Chi-square Goodness Of Fit Test Research Articles

Race and the NFL: Teaching the Chi-Square Goodness of Fit Test

Abstract Guest lecturer: Craig A. Foster, professor in the Psychology Department at SUNY Cortland

Temporal fluctuations of post-tonsillectomy haemorrhage

PurposeAlthough haemorrhage is a common and in some cases life-threatening complication after tonsillectomy, surprisingly little is known about the temporal fluctuations of the onset of bleeding. The purpose of this study was to assess circadian and seasonal rhythms of post-tonsillectomy haemorrhage (PTH) and potential ramifications to educate patients and health care staff.MethodsThis retrospective study carried out at a tertiary referral hospital included paediatric and adult patients requiring emergency surgery due to severe PTH between 1993 and 2019. Medical records were reviewed and patient demographics, details regarding the initial procedure, postoperative day of haemorrhage, and start time of emergency surgery were extracted. Descriptive statistics, Kruskal–Wallis test, Mann–Whitney U test, and Chi-square goodness of fit tests were used to detect potential differences.ResultsA total of 300 patients with severe PTH and subsequent emergency surgery were identified. The median postoperative duration until PTH was 6 (range: < 1–19) days. 64.7% (n = 194) of all emergency surgeries had to be performed during evening and night hours (6 pm—6 am) (p < 0.0001). Compared to diurnal incidents, the risk of a nocturnal PTH event increased, the longer ago the initial surgery was (p < 0.0001). No seasonal variations were identified. Age, sex, and details of the initial procedure had no significant influence on the start time according to the surgical protocol.ConclusionThe discovered temporal fluctuations of PTH are of relevance for patient awareness and preoperative education. Due to possible life-threatening complications, management of severe PTH requires specific resources and trained medical staff on call.

English

BACKGROUND COVID-19 (coronavirus disease 2019) was declared a pandemic by WHO in early 2020. In India during the month of March, a lockdown was announced. All dental institutions and clinics were closed by looking at the emergency situation all around the world. The study was intended to evaluate the knowledge, attitude and practice of parents in relation to the oral health of their children during the COVID-19 pandemic. METHODS A self-designed, structured, online questionnaire of 26 close-ended questions was distributed to 500 mothers of children aged 1 to 10 years of age through messages, WhatsApp, and emails. Participants were given a consent form to be filled online and it was a prerequisite to attend all the questions. Data obtained were subjected to statistical analysis using the chi-square goodness of fit test. The P-value where P ≤ 5 was considered statistically significant. RESULTS A standardized self-designed online questionnaire was used to perform this crosssectional survey. Before commencing with the study, the institutional review board reviewed and approved it. A panel of specialists created the questionnaire and consent form, which were then evaluated by parents to determine its face validity. A parent or caretaker then completed the questionnaire. CONCLUSIONS Parents’ knowledge, attitude, and perspective towards the oral hygiene of their children during the pandemic were very good and parents took proper home measures to tackle their oral health problems. KEY WORDS COVID-19, Oral Health, Child, Parents, Oral Hygiene

The Relative Age Effect in Czech U14 Male and Female Tennis Players in 2007–2016

The issue of the Relative Age Effect (RAE) has been long researched, discussed and published both in the academic and coaching community and the number of studies on it in various sports has significantly grown in recent years. The aim of this study was to verify the existence of RAE among Czech male (n = 6552) and female (n = 4131) junior tennis players and to identify possible differences in birthdate effect between male and female players. The research was carried out in players registered in the years 2007–2016 in the U14 age category in Czech Tennis Association (CTA) database; the athletes were divided into three subgroups (‘Ranked’, ‘Top 100’, ‘Top 10’). Research data were analysed by the methods of descriptive and inferential statistics: relative and absolute frequency, chi-square goodness of fit test () and chi-square test of independence () with the use of effect size (ES index w). A declining tendency of frequencies from Q1 to Q4 between male and female junior players was proven in all three subgroups.In the whole period of 2007–2016, a significant and strong RAE was demonstrated only in the ‘Top 10’ male subgroup (RAE was significant and ES was small or trivial in the other two subgroups). Among the female players, RAE was significant in all three subgroups (ES was small or trivial). Gender differences in RAE in favour of male players were significant in ‘Top 100’ and ‘Ranked’ (ES was small or trivial in all three subgroups). In the short and long term, RAE can have significant implications for the sport development of athletes; both coaches and the professional public can therefore be recommended to pay attention to this issue. The impact of RAE in sport, i.e. the uneven distribution of athletes’ birthdates, is more pronounced especially among junior athletes and often significantly affects their sports development and career.

Behavioral and Occupational Health in Military Firefighters: An Understudied Population.

To our knowledge, no studies on health conditions in U.S. military firefighters exist. Data and demographics from the Defense Medical Epidemiology Database were analyzed on several shared medical issues among military personnel and civilian firefighters. Descriptive statistics and Chi-Square goodness of fit tests were conducted to support study aims. Between 2001 and 2015, substantial incidence rate increases (per 10,000) of tinnitus, PTSD, insomnia, and OSA (2005-2015) were observed. Modest to large increases in depressive disorders, adjustment reaction, generalized anxiety disorder, and panic disorder were observed. Decreasing rates were observed for alcohol dependence, hypertension, and tobacco use disorder. While efforts have examined the impact of sustained operations on military members, first responder military subgroups like firefighters are deficient. Cognitive Behavior Therapy interventions are efficacious for preventing and reducing behavioral health problems; therefore, tailoring them specifically for U.S. military firefighters could significantly improve quality of life and long-term health.

English

BACKGROUND During the lockdown period of COVID-19 pandemic, dental colleges in Bangalore, India, had switched to online dental education and when the cases started to decline, the dental colleges finally welcomed students on campus in November 2020 following the Government directions. Majority of the dental procedures produce droplets and aerosols in a dental practice. In this context, the standard protective measures are not enough in the daily dental practice during this pandemic. Dental professionals, students in particular should be aware of the main symptoms of COVID-19, its mode of transmission and precautions to be adopted in the dental practice so as to break the chain of infection. The purpose of the study was to investigate the perception regarding COVID-19 among the dental students of a dental teaching institution in Bangalore city. METHODS An online questionnaire was created to assess the perception about COVID-19 among dental students. Total enumeration method was followed, and undergraduates, interns and post graduate students of a tertiary care dental hospital participated in the online survey. chi-square goodness of fit test was used to compare the differences in the distribution of respondents and independent chi- square test was used to do the comparison in the difference of responses towards the study questionnaire between the students studying in different undergraduate years; with level of significance set at P &lt; 0.05. RESULTS About 380 dental students participated in the online survey; correct response rate was slightly higher among clinical dental students than pre-clinical students. Educational and training programmes related to COVID-19, infection control and practices were implemented at the institution for the dental professionals in the academic level. CONCLUSIONS The perception about COVID-19 among pre-clinical dental students were slightly lower than the clinical students. KEY WORDS Clinical, COVID-19, Dental Students, Pre-Clinical

Norms for Automatic Estimation of Hippocampal Atrophy and a Step Forward for Applicability to the Italian Population.

IntroductionHippocampal volume is one of the main biomarkers of Alzheimer’s Dementia (AD). Over the years, advanced tools that performed automatic segmentation of Magnetic Resonance Imaging (MRI) T13D scans have been developed, such as FreeSurfer (FS) and ACM-Adaboost (AA). Hippocampal volume is considered abnormal when it is below the 5th percentile of the normative population. The aim of this study was to set norms, established from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) population, for hippocampal volume measured with FS v.6.0 and AA tools in the neuGRID platform (www.neugrid2.eu) and demonstrate their applicability for the Italian population.MethodsNorms were set from a large group of 545 healthy controls belonging to ADNI. For each pipeline, subjects with segmentation errors were discarded, resulting in 532 valid segmentations for FS and 421 for AA (age range 56–90 years). The comparability of ADNI and the Italian Brain Normative Archive (IBNA), representative of the Italian general population, was assessed testing clinical variables, neuropsychological scores and normalized hippocampal volumes. Finally, percentiles were validated using the Italian Alzheimer’s disease Repository Without Borders (ARWiBo) as external independent data set to evaluate FS and AA generalizability.ResultsHippocampal percentiles were checked with the chi-square goodness of fit test. P-values were not significant, showing that FS and AA algorithm distributions fitted the data well. Clinical, neuropsychological and volumetric features were similar in ADNI and IBNA (p > 0.01). Hippocampal volumes measured with both FS and AA were associated with age (p < 0.001). The 5th percentile thresholds, indicating left/right hippocampal atrophy were respectively: (i) below 3,223/3,456 mm3 at 56 years and 2,506/2,415 mm3 at 90 years for FS; (ii) below 4,583/4,873 mm3 at 56 years and 3,831/3,870 mm3 at 90 years for AA. The average volumes computed on 100 cognitively intact healthy controls (CN) selected from ARWiBo were close to the 50th percentiles, while those for 100 AD patients were close to the abnormal percentiles.DiscussionNorms generated from ADNI through the automatic FS and AA segmentation tools may be used as normative references for Italian patients with suspected AD.

Design and Validation of a Questionnaire on Influence of the University Classroom on Motivation and Sociability

In recent years, the changes experienced in the educational and social field have been reflected in the growing interest in defining how the attributes of the learning space affect students. This study seeks to determine the influence exerted by the design and organization of the university classroom on motivation and social interaction. The objective was to develop and validate a measurement instrument to evaluate the impact of the university classroom design on the student, considering their physical, environmental, perceptual, and motivational attributes. The questionnaire was applied to a sample of 402 students from the University of Almeria (Spain). The reliability and content validity of the construct were analyzed. Reliability was demonstrated by a Cronbach’s alpha of 0.938 for the dimensions with quantitative cut items, being highly satisfactory. The Chi-square goodness of fit test analyzed the qualitative items. Content validity was subject to expert judgment. It is concluded that the presented instrument meets the required technical attributes, to be considered a reliable and valid educational tool for measurement.

Assessing the reliability and validity of comprehensive score for financial toxicity (COST) among radiation oncology patients in India: a cross-sectional pilot study.

BackgroundBesides physical toxicity, cancer care imposes significant financial distress referred to as financial toxicity (FT). FT has become a growing concern among cancer patients. Researchers have associated FT among cancer patients with clinical outcomes like mortality, poor quality of life and non-adherence. Currently, no reliable tools are available for assessing FT among cancer patients in India. The aim of this pilot study was to test the reliability and validity of the Comprehensive Score for Financial Toxicity (COST) questionnaire among patients undergoing radiotherapy in India.Material and methodsThis cross-sectional pilot study was conducted among head and neck cancer patients on follow-up in radiation oncology department. The reliability of COST measure was assessed using Cronbach’s α. The underlying construct of COST was verified by Exploratory Factor Analysis (EFA). EFA was performed using parallel analysis technique.ResultsBased on inclusion and exclusion criteria, the COST questionnaire was administered to 29 patients using the interview method after written informed consent. The COST measure demonstrated excellent reliability with Cronbach’s α of 0.92. A Kaiser–Meyer–Olkin of 0.87 verified the sample adequacy and a p-value of ˂0.001on Bartlett’s sphericity test indicated that the strength of the correlation between 11 COST items was good to perform the EFA. Parallel analysis technique identified one factor on scree plot with eigenvalue of 6.21 explaining 56.5% of the variance by non-rotated solution. All the factor loadings in one factor model were ˃0.3 (range 0.35–0.97). The factor loadings indicated that the underlying construct can be considered as one factor domain as intended by the original COST development study. However, Chi-square goodness of fit test revealed the one factor model did not adequately depict the data. However, the results were consistent with the construct obtained in the original scale development study.ConclusionThis pilot study demonstrated excellent reliability of COST for measuring FT among radiation oncology patients. Further studies are warranted to study the clinical implications of FT in the Indian population for making better strategies and policies to ease the financial burden on cancer patients.

Chair dimension compatibility with elementary school students anthropometric data in North Jakarta

BACKGROUND In Indonesia, primary school begins at 6 years old and continues until 12, where most of their growth is experienced at that age. Non-ergonomic school furniture can harm the musculoskeletal system. This study evaluates the suitability of chair dimensions to elementary school student’s anthropometry in North Jakarta. METHODSA cross-sectional study of 98 students in North Jakarta. Chair dimension data and student anthropometry were measured using a tape measure, which was then analyzed using the Chi-Square Goodness of Fit Test to evaluate their suitability. RESULTSThe ages of the students ranged from 5 to 11 years. Anthropometric measurements of students show that the mean Sitting Shoulder Height is 41.81±4.36 cm, Popliteal Height 36.83±3.77 cm, Hip Breadth 25.88±3.47 cm, and Buttock-Popliteal Length 36.56±4.33 cm. While the average size assessed from the seat dimensions is Seat Height 41.71±0.22 cm, Seat Width 37.2±1.26 cm, Seat Depth 37.2±1.42 cm, and Backrest Height Above Seat 35.54±3.19 cm. The results of Goodness of Fit with Kendall's Tau-b critical value for the suitability of chair dimensions to student anthropometry were 0.37, and vice versa 0.672, which stated a discrepancy. CONCLUSIONThere is a mismatch between chair dimension and anthropometry of elementary school students in North Jakarta. Adjustment of chair dimensions needs to be done using a student's average size approach to prevent musculoskeletal disorders.

DISTRIBUTION OF CUTANEOUS LEISHMANIASIS BY SEX, AGE GROUPS AND RESIDENCE IN YEAR 2020 IN CUTANEOUS LEISHMANIASIS POPULATION OF DISTRICT D.I.KHAN, PAKISTAN

Background: Leishmaniasis is not an uncommon tropical disease. Cutaneous leishmaniasis is its most common form. The objectives of our study were to determine the distribution of cutaneous leishmaniasis by sex, age groups and residence in year 2020 in cutaneous leishmaniasis population of District D.I.Khan, Pakistan. Materials &amp; Methods: This cross-sectional study was conducted in Department of Community Medicine, Gomal Medical College, D.I.Khan, Pakistan from January 1, 2021 to January 23, 2021. The data for cutaneous leishmaniasis was retrieved from District Health Office, D.I.Khan for year 2020. A sample size of 419 was calculated from population at risk of 1,750,000 with 0.1034% margin of error, 95% confidence level and 0.01164% assumed prevalence of cutaneous leishmaniasis. Sex, age groups and residence were our three nominal variables. Distribution was analyzed by count and percentage with 95% confidence intervals. Three hypotheses for distribution were testified by chi-square goodness of Fit test. Results: Out of 419 positive cases of cutaneous leishmaniasis, 269 (64.20%) were men and 150 (35.80%) women, 254 (60.62%) were in age group up to 19 years, 101 (24.11%) in age group 20-39 years and 64 (15.27%) in age group ≥40 years, and 113 (26.97%) were urban and 306 (73.03%) rural. Our distribution by sex (p=0.01327), age groups (p=&lt;0.0001) and residence (p=&lt;0.0001) were not similar to expected. Conclusions: The prevalence of cutaneous leishmaniasis in year 2020 in cutaneous leishmaniasis population of District D.I.Khan, Pakistan was higher in men than women, highest in age group up to 19 years than age groups 20-39 and ≥40 years, and higher in rural than urban. The prevalence for men was higher than expected for men and prevalence for women was lower than expected for women. The prevalence for age group up to 19 years was highest than expected for this age group than age groups 20-39 and ≥40 years. The prevalence for rural was higher than expected for rural and the prevalence for urban was lower than expected for urban.

Spectrum of Inherited Metabolic Diseases in neonates and children presenting at Izzat Ali Shah Hospital, Wah Cantt.

Objective: To determine the frequency of various Inherited Metabolic Diseases (IMDs) in clinically suspected neonates and children in relation to age, gender, and distribution in rural and urban areas.Materials and Methods: A total of 275 symptomatic neonates and children were enrolled for IMDs. A complete medical history, baseline biochemical tests, cerebrospinal fluid analysis, arterial blood gases, anion gap, serum ammonia, lactate, and urinary ketones were assessed. Any significant microbiological cause for the presenting symptom was excluded. For screening of Inborn Metabolic Error simple Heel prick test was done on PerkinElmer 226 filter paper in newborns and infants. Samples were sent to Jordan for analysis. High-performance liquid chromatography combined with tandem mass spectrometry (LC-MS/MS) was the technique used in the screening of a variety of IMDs. The frequency of Inherited Metabolic Diseases and their relation with age, gender, and location was determined using the chi-square goodness of fit test. A p-value ≤ of 0.05 was considered statistically significant. Results: Of the 275 subjects screened, 47(17%) had an inherited metabolic disorder, of which 27 were male and 20 were female with a Male to Female ratio of 1.35:1. The difference in metabolic disorders was significantly different between age (p=0.01) and gender (p=0.04). Of the diagnosed cases G6PD disorder was found to be the most frequent disorder 14 (29.79%) of the total diagnosed cases, followed by Aminoaciduria in 9 (19.15%) and Carnitine Uptake Defect in 7 (14.8). Conclusion: The cases detected to have IMDs revealed a significant prevalence. G6PD was detected as the most frequent disorder. A simple Heel prick test on PerkinElmer 226 filter paper is a useful method to detect IMDs, though confirmation is usually required by other tests.&#x0D;  

Mixed Distribution Models Based on Single-Cell RNA Sequencing Data.

Progress in single-cell RNA sequencing (scRNA-seq) has yielded a lot of valuable data. Analysis of these data can provide a new perspective for studying the intratumoral heterogeneity and identifying gene markers. In this paper, the scRNA-seq data of colorectal cancer (CRC) are analyzed, and it is found that the shape of the gene expression difference (GED) data shows certain distribution regularity. To study the distribution regularity, mixed stable-normal distribution (MSND) model and mixed stable-exponential distribution (MSED) model are constructed to fit the GED data. And the estimated parameters of MSND and MSED are used to describe some characteristics of their distribution. Through the comparison of root mean square error and the chi-squared goodness of fit test, it is found that the fitting effect of MSED and MSND are both better than that of stable distribution and Cauchy distribution. Considering the given quantile thresholds, MSND and MSED can be used to identify tumor-related genes. The results of functional analysis indicate that the selected genes are highly correlated with CRC. In addition, the parameters of MSND and MSED exhibit a certain trend with the development of CRC. To explore the association, Gene-set enrichment analysis (GSEA) is performed. The results of GSEA reveal that the trend can well characterize the intratumoral heterogeneity of CRC. In addition, the application of MSED model on hepatocellular carcinoma shows that our model can analyze other cancers. Overall, MSND model and MSED model can well fit the GED data in different disease stages, the parameters of the two models can characterize the heterogeneity of CRC tumor cells, and the two models can be used to identify genes highly correlated with tumors.

(Un)Sustainability of the Time Devoted to Selected Housework—Evidence from Slovakia

Domestic appliances play a vital role in modern households. Appliances help simplify domestic work, but individuals become dependent on them. The present paper aims to contribute to the long-standing dilemma among scholars whether domestic appliances help to shorten the time devoted to household chores or not. The paper focuses on the utilization of various domestic appliances in Slovak households and on the influence of their utilization on the time of men and women in partner households and in the single-person households devoted to routine unpaid work activities. The results of the paper are based on the data from original field research conducted in Slovakia in 2015. A total of 1179 partner households, 182 single-man households and 226 single-woman households were included in the analysis. The jamovi version 1.2 statistical program was used to verify the hypothesis by chi-squared goodness of fit test and nonparametric Mann–Whitney U-test. In partner households and in single-man households, usage of automatic washing machines significantly influences time devoted to preparation and maintenance of the clothes. In single-woman households, usage of dishwasher significantly influences time devoted to food preparation. In partner households, men devote less time to routine unpaid work activities than women, regardless of usage or non-usage of domestic appliances.

The use of 3D printing for osteopathic medical education of rib disorders.

With the advent of increasingly accessible three-dimensional (3D) printing, the possibility to efficiently design and generate prototype innovations is also increasing. This type of manufacturing can potentially enhance medical education by allowing design of models specific to osteopathic manipulative medicine (OMM). To determine the viability of a 3D-printed mechanically moveable rib cage in enhancing the teaching of rib osteopathic principles. A single-blind, qualitative study was conducted to evaluate the use of educating students with this novel 3D-printed, movable rib model vs. a traditional static rib model. A total of 237 first-year medical students participated in the study and received the same standardized lecture on the rib dysfunction. Students were also assigned at random to either a comparison group, which would utilize the 3D printed rib model, or the control group, which would utilize the traditional static model. Students would also complete an entrance and exit surveys assessing subjective scores of overall student satisfaction and objective scores for knowledge of OMM rib dysfunction and treatment. An independent samples t-test was applied to assess potential differences between select student evaluation scores (those with continuous variables) of the rib model in the comparison and experiment groups. Chi-square goodness of fit test was conducted to determine if there were any significant differences in entry and exit survey responses between the two groups. Descriptive statistics of the mean and standard deviation were also reported. For both comparison and control groups, the mean score on an 11-point scale for the evaluation question, "Please rank on a scale of 0-10 how helpful you thought the rib models were to your education," was 9.08 (SD, 1.397). Independent t-test results showed that the comparison group had higher scores than the control group when queried about whether they felt the model accurately depicted the material presented (comparison group mean, 9.55 [SD, 978] vs. control group mean, 9.06[SD, 1.33; t(235)=3.253; p=0.01). Chi-square test of goodness-of-fit showed that the differences between the number of correct answers chosen by participants for Item 3 (a case-based question asking students which rib they would treat for a patient presenting to an OMT clinic) was statistically significantly higher for the comparison group (51.9% correct in comparison group vs. 48.1% in control group), even though both groups scored similarly on this item during the entry survey. The results of this study suggest that utilizing 3D printing to demonstrate somatic dysfunctions of the rib cage may improve understanding and student satisfaction for diagnosis and treatment.

Incidence of insomnia and obstructive sleep apnea in active duty United States military service members.

Epidemiologic studies of obstructive sleep apnea (OSA) and insomnia in the U.S. military are limited. The primary aim of this study was to report and compare OSA and insomnia diagnoses in active duty the United States military service members. Data and service branch densities used to derive the expected rates of diagnoses on insomnia and OSA were drawn from the Defense Medical Epidemiology Database. Single sample chi-square goodness of fit tests and independent samples t-tests were conducted to address the aims of the study. Between 2005 and 2019, incidence rates of OSA and insomnia increased from 11 to 333 and 6 to 272 (per 10,000), respectively. Service members in the Air Force, Navy, and Marines were diagnosed with insomnia and OSA below expected rates, while those in the Army had higher than expected rates (p < .001). Female service members were underdiagnosed in both disorders (p < .001). Comparison of diagnoses following the transition from ICD 9 to 10 codes revealed significant differences in the amounts of OSA diagnoses only (p < .05). Since 2005, incidence rates of OSA and insomnia have markedly increased across all branches of the U.S. military. Despite similar requirements for overall physical and mental health and resilience, service members in the Army had higher rates of insomnia and OSA. This unexpected finding may relate to inherent differences in the branches of the military or the role of the Army in combat operations. Future studies utilizing military-specific data and directed interventions are required to reverse this negative trend.

Oestrogen Receptor Alpha, Beta Genes and CYP17A Gene Polymorphism Analysis in Women with Uterine Leiomyoma

Introduction: Uterine Leiomyoma is a highly morbid condition with an increasing incidence in the Asian Indian ethnicity. The pathogenesis is multifactorial and not clearly delineated, making non-surgical treatment of limited success, thus making surgical intervention prevalent. Derangement of endocrinological parameters is the most evident aspect and cause of this condition. But the root genetic cause of this hormonal imbalance has seldom been explored in Indian women suffering from uterine leiomyoma. Aim: To explore the association of Single Nucleotide Polymorphism (SNPs) rs3020449, rs4986938 and rs743572 of ER alpha, ER beta and CYP17 genes respectively in women having uterine fibroid visiting a Tertiary Care Hospital in North India. Materials and Methods: Hundred patients diagnosed with uterine leiomyoma were selected from Gynaecology Out Patient Department (OPD) of a Tertiary Care Hospital in North India and equal age matched healthy women were taken as controls randomly, with a condition that they have no close blood relative with uterine leiomyoma. The blood was collected for DNA extraction and RFLP based polymorphism detection. Bands were visualised in agarose gel for Estrogen Receptor alpha (ER alpha), ER beta and CYP17 genes. Statistical analysis was performed using Graph Pad Prism 6.0. Hardy Weinberg equilibrium was tested using Chi-square goodness of fit test. Nominal variables were analysed using Fisher-exact test. Data is presented as Mean±SEM and p-value of &lt;0.05 was considered significant. Results: Early age at menarche (cases vs control 11.51±0.19 year vs 12.04±0.12, p=0.03) and less number of previous pregnancies (cases vs control 1.06±0.09 vs 1.41±0.12, p=0.01), which are known risk factors for the uterine fibroids, was reconfirmed in this study. The genotype distribution of all subjects studied in above genes followed Hardy Weinberg equilibrium and there was no significant difference in genotype frequencies between cases and controls [ER alpha rs9322331 C allele (cases vs controls; 62% vs 64%), T allele (38% vs 36%); ER beta rs4986938 G allele (64% vs 59%), A allele (36% vs 41%); CYP17 rs743572 T allele (44.95% vs 46.53%), C allele (55.05% vs 53.47%) p-value not significant in any]. However, there was an increased propensity of TC genotype of CYP17 rs743572 towards obesity (p&lt;0.05). Conclusion: The allelic frequencies of all the three SNPs were similar in cases and controls indicating that they do not affect susceptibility to disease. However, the association of TC allele of CYP17 SNP with higher BMI needs further analysis.

Modeling and Validation of the Hospital’s Ambulatory and Inpatients Operations Using a Non-Homogenous Discrete Time Markovian Chains

Overcrowded hospitals in its different process's levels is a very common issue all over the globe. Research through different works have studied this problem from different angles. Most of those focused on a very specific part of the internal flows. This study presents a mathematical model aiming to reflect patient flow and resources usage. This model presents a new perspective on how it is possible to organize a hospital flow for inpatients of different pathologies. It is based on Non-Homogenous Discrete Time Markovian chains. It takes into consideration the patient's pathology, survival function and the current beds distribution and discharges. To model the different variations of a patient's flow, our work uses an actual case study to validate that our mathematical model based on Markov Chains can represent a real scenario of patients flow in a hospital and can predict the resources occupancy. We used as entry to this model the arrival distribution of patients as represented in the NHS dataset. Served patients and overflowing patients relate proportionally to admission rate based on how much time every diagnosis and preliminary treatment will take, then using the previous beds availability ration will permit, with knowledge of all present patients in the system, calculate the beds occupancy in the actual time. Only based on inputs from the NHS database, bed occupancy can be calculated using our model. Then compare this calculus with published data of the bed's occupancy in the NHS. in the period between March 2020 and February 2021. The results of the simulation model were then compared to the dataset using the chi-square goodness of fit test. Non-homogenous discrete Markovian model, survival function, patient's pathology, time-dependent, pathology, primary allocations, secondary allocations.

Actual Frailty Conditions and Lifestyle Changes in Community-Dwelling Older Adults Affected by Coronavirus Disease 2019 Countermeasures in Japan: A Cross-Sectional Study.

IntroductionBecause of the countermeasures to prevent the spread of coronavirus disease 2019 (COVID-19) in Japan, it is easy to predict that the suspension of local activities and changes in lifestyle that lead to decreased activity will result in increased frailty and prefrailty rates in older adults.ObjectiveTo clarify the actual frailty conditions and lifestyle changes among community-dwelling older adults affected by COVID-19 countermeasures in Japan.MethodsThis cross-sectional study was conducted between May 8 and June 12, 2020. Self-reported questionnaires were distributed to 1,078 older adults aged ≥65 years. We used the frailty screening index to assess frailty status and developed the Questionnaire for Change of Life (QCL) to assess lifestyle changes, the amount of daily movement, leg muscle strength, meal size, worry or anxiety, and opportunities to talk to people. The differences in prevalence rates of frailty, prefrailty, and robustness between this study and the reference based on the Japanese meta-analysis were verified using the chi-square goodness of fit test. We compared each of the QCL results among the frailty, prefrailty, and robust groups using Fisher’s exact test.ResultsOf 680 older adults (63.1%) analyzed, 60 (8.8%) had frailty and 354 (52.1%) had prefrailty. There was a significant difference between the observed and expected prevalence based on the reference (p = 0.018). The frailty status was significantly associated with lifestyle changes. In participants with frailty, the amount of daily movement, leg muscle strength, and meal size significantly decreased (p < 0.001), whereas worry or anxiety significantly increased (p = 0.040). In contrast, regardless of the frailty status, opportunities to talk to people decreased.ConclusionThe prevalence of frailty and prefrailty might have increased due to the effects of COVID-19 countermeasures. Moreover, the lifestyle of community-dwelling older adults affected by COVID-19 countermeasures has changed. Lifestyle changes were more pronounced among older adults with frailty.

Impact of cleft lip and palate before and after treatment in a low-income population

Background: Individuals with cleft lip and palate (CLP) and other craniofacial deformities are often perceived negatively in various social circumstances, resulting in failure to achieve full socio economic potential. Aim of the study: This study aimed to identify social stigmata and their causes associated with CLP and other deformities in an Indian population from a low socio-economic background, ways to reduce such effects and the potential reduction of disability following surgery. Methods: To assess the general awareness of the patients and their families regarding clefts, A GSR Institute: Cleft-Awareness Questionnaire (Reddy SG et al 2018) was used for data collection. 100 consecutive patients treated in GSR Institute for Craniofacial and Facial Plastic Surgery in Hyderabad, Telangana, were invited to join the study Statistical analysis regarding consanguineous marriage, understanding of clefts by parents and members of their community and of their societal conditions and the impact before and after surgery was carried out. Results: Statistical analysis using chi-squared test regarding the frequency of consanguineous marriage revealed no significant difference between the expected and observed frequencies in Telangana whereas there was a significant difference (p<0.001) between the values in India and also for understanding of clefts by parents (p<0.001) and friends/neighbours (p<0.001). On Kruskall-Wallis test and Pearson Chi-Squared Goodness of Fit test, no significance was observed on social conditions and associated problems faced by child before and after surgery respectively. Conclusion: These results confirm the impact of social stigmata in an Indian population with CLP and other craniofacial deformities predominantly related to the lack of education due to low socio-economic background and a heightened sense of superstitions of family, friends/neighbours of the affected individual thereby, causing embarrassment and depression. However, these were alleviated by surgical intervention and adequate speech therapy, thereby, improving social acceptance.