatment (T1) and control (C) groups had significant differences in testosterone, androstendione, FAI, SHBG, prolactin, ACTH, and cortisol concentrations. After treatment, there were still significant differences in testosterone, androstendione, FAI, and SHBG concentrations between the post-treatment (T2) and control groups. We concluded that testosterone, androstendione, and cortisol concentrations correlate with acne severity. Acne in adult women may be an important clinical marker of androgen excess syndrome and cannot be considered a transient symptom of puberty. The mainstay of acne treatment is contraceptive therapy (ethonylestradiol and drospirenone). In this study, we confirmed the effectiveness of three contraceptive-based treatments using hormonal parameters and acne severity. [ABSTRACT FROM AUTHOR]

Variable message signs (VMS) are widely employed to offer drivers dynamic traffic information. However, it is still lacking practical guidance about the information volume displayed on a graphical VMS. Building on the result of the subjective questionnaire survey, a static cognitive experiment was conducted to analyze the influence of volume information (i.e., elements and displaying the number of roads) of graphical VMS on drivers' visual cognition characteristics and then determine the threshold number of roads displayed on VMS. Forty-five drivers participated in the static cognitive experiment. Five indicators, including visual cognition time, cognition accuracy, comprehension accuracy, general assessment, and information acceptance, were used to estimate the influences of graphical VMS. Study results by descriptive statistics and statistical hypothesis testing indicated that drivers also preferred auxiliary elements (i.e., distance or time information) besides basic design elements (i.e., driving direction, current position, and road name) displayed on graphical VMS. With the increase in information volume, driver visual cognition time increased while other companion indexes (i.e., visual cognition accuracy and comprehension accuracy) generally worsened. Combining the data of drivers' objective behavior and subjective scoring, the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method revealed that the number of roads shown on the graphical VMS should be no greater than five. The study results were verified by dynamic simulation experiments. This finding provides a supplement for the design standards and usage specifications for VMS. [ABSTRACT FROM AUTHOR]

Introduction: Anaemia remains a major public health concern, particularly, in sub-Saharan Africa (SSA), where it is one of the causes of maternal death. The most common cause of maternal anaemia is iron deficiency or malnutrition. This study examined the prevalence of and risk factors for anaemia among women that participated in the Nigerian Demographic Health Survey. Method: We used data of 14,454 women that participated in the 2018 Nigeria Demographic and Health Survey (NDHS). We extracted information such as demographic, social and housing, dietary characteristics and haemoglobin concentration. The descriptive statistic results, prevalence and 95% confidence interval (CIs) of anaemia with the selected respondents background characteristics were presented. The Poisson regression model with robust variance was used to assess the risk of anaemia among women of reproductive age. All analyses were weighted and adjusted for the complex survey design. Statistical significance was interpreted at p value < 0.05. Results: Maternal status, body mass index, education, residence, religion, ethnicity, region and type of cooking fuel were all important determinants of anaemia. The prevalence of anaemia was high among pregnant women (61.8%; 95% CI: 58.5–65.0), adolescents (60.4%; 95% CI: 58.1–62.6), underweight women (62.6%; 95% CI: 59.5–65.5), women who had no formal education (64.1%; 95% CI: 62.2–66.0) and those who belonged to the poorest wealth quintile (65.8%; 95% CI: 63.1–68.4). Similarly, anaemia was high among women residing in rural areas (61.5%; 95% CI: 60.0–63.0), Muslims (59.9%; 95% CI: 58.1–61.6) and women with six or more children (62.1%; 95% CI: 60.0–64.1). The risk of anaemia were 2% less likely among women who took minimum adequate diet compared to those who do not. Conclusion: To date, this is the largest data on maternal anaemia in Nigeria. The study highlighted the high burden of maternal anaemia in the country and different risk factors (medical and social) that are associated with this medical condition among women of reproductive age. We recommend future longitudinal studies to test hypothesis in order to assess whether there is any causal relationship between identified risk factors and anaemia in this group of women. [ABSTRACT FROM AUTHOR]

Following the guiding hypothesis in NLP, similar word frequency vectors may have similar implicatures, but some scholars are more inclined conversational implicatures cannot be obtained only through lexical features. To judge which view is more reasonable and explore the reasons for the divergence between them, whether conversational implicatures can be obtained only through lexical features is verified empirically. Main work of this paper includes: First, based on 600 corpora in the annotated dataset, the values of 20 lexical features of each corpus are obtained by automatic calculation. Second, meta-transformer of logistic regression for selecting features is adopted for feature selection and ranking. Third, after determining the features, the text is classified by the binomial logistic regression with the type of implicatures as labels. Fourth, results are tested for significance to identify relationships between variables. Experiments show that there is a statistical dependence between lexical features and conversational implicatures, and the text classification of implicatures can be performed only based on lexical features. In addition, the results of text classification will not be different due to the difference in context utterance or the type of implicature, and the text classification of implicatures only based on "response utterance" is more efficient. [ABSTRACT FROM AUTHOR]

With the growing number of insurance purchasers, the sophisticated claim analysis system has become an imperative must for any insurance firm. Claims Analysis can be utilized to better understand the customer strata and incorporate the findings throughout the insurance policy enrollment, including the underwriting and approval or rejection stages. In recent years machine learning (ML) technologies are increasingly being used to claims Analysis. However, choosing the optimal techniques, whether the features selection techniques, feature discretization techniques, resampling mechanisms, and ML classifiers for insurance decision assistance, is difficult and can harm the quality of claim suggestions. This study aims to develop appropriate decision models by combining binary classification, feature selection, feature discretization, and data resampling techniques. We did Extensive tests on three different datasets to evaluate the viability of the selected models. We used multiple assessment metrics besides the statistical significance test from The ANOVA test and the Friedman test to evaluate the ML models. The findings show that the models perform highly better after applying the feature discretization technique, reducing dimensionality using feature selection methods and solving the unbalanced data problem with resampling methods. [ABSTRACT FROM AUTHOR]

A physically reasonable anisotropic stellar model is constructed with the help of the gravitational decoupling via complete geometric deformation (CGD) technique under the condition of vanishing complexity factor [Contreras and Stuchlik in Eur Phys J C 82:706 2022; Herrera, in Phys Rev D 97:044010, 2018]. The source splits into a perfect fluid and an anisotropic distribution. The Finch Skea metric proves a useful seed solution to solve the Einstein sector while the condition of vanishing complexity is invoked to solve the remaining anisotropic system of equations. A comprehensive battery of tests for physical significance is imposed on the model. Through a careful choice of parameter space, it is demonstrated that the model is regular, stable, and contains a surface of vanishing pressure establishing its boundary. Matching with the exterior metric is also achieved. Finally, the energy flows between the two sectors of the source fluid are studied graphically. [ABSTRACT FROM AUTHOR]

In cognitive neuroscience research, computational models of event-related potentials (ERP) can provide a means of developing explanatory hypotheses for the observed waveforms. However, researchers trained in cognitive neurosciences may face technical challenges in implementing these models. This paper provides a tutorial on developing recurrent neural network (RNN) models of ERP waveforms in order to facilitate broader use of computational models in ERP research. To exemplify the RNN model usage, the P3 component evoked by target and non-target visual events, measured at channel Pz, is examined. Input representations of experimental events and corresponding ERP labels are used to optimize the RNN in a supervised learning paradigm. Linking one input representation with multiple ERP waveform labels, then optimizing the RNN to minimize mean-squared-error loss, causes the RNN output to approximate the grand-average ERP waveform. Behavior of the RNN can then be evaluated as a model of the computational principles underlying ERP generation. Aside from fitting such a model, the current tutorial will also demonstrate how to classify hidden units of the RNN by their temporal responses and characterize them using principal component analysis. Statistical hypothesis testing can also be applied to these data. This paper focuses on presenting the modelling approach and subsequent analysis of model outputs in a how-to format, using publicly available data and shared code. While relatively less emphasis is placed on specific interpretations of P3 response generation, the results initiate some interesting discussion points. [ABSTRACT FROM AUTHOR]

To assess the clinical and healthcare resource burden among C5 inhibitor (C5i)-treated patients with paroxysmal nocturnal haemoglobinuria (PNH), using patient-reported data. This web-based, cross-sectional survey (01FEB2021–31MAR2021) of adults with PNH treated with eculizumab (France, Germany, UK) or ravulizumab (Germany) included: patient characteristics; treatment patterns/dosage; haematological outcomes (haemoglobin [Hb] levels, transfusions, thrombotic events, breakthrough haemolysis); and medical encounters. Treatment and Hb-level subgroup differences were assessed with statistical significance tests. Among 71 patients, 98.6% were C5i-treated for ≥3 months. The majority (with reported Hb levels) had levels ≤12.0 g/dL (85.7%; n = 54/63). The mean Hb level was 10.2 g/dL (standard deviation [SD]: 2.0; median 10.0 g/dL). Treatment with above label-recommended doses was reported by 30.4% (eculizumab) and 5.3% (ravulizumab) of patients. Within the past 12 months among patients treated with C5i for ≥1 year: 24.1% had ≥1 transfusion; 3.2% had ≥1 thrombosis; and 28.6% had ≥1 breakthrough haemolysis. Among all patients, 26.8% and 31.0% reported emergency department/room [ER] and inpatient visits, respectively. Mean annual, per-patient all-cause medical encounters were: 0.5 (ER); 1.9 (inpatient); and overall outpatient visits ranged by setting from 2.0 to 6.4. Most encounters were PNH-related, with means of 0.4 (ER); 1.8 (inpatient); and 1.6–5.4 (outpatient). Primary haematological and medical encounter outcomes were similar between treatment as well as Hb-level subgroups, with almost no statistically significant differences. Despite at least 3 months of C5i treatment, high proportions of patients with PNH reported low haemoglobin levels and required transfusions and hospitalizations, which suggests remaining unmet needs. [ABSTRACT FROM AUTHOR]

Purpose: Heparin-based regimens are recommended for anticoagulation in hospitalized patients with COVID-19 though a study reported similar mortality with apixaban in critically ill hospitalized COVID-19 patients. Our pilot study sought to determine the differences in all-cause mortality, venous thromboembolism (VTE), and bleeding events between apixaban and therapeutic heparin-based regimens in hospitalized non-critically ill COVID-19 patients. Methods: We conducted a retrospective analysis of non-critically ill COVID-19 patients aged ≥ 18 years admitted to 3 campuses of Montefiore Medical Center during the first (March 2020 to May 2020) and second (January 2021 to February 2021) COVID-19 surges, who received within 48 hours of admission and continued for ≥72 hours a therapeutic dose of low-molecular-weight heparin (LMWH), unfractionated heparin (UFH), or any apixaban dose for VTE prophylaxis. Outcomes data analyzed included mortality, suspected or imaging-confirmed VTE, and bleeding using a defined criteria. Results: Overall, 162 patients met eligibility for analysis. Baseline characteristics were similar between the 2 groups except liver and renal functions. Mortality occurred in 10 (13.3%) patients on apixaban and 23 (26.4%) patients on a heparin-based regimen (P =.059). Confirmed VTE events were not different between the groups (8% vs 13.8%, P =.359), but higher incidence of bleeding occurred in heparin-based group (4% vs 52.9%, P <.001). Conclusion: There were no differences in mortality or confirmed VTE between apixaban and heparin-based regimens except for more bleeding events with the heparins. This study highlights the utility of apixaban in COVID-19. [ABSTRACT FROM AUTHOR]

Purpose – This research study aims to design a novel risk-managed time-series momentum approach. The present study also examines the time-series momentum effect in the Indian equity market. Apart from this, the study also proposes a novel risk-managed time-series momentum approach. Design/methodology/approach – The study considers the adjusted monthly closing prices of the stocks listed on the Bombay Stock Exchange from January 1996 to December 2020 to formulate long-short portfolios. Newey–West t statistics were used to test the significance of momentum returns. The present research has considered standard risk factors, i.e. market, size and value, to evaluate the risk-adjusted performance of timeseries momentum portfolios. Findings – The present research reports a substantial absolute momentum effect in the Indian equity market. However, absolute momentum strategies are exposed to occasional severe losses. The proposed time-series momentum approach not only yields 2.5 times higher return than the standard time-series momentum approach but also causes substantial enhancement in downside risks and higher-order moments. Practical implications – The study’s outcomes offer valuable insights for professional investors, capital market regulators and asset management companies. Originality/value – This study is one of the pioneers attempting to test the time-series momentum effect in emerging economies. Besides, current research contributes to the escalating literature on risk-managed momentum by suggesting a novel revised time-series momentum approach. [ABSTRACT FROM AUTHOR]

Background: Null Hypothesis Significance Testing (NHST) has been well criticised over the years yet remains a pillar of statistical inference. Although NHST is well described in terms of statistical models, most textbooks for non-statisticians present the null and alternative hypotheses (H0 and HA, respectively) in terms of differences between groups such as (μ1 = μ2) and (μ1 ≠ μ2) and HA is often stated to be the research hypothesis. Here we use propositional calculus to analyse the internal logic of NHST when couched in this popular terminology. The testable H0 is determined by analysing the scope and limits of the P-value and the test statistic's probability distribution curve. Results: We propose a minimum axiom set NHST in which it is taken as axiomatic that H0 is rejected if P-value< α. Using the common scenario of the comparison of the means of two sample groups as an example, the testable H0 is {(μ1 = μ2) and [( x ¯ 1 ≠ x ¯ 2) due to chance alone]}. The H0 and HA pair should be exhaustive to avoid false dichotomies. This entails that HA is ¬{(μ1 = μ2) and [( x ¯ 1 ≠ x ¯ 2) due to chance alone]}, rather than the research hypothesis (HT). To see the relationship between HA and HT, HA can be rewritten as the disjunction HA: ({(μ1 = μ2) ∧ [( x ¯ 1 ≠ x ¯ 2) not due to chance alone]} ∨ {(μ1 ≠ μ2) ∧ [ (x ¯ 1 ≠ x ¯ 2) not due to (μ1 ≠ μ2) alone]} ∨ {(μ1 ≠ μ2) ∧ [( x ¯ 1≠ x ¯ 2) due to (μ1 ≠ μ2) alone]}). This reveals that HT (the last disjunct in bold) is just one possibility within HA. It is only by adding premises to NHST that HT or other conclusions can be reached. Conclusions: Using this popular terminology for NHST, analysis shows that the definitions of H0 and HA differ from those found in textbooks. In this framework, achieving a statistically significant result only justifies the broad conclusion that the results are not due to chance alone, not that the research hypothesis is true. More transparency is needed concerning the premises added to NHST to rig particular conclusions such as HT. There are also ramifications for the interpretation of Type I and II errors, as well as power, which do not specifically refer to HT as claimed by texts. [ABSTRACT FROM AUTHOR]

Background: Flipped learning excessively boosts the conceptual understanding of students through the reversed arrangement of pre-learning and in classroom learning events and challenges students to independently achieve learning objectives. Using a gamification method in flipped classrooms can help students stay motivated and achieve their goals. Methods: This study adopted a randomized controlled study design with a pre-test and post-test and involved 128 nursing students at Mansoura University. This study randomly divided the students into the study and control groups. Data were collected at three time points using six tools. In the intervention group, Moodle was gamified for 6 weeks. Results: A significant difference in the students' self-confidence (p = 0.021), skills knowledge (p < 0.001), intensity of preparation (p < 0.001), and motivation (p < 0.001) was observed between the two groups; however, no difference in the students' skills performance (p = 0.163) was observed between the two groups after using gamified flipped classrooms. Conclusions: Compared with the traditional flipped classrooms, gamified flipped classrooms improved nursing students' motivation, intensity of preparation, skills knowledge, and self-confidence during laboratory clinical practice. Thus, gamification is a learning approach that can be implemented in conjunction with the flipped classroom model to motivate students to participate in the learning process. Trial registration. Prospectively registered with ClinicalTrials.gov on 26/04/2021; registration number NCT04859192. [ABSTRACT FROM AUTHOR]

Background: Adjuvant chemotherapy (ACT) is considered for high‐risk patients in stage IB lung adenocarcinoma (LUAD). However, these risk factors are recognized as negative prognostic factors, not as predictors of ACT efficacy. This study aimed to analyze the efficacy of ACT in stage IB patients by retrospectively examining patients who had recurrence. Methods: We reviewed 1399 patients with stage IB (American Joint Committee on Cancer 7th edition) LUAD from 2012 to 2017 in our institution and found 147 patients with recurrence. The last follow‐up date was December 30, 2021. One‐to‐one propensity‐score matching (PSM) was used to reduce the potential selection bias. Results: Fifty‐five (37.4%) patients had received ACT and 92 (62.6%) had not (non‐ACT). Patients with ACT were younger (p < 0.001), had larger tumors (p < 0.001) and more lymphovascular invasion (p = 0.02), and seemed to have less distant recurrence (p = 0.001). After PSM, 110 patients were matched and baseline characteristics were balanced. ACT was not associated with improved disease‐free survival (DFS) after matching (mDFS = 23.5 m for ACT vs. 29.5 m for non‐ACT, p = 0.13). ACT failed to prolong DFS of patients in the extracranial recurrence subgroup and EGFR mutation subgroups, and was even associated with shorter DFS in intracranial relapsed patients (mDFS = 30.3 m vs. 33.5 m, p = 0.083) and patients with tumor ≤30 mm (mDFS = 21.9 m vs. 30.8 m, p = 0.076). Conclusion: In patients who were destined to develop recurrence after completely resected stage IB LUAD, ACT might not be associated with improved DFS. Further large multicenter studies are warranted to validate these findings. [ABSTRACT FROM AUTHOR]

Background: Effective team leadership and good activation criteria can effectively initiate rapid response system (RRS) to reduce hospital mortality and improve quality of life. The first reaction time of nurses plays an important role in the rescue process. To construct a nurse-led (nurse-led RRS) and activation criteria and then to conduct a pragmatic evaluation of the nurse-led RRS. Methods: We used literature review and the Delphi method to construct a nurse-led RRS and activation criteria based on the theory of "rapid response system planning." Then, we conducted a quasi-experimental study to verify the nurse-led RRS. The control group patients were admitted from August to October 2020 and performed traditional rescue procedures. The intervention group patients were admitted from August to October 2021 and implemented nurse-led RRS. The primary outcome was success rate of rescue. Setting: Emergency department, Gansu Province, China. Results: The nurse-led RRS and activation criteria include 4 level 1 indicators, 14 level 2 indicators, and 88 level 3 indicators. There were 203 patients who met the inclusion criteria to verify the nurse-led RRS. The results showed that success rate of rescue in intervention group (86.55%) was significantly higher than that in control group (66.5%), the rate of cardiac arrest in intervention group (33.61%) was significantly lower than that in control group (72.62%), the effective rescue time of intervention group (46.98 ± 12.01 min) was shorter than that of control group (58.67 ± 13.73 min), and the difference was statistically significant (P < 0.05). The rate of unplanned ICU admissions in intervention group (42.85%) was lower than that in control group (44.04%), but the difference was not statistically significant (P > 0.05). Conclusions: The nurse-led RRS and activation criteria can improve the success rate of rescue, reduce the rate of cardiac arrest, shorten the effective time of rescue, effectively improve the rescue efficiency of patients. [ABSTRACT FROM AUTHOR]

Background: Decreasing healthcare provider (HCP) exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) virus in emergency departments (EDs) is crucial. Approaches include limiting the HCP presence and ensuring sealed isolation rooms, which can result in communication difficulties. This quality improvement (QI) initiative aimed to decrease by 50% duration of isolation room door opening and increasing HCP-perceived communication clarity by one point on a five-point Likert scale. Methods: This was a prospective, multi-stage project with three Plan-Do-Study-Act (PDSA) cycles between May and July 2020: (1) an educational intervention, (2) the introduction of a novel transceiver communication device, and (3) utilizing a clinical champion. Statistical Process Control XbarR charts were used to assess for special cause variation, and two-tailed Mann-Whitney U tests were used for statistical significance between Likert survey means. Qualitative responses underwent thematic analysis. Results: Observation of 174 patient encounters was completed over 33 days, with 95 meeting the inclusion criteria. Door opening decreased from baseline (n=40; mean 72.97%) to PDSA 3 (n=21; mean 1.58%; p<0.0001). HCP-perceived communication clarity improved from baseline (n=36; mean 3.36) to PDSA-3 (n=49; mean 4.21; p<0.001). Survey themes included positive effects on communication and workflow, with some challenges on the integration of the new device into the clinical workflow. HCP-perceived errors, workarounds, and workflow pauses showed significant improvements. Conclusion: This QI initiative with a novel transceiver showed significant decreases in isolation room door opening and increases in communication clarity. Future work will expand to operating rooms and intensive care units. [ABSTRACT FROM AUTHOR]

We conducted a six-month clinical follow-up on computer-aided design/computer-aided manufacturing-fabricated molar polyetheretherketone PEEK crowns to investigate their therapeutic effect. Only the PEEK crowns were examined as our study focused on short-term clinical evaluation of the new PEEK material. Twenty-three cases of PEEK crowns placed on the molars of 20 subjects (7 males and 13 females, mean age: 60.6 ± 14.2 years) were included in the study. The evaluation items were the condition of the crowns at the time of cementation and after six months, patient satisfaction, masticatory ability, and occlusal force. Mann–Whitney U tests with a significance level of 5% were used to examine the difference in glucose concentration by masticatory ability, occlusal pressure, and occlusal force, with and without PEEK crowns. The occlusion, margin fit, and contact of all 23 cases at the time of cementing were good. Six months after cementation, there was no crown desorption, fracture or crack, and prosthodontics was not needed in the 22 cases (one patient dropped out). No wear of the dental antagonist was observed. Patient satisfaction was generally high. There was no significant difference in masticatory ability between the groups with and without PEEK crowns. The subject's occlusal force was within the normal range. PEEK crowns used on molars can replace metal crowns and hold promise for an appropriate and effective treatment. [ABSTRACT FROM AUTHOR]

Null-hypothesis significance testing (NHST) has become the main tool of inference in neuroscience, and yet evidence suggests we do not use this tool well: tests are often planned poorly, conducted unfairly, and interpreted invalidly. This editorial makes the case that in addition to reforms to increase rigor we should test less, reserving NHST for clearly confirmatory contexts in which the researcher has derived a quantitative prediction, can provide the inputs needed to plan a quality test, and can specify the criteria not only for confirming their hypothesis but also for rejecting it. A reduction in testing would be accompanied by an expansion of the use of estimation [effect sizes and confidence intervals (CIs)]. Estimation is more suitable for exploratory research, provides the inputs needed to plan strong tests, and provides important contexts for properly interpreting tests. [ABSTRACT FROM AUTHOR]

We discuss a newly published study examining how phrases are used in clinical trials to describe results when the estimated P-value is close to (slightly above or slightly below) 0.05, which has been arbitrarily designated by convention as the boundary for 'statistical significance'. Terms such as 'marginally significant', 'trending towards significant', and 'nominally significant' are well represented in biomedical literature, but are not actually scientifically meaningful. Acknowledging that 'statistical significance' remains a major determinant of publication, we propose that scientific journals de-emphasise the use of P-values for null hypothesis significance testing, a purpose for which they were never intended, and avoid the use of these ambiguous and confusing terms in scientific articles. Instead, investigators could simply report their findings: effect sizes, P-values, and confidence intervals (or their Bayesian equivalents), and leave it to the discerning reader to infer the clinical applicability and importance. Our goal should be to move away from describing studies (or trials) as positive or negative based on an arbitrary P-value threshold, and rather to judge whether the scientific evidence provided is informative or uninformative. [ABSTRACT FROM AUTHOR]

Objective The prognostic markers of hepatocellular carcinoma (HCC) patients with bone metastasis are of great significance for the design of treatment strategy, the maintenance of life quality of the patients, and the improvement of cancer prognosis. MicroRNA-149 (miR-149) rs2292832 C/T polymorphism in HCC patients has been reported to be associated with the risk of HCC, but whether it can predict the prognosis of HCC patients with bone metastasis remains unclear. The goal of our study was to examine the prognostic impact of miR-149 rs2292832 C/T polymorphism on HCC patients with bone metastasis. Methods A total of 67 cases of HCC patients with bone metastasis (BC group) and 73 cases of HCC patients without bone metastasis (NC group) were included in this study. The miR-149 levels in blood leukocytes and tumor tissues were determined by qRT-PCR. Genotyping analysis of miR-149 rs2292832 was performed using polymerase chain reaction (PCR)-restriction fragment length polymorphism assay. Results The blood leukocyte miR-149 levels were significantly decreased in HCC patients, compared with the healthy controls, and they were significantly decreased in the BC patients, compared with the NC cases. BC patients carrying miR-149 rs2292832 CC+CT phenotype have a better overall survival (OS) rate, whereas no significant correlation was found between miR-149 rs2292832 CC+CT phenotype and the OS rate in NC group. The miR-149 rs2292832 CC+CT phenotype was correlated with certain bone turnover markers and bone metabolism markers but was not correlated with receptor activator of nuclear factor-kappaB ligand (RANKL) expression. Meanwhile, the combination of miR-149 rs2292832 CC+CT phenotype and RANKL expression could improve the prognosis assessment of HCC patients with bone metastasis. Conclusion miR-149 rs2292832 polymorphism might be a novel prognostic biomarker for HCC patients with bone metastasis. A follow-up study with a larger cohort from a multicenter should be performed to test our conclusions. [ABSTRACT FROM AUTHOR]

Occlusal analysis is important to analyze any disharmony in occlusion. Atraumatic dental occlusion leads to evolution of T-scan. T-scan gives a valuable procedure for clinical assessment and perception of occlusal problems. T-scan can also be used in periodontitis patients for checking the occlusal pattern. Occlusal problems and periodontal disease relationship remains controversial. Further research is needed to determine whether occlusal adjustment is necessary for periodontal treatment. The main aim of the study was to assess the occlusal pattern using T-scan in periodontitis patients. Thirty periodontitis subjects were taken and checked for occlusion using T-scan. The subject's age group was 35–55 years. The study included 15 males and 15 females. Plaque index, gingival index, attachment loss, probing depth, centric occlusion (CO), protrusion, right lateral, and left lateral were the parameters studied. Occlusal adjustments were needed to decrease and dissipate the abnormal occlusal forces. The significance of statistical tests for various movements are as follows: CO (right and left) (P = 0.077) P > 0.05; protrusion (right and left) (P = 0.09) P > 0.05; left side lateral (right side and left side) (P = 0.01) P < 0.05; right lateral (right side and left side) (P = 0.00) P < 0.05. CO and protrusion (right, left) for males and females are not significant. Left lateral and right lateral (right, left) for males and females were significant. The T-scan manages adequate specificity and sensitivity. Hence, these act as a distinctive tool for diagnosis and better unreliable when used intraorally. The T-scan method is definitely a valuable tool for examining and evaluating the occlusal contacts during maximal intercuspation. [ABSTRACT FROM AUTHOR]

Background: Opium abuse is one of the social hazards in the Middle Eastern countries. Opium consumption attributes to various malignancies. However, the exact molecular mechanism of this correlation still remains unclear. Cancer and inflammation are closely correlated. Interleukin-33 (IL-33) and its receptors, transmembrane ST2 (ST2L) and soluble ST2 (sST2), have been significantly associated with tumorigenicity. The present study aimed to investigate whether IL-33 and sST2 levels serve as cancer biomarkers in opium users. Methods: Serum samples were collected from 100 opium users and 100 healthy non-opium users in a nested case-control design. The subjects with over five years of history of opium abuse were enrolled. To assess the incidence of malignancies, the opium users were followed up from 2014 to 2019. Serum levels of IL-33 and sST2 were measured using an ELISA kit. For comparison of IL-33 and sST2 levels between the groups, two-tailed Student's t test and Mann-Whitney U test were utilized, accordingly. Logistic regression analysis was performed to evaluate the influence of confounders on the incidence of cancer. Results: During the five-year follow-up, eight opium users were diagnosed with cancer. Cancer was developed by 9.3 folds in the individuals abusing opium compared to that in the non-opium users (P=0.040, OR=9.3; 95%CI [1.1-79.4]). Serum levels of IL-33 were found to be significantly higher in the opium users than those in the healthy control group (P=0.001). The sST2 levels were significantly lower in the opium users (P=0.001). The opium users with cancer exhibited significantly higher levels of IL-33 and lower levels of sST2 than the cancer-free ones (P=0.001). Conclusion: Decline in sST2 levels and rise in the level of IL-33 are valuable biomarkers in predicting cancers. Regarding the significant alterations in the levels of these biomarkers in the opium users, as well as those in the opium users diagnosed with cancer, IL-33 and sST2 may serve as potential biomarkers in the early prediction of cancer. [ABSTRACT FROM AUTHOR]

Earthquake and tsunami predictions comprise huge uncertainties, thus necessitating probabilistic assessments for the design of defense facilities and urban planning. In recent years, computer development has advanced probabilistic tsunami hazard assessments (PTHAs), where hazard curves show the exceedance probability of the maximum tsunami height. However, owing to the lack of historical and geological tsunami records, this method is generally insufficient for validating the estimated hazard curves. The eastern coast of Shikoku in the Nankai subduction zone, Japan, is suitable for validation because tsunami records from historical Nankai Trough earthquakes are available. This study evaluated PTHAs by comparing the tsunami hazard curves and exceedance frequencies of historical Nankai Trough tsunamis. We considered 3480 earthquake scenarios representing the rupture patterns of past Nankai earthquakes and calculated all tsunamis. The probability of earthquake occurrence was based on the Gutenberg–Richter law. We considered uncertainty in tsunami calculations with astronomical tide variations. The estimated tsunami hazard curves are consistent with the exceedance frequencies obtained from historical tsunamis. In addition, sensitivity tests indicate the significance of the earthquake slip heterogeneity and tsunami defense facilities in PTHAs. We also extended the PTHAs to tsunami inundation maps in high resolution and proposed an effective new method for reducing the tsunami computation load. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the performance of a new, highly flexible radiofrequency (RF) coil system for imaging patients undergoing MR simulation. Methods: Volumetric phantom and in vivo images were acquired with a commercially available and prototype RF coil set. Phantom evaluation was performed using a silicone-filled humanoid phantom of the head and shoulders. In vivo assessment was performed in five healthy and six patient subjects. Phantom data included T1-weighted volumetric imaging, while in vivo acquisitions included both T1- and T2-weighted volumetric imaging. Signal to noise ratio (SNR) and uniformity metrics were calculated in the phantom data, while SNR values were calculated in vivo. Statistical significance was tested by means of a non-parametric analysis of variance test. Results: At a threshold of p = 0.05, differences in measured SNR distributions within the entire phantom volume were statistically different in two of the three paired coil set comparisons. Differences in per slice average SNR between the two coil sets were all statistically significant, as well as differences in per slice image uniformity. For patients, SNRs within the entire imaging volume were statistically significantly different in four of the nine comparisons and seven of the nine comparisons performed on the per slice average SNR values. For healthy subjects, SNRs within the entire imaging volume were statistically significantly different in seven of the nine comparisons and eight of the nine comparisons when per slice average SNR was tested. Conclusions: Phantom and in vivo results demonstrate that image quality obtained from the novel flexible RF coil set was similar or improved over the conventional coil system. The results also demonstrate that image quality is impacted by the specific coil configurations used for imaging and should be matched appropriately to the anatomic site imaged to ensure optimal and reproducible image quality. [ABSTRACT FROM AUTHOR]

We re-examine possible dependencies on redshift of the spectral parameters of blazars observed at very-high energies (VHEs) with Imaging Atmospheric Cherenkov telescopes. This is relevant to assess potential effects with the source distance of the photon to axion-like particle mixing that would deeply affect the propagation of VHE photons across the Universe. We focus our spectral analysis on 38 BL Lac objects (32 high-peaked and 6 intermediate-peaked) up to redshift z ≃ 0.5, and a small sample of 5 Flat Spectrum Radio Quasars up to z  = 1 treated independently to increase the redshift baseline. The 78 independent spectra of these sources are first of all carefully corrected for the gamma–gamma interaction with photons of the Extragalactic Background Light that are responsible for the major redshift-dependent opacity effect. Then, the corrected spectra are fitted with simple power laws to infer the intrinsic spectral indices Γem at VHE, to test the assumption that such spectral properties are set by the local rather than the global cosmological environment. We find some systematic anticorrelations with redshift of Γem that might indicate, although with low-significance, a spectral anomaly potentially requiring a revision of the photon propagation process. More conclusive tests with higher statistical significance will require the observational improvements offered by the forthcoming new generation of Cherenkov arrays (CTA, ASTRI, LHAASO). [ABSTRACT FROM AUTHOR]

Introduction: Older adults with Alzheimer's disease (AD) experience drastic changes in their physical and mental abilities. AD patients became heavily dependent on their caregivers for everyday functions, which have significant implications not only for them but also for their caregivers. So, many AD caregivers experienced an increased level of depression and anxiety symptoms, lower perceived control, and higher burden compared to non-AD caregivers. Therefore, psychological first aid (PFA) and educational interventions are designed to enable those caregivers to meet the daily requirements of their patient care and to cope with its challenges. Aim: Determine the effect of psychological first aid program on stress level and psychological well-being among caregivers of older adults with Alzheimer's disease. Design: One group pre-test post-test was followed. Subjects: A convenience sample of one hundred (100) caregivers of older adults with AD. Setting: All online groups concerned with the care of Alzheimer's disease patients on Facebook. Tools: Socio-demographic and clinical data of older adults with Alzheimer's disease and their caregivers' questionnaire, Alzheimer's disease knowledge scale, Kingston caregiver stress scale, and authentic identity measures (AIM) scale of psychological well-being Results: The psychological first aid program has highly statistically significant effect on the AD caregivers' knowledge, stress level and psychological well-being as (t=-30.707, P = 0.000, t = 8.500, P = 0.000 & t= -4.763, P = 0.000 respectively). Conclusion: Psychological first aid program is considered an effective intervention in decreasing the AD caregivers' stress and increasing their psychological wellbeing and knowledge regarding delivering care for AD patients. [ABSTRACT FROM AUTHOR]

Background: The outbreak of the Covid-19 pandemic in Indonesia impacts women's reproductive health services, including pregnant women services that meet the standard, namely the administration of TT immunization. Officers at the Community Health Center (Puskesmas) are more focused on controlling the spread of COVID-19. The problem that arises due to pregnant women who are not administered Tetanus Toxoid during pregnancy is the occurrence of tetanus in the mother and baby. Objective: To determine the relationship between knowledge, attitudes, and support of MCH officers towards the administration of Tetanus Toxoid immunization during the COVID-19 pandemic at UPT PuskesmasPasundan, Garut Regency, for the period of June-July 2021.Method: Analytic observational with the cross-sectional approach. The study was conducted from June to July 2021. The population and research sample consisted of 50 people. A questionnaire was used as a research instrument. Analysis: Univariate to explain the research variables and bivariate analysis to explain the relationship between knowledge, attitudes of pregnant women, and the support of MCH officers in administering Tetanus Toxoid immunization during the covid-19 pandemic. Hypothesis testingused a statistical test, namely the Chi-Square test with SPSS 2013, and the significance level was 0.05. Results: Relationship between Knowledge and Administration of Tetanus Toxoid Immunization, p-value = 0.015 (p < 0.05). Relationship between Attitude and Administration of Tetanus Toxoid Immunization, p-value = 0.0001 (P <0.05). Relationship between support of MCH officers and Administration of Tetanus Toxoid immunization, p-value = 0.0001 (p < 0.05). Conclusion: There is a relationship between knowledge, attitudes, and support of MCH officerstowards the administration of Tetanus Toxoid immunization. It illustrates that the presence of COVID-19 slightly interferes with the administration of TT immunization to pregnant women. Suggestion: It is important to make various efforts and ways to increase the coverage of TT immunization for pregnant women during the covid-19 pandemic. [ABSTRACT FROM AUTHOR]

Banks are the pivot of development. The way the banking organisations function (Payer) will influence the performance of the banks as well as the target group (The Receiver). There will be always a business relationship between the banks and their customers. This relationship will be solidified and continue to exist for a lifetime and beyond (generation customers). When a bank lives longer, it means better performance by establishing a continuous customer relationship. It is in this context, a study on the organisational foundations to its performance is critical and essential. The present study aims at establishing a temporal relationship between organisational foundations - Vision, Mission, Objectives, Goals / Values, and Strategies and needs to be juxtaposed for a concomitant relationship. The study covers four types of banks in India - Public Sector (PSBs), Private Sector(Pvt_SBs), Foreign Banks(FBs), and All Scheduled Commercial Banks (ASCBs). The organisational foundational variables such as Vision, Mission, Objectives, Goals/Values, and Strategies are culled out to test the hypothesis of the significance of organisational foundations as explicitly stated will lead to better performance of the banks by type. The above hypothesis is tested using ANOVA Fixed Effects Model for all performance variables at the aggregate level. The data are culled out from reports of eighty banks which form a major chunk of the banks in India. The sources of data are bank websites, annual reports, RBI websites, EPWRF data sets, and the like. The data have been tabulated by bank type from 1991-92 to 2019-20 - the post-liberalization period in India. The findings of the study are: PSBs although form 56.5% of the total transactions (credit) have mixed levels of performance. Some areas are statistically significant and some are not. The organisational foundational variables have moderate clarity and are in most of the cases, objectives and goals are not specified. The Pvt_SBs have a market share of 35.4% of total transactions that are urban-centric and have been performing well and most of the variables are documented. The FBs which are operating in India are clear about all the organisational variables except strategy. The share of the FBs in Indian urban transactions is 4.19% of the total and all the parameters of performance show the statistically significant result at 1% level. Generally, there will be no autocorrelation effect in the time model tested. This means Foreign Banks make very little or minimum time-oriented errors. The paper suggests that all types of banks in India must emulate the FBs to have stronger organisational foundations which in the long run facilitate better competitive performance. [ABSTRACT FROM AUTHOR]

Aim: This study aims to study and analyze the effect of beet flour substitution on manufacturing steamed brownies on the physical quality. Material and Methods: This research was conducted at the Pastry and Bakery Processing Laboratory of the Culinary Education Study Program, State University of Jakarta. The time of research starts from July 2021 to June 2022. The method used in this study is experimental. The research samples used were steamed brownies with beet flour substitution of as much as 35%, 45%, and 55%, then tested three times. Results: Based on the results of the statistical hypothesis test, the physical quality test using the ANOVA test showed that the aspects of swell ability, stability, and crumb morphology had no significant effect or difference in the substitution of beetroot flour as much as 35%, 45%, and 55% in the manufacture of steamed brownies. Conclusion: The conclusion of this study is to recommend steamed brownies with 55% beet flour substitution to be developed to optimize the utilization of beetroot flour as a nutritional value enhancer. [ABSTRACT FROM AUTHOR]

Aim: Objective is to improve precision for credit card fraud detection by using Novel Optimized Random Forest Technique (NORFT) and comparison with Logistic Regression (LT). Materials and Methods: In NORFT, it uses multiple Decision Trees to detect the credit card fraud by culminating the maximum attained probability values. The groups consist of NORFT and LR for comparison analysis. The sample size was estimated by using Clinicalc online tool, which is determined as N=2500 for each group with g-power value as 80% and datasets are collected from various web sources with recent study findings and threshold 0.05%, confidence interval 95% mean and standard deviation. Results: The implementation resulted in precision as such NORFT (92.52%) and LR (71.60%). The statistical significance was performed using Independent Sample T-test between the groups, the study has a significance value of (p>0.05) i.e. p=0.649 and states does not have any difference in research. Conclusion: Novel Optimized Random Forest Algorithm (NORFT) has significantly finer precision than Logistic Regression Algorithm (LR). [ABSTRACT FROM AUTHOR]

Background: Transgenerational epigenetic risks associated with complex health outcomes, such as autism spectrum disorder (ASD), have attracted increasing attention. Transgenerational environmental risk exposures with potential for epigenetic effects can be effectively identified using space-time clustering. Specifically applied to ancestors of individuals with disease outcomes, space-time clustering characterized for vulnerable developmental stages of growth can provide a measure of relative risk for disease outcomes in descendants. Objectives: (1) Identify space-time clusters of ancestors with a descendent with a clinical ASD diagnosis and matched controls. (2) Identify developmental windows of ancestors with the highest relative risk for ASD in descendants. (3) Identify how the relative risk may vary through the maternal or paternal line. Methods: Family pedigrees linked to residential locations of ASD cases in Utah have been used to identify space-time clusters of ancestors. Control family pedigrees of none-cases based on age and sex have been matched to cases 2:1. The data have been categorized by maternal or paternal lineage at birth, childhood, and adolescence. A total of 3957 children, both parents, and maternal and paternal grandparents were identified. Bernoulli space-time binomial relative risk (RR) scan statistic was used to identify clusters. Monte Carlo simulation was used for statistical significance testing. Results: Twenty statistically significant clusters were identified. Thirteen increased RR (> 1.0) space-time clusters were identified from the maternal and paternal lines at a p-value < 0.05. The paternal grandparents carry the greatest RR (2.86–2.96) during birth and childhood in the 1950's–1960, which represent the smallest size clusters, and occur in urban areas. Additionally, seven statistically significant clusters with RR < 1 were relatively large in area, covering more rural areas of the state. Conclusion: This study has identified statistically significant space-time clusters during critical developmental windows that are associated with ASD risk in descendants. The geographic space and time clusters family pedigrees with over 3 + generations, which we refer to as a person's geographic legacy, is a powerful tool for studying transgenerational effects that may be epigenetic in nature. Our novel use of space-time clustering can be applied to any disease where family pedigree data is available. [ABSTRACT FROM AUTHOR]

In a prospective cohort study, stools from children <3 years with and without diarrhea who were Clostridioides difficile nucleic acid amplification test-positive underwent ultrasensitive and quantitative toxin measurement. Among 37 cases and 46 controls, toxin concentration distributions overlapped substantially. Toxin concentration alone does not distinguish C. difficile infection from colonization in young children. [ABSTRACT FROM AUTHOR]

A new method of identifying the validity of pressure sensor readings has been developed. The method uses duplication of measurements which allows an estimation of the magnitude of an error, although it does not make it possible to establish which sensor is responsible for the error. The method helps to evaluate the systematic error magnitude and to test whether the error exists within a permission range accounting for a correlation structure of measurement series. An autoregressive model with a drift coefficient is applied to investigate a time series of the differences in readings. To test the significance of this coefficient, a modified Student’s test is used. Unlike the standard Student’s test, this new method tests an interval hypothesis. The null hypothesis assumes the systematic error is within the range and the alternative is out of the range. Error probabilities of type I and type II are calculated. An example of 2nd order autoregressive model was considered and the sensitivity of the proposed method was investigated. [ABSTRACT FROM AUTHOR]

The Canonical Correlation Analysis (CCA) estimates the correlation between two vector variables by maximizing the correlation of linear combinations of their respective components. Here, the CCA is used to find correlation patterns in the last five successive, per pairs, earthquakes ( M ≥ 4.0) preceding 271 main shocks ( M ≥ 5.5) that occurred in the Greek territory during 1964–2018. The vector variables have two components, the earthquake magnitude and interevent time. The statistical significance of CCA is determined by the standard parametric test along with two proposed randomization tests, one using random shuffling of each paired dataset and one using randomly selected pairs of successive earthquakes. Simulations were designed on synthetic data from vector variables having the statistical characteristics of the real observations. The results on uncorrelated variables showed the correct size for the two randomization tests but larger type I error for the parametric significance test for small sample size. For correlated variables, the test power was equally high for both test types. The application of CCA and the significance tests to the Greek seismicity evidence the significant correlation among the last five successive preshocks, proving to be a promising tool in an a posteriori short-term earthquake forecasting. [ABSTRACT FROM AUTHOR]

Simple Summary: Resistance to standard therapies impose a huge challenge on the treatment for glioblastoma multiforme (GBM), which is often considered as a cell intrinsic property of either GBM or, more significantly, of GBM stem-like cells. Tumor-associated macrophages and microglia (TAMs) take up the majority of the immune population in the tumor microenvironment of GBM and potentially participating in modulating therapy responses. However, little is known about the mechanisms underlying the effect of TAMs on temozolomide (TMZ) induced chemoresistance. Members of the metzincin superfamily such as Matrix Metalloproteases (MMPs) and A Disintegrin and Metalloprotease (ADAM) proteases are important participants in the process of intercellular communications in the tumor microenvironment. Herein, we revealed a novel concept of an intra-tumoral ADAM8 mediated malignant positive feedback loop constituted by the intimate interaction of tumor associated macrophages (TAMs) and GBM cells under TMZ treatment. These findings provide a convincing example and further support the notion that the tumor microenvironment, in addition to GBM cells and GBM stem-like cells, should be considered as an essential modulator of therapy in GBM. In conclusion, our study provides a rational basis for TAM sparing ADAM8-targeting in GBM to optimize standard chemotherapy. Standard chemotherapy of Glioblastoma multiforme (GBM) using temozolomide (TMZ) frequently fails due to acquired chemoresistance. Tumor-associated macrophages and microglia (TAMs) as major immune cell population in the tumor microenvironment are potential modulators of TMZ response. However; little is known about how TAMs participate in TMZ induced chemoresistance. Members of the metzincin superfamily such as Matrix Metalloproteases (MMPs) and A Disintegrin and Metalloprotease (ADAM) proteases are important mediators of cellular communication in the tumor microenvironment. A qPCR screening was performed to identify potential targets within the ADAM and MMP family members in GBM cells. In co-culture with macrophages ADAM8 was the only signature gene up-regulated in GBM cells induced by macrophages under TMZ treatment. The relationship between ADAM8 expression and TAM infiltration in GBM was determined in a patient cohort by qPCR; IF; and IHC staining and TCGA data analysis. Moreover; RNA-seq was carried out to identify the potential targets regulated by ADAM8. CCL2 expression levels were determined by qPCR; Western blot; IF; and ELISA. Utilizing qPCR; IF; and IHC staining; we observed a positive relationship between ADAM8 expression and TAMs infiltration level in GBM patient tissues. Furthermore; ADAM8 induced TAMs recruitment in vitro and in vivo. Mechanistically; we revealed that ADAM8 activated HB-EGF/EGFR signaling and subsequently up-regulated production of CCL2 in GBM cells in the presence of TMZ treatment; promoting TAMs recruitment; which further induced ADAM8 expression in GBM cells to mediate TMZ chemoresistance. Thus; we revealed an ADAM8 dependent positive feedback loop between TAMs and GBM cells under TMZ treatment which involves CCL2 and EGFR signaling to cause TMZ resistance in GBM. [ABSTRACT FROM AUTHOR]

Simple Summary: The application of IL-2 for treating cancer is limited owing to its toxicity and short half-life. Its high binding ability to IL-2 receptor α expands immunosuppressive Treg cells, which represents an undesirable toxicity in cancer immunotherapy. Moreover, its small molecular size is the reason for its short half-life. We solved these problems by using a covalent modification strategy of IL-2 variant IL-2K35C with fatty acid by maleimide chemistry, namely, IL-2K35C-moFA. The experiments performed in vitro and in vivo proved that IL-2K35C-moFA is a novel immunotherapeutic agent with the potential to selectively stimulate CD8+ T cells and NK cells. Compared to IL-2WT, IL-2K35C-moFA showed a specifically reduced potency for the stimulation of Treg cells. Our results also showed that fatty acid conjugation appears to be effective in half-life extension. The combination of selective lymphocyte expansion and its long half-life means IL-2K35C-moFA should be evaluated as a potential human immunotherapeutic in the future. Human interleukin 2 (IL-2) has shown impressive results as a therapeutic agent for cancer. However, IL-2-based cancer therapy is limited by strong Treg amplification owing to its high binding affinity to IL-2 receptor α (IL-2Rα) and its short half-life owing to its small molecular size. In this study, we solved these problems using a covalent modification strategy of the IL-2 variant, i.e., substituting cysteine (C) for lysine (K) at position 35, using octadecanedicarboxylic acid through maleimide chemistry, creating IL-2K35C-moFA. IL-2K35C-moFA was equipotent to human IL-2 wild type (IL-2WT) in activating tumor-killing CD8+ memory effector T cells (CD8+ T) and NK cells bearing the intermediate affinity IL-2 receptors, and less potent than IL-2WT on CTLL-2 cells bearing the high-affinity IL-2 receptors. Moreover, it was shown to support the preferential activation of IL-2 receptor β (IL-2Rβ) over IL-2Rα because of the mutation and fatty acid conjugation. In a B16F10 murine tumor model, IL-2K35C-moFA showed efficacy as a single dose and provided durable immunity for 1 week. Our results support the further evaluation of IL-2K35C-moFA as a novel cancer immunotherapy. [ABSTRACT FROM AUTHOR]

The Chernoff information between two probability measures is a statistical divergence measuring their deviation defined as their maximally skewed Bhattacharyya distance. Although the Chernoff information was originally introduced for bounding the Bayes error in statistical hypothesis testing, the divergence found many other applications due to its empirical robustness property found in applications ranging from information fusion to quantum information. From the viewpoint of information theory, the Chernoff information can also be interpreted as a minmax symmetrization of the Kullback–Leibler divergence. In this paper, we first revisit the Chernoff information between two densities of a measurable Lebesgue space by considering the exponential families induced by their geometric mixtures: The so-called likelihood ratio exponential families. Second, we show how to (i) solve exactly the Chernoff information between any two univariate Gaussian distributions or get a closed-form formula using symbolic computing, (ii) report a closed-form formula of the Chernoff information of centered Gaussians with scaled covariance matrices and (iii) use a fast numerical scheme to approximate the Chernoff information between any two multivariate Gaussian distributions. [ABSTRACT FROM AUTHOR]

In many hypothesis testing applications, we have mixed priors, with well-motivated informative priors for some parameters but not for others. The Bayesian methodology uses the Bayes factor and is helpful for the informative priors, as it incorporates Occam's razor via the multiplicity or trials factor in the look-elsewhere effect. However, if the prior is not known completely, the frequentist hypothesis test via the false-positive rate is a better approach, as it is less sensitive to the prior choice. We argue that when only partial prior information is available, it is best to combine the two methodologies by using the Bayes factor as a test statistic in the frequentist analysis. We show that the standard frequentist maximum likelihood-ratio test statistic corresponds to the Bayes factor with a non-informative Jeffrey's prior. We also show that mixed priors increase the statistical power in frequentist analyses over the maximum likelihood test statistic. We develop an analytic formalism that does not require expensive simulations and generalize Wilks' theorem beyond its usual regime of validity. In specific limits, the formalism reproduces existing expressions, such as the p-value of linear models and periodograms. We apply the formalism to an example of exoplanet transits, where multiplicity can be more than 10 7 . We show that our analytic expressions reproduce the p-values derived from numerical simulations. We offer an interpretation of our formalism based on the statistical mechanics. We introduce the counting of states in a continuous parameter space using the uncertainty volume as the quantum of the state. We show that both the p-value and Bayes factor can be expressed as an energy versus entropy competition. [ABSTRACT FROM AUTHOR]

Introduction: Differentiation between Chronic Hand Eczema (CHE) and Palmoplantar Psoriasis (PP) is a diagnostic challenge. Dermoscopy can helpto distinguish between the two conditions. Aim: To establish and compare the dermoscopic findings of the CHE and PP using DermLite DL4 dermoscope and to confirm the accuracy of the dermoscopic findings with the histopathological findings. Materials and Methods: A cross-sectional study was conducted at Navodaya Medical College, Hospital and Research Centre, Raichur, Karnataka, India, from January 2017 to June 2018. Fifty patients each of CHE (26 male and 24 female subjects) and PP (25 male and 25 female subjects) were included in the study. A detailed clinical history, cutaneous clinical and dermoscopic findings of each case were noted. A 4 mm punch biopsy was taken from 30 patients for histopathological analysis. The data was tabulated, analysed and tested for significance using the Chi-square test. Results: The mean age of the patients was 46±4 years. On dermoscopic examination, diffuse white scales in 45 (90%) patients, over a red background in 49 (98%) patients with regularly arranged dots and globules in 45 (90%) patients was seen in PP. Patchy yellow scales 46 (90%), yellow dots, globules and yellow to brown crusts against a yellow background was seen in all patients (100%) of CHE (p-value <0.001). Histopathological findings are in agreement with dermoscopic findings in 9/16 and 10/14 cases of CHE and PP respectively. Conclusion: Dermoscope is a useful non invasive clinical aid to differentiate between CHE and PP. The presence of diffuse white scales over a red background and regularly arranged vessels indicates PP, whereas the presence of patchily distributed yellow scales, yellow dots and globules; and yellow to brown crusts against a yellow background is more suggestive of CHE. [ABSTRACT FROM AUTHOR]