Analysis Of Deviance Research Articles

Redescription mining-based business process deviance analysis

AbstractBusiness processes often deviate from their expected or desired behavior. Such deviations can be either positive or negative, depending on whether or not they lead to better process performance. Deviance mining addresses the problem of identifying such deviations and explaining why a process deviates. In this paper, we propose a novel approach to identify and explain the causes of deviant process executions based on the technique of redescription mining, which extracts knowledge in the form of logical rules. By analyzing, comparing, and filtering these rules, the reasons for the deviant behaviors of a business process are identified both in general and for particular process instances. Afterward, the results of this analysis are transformed into a concise and well-readable natural language text that can be used by business analysts and process owners to optimize processes in a reasoned manner. We evaluate our approach from different angles using four process models and provide some advice for further optimization.

Multi-trait selection for mean performance and stability in purple-fleshed sweet potato

Few purple-fleshed sweet potato (PFSP) cultivars are available for Brazilian growers, urging for the development of new and adapted cultivars. PFSP breeding programs should include multiple traits during the selection process to increase the chances of developing an adequate genotype, specially yield-related and quality-related traits. The objective was to select promising PFSP genotypes based on yield and tuberous-roots-related traits exploring genotype x environment interaction (GEI). Four experiments were carried out, in which 23 pre-selected PFSP genotypes were evaluated based on yield and quality traits, after screening among 2500 experimental genotypes. The first experiment adopted an augmented block design, with ‘Luiza’ interspersed as a control. From this first experiment, the 19 experimental genotypes with the best performance were selected for the following three experiments, which were conducted in a randomized block experimental design, with three replications each, including ‘Luiza’ as control. The best genotypes were selected in the first experiment using the multi-trait genotype-ideotype distance index (MGIDI). For the following experiments, the performance of the genotypes was assessed using deviance analysis, genotypic stability through weighted average of absolute scores (WAASB) index, and the multi-trait stability index (MTSI). In the first experiment, three factors were retained, being associated to commercial production of tuberous roots (‘K-104′, ‘K-25′ and ‘U1–29′), total production of tuberous roots (‘K-110′, ‘C-42′, ‘F-16′, and ‘U1–29′), and quality of tuberous roots (‘F-22′), respectively. Desired gains were observed for all traits. For the experiments II, III, and IV five factors were retained, being four related to quality of tuberous roots and one to yield components. The GEI was significant for yield-related traits and desired gains were observed for most traits. Due to high commercial tuberous root yield and low WAASB values, the genotypes ‘U1–29′, ‘K-98′, ‘F-22′, ‘K-57′, ‘C-36′, ‘U1–15′, ‘K-25′, and ‘U2–12′ were highly productive and stable. The genotypes selected by the MTSI index were ‘U1–15′, ‘U2–10′, ‘U1–29′, ‘K-98′, and ‘K-78′. The multi-trait selection enabled the identification of promising genotypes highlighting their strengths and weaknesses.

Generalized Linear Model (GLM) Applications for the Exponential Dispersion Model Generated by the Landau Distribution

The exponential dispersion model (EDM) generated by the Landau distribution, denoted by EDM-EVF (exponential variance function), belongs to the Tweedie scale with power infinity. Its density function does not have an explicit form and, as of yet, has not been used for statistical aspects. Out of all EDMs belonging to the Tweedie scale, only two EDMs are steep and supported on the whole real line: the normal EDM with constant variance function and the EDM-EVF. All other absolutely continuous steep EDMs in the Tweedie scale are supported on the positive real line. This paper aims to accomplish an overall picture of all generalized linear model (GLM) applications belonging to the Tweedie scale by including the EDM-EVF. This paper introduces all GLM ingredients needed for its analysis, including the respective link function and total and scaled deviance. We study its analysis of deviance, derive the asymptotic properties of the maximum likelihood estimation (MLE) of the covariate parameters, and obtain the asymptotic distribution of deviance, using saddlepoint approximation. We provide numerical studies, which include estimation algorithm, simulation studies, and applications to three real datasets, and demonstrate that GLM using the EDM-EVF performs better than the linear model based on the normal EDM. An R package accompanies all of these.

Postprandial nutrient dynamics and their implications for formulated feed development for the ornate spiny lobster (Panulirus ornatus)

AbstractCrustacean feeding morphology and postprandial nutrient processing is a highly size‐selective procedure. The digestive system of lobsters is predicated on grinding feed to a fine particle size before digestion. Therefore, fine pregrinding of raw materials may bypass the need for extensive grinding in the proventriculus and expedite digestive and absorptive processes. Panulirus ornatus juveniles (N = 56) were allocated to four feed groups (n = 14). Groups A, B and C were fed nutritionally identical feeds featuring raw materials ground to 1000 µm (Feed A), 500 µm (Feed B) and 200 µm (Feed C) while the fourth group (Group S) acted as a 24‐h nonfeeding baseline control group. Sequential postprandial haemolymph extractions were performed at 0.5, 1, 1.5, 2, 3.5, 5.5 and 24 h across treatment groups. Haemolymph samples were assessed and analysed for brix (%), total proteins (g L–1), glucose (mmol L–1) and cholesterol (mmol L–1). Brix was found to have significant positive correlations with all the haemolymph biochemical properties while no significant correlations were identified between individual lobster size and haemolymph properties. Analysis of deviance applied to mixed effects models did not identify significant differences in haemolymph properties across feed groups. Trends identified here are indicative of diurnal rhythm patterns, likely orchestrated by the release of the crustacean hyperglycaemic hormone (CHH) when anticipating a meal. Additionally, the use of brix values, may not be optimal for identifying postprandial trends, yet could remain a valid indicator of longer‐term nutritional status.

Exploration of the relationship between partial pressure of brain tissue oxygen and intracranial pressure

IntroductionPartial pressure of brain tissue oxygen (PbtO2) has been shown to be a safe an effective monitoring modality to compliment intracranial pressure (ICP) monitoring. It is related to metabolic activity, disease severity and mortality. Research questionUnderstanding the complex relationship between PbtO2 and ICP for patients with traumatic brain injury will enable better clinical decision making beyond simple threshold treatment strategies. Material and methodsPatients with PbtO2 monitoring were identified from the BrainIT database, a multi-centre dataset, containing minute by minute PbtO2 and ICP readings. Missing data was imputed and a multi-level log-normal regression model with a compound symmetry correlation structure was built. This accounted for any increased correlation due to the repeated measurements. The model was adjusted for mean arterial pressure and the partial pressure of carbon dioxide. Non-linearity was assessed using analysis of deviance and trends using expected marginal means. Results11 subjects with over 82,000 readings were included. They had a median age of 38 (IQR: 37–47), 73% were male, a median length of stay of 11.8 (IQR: 6.6–19.7) days and a median extended Glasgow outcome scale of 7.00 (IQR: 5–8).There is a statistically significant (p < 0.001) non-linear effect of ICP on PbtO2. With an overall increase in PbtO2 of 5.2% (95% CI 4%–6.4%, p < 0.001) for a 10 mmHg increase in ICP below 22 mmHg and a decrease of 5.5% (95% CI 2.7%–8.3%, p=<0.001) in PbtO2 for a 10 mmHg increase in ICP above 22 mmHg. As well as a decrease of 40.9% (95% CI 2.3%–64.3%, p = 0.040) in PbtO2 per day in the intensive care unit. Discussion and conclusionThis model demonstrates that there is a significant non-linear relationship between ICP and PbtO2, however, this is a small heterogeneous cohort and further validation will be required.

610 Environmental exposures and disparities in infant mortality: a positive deviance analysis

610 Environmental exposures and disparities in infant mortality: a positive deviance analysis

64 Effects of Age and Task Difficulty on the Presence of EEG Midline-Frontal Theta Power During Administration of the Repeatable Battery for the Assessment of Neuropsychological Status-Update (RBANS)

Objective:Concurrent electroencephalography (EEG) during neuropsychological assessment offers a promising method to understand realtime neural and cognitive processes during task performance. For example, previous studies using experimental tasks suggest that midline-frontal theta power (MFT) could serve as a measure of mental exertion and subjective difficulty. The RBANS provides an opportunity to examine this issue in neuropsychological assessment, as a widely-used screening battery that was explicitly developed with subtests that vary according to difficulty within its five domains. This study investigated the effects of task difficulty, cognitive domain, and age on elicitation of MFT during rest and RBANS administration.Participants and Methods:EEG was recorded during eyes-closed and eyes-open resting periods and RBANS administration in a sample of 45 healthy younger adults (n = 21; mean age = 23.29, SD = 3.27, range = 19-33; 48% female) and older adults (n = 24; mean age = 70.58, SD = 5.77, range = 59-83; 83% female). MFT was defined as the highest peak above the overall power spectrum within 4-8Hz from electrode Fz, and operationalized as a binary variable (present/absent). A multilevel generalized logistic regression model was run to assess the main effects of Age (Younger, Older), Difficulty (Easy, Hard), Domain (Rest, Immediate Memory, Visuospatial/Constructional, Language, Attention, Delayed Memory), and their potential interactions, on the presence of MFT.Results:In the full sample, the Coding, Figure Recall, and Picture Naming subtests were numerically most likely to elicit MFT (71.1%, 66.7%, and 62.2%, respectively), whereas Semantic Fluency, Eyes-Closed Rest, and List Recall had the lowest likelihoods (37.7%, 31%, 28.9%). Older adults were also numerically less likely to exhibit MFT (37.50% present) compared to younger adults (62.24% present). An analysis of deviance revealed a significant effect of Age (F(1,43) = 7.22, p = .01) and a significant interaction between Difficulty and Domain (F(5,220) = 4.78, p &lt; .001). Specifically, Hard subtests in the Visuospatial/Constructional (Figure Copy; b = -2.63, p &lt; .05) and Language (Semantic Fluency; b = -2.92, p &lt; .01) Domains were less likely to elicit MFT than the Easy subtests (i.e., Line Orientation and Picture Naming, respectively).Conclusions:Results indicated that MFT can be reliably measured during neuropsychological assessment, and varies in relation to both age and task-related factors. Consistent with previous studies, older adults exhibited less MFT than younger adults in general, possibly suggesting a failure to recruit the relevant networks. Further, present findings suggest that the presence of MFT varies not only by the type of task but also by the level of difficulty. Future research with larger samples can clarify whether and how the amount of MFT elicited during specific subtests relates to objective and subjective difficulty. Overall, MFT can reliably be elicited by cognitive tasks and bears further study as a measure of real-time neural expenditure.

Rural libraries implementing walking groups or walking groups plus civic engagement for walkability in rural communities: a comparative effectiveness trial study protocol

BackgroundRural residents generally lack adequate physical activity to benefit health and reduce disparities in chronic diseases, such as cardiovascular disease and certain cancers. The Socioecological Model describes physical activity as involving a dynamic and reciprocal interaction between individual, social, and community factors. Community group-based walking programs and civic engagement interventions aimed at enhancing physical activity have been successful in rural communities but have not targeted all three socioecological levels. Public libraries can act as innovative public health partners in rural communities. However, challenges remain because rural libraries often lack the capacity to implement evidence-based health promotion programming. The goals of this study are (1) build the capacity for rural libraries to implement evidence-based health promotion programs, (2) compare changes in physical activity between a group-based walking program and a combined group-based walking and civic engagement program with rural residents, and (3) conduct an implementation evaluation.MethodsWe will conduct a comparative effectiveness study of a group-based walking (standard approach) versus a group-based walking plus civic engagement program (combined approach) aimed at enhancing walkability to increase physical activity among rural adults. Key mediators between the program effects and change in outcomes will also be identified. Finally, we will evaluate program implementation, conduct a cost effectiveness evaluation, and use a positive deviance analysis to understand experiences of high and low changers on key outcomes. Twenty towns will be matched and randomized to one of the two conditions and our aim is to enroll a total of 350–400 rural residents (15–20 per town). Study outcomes will be assessed at baseline, and 6, 12, and 24 months.DiscussionThis study will build the capacity of rural libraries to implement evidence-based walking programs as well as other health promotion programs in their communities. The study results will answer questions regarding the relative effectiveness and cost effectiveness of two multilevel physical activity interventions targeting rural communities. We will learn what works and how these multilevel interventions can be implemented in rural populations.Trial RegistrationClinicalTrials.gov Identifier: NCT05677906.

Acoustic and phonemic processing are impaired in individuals with aphasia

Acoustic and phonemic processing are understudied in aphasia, a language disorder that can affect different levels and modalities of language processing. For successful speech comprehension, processing of the speech envelope is necessary, which relates to amplitude changes over time (e.g., the rise times). Moreover, to identify speech sounds (i.e., phonemes), efficient processing of spectro-temporal changes as reflected in formant transitions is essential. Given the underrepresentation of aphasia studies on these aspects, we tested rise time processing and phoneme identification in 29 individuals with post-stroke aphasia and 23 healthy age-matched controls. We found significantly lower performance in the aphasia group than in the control group on both tasks, even when controlling for individual differences in hearing levels and cognitive functioning. Further, by conducting an individual deviance analysis, we found a low-level acoustic or phonemic processing impairment in 76% of individuals with aphasia. Additionally, we investigated whether this impairment would propagate to higher-level language processing and found that rise time processing predicts phonological processing performance in individuals with aphasia. These findings show that it is important to develop diagnostic and treatment tools that target low-level language processing mechanisms.

Success in Education by Defying Great Odds: A Positive Deviance Analysis of Educational Policies

EEducation is seen as a resource at a global level but is currently considered to be in crisis in many parts of the world. This constitutes a significant drawback in terms of humanity’s prosperity and well-being since education is the key not only to an educated workforce but also to humane, collaborative, and caring societies. Even within this dim landscape, there are certain educational systems that defy the odds and perform significantly higher than their otherwise comparable systems. This paper proposes using an unusual lens for educational policy comparative studies, that of positive deviance, to aid us in progressing towards a more stable educational state of affairs. Using a positive deviance methodology, which focuses on learning what is working well in systems that defy and overcome substantial challenges, this study investigates the patterns, attitudes, and actions of three selected cases: Massachusetts as a positive deviant in the US, Estonia as a positive deviant in Europe, and Castile-Leon as a positive deviant in Spain. The purpose is, by analysing educational policies, laws, and other related documents, to find commonalities that explain why these systems outperform others. The results of the comparative analysis pinpoint areas and strategies informative to those leading struggling educational systems, such as a strong commitment to equity and justice, placing teachers at the centre of reforms, using assessment as a tool for process monitoring and summative inquiry, and making preschool education accessible to all.

A new method to assess sustainability of agricultural systems by integrating ecosystem services and environmental impacts

Agricultural stakeholders disagree on how to put the general concept of sustainability into practice. But most recognize the need for assessment methods to characterize the current situation and gauge progress yet to be made. Many sustainability assessment methods for agricultural systems have been published, but very few integrate ecosystem services (ES). And yet, ES indicators are key to better integrating biological processes to support the agroecological transition. Although researchers have attempted to link the concept of environmental impact (EI) and ES through life cycle analysis (LCA), gaps remain when it comes to doing so within a sustainability assessment method. Here a new method based on an original conceptual indicator framework embedding new predictive indicators of EI and ES indicators was developed. This framework covers 22 environmental themes and integrates few basic economic and social indicators. The method was implemented on 33 farms with different certifications and production specifications. All farms were members of an agricultural cooperative in north-eastern France. We selected 250 plots to cover the farms’ crop rotations. The correlation analysis showed no systemic trade-off between EI or ES and economic indicators. Meanwhile, the joint assessment of ES and EI (like the multivariate analysis), delivered more nuanced results than a classical opposition between intensive and organic farming. Some farms with a moderate or even good level of ES often do not leverage them, as shown by their high EI. The principle component analysis and subsequent hierarchical ascendant classification allowed us to distinguish five clusters providing a more complex picture than simply opposing conventional and organic agriculture. Finally, the positive deviance analysis revealed that economic, environmental and social considerations can be balanced in a way that seems to be more sustainable than, for example, an organic farm that has very successfully reduced EI but at a cost of several economic and social trade-offs.

Identifying temporal drivers of product acceptance and rejection across sips during whole product consumption

AbstractMeasuring emotional response gives insights into consumer product experiences beyond liking. However, existing research rarely considers that emotional and hedonic responses can change during consumption of a whole portion. This research considered how well a combined multiple‐sip temporal check‐all‐that‐apply approach captured temporal drivers of product acceptance and rejection. Consumers (n = 104) profiled temporal sensory, liking and emotional responses to three milkshakes. Associations in temporal sensory, liking and emotional response citation pattern across multiple sips were investigated using generalized linear models, analysis of deviance and Pearson's chi‐square test. Differences in the temporal dynamics of sensory, liking and emotional responses and associations between temporal sensory and affective responses were identified highlighting liking and emotional experience were related to the evolution of sensory attributes over time. Notably, sensory associations with emotional responses, including “bored,” “relaxed,” and “satisfied,” were better at identifying temporal drivers of acceptance/rejection more than associations to level of liking.Practical ApplicationsThe research demonstrated that a combined multiple‐sip temporal check‐all‐that‐apply (TCATA) approach, representing whole product consumption, is an effective approach to gain deeper insights into the sensory drivers of consumer affective response. However, the applicability of analyzing within‐sip variations in perception, and potential to use check all that apply by sip as opposed to TCATA needs to be considered on a product category basis.

Health service quality in 2929 facilities in six low-income and middle-income countries: a positive deviance analysis

Primary care is of insufficient quality in many low-income and middle-income countries. Some health facilities perform better than others despite operating in similar contexts, although the factors that characterise best performance are not well known. Existing best-performance analyses are concentrated in high-income countries and focus on hospitals. We used the positive deviance approach to identify the factors that differentiate best from worst primary care performance among health facilities across six low-resource health systems. This positive deviance analysis used nationally representative samples of public and private health facilities from Service Provision Assessments of the Democratic Republic of the Congo, Haiti, Malawi, Nepal, Senegal, and Tanzania. Data were collected starting June 11, 2013, in Malawi and ending Feb 28, 2020, in Senegal. We assessed facility performance through completion of the Good Medical Practice Index (GMPI) of essential clinical actions (eg, taking a thorough history, conducting an adequate physical examination) according to clinical guidelines and measured with direct observations of care. We identified hospitals and clinics in the top decile of performance (defined as best performers) and conducted a quantitative, cross-national positive deviance analysis to compare them with facilities performing below the median (defined as worst performers) and identify facility-level factors that explain the gap between best and worst performance. We identified 132 best-performing and 664 worst-performing hospitals, and 355 best-performing and 1778 worst-performing clinics based on clinical performance across countries. The mean GMPI score was 0·81 (SD 0·07) for the best-performing hospitals and 0·44 (0·09) for the worst-performing hospitals. Among clinics, mean GMPI scores were 0·75 (0·07) for the best performers and 0·34 (0·10) for the worst performers. High-quality governance, management, and community engagement were associated with best performance compared with worst performance. Private facilities out-performed government-owned hospitals and clinics. Our findings suggest that best-performing health facilities are characterised by good management and leaders who can engage staff and community members. Governments should look to best performers to identify scalable practices and conditions for success that can improve primary care quality overall and decrease quality gaps between health facilities. Bill & Melinda Gates Foundation.

Effect of cervical margin relocation on marginal adaptation and microleakage of indirect ceramic restorations.

This study evaluated the effect of cervical margin relocation (CMR) with two different materials and contamination with hemostatic agents on the margin adaptation and microleakage of ceramic restorations. Mesial-occlusal-distal cavities were prepared in 60 human first molars and distributed to 3 groups (n=20) according to the margin relocation procedure. The groups were: group F; flowable composite applied in two 2mm increments, group B; bulk-fill flowable composite applied as a bulk increment of 4mm thickness and group C (control); no CMR was done. Each group was subdivided into two subgroups (subgroup N; no hemostatic agent applied and subgroup H; hemostatic agent was applied). In all groups, ceramic inlays were prepared and cemented. The samples were subjected to thermocycling (10,000 cycles). The adaptation of the cervical margin was evaluated with scanning electron microscopy (200×). Samples were then assessed for microleakage analysis with the dye penetration method. Marginal adaptation data were normally distributed and analyzed using two-way ANOVA followed by Tukey's post hoc test. Ordinal microleakage score data were analyzed using cumulative link models followed by the analysis of deviance using Wald chi-square tests. Both CMR and contamination with a hemostatic agent had significant effects on the margin adaptation of the cervical margin. Group C showed the highest adaptation with no significant difference from group F. The lowest adaptation was revealed in group B with a significant difference from group C. Subgroup N (in all groups) showed a statistically higher adaptation than subgroup H. Regarding microleakage assessment, CMR had no significant effect but hemostatic agent application showed a significantly higher microleakage score for all groups. Both the CMR procedure and contamination with AlCl3 hemostatic agent had a negative effect on marginal adaptation. For microleakage assessment, only contamination with hemostatic agent negatively affected the microleakage with no effect on the margin relocation procedure.

Abstract 5559: Exploratory analysis of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) PIK3CA mutated (mut) advanced breast cancer (aBC) treated with taselisib (TAS) and/or fulvestrant (FUL) reveals increased CCNE2 expression with poor outcome to placebo (PBO) + FUL but not TAS + FUL in SANDPIPER

Abstract PIK3CA mutations occur in ~40% of patients (pts) with HR+/HER2- aBC. TAS is a potent and selective β-sparing PI3K inhibitor that has shown modest clinical benefit when combined with FUL endocrine therapy in patients (pts) with PIK3CAmut aBC. To better understand the molecular features associated with response to TAS and/or FUL, we examined the gene expression profiles of archival tissue from pts enrolled in SANDPIPER (NCT02340221). Most patients did not have prior treatment with a CDK4/6i. RNA sequencing was performed on baseline tissue samples from 456 pts with PIK3CAmut tumors. Exploratory biomarker analyses revealed 28 genes associated with worse outcome. Of these, CCNE2 [HR=1.11 (1.04-1.19), p=0.002], RRM2 [HR=1.14 (1.07-1.22), p&amp;lt;0.0001] and TUB4A [HR=1.15 (1.05-1.26), p=0.004] are involved in the regulation of mitotic cell cycle. CCNE2 encodes CYCLIN E2, a G1 cyclin that binds and activates CDK2. Elevated expression of CCNE2 has been associated with poor outcome in ER-positive breast cancer, and has been identified as part of gene signatures that predict disease progression in tamoxifen-resistant breast cancer or advanced breast cancer. Since CCNE2 expression may be a marker of more proliferative tumors, we assessed whether the inclusion of CCNE2 gene expression would add value to a prognostic model that already includes cell cycle as a factor. Analysis of deviance after sequential addition of variables into Coxph models with stratification factors showed that elevated CCNE2 expression is significant, in addition to cell cycle signature scores, for association with worse PFS (likelihood ratio test p = 0.001). When we grouped patients based on CCNE2 expression split by quartile with the highest values (Q4) grouped as CCNE2 high vs lower values (Q1-Q3), we found that the CCNE2 high group does worse in the PBO + FUL treatment arm. Median PFS for CCNE2-high group in the placebo arm was 3.75 months compared to the other groups (log-rank p &amp;lt; 0.0001; PBO, CCNE2-low 7.3 months, TAS, CCNE2-high 7.6 months; TAS, CCNE2-low 7.3 months). A significant statistical interaction was observed between high CCNE2 gene expression and PBO + FUL treatment arm HR=1.51 (1.03-2.20), p=0.04], suggesting that CCNE2 expression may be associated with poor PFS to in 2L ER+/HER2- PIK3CAmut aBC patients that receive PBO + FUL. Our analysis revealed an association between high CCNE2 expression and worse PFS in patients that received PBO + FUL. Further, this association was not observed in the patients that received the combination of TAS+FUL, which may inform future rational combination strategies for the clinical development of PI3K inhibitors in ER+/HER2- PIK3CAmut aBC. Citation Format: Radia M. Johnson, Bonnie Liu, Javier Cortés, Susan Dent, Nadia Harbeck, Ian E. Krop, William Jacot, Robert L. Yauch, Thomas J. Stout, Frauke Schimmoller, Steven Gendreau, Timothy R. Wilson. Exploratory analysis of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) PIK3CA mutated (mut) advanced breast cancer (aBC) treated with taselisib (TAS) and/or fulvestrant (FUL) reveals increased CCNE2 expression with poor outcome to placebo (PBO) + FUL but not TAS + FUL in SANDPIPER. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5559.

Índices de seleção e componentes principais para caracteres agronômicos e bromatológicos em palma forrageira

ABSTRACT The objective of the present work was to compare selection indexes focused on the selection of forage cactus (Opuntia ficus-indica) accessions at initial generations. Sixty-five accessions from different locations in the semiarid region of the state of Bahia, Brazil, were evaluated in a randomized complete block design with three replications. Agronomic and bromatological traits were evaluated. The genetic parameters were predicted by using mixed models (REML/BLUP). The linear correlation degree between variables was estimated through Pearson's correlation analysis. Selection gains were predicted using four selection indexes: Smith-Hazel index, with two combinations of economic weights; rank sum index of Mulamba and Mock; and Elston's multiplicative index. The selection intensity applied was 30%, which allowed the selection of the 20 best accessions. The analysis of deviance showed significant effect for all traits. The estimate of genetic parameters evidenced the existence of genetic variability for the O. ficus-indica accessions. The Smith-Hazel index (combination 1) was important for primary (fresh weight and cladode dry weight) and bromatological traits (acid detergent fiber and neutral detergent fiber), expressing higher selection gains than the other indexes. The rank sum and multiplicative indexes resulted in selection gains for most evaluated traits. The results of accessions 2, 4, 5, 7, 9, 11, 14, 15, 18, 26, 27, 34, 37, 38, 39, 41, 45, 49, 51, 52, 53, and 58 were promising for their inclusion in breeding programs, as they were selected by at least two of the four selection indexes used.

Reducing Overuse by Healthcare Systems: A Positive Deviance Analysis.

Healthcare in the USA is increasingly delivered by large healthcare systems that include one or more hospitals and associated outpatient practices. It is unclear what role healthcare systems play in driving or preventing overutilization of healthcare services in the USA. To learn how high-value healthcare systems avoid overuse of services DESIGN: We identified "positive deviant" health systems using a previously constructed Overuse Index. These systems have much lower-than-average overuse of healthcare services. We confirmed that these health systems also delivered high-quality care. We conducted semi-structured interviews with executive leaders of these systems to validate a published framework for understanding drivers of overuse. Leaders at select healthcare systems in the USA. None APPROACH: We developed an interview guide and conducted semi-structured interviews. We iteratively developed a code book. Paired reviewers coded and reconciled each interview. We analyzed the interviews by applying constant comparative techniques. We mapped the emergent themes to provide the first empirical data to support a previously developed theoretical framework. We interviewed 15 leaders from 10 diverse healthcare systems. Consistent with important domains from the overuse framework, themes from our study support the role of clinicians and patients in avoiding overuse. The leaders described how they create a culture of professional practice and how they modify clinicians' attitudes to facilitate high-value practices. They also described how their patients view healthcare consumption and the characteristics of their patient populations allowed them to practice high-value medicine. They described the role of quality metrics, insurance plan ownership, and alternative payment model participation as encouraging avoidance of overuse. Our qualitative analysis of positive deviant health systems supports the framework that is in the published literature, although health system leaders also described their financial structures as another important factor for reducing overuse and encouraging high-value care delivery.

Temporal dynamics of Apis mellifera (Hymenoptera: Apidae) during flowering in indeterminate soybean (Glycine max).

Soybean varieties with indeterminate growth habit are widely used in the state of Mato Grosso do Sul and are characterized by not having well-defined phenological stages. Due to the importance of bee conservation, studies on the frequency and time of visitation in indeterminate soybean are needed. Samples were collected in a 4-ha plot of soybeans not treated with insecticides. Sampling was carried out at random spots, throughout the flowering period, starting at 08h:00min, during 15 min/hour, successively until 16h:00min. Generalized Linear Models were generated and the Poisson regression model provided the best fit, reflecting the significant differences revealed by the deviance analysis. The association between bees and climatic variables was tested with the Spearman's correlation. The temporal pattern of bee visitation was independently influenced by flowering period and time of day. However climatic variables did not influence significantly bee visitation rate. In the first days of flowering, bees were more abundant, especially between 10h and 15h. These results have practical implications in the maintenance of this species during soybean management practices, contributing to a balanced coexistence between beekeepers and soybean growers, by avoiding applications of phytosanitary products during the periods of high bee visitation.

Mean corpuscular haemoglobin concentration (MCHC): a new biomarker for high-altitude pulmonary edema in the Ecuadorian Andes

Ascent to high altitude (> 3000 m height above sea level or m.a.s.l) exposes people to hypobaric atmospheric pressure and hypoxemia, which provokes mountain sickness and whose symptoms vary from the mild acute mountain sickness to the life-threatening, high-altitude pulmonary edema (HAPE). This study analysed the risk factors underlying HAPE in dwellers and travellers of the Ecuadorian Andes after sojourning over 3000 m height. A group of HAPE patients (N = 58) was compared to a NO HAPE group (N = 713), through demographic (ethnicity, sex, and age), red blood cell parameters (erythrocytes counts, hematocrit, median corpuscular volume, median corpuscular haemoglobin, and median corpuscular haemoglobin concentration (MCHC)), altitude (threshold: 3000 m.a.s.l.), and health status (vital signs) variables. Analysis of Deviance for Generalised Linear Model Fits (logit regression) revealed patterns of significant associations. High-altitude dwellers, particularly children and elder people, were HAPE-prone, while women were more tolerant of HAPE than men. Interestingly, HAPE prevalence was strongly related to an increment of MCH. The residence at middle altitude was inversely related to the odds of suffering HAPE. Ethnicity did not have a significant influence in HAPE susceptibility. Elevated MCHC emerges like a blood adaptation of Andean highlanders to high altitude and biomarker of HAPE risk.

Learning health system, positive deviance analysis, and electronic health records: Synergy for a learning health system.

Over the past decade, numerous efforts have encouraged the realization of the learning health system (LHS) in the United States. Despite these efforts, and promising aims of the LHS, the full potential and value of research conducted within LHSs have yet to be realized. New technology coupled with a catalyzing global pandemic have spurred momentum. In addition, the LHS has lacked a consistent framework within which "best evidence" can be identified. Positive deviance analysis, itself reinvigorated by recent advances in health information technology (IT) and ubiquitous adoption of electronic health records (EHRs), may finally provide a framework through which LHSs can be operationalized and optimized. We describe the synergy between positive deviance and the LHS and how they may be integrated to achieve a continuous cycle of health system improvement. As we describe below, the positive deviance approach focuses on learning from high-performing teams and organizations. Such learning can be enabled by EHRs and health IT, providing a lens into how digital clinical interventions are successfully developed and deployed.