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BACKGROUND Disease knowledge is associated with increased treatment compliance and improvement of symptoms in inflammatory bowel disease (IBD). IBD-knowledge inventory device (IBD-KID) was developed and validated specifically as a tool to measure disease-related knowledge in children with IBD and their parents. AIM To prospectively assess the determinants of disease-related knowledge regarding paediatric IBD patients and their parents, using the IBD-KID. METHODS A questionnaire-based survey was carried out in paediatric patients and their parents. The determinants of patients' and parents' IBD-KID scores were assessed according to hierarchical linear regression models. RESULTS The study group consisted of 269 IBD patients and 298 parents. The patients' mean (standard deviation, SD) IBD-KID score was 10.87 (± 3.97), while the parents' was 11.95 (± 3.97). Both groups exhibited poor knowledge of the side effects of steroid therapy, the role of surgical treatment in IBD, dietary restrictions and the risks associated with the use of herbal medicines. The patients' IBD-KID scores were statistically associated with patient sex [B coefficient (standard error, SE) = 1.03 (0.44), P = 0.021] and patient age [B (SE) = 0.03 (0.01), P < 0.001]. The parents' IBD-KID scores were significantly related to patient age [B (SE) = 0.02 (0.01), P = 0.003], and treatment with immunosuppressive agent [B (SE) = 1.85 (0.48), P < 0.001]. The final models explained 26.9% of the variance of patients' IBD-KID scores and 18.5% of the variance of parents' scores. CONCLUSION The variables originating from parents' knowledge were significantly associated with patients' IBD-KID scores. The study results indicate the need to implement better education programmes for patients and parents.

Background Upper respiratory tract infections (URTIs) are a major cause of exacerbations in patients with chronic obstructive pulmonary disease (COPD). We assessed the effectiveness of Oscillococcinum® in the protection from URTIs in patients with COPD who had been vaccinated against influenza infection over the 2018-2019 winter season. Methods Patients (n=106; mean ± standard deviation age: 66.0 ± 10.3 years; 89.6% men) were randomized into two groups: group V received influenza vaccination only and group OV received influenza vaccination plus Oscillococcinum® (one oral dose per week from inclusion in the study until the end of follow-up, with a maximum of 6 months follow-up over the winter season). The primary endpoint was the incidence rate of URTIs (number of URTIs/1000 patient-treatment exposure days) during follow-up compared between the two groups. Results There was no significant difference in any of the demographic characteristics, baseline COPD, or clinical data between the two treatment groups (OV and V). The URTI incidence rate was significantly higher in group V than in group OV (2.9 versus 1.2 episodes/1000 treatment days, difference OV-V = -1.7; p=0.0312). There was a significant delay in occurrence of an URTI episode in the OV group versus the V group (mean ± standard error: 48.7 ± 3.0 versus 67.0 ± 2.8 days, respectively; p=0.0158). Limitations to this study include its small population size and the self-recording by patients of the number and duration of URTIs and exacerbations. Conclusion Oscillococcinum may decrease the incidence rate and delay the appearance of URTIs in patients with COPD.

In the present study, the multi-component lactoperoxidase system (LPS) is used for improving milk safety and requires thiocyanate (SCN−) as a substrate for the generation of antimicrobial hypothiocyanite (OSCN−). The influence of four independent variables for activation of lactoperoxidase system on the improving the quality of raw goat milk were investigated and optimized using an artificial neural network and response surface methodology on the growth of total coliform count and bacterial count. The two models' predictive capabilities were compared in terms of root mean square error, mean absolute error, standard error of prediction, absolute average deviation, and coefficient of determination based on the validation data set. The results showed that properly trained artificial neural network model is more accurate in prediction than the RSM model. The optimum conditions were a temperature of 25 °C, storage time of 10 hr, NaSCN of 30 ppm and hydrogen peroxide of 18 ppm. For these conditions, an experimental total coliform count of 4.51 × 102cfu/mL and total bacteria count of 5.44× 104cfu/mLwas obtained, which was in reasonable agreement with the predicted content.The results indicate that the model is in substantial agreement with current research, and activating the LP System can extend the storage period of goat milkfor up to10hr when stored at 25 °C.The results revealed no significant differences in milk composition (protein content, fat content, lactose content, total solids, moisture content and ash content) were observed among activated and control goat milk samples.

Background There is little information about how diet quality evolves in early childhood, whether children exhibit varying diet quality trajectories, or which components of diet quality should be targeted for intervention. Objective The goal of this study was to identify and evaluate trajectories of dietary quality in young children. Design This was a secondary analysis of an observational, longitudinal cohort study of non-Hispanic African American or White children and their parents from racially concordant households with 4 years of follow-up (up to 13 study visits). Data on mother, infant feeding, and body mass index were assessed at baseline. Diet was evaluated using 3-day diaries at each visit. Participants/setting Of 372 children enrolled, 349 children had at least 3 study visits with dietary data for this analysis. Participants were enrolled at age 3 years between March 2001 and August 2002 in Cincinnati, OH. Final study visits were conducted between February 2005 and June 2006. Main outcome measure The main outcome measure was the total Healthy Eating Index 2005 (HEI-2005) score and HEI-2005 component scores. Statistical analyses Diet quality trajectories were modeled using group-based modeling techniques. Results The total HEI-2005 score was low at age 3 years (mean ± standard error = 55.1 ± 0.4 of maximum 100 points) and remained stable to age 7 years (mean ± standard error = 54.0 ± 0.6; P = 0.08 for trend). Five HEI-2005 trajectory groups were identified, of which 1 declined and 1 improved over time. HEI-2005 component scores, except milk intake and meat/beans scores, differed significantly (all, P ≤ 0.02) among trajectory groups at age 3 years, and most differences were maintained at age 7 years. Total vegetables, dark green and orange vegetables and legumes, and whole grains component scores were low for all trajectory groups. Whole fruit; total fruit; saturated fat; and calories from solid fats, alcoholic beverages, and added sugars (SoFAAS) were highly variable among trajectory groups. Children in the lowest diet quality trajectory group were less likely to be breastfed and more likely to have been regular consumers of soft drinks (e.g., powdered drink mixes, sport drinks, or soda pop) before age 3 years. Conclusions Young childhood diet quality was low at age 3 years and remained stable to age 7 years. Improving intake of vegetables and whole grains is needed for all children. Focused attention regarding increasing fruit intake and reducing SoFAAS may be needed for families at increased risk for low overall diet quality.

The purpose of the Dutch Travel Survey is to produce reliable estimates on mobility of the Dutch population. In this paper mobility trends are estimated at several aggregation levels, using multilevel time series models. The models account for discontinuities induced by two survey redesigns and outliers due to less reliable outcomes in one particular year. The input for the model is direct annual estimates with their standard errors for the period 1999–2017 for a detailed cross-classification in 504 domains. Appropriate transformations for the direct estimates and generalized variance functions to smooth the standard errors of the direct estimates are proposed. The models are fitted in an hierarchical Bayesian framework using MCMC simulations. From the model outputs smooth trend estimates are computed at the most detailed domain level. Predictions at higher aggregation levels obtained by aggregation of the most detailed domain predictions result in a numerically consistent set of trend estimates for all target variables.

Dried fruits are shelf-stable alternatives to fresh fruit that avert common barriers to consuming fruit. Consumption of dried fruits may facilitate greater fruit consumption and contribute to better diet quality and nutrient intakes.Our aims were to assess differences in diet quality and cardiometabolic health between dried fruit consumers and nonconsumers, and evaluate differences in nutrient intakes on days when dried fruits were consumed vs not consumed.This is a cross-sectional analysis of data from the National Health and Nutrition Examination Survey 2007-2016.Mean dried fruit intakes were estimated in adults 20 years and older (n = 25,590) who completed a dietary recall. Dried fruit consumers (one-quarter cup-equivalent/day or more) were defined in respondents with 2 complete dietary recalls (n = 22,311). Within-person differences in nutrient intakes were assessed in respondents who consumed dried fruit on 1 of 2 dietary recalls (n = 1,233).Cardiometabolic risk factors, diet quality scored using the Healthy Eating Index 2015, and nutrient intakes were assessed.Diet quality and cardiometabolic health were compared in consumers vs nonconsumers using multivariate linear regression, adjusted for demographic and lifestyle factors. Within-person differences in nutrient intakes on days when dried fruits were consumed vs not were assessed using multivariate linear regression.Mean ± standard error dried fruit intake was 0.04 ± 0.001 cup-equivalents and represented 3.7% of total fruit consumed. Consumers (7.2% of adults) had higher quality diets than nonconsumers (mean ± standard error Healthy Eating Index 2015 score = 60.6 ± 0.5 vs 52.6 ± 0.3; P0.001) and lower mean body mass index, waist circumference, and systolic blood pressure (P0.01). Total carbohydrate, dietary fiber, potassium, and polyunsaturated fat intakes were greater on days when dried fruits were consumed vs not consumed (P0.001). Total calorie intakes were also greater (208-215 kcal; P ≤ 0.002) when dried fruits were consumed.Dried fruit consumption is associated with higher diet quality and greater intakes of underconsumed nutrients. However, dried fruits do not appear to displace other calorie sources on days when consumed.

Background The transmission dynamics and severity of coronavirus disease 2019 (COVID-19) pandemic is different across countries or regions. Differences in governments’ policy responses may explain some of these differences. We aimed to compare worldwide government responses to the spread of COVID-19, to examine the relationship between response level, response timing and the epidemic trajectory. Methods Free publicly-accessible data collected by the Coronavirus Government Response Tracker (OxCGRT) were used. Nine sub-indicators reflecting government response from 148 countries were collected systematically from January 1 to May 1, 2020. The sub-indicators were scored and were aggregated into a common Stringency Index (SI, a value between 0 and 100) that reflects the overall stringency of the government’s response in a daily basis. Group-based trajectory modelling method was used to identify trajectories of SI. Multivariable linear regression models were used to analyse the association between time to reach a high-level SI and time to the peak number of daily new cases. Results Our results identified four trajectories of response in the spread of COVID-19 based on when the response was initiated: before January 13, from January 13 to February 12, from February 12 to March 11, and the last stage—from March 11 (the day WHO declared a pandemic of COVID-19) on going. Governments’ responses were upgraded with further spread of COVID-19 but varied substantially across countries. After the adjustment of SI level, geographical region and initiation stages, each day earlier to a high SI level (SI > 80) from the start of response was associated with 0.44 (standard error: 0.08, P 2 = 0.65) days earlier to the peak number of daily new case. Also, each day earlier to a high SI level from the date of first reported case was associated with 0.65 (standard error: 0.08, P 2 = 0.42) days earlier to the peak number of daily new case. Conclusions Early start of a high-level response to COVID-19 is associated with early arrival of the peak number of daily new cases. This may help to reduce the delays in flattening the epidemic curve to the low spread level. Graphic abstract

Background The amount of muscle volume (MV) varies between individuals and is important for health, well-being and performance. Therefore, the monitoring of MV using different imaging modalities is important. Magnetic resonance imaging (MRI) is considered the gold standard, but is not always easily accessible, and the examinations are expensive. Ultrasonography (US) is a much less expensive imaging method widely used to measure changes in muscle thickness (MT). Whether MT may translate into MV needs further investigation. Purpose The aim of this review is to clarify whether US-derived equations based on MT predict MV based on MRI. Methods A systematic literature review was conducted according to the PRISMA statement, searching the electronic databases PubMed, CINAHL and Web of Science, for currently published equations to estimate MV with US. Results The literature search resulted in 363 citations. Twelve articles met the eligibility criteria. Ten articles scored eight out of eleven on QUADAS and two scored nine. Thirty-six prediction equations were identified. R values ranged between 0.53 and 0.961 and the standard error of the estimate (SEE) ranged between 6 and 12% for healthy adult populations, and up to 25.6% for children with cerebral palsy. Eight studies evaluated the results with a Bland–Altman plot and found no systematic errors. The overall strength and quality of the evidence was rated “low quality” as defined by the GRADE system. Conclusions The validity of US-derived equations based on MT is specific to the populations from which it is developed. The agreement with MV based on MRI is moderate with the SEE ranging between 6 and 12% in healthy adult populations. Suggestions for future research include investigations as to whether testing positions or increasing the number of measuring sites could improve the validity for prediction equations.

Background Meta-analyses typically consider multiple outcomes and report univariate effect sizes considered as independent. Multivariate meta-analysis (MVMA) incorporates outcome correlation and synthesises direct evidence and related outcome estimates within a single analysis. In a series of meta-analyses from the critically ill literature, the current study contrasts multiple univariate effect estimates and their precision with those derived from MVMA. Methods A previous meta-epidemiological study was used to identify meta-analyses with either one or two secondary outcomes providing sufficient detail to structure bivariate or tri-variate MVMA, with mortality as primary outcome. Analysis was performed using a random effects model for both odds ratio (OR) and risk ratio (RR); borrowing of strength (BoS) between multivariate outcome estimates was reported. Estimate comparisons, β coefficients, standard errors (SE) and confidence interval (CI) width, univariate versus multivariate, were performed using Lin’s concordance correlation coefficient (CCC). Results In bivariate meta-analyses, for OR (n = 49) and RR (n = 48), there was substantial concordance (≥ 0.69) between estimates; but this was less so for tri-variate meta-analyses for both OR (n = 25; ≥ 0.38) and RR (≥ -0.10; n = 22). A variable change in the multivariate precision of primary mortality outcome estimates compared with univariate was present for both bivariate and tri-variate meta-analyses and for metrics. For second outcomes, precision tended to decrease and CI width increase for bivariate meta-analyses, but was variable in the tri-variate. For third outcomes, precision increased and CI width decreased. In bivariate meta-analyses, OR coefficient significance reversal, univariate versus MVMA, occurred once for mortality and 6 cases for second outcomes. RR coefficient significance reversal occurred in 4 cases; 2 were discordant with OR. For tri-variate OR meta-analyses reversal of coefficient estimate significance occurred in two cases for mortality, nine cases for second and 7 cases for third outcomes. In RR meta-analyses significance reversals occurred for mortality in 2 cases, 6 cases for second and 3 cases for third; there were 7 discordances with OR. BoS was greater in trivariate MVMAs compared with bivariate and for OR versus RR. Conclusions MVMA would appear to be the preferred solution to multiple univariate analyses; parameter significance changes may occur. Analytic metric appears to be a determinant.

Background The gait initiation (GI) process can be characterized by anticipatory postural adjustments (APAs) and first step characteristics. However, even within a constrained environment, it is unclear how many trials are necessary to obtain a reliable measurement of the GI process within one assessment. Research question How many gait initiation trials are necessary to reliably detect APAs and first step characteristics in healthy elderly (HC) and people with Parkinson’s disease with Freezing of Gait (PD + FOG) under single (ST) and dual task (DT) conditions and are there any potential systematic errors? Methods Thirty-eight PD + FOG (ON-medication) and 30 HC performed 5 trials of GI under ST and DT (auditory stroop test). APAs and first-step-outcomes were captured with IMUs placed on the lower back and on each foot. Intraclass correlation coefficients (ICCs) and the standard error of measurement (SEM) were computed to investigate reliability and mixed model analysis to find potential systematic errors. Additionally, we computed an estimation for the number of necessary trials to reach acceptable reliability (ICC = 0.75) for each outcome. Results ICCs varied from low reliability to excellent reliability across outcomes in PD + FOG and HC. ICCs were comparable under ST and DT for most outcomes. SEM results confirmed the ICC results. A systematic error was found for the first trial in first step ROM. Number of necessary trials varied largely across outcomes. Significance Within-session reliability varied across outcomes but was similar for PD + FOG and HC, and ST and DT. ML size of APA and first step ROM were most reliable, whereas APA duration and latency were least reliable. Depending on the outcome of interest, future studies should conduct multiple trials of GI to increase reliability. ispartof: Gait & Posture vol:88 issue:July 2021 pages:126-131 ispartof: location:England status: Published online

Indivíduos com deficiência visual podem apresentar déficits de equilíbrio e existem diversos métodos capazes de avalia-lo, sendo a baropodometria um método em expansão, porém com escassez de estudos que abordem suas medidas psicométricas e avaliações padronizados. Objetivo: Avaliar a confiabilidade relativa e absoluta da baropodometria em um protocolo de avaliação de equilíbrio para pessoas com deficiência visual. Método: Estudo observacional, de corte transversal, com 38 indivíduos, de ambos os sexos, com e sem diagnóstico de deficiência visual, sendo alocados: grupo controle (GCO) (n= 13) composto por indivíduos sem deficiência visual, grupo baixa visão (GBV) (n= 15), grupo cegueira (GCE) (n= 10) e posteriormente realizada a junção do GBV e GCE, compondo o grupo deficiência visual (GDV) (n= 25). Para avaliar a confiabilidade da baropodometria, utilizou-se o método teste e reteste, com um intervalo de sete dias. Os indivíduos foram avaliados em três condições, apoio bipodal, apoio unipodal direito e apoio unipodal esquerdo considerando as variáveis área, amplitude e velocidade média anteroposterior e laterolateral. Para confiabilidade relativa foi utilizado o Coeficiente de Correlação Intraclasse (CCI) e para a confiabilidade absoluta o erro padrão da medida (EPM). Resultados: Em relação a confiabilidade relativa, os CCIs das variáveis da baropodometria variaram de baixo a muito alto em todos os grupos, com melhor confiabilidade nas condições de apoios unipodais e maior índice no GCE. Na confiabilidade absoluta, 14 variáveis apresentaram boa confiabilidade. Conclusão: A baropodometria apresenta-se como um método confiável, porém deve-se ter cautela na escolha do posicionamento e da variável a ser analisada.

Stature is one of the main biological features which can be used to classify unidentified skeletal deceased. Also, precise population data is crucial for forensic anthropology frameworks. Nonetheless, the studies concerning this subject in Thailand are limited and regularly focus on long bones. This study attempts to establish stature estimation equations from clavicular dry bone and radiographic measurements. Both sides of the clavicular bones are separated from 25 female and 112 male deceased in an autopsy room situated in Bangkok, Thailand. Twelve variables of each side of the clavicle are measured. The study outcomes show that stature can be estimated by applying 3 variables in a stepwise regression analysis model in unidentified sex remains, with R2 = 0.49 and standard error of estimation (SEE) 5.238 cm. Moreover, the height of the sternal end of clavicle bones can be used to estimate stature in cases of fragmented clavicles recovered from crime scenes with R2 = 0.238 and SEE 6.353 cm. Maximum length shows the best correlation and model fit with stature (R = 0.562, R2 = 0.316 and SEE 6.020 cm) from radiographic measurements. Therefore, this study presents a complementary, beneficial method for forensic anthropologists to create biological profiles of unidentified skeletal remains in cases where the long bones are not obtainable. Moreover, stature estimation from radiographic measurements can be applied in cases of partial skeletonisation.

Background The aim of this study was to determine the relative and absolute reliabilities of 5 key performance-based measures of physical function in the Canadian Longitudinal Study on Aging (CLSA). Methods An age-stratified subsample of 147 participants from the CLSA who were undergoing their 3-year data collection visit participated in 2 repeat visits (within 1 week). Participants underwent tests of grip strength, 4-m gait speed, Timed Up and Go (TUG), chair rise, and single-leg stance (left, right, mean, maximum). Intraclass correlation coefficients (ICCs), standard error of measurement, and minimal detectable change (MDC) values were calculated. Results The relative reliability for grip strength was excellent (ICC = 0.95); the TUG and single-leg stance tests had good reliability (ICC = 0.80 or 0.78–0.82, respectively); gait speed and the chair-rise test had moderate reliability (ICC = 0.64 for both) for participants overall. For participants between 50 and 64 years, TUG and gait speed had poor reliabilities (ICC = 0.38 or 0.33, respectively). For participants aged 75 years and older, the single-leg stance had poor reliability (ICC = 0.30–0.39). The MDC90 was about 6 kg for grip strength, 2.3 seconds for TUG, 0.2 m/second for gait speed, 5.2 seconds for chair rise, and ranged from 22.8 to 26.2 seconds for the single-leg stance. Conclusions Among community-dwelling Canadians older than 50 years, the reliabilities of the CLSA measures were moderate to excellent. The TUG and gait speed in the youngest age group, and the single-leg stance in the oldest age group, showed poor reliability. MDC values can be used to interpret changes over time.

An important element of evidence-based medicine is to take into account the individual variability of the indicators of the norm of intervertebral discs, which is undoubtedly the basis for early preclinical detection of their pathology. Mathematical modeling and comprehensive assessment of the parameters of the intervertebral discs can not only predict and determine the early manifestations of pathological changes, but also help to correct them in advance. The aim of the study was to calculate and evaluate the variability of absolute, calculated and relative metric parameters of intervertebral discs in the norm with the subsequent possibility of modeling standards based on individual linear dimensions of intervertebral discs of the lumbar spine and general anthropometric characteristics (body length and weight) in young men and men of the first period of adulthood (17-28 years), both in separate age groups and in the combined group. The series of MRI scans obtained on a Phillips Achieva 1.5T scanner measured the anterior, middle and posterior vertical dimensions, maximum sagittal and frontal dimensions of the intervertebral discs L1-L2, L2-L3, L3-L4, L4-L5 segments of the spine (IVDL1-L2, IVDL2-L3, IVDL3-L4, IVDL4- L5). We calculated the average height of the intervertebral discs, cross-sectional area and volume of intervertebral discs, as well as relative indicators - the ratio of the sum of sagittal and transverse dimensions, the sum of three dimensions, cross-sectional area and volume of intervertebral discs to the average intervertebral disc height. Statistical analysis of the obtained morphometric parameters was performed in the license package “STATISTICA 6.1”. The distribution of variation series indicators, their average values and standard errors, coefficients of variation and asymmetry were evaluated. It was determined that the sums of the transverse and sagittal sizes and the sums of the three sizes increase proportionally in the caudal direction, have a distribution of indicators as close as possible to normal, and their coefficients of variation are many times smaller than for cross-sectional areas and volumes. Indicators of the ratio of the sum of the sagittal and transverse size and the sum of the three sizes to the average height of the intervertebral discs have a variability of less than 10% and correspond to the characteristics of the general population. Body weight and length have significantly higher correlation coefficients with the sums of sagittal and transverse dimensions, the sums of three dimensions and cross-sectional areas than with the partial dimensions of the intervertebral discs.

This work estimated the standard error of the maximum likelihood estimator (MLE) and the robust estimators of the exponential mixture parameter (θ) using the influence function and the bootstrap approaches. Mixture exponential random samples of sizes 10, 15, 20, 25, 50, and 100 were generated using 3 mixture exponential models at 2%, 5% and 10% contamination levels. The selected estimators namely: mean, median, alpha-trimmed mean, Huber M-estimate and their standard errors (Tn ) were estimated using the two approaches at the indicated sample sizes and contamination levels. The results were compared using the coefficient of variation, confidence interval and the asymptotic relative efficiency of Tn in order to find out which approach yields the more reliable, precise and efficient estimate of Tn. The results of the analysis show that the two approaches do not equally perform at all conditions. From the results, the bootstrap method was found to be more reliable and efficient method of estimating the standard error of the arithmetic mean at all sample sizes and contamination levels. In estimating the standard error of the median, the influence function method was found to be more effective especially when the sample size is small and yet contamination is high. The influence function based approach yielded more reliable, precise and efficient estimates of the standard errors of the alpha-trimmed mean and the Huber M-estimate for all sample sizes and levels of contamination although the reliability of the bootstrap method improved better as sample size increased to 50 and above. All simulations and analysis were carried out in R programming language.

Hydrologic design requires estimation of extreme hydrological events, whose magnitude and probability are estimated using a probability distribution function (PDF). Since estimations can vary considerably depending on the PDF that is used, the selection of an appropriate PDF is essential. This study compares the performance of four different methods for selecting probability distributions analyzing 56 data series of annual maximum precipitation in Mexico: the Akaike Information Criterion (AIC), the Bayesian Information Criterion (BIC), the Kolmogorov–Smirnov (KS) test, and the standard error of fit (SEF) statistic. Comparison of these methods was done by means of Monte Carlo simulations, in which data were generated from a mother distribution, and the ability of the different selection procedures to choose the right distribution was observed. Several different simulation scenarios were analyzed, varying the mother distribution and the sample size. None of the selection criteria proved to be superior to the others in all cases. AIC and BIC performed better when the mother distribution had two parameters, while the KS and SEF performed better when the mother distribution had three parameters. It was observed that the SEF and KS tend to select three- parameter distributions even when a third parameter is not justified, whereas the AIC and BIC tend to penalize excessively the addition of a third parameter, even when it is necessary.

BACKGROUND: Measurement-based care is an effective clinical strategy underutilized for bipolar disorder partly due to lacking a widely adopted patient-reported manic symptom measure. OBJECTIVE: To report development and psychometric properties of a brief patient-reported manic symptom measure. DESIGN: Secondary analysis of data collected in a randomized effectiveness trial comparing two treatments for 1004 primary care patients screening positive for bipolar disorder and/or PTSD. PARTICIPANTS: Two analytic samples included 114 participants with varied diagnoses and test-retest data, and 179 participants with psychiatrist-diagnosed bipolar disorder who had two or more assessments with the nine-item Patient Mania Questionnaire-9 [PMQ-9]). MAIN MEASURES: Internal and test-retest reliability, concurrent validity, and sensitivity to change were assessed. Minimally important difference (MID) was estimated by standard error of measurement (SEM) and by standard deviation (SD) effect sizes. KEY RESULTS: The PMQ-9 had high internal reliability (Cronbach’s alpha = 0.88) and test-retest reliability (0.85). Concurrent validity correlation with manic symptom measures was high for the Internal State Scale-Activation Subscale (0.70; p

Maleo bird (Macrocephalon maleo) is the one of protected bird’s species and originated from Sulawesi island of Indonesia. This study was carried out to obtain the growth curve of body weight (BW) in mixed-sex Maleo birds from hatching to yearling ages. The growth curve in this study was calculated with non-linear regression of Logistic (L) and Gompertz (G) models using CurveExprt 1.4. computer program. The primary data in this study was cited from previous study through a literature study. Research showed that the asymptotic weight (A) in birds was 1825.34 g (L) and 3429.23 g (G). The weight of inflection (Wi) in studied birds were 912.67 g (L) and 1260.75 g (G). The time of inflection (ti) in birds was 8.51 months (L) and 11.00 months (G). The maximum growth rate in birds was 159.72 g/month (L) and 151.29 g/month (G). The coefficient of determination (R2) in both models included of very high category (0.80

OBJECTIVE We investigated serum uric acid changes and incident hyperuricemia in relation to the achieved blood pressure (BP) after 12 weeks of antihypertensive therapy with the irbesartan/hydrochlorothiazide combination. METHODS The study participants were 449 patients who completed the study. Analysis of covariance and multiple logistic regression analyses were performed to calculate the least square mean changes (± standard error) from baseline in serum uric acid and odds ratios (ORs) for incident hyperuricemia according to the achieved levels of BP. RESULTS Adjusted analyses showed that serum uric acid changes differed according to the achieved SBP/DBP (P = 0.002), with a smaller mean (± standard error) increase in the range of 130-139/

Use of mixed models is advocated almost ubiquitously when regression analysis is applied in data sets that contain multiple measurements in individual sampling units that lead to intercorrelation amongst the residuals. Using two examples, simulation studies were undertaken comparing models that contained fixed effects only with mixed models in which random effects identified the sampling units within the data set. Both approaches resulted in unbiased estimates of the parameters. The choice of a suitable parameterization for the mixed model proved difficult. It was found that use of either an appropriate mixed model or a lesser-known method (‘adjusted ordinary least squares regression’) to fit models with fixed effects only could yield unbiased estimates of the standard errors of the parameter estimates. However, difficulties remain with computational methods in both cases and it cannot be assumed, a priori, that either approach is necessarily superior to the other for any particular data set.

AIM The study assessed the association between boosting the workforce supply by types of long-term care services and in-home deaths among older people at the municipality level. METHODS A fixed-effect panel data analysis was conducted using administrative data for every 3 years from 2008 to 2014. The outcome was the proportion of home deaths, excluding those due to external factors, such as suicide or accident. The explanatory variables were the full-time equivalent numbers of care workers engaged in in-home services, day services, short-stay services, and long-term care facilities per 1000 population aged 65 years and older. Ordinary least squares estimation was conducted, with standard errors corrected for clustering at the prefecture level, adjusting the covariates. RESULTS Analysis included 1706 municipalities. One care worker increase providing day services per 1000 population aged 65 years and older was associated with a 0.09% increase in the proportion of deaths at home (95% CI: 0.008-0.17). Although statistically non-significant, the number of care workers providing in-home services was positively associated with the proportion of home deaths, whereas the number of those providing short-stay services and providing long-term care facilities and nursing home services were inversely associated with home deaths. CONCLUSIONS Given the increased number of care-dependent older people who opt to stay at home until death, and their informal caregivers who have the burden and stress of care, the findings suggest that policymakers should ensure that the number of care workers for day services is sufficient for supporting care recipients and informal caregivers. Geriatr Gerontol Int 2021; 21: 712-717.

Due to the COVID-19 pandemic, restrictions and guidelines are being enacted for the safety of the people, and generally, it has caused difficulties in the daily activities among students. Hence, this quantitative non-experimental study aimed to determine if emotional stability is a predictor of stress management among Senior High School students of the University of San Carlos in Cebu City, Philippines in the school year 2020-2021, who engage in a flexible online modality of learning. Adapted Likert-type survey tools were utilized to gather data online from 80 Grade 12 students who were selected through stratified non-proportionate random sampling. Results using linear regression analysis revealed a significant R and R2 value of .28 and .08(adjusted R2 was .07) respectively, which means highly significant F (1, 78) = 6.79, MSresidual = .31, p < .05 using a 95% level of confidence with a .39 standard error of the estimate from the population standard deviation of the residuals. This means that the independent variable emotional stability (ES) significantly and statistically affects the dependent variable stress management (SM). The modeled equation SM = 1.71 + .50 (ES) predicts that the higher the level of emotional stability, the higher the level of stress management. This implies that emotionally stable students are better at managing their stress. These results encouraged collaboration among the academic and administrative support services in every institution and stronger social support at home. This time, parental involvement plays a vital role in the holistic development and formation of every student.

The reliable change index has been used to evaluate the significance of individual change in health-related quality of life. We estimate reliable change for two measures (physical function and emotional distress) in the Patient-Reported Outcomes Measurement Information System (PROMIS®) 29-item health-related quality of life measure (PROMIS-29 v2.1). Using two waves of data collected 3 months apart in a longitudinal observational study of chronic low back pain and chronic neck pain patients receiving chiropractic care, and simulations, we compare estimates of reliable change from classical test theory fixed standard errors with item response theory standard errors from the graded response model. We find that unless true change in the PROMIS physical function and emotional distress scales is substantial, classical test theory estimates of significant individual change are much more optimistic than estimates of change based on item response theory. Supplementary Information The online version supplementary material available at 10.1007/s11336-021-09774-1.

The objective of this study is to investigate a possible correlation between anxiety status and anti-Mullerian hormone (AMH) levels among healthcare professionals who provide medical care directly to COVID-19-positive patients during the recent pandemic. Fifty-two healthcare professionals (nurses, midwives, and residents) who provide medical care directly to COVID-19-positive patients in inpatient clinics or intensive care units were enrolled in this study. Serum AMH levels were analyzed to reflect ovarian reserve. The Beck Anxiety Inventory (BAI) and the State-Trait Anxiety Inventory (STAI-S and STAI-T, respectively) were completed by participants to assess their anxiety status. A linear regression model with participant age as the constant variable was applied to analyze the relationship between inventory scale scores and AMH levels. P-values less than 0.05 were considered statistically significant. The mean AMH value was significantly lower for the participants in the moderate/severe anxiety group compared to the minimal/mild anxiety group (p = 0.007). A linear regression analysis revealed a significant negative correlation between AMH levels and both BAI (B = -0.030, standard error = 0.010, p = 0.004) and STAI-S and STAI-T scores when age was controlled (both p = 0.003). The severity of anxiety experienced during the recent COVID-19 pandemic among healthcare professionals, who provide medical care directly to COVID-19-positive patients, is found to be related to low AMH levels.

Objective To evaluate the impact of fremanezumab on the severity and duration of remaining migraine attacks in patients with chronic migraine (CM) or episodic migraine (EM). Background Fremanezumab is a fully humanized monoclonal antibody (IgGΔa) that selectively targets calcitonin gene‐related peptide and is efficacious in reducing migraine frequency. Methods This exploratory post hoc analysis included data from three randomized, double‐blind, 12‐week, phase 3 studies (HALO CM, HALO EM, and FOCUS). In all three studies, patients with CM or EM were randomized 1:1:1 to receive subcutaneous quarterly fremanezumab (month 1/2/3: 675 mg/placebo/placebo), monthly fremanezumab (month 1/2/3: 675 mg [CM], 225 mg [EM]/225 mg/225 mg), or matched monthly placebo. Changes from baseline were evaluated in the proportion of headache days of at least moderate severity, peak severity of headache days, mean monthly headache hours (of any severity and at least moderate severity), and mean headache hours per headache day of any severity. Results A total of 2843 patients were randomized with 2823 patients included in the efficacy analyses across all studies (HALO CM, N = 1121; HALO EM, N = 865; FOCUS, N = 837). At study baseline, mean (standard deviation [SD]) monthly number of headache days rated moderate or severe in the quarterly fremanezumab, monthly fremanezumab, and placebo groups, respectively, were 13.2 (5.5), 12.8 (5.8), and 13.3 (5.8) in HALO CM; 7.2 (3.1), 6.8 (2.9), and 6.9 (3.1) in HALO EM; and 12.4 (5.8), 12.7 (5.8), and 12.8 (5.9) in FOCUS. Patients experienced significant least‐squares mean (LSM; 95% confidence interval) percent reductions from baseline in monthly number of headache days rated moderate or severe during the 12 weeks: HALO CM, quarterly fremanezumab, 34.5% (−39.8, −29.2) and monthly fremanezumab, 36.2% (−41.4, −31.0) vs. placebo, 19.6% (−20.0, −14.3); HALO EM, quarterly fremanezumab, 40.7% (−47.8, −33.5) and monthly fremanezumab, 43.4% (−50.4, −36.3) vs. placebo, 17.9% (−24.9, −11.0); and FOCUS, quarterly fremanezumab, 36.5% (−41.9, −31.1) and monthly fremanezumab, 38.6% (−44.0, −33.3) vs. placebo, 3.5% (−8.9, 1.8); all p

This research aims to see the effect of work experience and occupational health and safety (OHS) on the staff’s performance at the Tax Service Office (KPP). In this study, the research took place at KPP Madya Palembang and KPP Minyak dan Gas Bumi. The research method used is quantitative research. The population in this study were all staff at KPP Madya Palembang and KPP Minyak dan Gas Bumi totaling 70 people. Sampling using Slovin with a standard error of 10%. The data collection techniques used were interview and questionnaire techniques. The data were processed using multiple linear regression analysis models with the help of the SPSS program. From the research results, it is known that work experience and occupational safety and health have a positive and significant effect on the staff’s performance of the tax service office.

Nutrient intake for adult cancer survivors is of clinical importance for managing metabolic health. Whether dietary fiber intake is associated with metabolic syndrome (MetS) or not in adult cancer survivors is uncertain. We aim to investigate the association between dietary fiber intake and MetS in adult cancer survivors using a population-based cross-sectional study. A study sample of 1301 adult cancer survivors aged more than 20 years from the sixth and seventh Korea Nutrition Examination Survey (KNHANES) from 2013 to 2018 was identified. Odds ratio (OR) and 95% confidence intervals (95% CI) were estimated from multiple logistic regression adjusted for sociodemographic factors, health behavior, and nutritional status. Among 1,301 adult cancer survivors identified from the KNHANES 2013–2018, the mean dietary fiber intake was 28.1 g/day (standard error, 0.54). Compared to the first quintile of dietary fiber intake, the adjusted ORs and 95% CIs for MetS in the second, third, fourth, and fifth quintiles of dietary fiber intake were 0.84 (0.27–2.61), 0.77 (0.16–3.74), 0.55 (0.14–2.22), and 0.26 (0.05–1.39), respectively (p value for trend = 0.0007). Our findings suggest that high dietary fiber intake is marginally associated with reduced odds of MetS in adult cancer survivors.

The hexagon agility test is widely used in tennis players’ fitness evaluation, although its validity has not been fully stablished. This study aimed to assess the relationships between sprinting, jumping, and change of direction (COD) ability and hexagon test performance. Thirty-five under-16 tennis players completed a testing battery including the hexagon test, 20-m linear sprint, bilateral and unilateral countermovement jumps (CMJ), triple leg-hop for distance, T-Test, 5-0-5 and Pro-Agility test on two different sessions, separated by one week. The intraclass correlation coefficient (ICC) and the standard error of measurement (SEM) were used to assess the reliability of the test. Pearson’s product correlations (r) were used to analyze the relationships between the hexagon test and the other fitness tests. Statistical significance was set at p < 0.05. The hexagon test showed high relative reliability (ICC = 0.88) and low SEM values (0.17 s). Significant small to large correlations were found between the hexagon test time and linear sprint time (r = 0.40 to 0.60), COD tests (r = 0.53 to 0.79), and jumping performance (r = -0.40 to -0.68). The hexagon test is a simple, quick, easy-to-implement and reliable test, which allow it to be included in tennis players’ testing batteries. The test is related to measures of speed, power and agility, although the magnitude of these relationships does not allow for the replacement of the more traditional assessments (e.g., CMJ, 20-m sprint, T-Test) within tennis players’ testing batteries.

To examine whether BMI-associated genetic risk variants modify the association of intrauterine diabetes exposure with childhood BMI z-scores, we assessed the interaction between 95 BMI-associated genetic variants and in utero exposure to maternal diabetes among 459 children in the Exploring Perinatal Outcomes among Children historical prospective cohort study (n = 86 exposed, 373 unexposed) in relation to age- and sex-standardized childhood BMI z-scores (mean age = 10.3 years, standard deviation = 1.5 years). For the genetic variants showing a nominally significant interaction, we assessed the relationship in an additional 621 children in Project Viva, which is an independent longitudinal cohort study, and used meta-analysis to combine the results for the two studies. Seven of the ninety-five genetic variants tested exhibited a nominally significant interaction with in utero exposure to maternal diabetes in relation to the offspring BMI z-score in EPOCH. Five of the seven variants exhibited a consistent direction of interaction effect across both EPOCH and Project Viva. While none achieved statistical significance in the meta-analysis after accounting for multiple testing, three variants exhibited a nominally significant interaction with in utero exposure to maternal diabetes in relation to offspring BMI z-score: rs10733682 near LMX1B (interaction β = 0.39, standard error (SE) = 0.17), rs17001654 near SCARB2 (β = 0.53, SE = 0.22), and rs16951275 near MAP2K5 (β = 0.37, SE = 0.17). BMI-associated genetic variants may enhance the association between exposure to in utero diabetes and higher childhood BMI, but larger studies of in utero exposures are necessary to confirm the observed nominally significant relationships.

Two-dimensional fluoroscopic imaging allows measurement of small magnitude humeral head translations that are prone to errors due to optical distortion, out-of-plane imaging, repeated manual identification of landmarks, and magnification. This article presents results from in vivo and in vitro fluoroscopy-based experiments that measure the errors and variability in estimating the humeral head translated position in true scapular plane and axillary views. The errors were expressed as bias and accuracy. The variability with repeated digitization was calculated using the intraclass correlation coefficient (ICC) and the standard error of measurement. Optical distortion caused underestimation of linear distances. The accuracy was 0.11 and 0.43 mm for in vitro and in vivo experiments, respectively, for optical distortion. The intrarater reliability was excellent for both views (ICC = .94 and .93), and interrater reliability was excellent (ICC = .95) for true scapular view but moderate (ICC = .74) for axillary views. The standard error of measurement ranged from 0.27 to 0.58 mm. The accuracy for the humeral head position in 10° out of true scapular plane images ranged from 0.80 to 0.87 mm. The current study quantifies the magnitude of error. The results suggest that suitable measures could be incorporated to minimize errors and variability for the measurement of glenohumeral parameters.

Major objective of the present study is estimate regression model and Correlation coefficient. The data were collected from the wheat section, Agriculture Research Institute (ARI) Tandojam, regarding various factors influencing on the wheat production. The survey result show that yield has significant positive correlation with the parameters such as the number of tillers per plant, number of seed per spike, length of spike in cm, the number of spikes let per, tiller per hectare and plant height cm. The parameter of wheat number of tillers per plant meter square standard error is (0.569), coefficient is (0.816). T-value is (1.43) and with positively significant is (0.018). The parameter of number of seed per spike standard error is (0.107) coefficient is (0.0811) To determine the effect of dependent and independent T-value of (0.75) with significant (0.4724).The parameter of wheat is length of spike in cm is standard error is (1.704), Coefficient is (1.092), T-value is (0.64) with the positively significant is (0.029) T-value is (2.20) and with positively significant is (0.039).The parameter of tiller per hectare is standard error is (0.026), standardized The Number of spike let per spike with standard error of this parameter (0.5172)coefficient is (1.135), the coefficients beta is (0.041), and T-value of this parameter is (1.73) and with the positively significant value is (0.121). The parameter of wheat is day of heading cm with the standard error is (0.650), the standardized coefficient beta is negative (1.426), the T – value of this parameter is (-2.19) with the weak significant of (0.059). The parameter of wheat is plant height cm standard error is (0.203), with standardized coefficient beta is (0.081), T-value of this parameter is (0.40) with the significant value is (0.697). The parameter of lodging score per hector centimeter with standard error is (0.662), the standard coefficient of beta is (-0.504), T-value of this parameter is (-0.76), with the significant of (0.468).The parameter of number of grains weight in grams with standard error is (0.245) standardized coefficient of beta is (0.106), T-value is (0.43) with the significant value is (0.677). The parameter of wheat is seed index 1000 grains weight with standard error is (3.437) , coefficient is (0.384) , T-value is (0.11) With the significant value is (0.913).The parameter of wheat is plot yield gram with standard error is (0.0215), with coefficients is (-0.036), is T-value of this parameter is (-1.72) with the significant value is (0.124). The Parameter of wheat is nitrogen per hector kilogram with standard error is (0.168), coefficient is (0.1688), is T-value is (1.00) with the significant of (0.345).The parameter of Phosphorus per hack Kg with standard error is (0.333), coefficient of is (-0.138), T-value is this parameter is (-0.42) with the significant of (0.688). It is suggested that the more factors can be studied and different statistical techniques, agronomics practices and different doses of fertilizer can be applied for the high production of wheat crop.

The Cormack–Jolly–Seber (CJS) model and its extensions have been widely applied to the study of animal survival rates in open populations. The model assumes that individuals within the population of interest have independent fates. It is, however, highly unlikely that a pair of animals which have formed a long‐term pairing have dissociated fates.We examine a model extension which allows animals who have formed a pair‐bond to have correlated survival and recapture fates. Using the proposed extension to generate data, we conduct a simulation study exploring the impact that correlated fate data has on inference from the CJS model. We compute Monte Carlo estimates for the bias, range, and standard errors of the parameters of the CJS model for data with varying degrees of survival correlation between mates. Furthermore, we study the likelihood ratio test of sex effects within the CJS model by simulating densities of the deviance. Finally, we estimate the variance inflation factor c^ for CJS models that incorporate sex‐specific heterogeneity.Our study shows that correlated fates between mated animals may result in underestimated standard errors for parsimonious models, significantly deflated likelihood ratio test statistics, and underestimated values of c^ for models taking sex‐specific effects into account.Underestimated standard errors can result in lowered coverage of confidence intervals. Moreover, deflated test statistics will provide overly conservative test results. Finally, underestimated variance inflation factors can lead researchers to make incorrect conclusions about the level of extra‐binomial variation present in their data., We present an extension to the Cormack–Jolly–Seber (CJS) model that allows animals who have formed a pair‐bond to have correlated survival and recapture fates. Using the proposed extension to generate data, we conduct a simulation study exploring the impact that correlated fate data has on inference from the CJS model. Our study shows that correlated fates between mated animals may result in underestimated standard errors for parsimonious models, significantly deflated likelihood ratio test statistics, and underestimated values of ĉ for models taking sex‐specific effects into account.

The present study examined the validity of the force-velocity (F-V) mechanical parameters of the lower limbs as a predictors of the competitive performance in junior male speed climbing. The second aim was to evaluate F-V characteristics in competitive speed climbers in the junior male category. Ten junior male speed climbers (age: 18±0.5 years; BH: 174.7±4.5 cm; BW: 66.4±6.6 kg; with mean best climbing time from the competition BCT: 7.29±0.66 s) were participants in the research. All they were participants in the Youth European Cup in speed climbing. F-V characteristics were measured using a cycle ergometer test according to the Vandewalle’s protocol. To evaluate of the validity between BCT (criterion) and mechanical parameters (practical measures) from F-V test a standard error of the estimate (expressed as a raw and standardized typical error, TE) and correlation coefficients (rx,y) were used. Moreover, the validity of BCT as a potentially predictor of final competition rank (as a criterion for BCT) was evaluated. Additionally the mean value and standard deviation were calculated for all measured variables. Validity of the BCT as a competition place predictor was largely overestimated (TE=0.73 and rx,y=0.81, p p≤0.05). Accuracy of the BCT prediction for somatic and mechanical variables were very largely error biased. The standardized values of TE for these variables were: 1.93÷7.25. The rx,y were in the range of -0.18 to -0.46. The level of the mechanical variables from the F-V cycle ergometer as a predictors of the BCT in speed climbing may be largely error biased. Application of the cycle ergometer F-V test of prediction BCT values in speed climbing may have low practical value. Moreover, BCT variable may be a poor predictor of the final competition result. Coaches should take these suggestions into account during preparations to speed climbing competitions.

To investigate the test–retest, intra- and inter-rater reliabilities of an ultrasound (US) reflection coefficient (RC) index measured in a lumbar vertebra to reflect bone strength on children with AIS. Fifty-eight participants (47F; 11M) were scanned by an US imager in standing position. Twenty-four were scanned twice for a test–retest study. The RC index measures the US signal reflected from L5 to indicate bone strength. Five measurements were obtained using three different methods: (i) the maximum RC (MRC) values on the left and right sides, (ii) the average RC (ARC) values on left and right sides, and (iii) the combined average RC (CARC) from both sides. Only rater 1 measured the 24 repeated US scans once. Raters 1 and 2 measured the RC index twice on all 58 images in 1 week apart. The intraclass correlation coefficient ICC [3, 1] for test–retest and ICC [2, 1] for intra- and inter-rater reliabilities as well as the standard error of measurements (SEM) were reported. The means of scan 1 versus scan 2 were 0.16 ± 0.08 versus 0.16 ± 0.07 for left-MRC, 0.17 ± 0.11 versus 0.18 ± 0.11 for right-MRC, 0.08 ± 0.04 versus 0.09 ± 0.04 for left-ARC, 0.09 ± 0.04 versus 0.09 ± 0.05 for right-ARC and 0.08 ± 0.04 versus 0.09 ± 0.03 for CARC and all ICC[3, 1] ≥ 0.77. Among these 5 approaches, the CARC provided the best intra-rater and inter-rater reliabilities with ICC [2, 1] ≥ 0.84 and SEM ≤ 0.01. The RC index could be measured repeatably and reliably. The high RC value may reduce the risk of progression of scoliosis.

BACKGROUND: Pressure pain threshold (PPT) is decreased in several musculoskeletal disorders, giving indirect evidence regarding pain status. Despite the fact that PPT has been already proven to be reliable in patients with acute conditions, there is great variability of methods and results observed within studies, and only a few evidences confirming its reliability in chronic conditions. OBJECTIVE: The objective of this study was to determine the test-retest reliability of PPT in the neck and low back regions to discriminate individuals with neck or low back pain from healthy individuals. Additionally, one secondary aim was to establish the minimum detectable change (MDC) and the standard error of measurement for future clinical studies and interventions. METHODS: In this reliability study, 74 individuals (15 individuals from the neck pain and 17 from the neck control group; 21 individuals from the low back pain and 21 from the low back control group). PPT was measured in the neck region (suboccipital, trapezius and supraspinal muscles) and in the lower back region (paraspinal muscles in the levels of L1, L3 and L5). Intrarater reliability was assessed using intraclass correlation coeficient and Bland-Altman. RESULTS: Excellent intra-rater reliability was observed for both (ICC of 0.874 for the neck pain versus ICC of 0.895 in neck control group; ICC of 0.932 for the low back pain group versus ICC of 0.839 for the control group). A small bias was observed for all groups (-0.08 for the neck pain group versus 0.10 in the control group; and 0.32 in low back pain group versus 0.44 in the control group). Minimum detectable change of 0.63 kgf of neck pain and 1.21 kgf of low back pain was calculated. It was found difference in PPT between pain and control groups (p< 0.05). CONCLUSION: It may be suggested that the protocol with PPT is reliable and able to discriminate individuals with and without neck and low back pain with a minor measurement error. Therefore, this method may be used to detect possible progress after interventions in patients with neck or low back pain.

Objectives Friedreich ataxia (FRDA) is a rare disorder with progressive neurodegeneration and cardiomyopathy. Luvadaxistat (also known as TAK‐831; NBI‐1065844), an inhibitor of the enzyme d‐amino acid oxidase, has demonstrated beneficial effects in preclinical models relevant to FRDA. This phase 2, randomized, double‐blind, placebo‐controlled, parallel‐arm study evaluated the efficacy and safety of oral luvadaxistat in adults with FRDA. Methods Adult patients with FRDA were randomized 2:1:2 to placebo, luvadaxistat 75 mg twice daily (BID), or luvadaxistat 300 mg BID for 12 weeks. The primary endpoint changed from baseline at week 12 on the inverse of the time to complete the nine‐hole peg test (9‐HPT−1), a performance‐based measure of the function of the upper extremities and manual dexterity. Comparisons between luvadaxistat and placebo were made using a mixed model for repeated measures. Results Of 67 randomized patients, 63 (94%) completed the study. For the primary endpoint, there was no statistically significant difference in change from baseline on the 9‐HPT−1 (seconds−1) at week 12 between placebo (0.00029) and luvadaxistat 75 mg BID (−0.00031) or luvadaxistat 300 mg BID (−0.00059); least squares mean differences versus placebo (standard error) were −0.00054 (0.000746) for the 75 mg dose and −0.00069 (0.000616) for the 300 mg dose. Luvadaxistat was safe and well tolerated; the majority of reported adverse events were mild in intensity. Interpretation Luvadaxistat was safe and well tolerated in this cohort of adults with FRDA; however, it did not demonstrate efficacy as a treatment for this condition.

To study the serum sodium level and clinical outcome in pediatric nontraumatic coma.A prospective cohort study was conducted in a tertiary care pediatric intensive care unit (PICU) from September 2015 to June 2016. Children aged13 y with nontraumatic coma [modified-Glasgow Coma Scale (m-GCS) score ≤ 8 or fall of ≥ 3 from baseline within 24 h of admission] were included. Children who received intravenous fluids for24 h, those with developmental delay, or died within 24 h of admission were excluded. The serum sodium profile (mEq/L) in the first 72 h and clinical outcome [mortality, length of stay in mechanical ventilation, PICU, and hospital] were studied.Eighty patients [Died n = 26 and Survived n = 54] were enrolled. Median [interquartile range (IQR)] age and m-GCS were 21 (4-78) mo and 9 (7-11), respectively. The mean [standard deviation (SD)] Pediatric Risk of Mortality-III (PRISM-III) was 17.7 (4). The most common etiology was acute central nervous system (CNS) infections (30%, n = 24) followed by an intracranial bleed (11.3%, n = 9). Mean (Standard error, SE) sodium levels and fluctuation of serum sodium from baseline up to 72 h were similar between nonsurvivors and survivors [140.8 (1.3) vs. 139.6 (0.8), p = 0.421] and [1.2 (0.3) vs. 0.8 (0.2), p = 0.307], respectively. On multivariate analysis, the need for vasoactive therapy was an independent predictor of mortality [adjusted odds ratio = 20.78, 95% CI 4.24-101.85, p = 0.001, RMean serum sodium within normal range and fluctuation of serum sodium of 0.8 to 1.2 mEq/L over 72 h was not associated with poor outcomes in pediatric nontraumatic coma. Vasoactive therapy was an independent predictor of mortality.

The immune system has been for long considered a marker of health. The age-related decline in its function results in a greater incidence of infections, autoimmune diseases, and cancer. Nevertheless, it is still not known if immune function can be used to accurately estimate the rate of aging of an individual. A set of 14 immune function variables were measured in 214 healthy individuals ranging from 19 to 88 years old. All immune variables were selected as independent variables for the prediction of age by multiple linear regression. The Immunity Clock was constructed including the following 5 immune variables: natural killer activity, phagocytosis and chemotaxis of neutrophils, and chemotaxis and proliferative capacity of lymphocytes, reaching an adjusted R2 of 80.3% and a standard error of the estimate of 4.74 years. The Immunity Clock was validated in a different group of healthy individuals (N = 106) obtaining a Pearson’s correlation coefficient of .898 (p < .001) between chronological age and the age estimated by the Immunity Clock, the ImmunolAge. Moreover, we demonstrate that women with anxiety (N = 10) show a higher ImmunolAge than their chronological age, whereas healthy centenarians (N = 8) show a lower one. In addition, the Immunity Clock provided here proves to be useful for monitoring the effectiveness of a nutritional intervention lasting 1 month, by detecting a diminished ImmunolAge in the same individuals. Further research will be needed to ascertain if the Immunity Clock is a passive marker of the aging process or it plays an active role in it.

El crecimiento de la población mundial conlleva a la demanda de alimentos, y estos se deben obtener mediante el uso eficiente de los recursos, esto se podría lograr mediante la planificación y priorización de los factores que intervienen en los procesos de producción. Los modelos de simulación son una herramienta con la que se puede visualizar escenarios y cuantificar los insumos a usar. En el presente trabajo, con datos de los rendimientos máximos de maíz (RG) de 1943 a 2017 obtenidos de experimentos de campo a nivel mundial y con predominancia de datos de Estados Unidos de América (80%), se generó un modelo estadístico para estimar el rendimiento del grano en maíz (RGE) y sirva de apoyo para la toma de decisiones de quienes participan en el proceso de producción de maíz para grano. Las variables de mayor peso para expresar el modelo fueron: densidad de población (DP), dosis de potasio (K), lamina de riego (LR), dosis de nitrógeno (N) y dosis de fósforo (P) y se usaron para generar el modelo con el método de regresión múltiple stepwise, y se expresó como: RGE = 3.158205 + 0.693319 (DP) - 0.022246 (K) + 0.005990 (LR) + 0.010687 (N) + 0.013794 (P), tuvo un R2= 0.73 y un error estándar de 0.964 Mg ha-1. La DP fue la variable que explicó en mayor proporción el valor del RGE, con el análisis de datos de RG se observó el incremento de la tasa de siembra a través del tiempo para lograr una mayor DP e incrementar el RG, lo cual generó la demanda de insumos.

OBJECTIVE To quantify the effect of age on two-dimensional (2D) radiographic lung and diaphragm morphology and determine if 2D radiographic lung measurements can be used to estimate computer tomography (CT)-derived lung volume in normative pediatric subjects. MATERIALS AND METHODS Digitally reconstructed radiographs (DRRs) were created using retrospective chest CT scans from 77 pediatric male and female subjects aged birth to 19 years. 2D lung and diaphragm measurements were made on the DRRs using custom MATLAB code, and Spearman correlations and exponential regression equations were used to relate 2D measurements with age. In addition, 3D lung volumes were segmented using CT scans, and power regression equations were fitted to predict each lung's CT-derived volume from 2D lung measurements. The coefficient of determination (R2 ) and standard error of the estimate (SEE) were used to assess the precision of the predictive equations with p

Background Trends in off-label postpartum use of domperidone and the impact of safety advisories on its use remain unknown. Our objectives were to describe postpartum use of domperidone in Canada, to evaluate the impact of Health Canada advisories on prescribing patterns, and to describe the association between domperidone use and a composite end point of sudden cardiac death or ventricular tachycardia (VT) among postpartum patients. Methods We conducted a multidatabase cohort study involving pregnant patients with live births between 2004 and 2017 using administrative health databases from 5 Canadian provinces (British Columbia, Alberta, Saskatchewan, Manitoba and Ontario). We excluded patients with less than 1 year of prepregnancy database history and with approved indications for domperidone. We assessed domperidone use in the 6 months postpartum and the impact of the 2012 and 2015 Health Canada advisories on prescribing via interrupted time series analysis. We estimated crude rates of VT and sudden cardiac death. Results We included 1 190 987 live births. Mean maternal age was 28.6 (standard error 0.6) years. Domperidone use increased over time, from 7% in 2003-2005 to 12% in 2009-2011, when it plateaued. The 2012 advisory was followed by a drop in use and a reduction in slope, and the 2015 advisory had a more modest impact. Crude analysis suggests that domperidone may be associated with increased VT or sudden cardiac death (0.74 v. 0.37 per 10 000 person-years; difference per 10 000 person-years: 0.37, 95% confidence interval -0.67 to 1.41). Interpretation Postpartum domperidone use increased between 2004 and 2017, with prescribing attenuated after Health Canada advisories and a very low absolute rate of VT or sudden cardiac death. These findings suggest that Health Canada advisories affected prescribing; any potential increase in VT or sudden cardiac death with use of domperidone is small and could not be confirmed in this large study STUDY REGISTRATION: ClinicalTrials.gov, no. NCT04024865.

High frequency financial data has become an essential component of the digital economy, yielding an increasing number of estimators. However, it is hard to reliably assess the uncertainty of such estimators. The Observed Asymptotic Variance (observed AVAR) is a non-parametric estimator for (squared) standard error in high frequency data. The device is related to observed information in likelihood theory, but in this case it is non-parametric and uses the high-frequency data structure. An earlier paper has developed the estimator in the case where edge effects are small to moderate. In practical data, it is often more realistic to assume that edge effects can be large, and this is the problem that we tackle in the current paper. We here find a regression approach to observed AVAR which is highly robust to large edges. This approach covers most high frequency estimators.

Background: Cardiac resynchronization therapy (CRT) has been demonstrated to improve heart failure (HF) symptoms, reverse LV remodeling, and reduce mortality and HF hospitalization (HFH) in patients with a reduced left ventricular (LV) ejection fraction (LVEF). Prior studies examining outcomes based on right ventricular (RV) lead position among CRT patients have provided mixed results. We performed a systematic review and meta-analysis of randomized controlled trials and prospective observational studies comparing RV apical (RVA) and non-apical (RVNA) lead position in CRT. Methods: Our meta-analysis was constructed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews and meta-analyses. We searched EMBASE and MEDLINE. Eligible studies reported on at least one of the following outcomes of interest: all-cause mortality, the composite endpoint of death and first HFH hospitalization, change in LVEF, New York Heart Association (NYHA) class improvement, and change in LV end systolic volume (LVESV). We performed meta-analysis summaries using a DerSimonian-Laird random-effects model and conservatively used the Knapp-Hartung approach to adjust the standard errors of the estimated model coefficients. Results: We included nine studies representing a total of 1832 patients. Of those, 1318 (72%) patients had RVA lead placement and 514 (28%) had RVNA lead placement. The mean age of patients was 65.5 ± 4.4 years, and they were predominantly men (69%–97%). There was no statistically significant difference in all-cause mortality by RVA vs. RVNA (OR = 0.77, 95% CI 0.32–1.89; I2 = 16.7%, p = 0.31), or in the combined endpoint of all-cause mortality and first HFH (OR 0.88, 95% CI 0.62–1.25; I2 = 0%, p = 0.84). Also, there was no difference between RVA and RVNA for NYHA class improvement (OR = 1.03, 95% CI 0.9–1.17; I2 = 0%, p = 0.99), change in LVEF (mean difference (MD) = 1.33, 95% CI -1.45 to 4.10; I2 = 47%; p = 0.093), and change in LVESV (MD = −1.11, 95% CI −3.34 to 1.12; I2 = 0%; p = 0.92). Conclusion: This meta-analysis shows that in CRT pacing, RV lead position does not appear to be associated with clinical outcomes or LV reverse remodeling. Further studies should focus on the relationship of RV lead vis-a-vis LV lead location, and its clinical importance.

Background The oral anticoagulant dabigatran offers an effective alternative to vitamin K antagonists (VKAs) for stroke prevention in atrial fibrillation (AF), yet patient preference data are limited. The prospective observational RE-SONANCE study demonstrated that patients with AF, newly initiated on dabigatran, or switching to dabigatran from long-term VKA therapy, reported improved treatment convenience and satisfaction compared with VKA therapy. This pre-specified sub-study aimed to assess the impact of country and age on patients’ perceptions of dabigatran or VKA therapy in AF. Methods RE-SONANCE was an observational, prospective, multi-national study (NCT02684981) that assessed treatment satisfaction and convenience in patients switching from VKAs to dabigatran (Cohort A), or newly diagnosed with AF receiving dabigatran or VKAs (Cohort B), using the PACT-Q questionnaire. Pre-specified exploratory outcomes: variation in PACT-Q2 scores by country and age ( Results Patients from 12 countries (Europe/Israel) were enrolled in Cohort A (n = 4103) or B (n = 5369). In Cohort A, mean (standard deviation) PACT-Q2 score increase was highest in Romania (convenience: 29.6 [23.6]) and Hungary (satisfaction: 26.0 [21.4]) (p p p Conclusions Treatment satisfaction and convenience tended to favor dabigatran over VKAs. Regional differences in treatment expectations exist across Europe. Trial and clinical registry Trial registration number: ClinicalTrials.gov NCT02684981. Trial registration date: February 18, 2016.

This study explains administrative functions of local governance in Godavari municipality of district. For that purpose, the quantitative research approach and instrumental case study in multi-site research design has been applied. The required data were collected from 234 respondents (Administrative staffs 12 elected representatives and local intellectuals 30 and service receivers 192) through institutional survey and exit poll survey techniques selected by , cluster and stratified random sampling methods. This study found that average value of administrative functions related variables was 1.88 to 2.14 or perceptions of the respondents over studied variables felled between "strongly agree and agree". And the average value of quality of administrative functions related variables also found 1.96 to 2.76 (strongly agree and nearer to neutral" with 0.60 to 1.44 standard deviation and 0.15 standard errors for the . However, Pearson correlation coefficient between administrative function index (maximum 35, minimum 7, mean 24.08 and standard deviation 3.41) and quality of administrative function index (maximum 28, minimum 4, mean 14.26 and standard deviation 2.57), r= 0.88, > r2= 0.05 and p=0.00 found significant (strong positive correlation)

The Behavioral Assessment Screening Tool (BAST) measures neurobehavioral symptoms in adults with traumatic brain injury (TBI). Exploratory Factor Analyses established five subscales: Negative Affect, Fatigue, Executive Function, Impulsivity, and Substance Abuse. In the current study, we assessed all the subscales except Substance Abuse using Rasch analysis following the Rasch Reporting Guidelines in Rehabilitation Research (RULER) framework. RULER identifies unidimensionality and fit statistics, item hierarchies, targeting, and symptom severity strata as areas of interest for Rasch analysis. The BAST displayed good unidimensionality with only one item from the Impulsivity scale exhibiting potential item misfit (MnSQ 1.40). However, removing this item resulted in a lower average domain measure (1.42 to − 1.49) and higher standard error (0.34 to 0.43) so the item was retained. Items for each of the four subscales also ranged in difficulty (i.e. endorsement of symptom frequency) with more severe symptoms being endorsed in the Fatigue subscale and more mild symptoms being endorsed in the Impulsivity subscale. Though Negative Affect and Executive Function displayed appropriate targeting, the Fatigue and Impulsivity Subscales had larger average domain values (1.35 and − 1.42) meaning that more items may need to be added to these subscales to capture differences across a wider range of symptom severity. The BAST displayed excellent reliability via item and person separation indices and distinct strata for each of the four subscales. Future work should use Rasch analysis in a larger, more representative sample, include more items for the Fatigue and Impulsivity subscale, and include the Substance Abuse subscale.

BackgroundBalloon sinuplasty is a relatively new surgical technology proposed as a less invasive way of treating chronic rhinosinusitis and frontal sinus disease. It is crucial to monitor safety and efficacy to allow informed clinical decisions and appropriate counselling of patients. There are few papers with long-term follow up.MethodPatients were selected for surgery based on symptoms of frontal pain and pressure or headache, pre-operative Sino-Nasal Outcome Test-22 scores, and computed tomography findings. All were resistant to appropriate medical therapy. Balloon sinuplasty was performed followed by a Sino-Nasal Outcome Test-22 questionnaire at two months and then two years.ResultsAll patients underwent successful operations with no failure of technology or technique. There were no significant complications. The average Sino-Nasal Outcome Test-22 score reduced from 46 pre-operatively (standard error: +/− 5.7, n = 9) to 23 at 2 months (standard error: +/− 7.6, n = 7). At 2 years, the average Sino-Nasal Outcome Test score was 23 (standard error: +/− 4.3, n = 6). There was an even larger lasting benefit when pain or pressure symptoms were analysed in isolation.ConclusionThis study adds to the evidence of technique safety and feasibility. The procedure resulted in a significant long-term improvement in symptoms.