General Regression Model Research Articles

HIV replication and tuberculosis risk among people living with HIV in Europe: A multicohort analysis, 1983-2015.

HIV replication leads to a change in lymphocyte phenotypes that impairs immune protection against opportunistic infections. We examined current HIV replication as an independent risk factor for tuberculosis (TB). We included people living with HIV from 25 European cohorts 1983-2015. Individuals <16 years or with previous TB were excluded. Person-time was calculated from enrolment (baseline) to the date of TB diagnosis or last follow-up information. We used adjusted Poisson regression and general additive regression models. We included 272,548 people with a median follow-up of 5.9 years (interquartile range [IQR] 2.3-10.9). At baseline, the median CD4 cell count was 355 cells/μL (IQR 193-540) and the median HIV-RNA level 22,000 copies/mL (IQR 1,300-103,000). During 1,923,441 person-years of follow-up, 5,956 (2.2%) people developed TB. Overall, TB incidence was 3.1 per 1,000 person-years (95% confidence interval [CI] 3.02-3.18) and was four times higher in patients with HIV-RNA levels of 10,000 compared with levels <400 copies/mL in any CD4 stratum. CD4 and HIV-RNA time-updated analyses showed that the association between HIV-RNA and TB incidence was independent of CD4. The TB incidence rate ratio for people born in TB-endemic countries compared with those born in Europe was 1.8 (95% CI 1.5-2.2). Our results indicate that ongoing HIV replication (suboptimal HIV control) is an important risk factor for TB, independent of CD4 count. Those at highest risk of TB are people from TB-endemic countries. Close monitoring and TB preventive therapy for people with suboptimal HIV control is important.

Per and poly-fluoroalkyl substances and respiratory health in an Inuit community

BackgroundConcentrations of plasma per and poly-fluoroalkyl substances (PFAS) are elevated in the Inuit population of Nunavik and may be causing adverse health effects. Respiratory health outcomes have been associated with PFAS, but have not been explored in Inuit communities. The aim of the study was to examine the association between PFAS and respiratory health outcomes, and the moderating role of nutritional biomarkers.MethodsWe included up to 1298 participants of the Qanuilirpitaa? 2017 survey aged 16–80 years. Generalized regression models were used to estimate the associations between six individual PFAS congeners and four self-reported symptoms, four spirometry measures, and physician-diagnosed asthma. Outcomes associated with PFAS from single chemical models were further explored using Bayesian Kernel Machine Regression (BKMR). The modifying effect of n-3 PUFA in red blood cell quartiles and vitamin D deficiency were examined on the associations between PFAS and respiratory outcomes.ResultsPFNA and PFOS were associated with asthma (odds ratio (OR) 1.61, 95% confidence interval (CI) 1.12, 2.32; OR 1.45 95% CI 1.04, 2.03). PFOA, PFNA, PFDA and PFHxS were associated with a decrease in the ratio between the forced expiratory volume in the first second and forced vital capacity (FEV1/FVC). No associations were observed with self-reported respiratory symptoms. No associations were observed between a PFAS mixture and asthma. Some associations were modified by nutritional factors, namely, stronger associations between PFOA and PFHxS and asthma with lower n-3 PUFA levels and stronger associations between PFDA, PFUnDA and PFOS and FEV1/FVC with vitamin D deficiency.ConclusionThese findings add to the growing literature on the impacts of PFAS on respiratory health, and the importance of their global regulation. Associations were modified by nutritional factors pointing to the nutritional value of traditional Inuit foods.

Abstract A163: Factors associated with human papillomavirus vaccination uptake among a clinic-based sample in Puerto Rico

Abstract BACKGROUND: Human papillomavirus (HPV) vaccine can protect against several cancers such as anal, cervical, vulvar, vagina, penis, and oropharyngeal. HPV vaccination is recommended for individuals, regardless of sex-at-birth, aged 9 through 26 years old. In addition, patient-physician clinical decision-making is recommended for individuals up to the age of 45. HPV vaccination can protect against the most common HPV genotypes that cause cancer and is the only preventive strategy for HPV infection. Therefore, this study aims to assess factors associated with HPV vaccination uptake among patients from the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center (ANC-UPRCCC). Methods: Data from baseline visit of individuals aged ≥18 years of age who received services at the ANC- UPRCCC were used for this analysis (N=1,170). During this visit, all patients completed a questionnaire given by the clinic physicians, which collects information on sociodemographic, clinical, and lifestyle characteristics. HPV vaccination uptake was defined as having ≥1doses. Pearson chi-square and generalized regression models were used to evaluate factors associated with HPV vaccination uptake. Results: Most participants were men (66.9%), aged ≥46 years old (50.7%), and people living with human immunodeficiency virus (PLWH) (72.0%). Although HPV vaccine uptake was 15.7%, only 8% of participants reported vaccine completion (3 doses). Higher uptake was seen among younger people, men who have sex with men, people with a history of sexually transmitted infections (STIs), people without HIV, and people with anal pap uptake history (p&amp;lt;0.05). Given that a statistically significant interaction with age was observed, logistic regression models were stratified by age. On multivariable analysis, we observed higher odds of HPV vaccine uptake among persons with a history of STIs aged 27-45 (OR27-45:1.12, 95% CI: 1.01, 1.26) and ≥46 years (OR≥46:1.06, 95% CI: 1.01,1.11) in comparison to those without a history of STIs. Higher HPV vaccine uptake was also observed among people aged ≥46 with anal pap uptake history (OR≥46:1.09, 95% CI:1.01-1.19) in comparison to their counterparts. PLWH had lower odds of HPV vaccine uptake than people without HIV across all age groups (OR18-26:0.73, 95% CI:0.57-0.93; OR27-45:0.77, 95% CI:0.71-0.83; OR≥46:0.93, 95% CI:0.89-0.98). Conclusions: Despite their increased high-risk for HPV-related cancers, our results showed lower HPV vaccination uptake for PLWH across all age groups. This is concerning and highlights the importance of including educational materials about the HPV vaccine during consultation with healthcare providers, especially among individuals at high-risk for HPV-related cancers, such as PLWH. Citation Format: Jeslie M. Ramos-Cartagena, Maribel Tirado, Miriam Matos, Keimari Méndez, José Torres-Russe, Gabriela Pisiellos-Echevarria, Cristina Muñoz, Karen Del Valle, Humberto M. Guiot, Ana Patricia Ortiz. Factors associated with human papillomavirus vaccination uptake among a clinic-based sample in Puerto Rico [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A163.

Effect analysis of government intervention on scale-heterogeneous farmers' behavior of groundwater exploitation.

Government intervention has become an important measure to restrain groundwater overexploitation. This paper analyzes the effect of three types of government intervention measures, namely, guidance, incentive and constraint, on farmers' groundwater utilization behavior, from the perspective of scale-heterogeneity, using general quantile regression model, by survey data of 1122 households in well irrigation area of north China. The results showed that: (1) the incentive and guiding measures have negative effects on farmers' groundwater usage, while the effect of restrictive measures is not obvious. The guided policy is superior to the incentive measure as to governance effect. (2) With the increase of farmers' land scale, the influence of incentive measures shows a trend of weakening, and the effect of guided measures on groundwater demand reduction of farmers is stronger. When it comes to the different point of water consumption, when at the point level of 0.25, the incentive measures have the most obvious inhibitory effect. With the increase of water consumption of farmers, the guided measures begin to play a core role. The effect of restrictive measures is not obvious with the increase of water consumption. (3) In addition, farmers' irrigation water consumption also is affected by gender, cognition of water resources shortage, ecological cognitive level, acquisition ability of disaster information, village rain conditions, the degree of water rights market development, feelings of water fee increase, irrigated disputes in the village, collective economic level of village. The selection of policy tools is flexible according to the farmers' land scale for groundwater over-extraction control.

Robust tests for equality of regression curves based on characteristic functions

This paper focuses on the problem of testing the null hypothesis that the regression functions of several populations are equal under a general nonparametric homoscedastic regression model. It is well known that linear kernel regression estimators are sensitive to atypical responses. These distorted estimates will influence the test statistic constructed from them so the conclusions obtained when testing equality of several regression functions may also be affected. In recent years, the use of testing procedures based on empirical characteristic functions has shown good practical properties. For that reason, to provide more reliable inferences, we construct a test statistic that combines characteristic functions and residuals obtained from a robust smoother under the null hypothesis. The asymptotic distribution of the test statistic is studied under the null hypothesis and under root − n contiguous alternatives. A Monte Carlo study is performed to compare the finite sample behaviour of the proposed test with the classical one obtained using local averages. The reported numerical experiments show the advantage of the proposed methodology over the one based on Nadaraya–Watson estimators for finite samples. An illustration to a real data set is also provided and enables to investigate the sensitivity of the p − value to the bandwidth selection.

Adherence and Retention Rates to Home-Based Video Exercise Programs in Older Adults-Systematic Review and Meta-Analysis.

Introduction: This systematic review and meta-analysis aimed to investigate adherence and retention rates to home-based video exercise programs and identify key factors associated with these rates in older adults to understand the effectiveness of home-based video exercise interventions. Methods: We searched PubMed, Web of Science, and Scopus for articles addressing adherence to and retention of home-based video exercise programs. The study was conducted following PRISMA recommendations. Results: A total of 26 articles, including 1,292 participants older than 65, were included in the final qualitative and quantitative syntheses. The weighted mean of the retention rate was 91.1, and of the attendance rate was 85.0, with low I2 = 3.5, not significant p = 0.409 heterogeneity. The generalized regression models showed a positive effect of session duration on the attendance rate (%), where the possible change from <20 min to >60 min duration could decrease the attendance rate (%) B = -24.390 (p <0.001). The delivery method had a significant effect, where the absence of live contact with the coach in web-based or DVD-delivered interventions could decrease the attendance rate (%) compared to the online sessions B = -11.482 (p = 0.010). The lockdown during the COVID-19 pandemic had a positive effect on both the attendance rate (%) B = 10.321 (p = 0.019) and retention rate (%) B = 9.577 (p = 0.032). Conclusions: This systematic review and meta-analysis indicate that supervised home-based video exercise programs lasting less than 60 min might be a suitable and sustainable exercise mode to keep older adults active, especially in times resembling feelings of confinement.

Innovative Approach for Human Semen Quality Assessment Based on Volatilomics.

The volatilome profile of some biofluids (blood, urine, and human semen) identified by Solid-Phase Microextraction-Gas Chromatography/Mass Spectrometry (SPME-GC/MS) and collected from young men living in two high-pollution areas in Italy, i.e., Land of Fires and Valley of Sacco River, have been coupled to sperm parameters obtained by spermiogram analysis to build general multiple regression models. Panels of volatile organic compounds (VOCs) have been selected to optimize the models and used as predictive variables to estimate the different sperm quality parameters (sperm cell concentration, total and progressive motility/immotile cells, total/head/neck/tail morphology anomalies, semen round cell concentration). The results of the multiple linear regression models based on the different subgroups of data joining VOCs from one/two or three biofluids have been compared. Surprisingly, the models based on blood and urine VOCs have allowed an excellent estimate of spermiogram values, paving the way towards a new method of indirect evaluation of semen quality and preventive screening. The significance of VOCs in terms of toxicity and dangerousness was discussed with the support of chemical databases available online.

Endothelial injury and decline in lung function in persons living with HIV: a prospective Danish cohort study including 698 adults.

Endothelial injury may promote declining lung function. We aimed to investigate in well-treated persons living with HIV (PLWH) whether elevated levels of thrombomodulin (TM) and syndecan-1 (SDC1) are associated with excess lung function decline and worsening dyspnea. A prospective cohort study comprising patients from the Copenhagen municipality. We included 698 PLWH with undetectable viral load. Biomarkers and demographics were measured at baseline, spirometry [forced expiratory volume in one second (FEV1) and forced vital capacity (FVC)] and dyspnea score both at baseline and 2-year follow-up.Both biomarkers were dichotomized at the 3rd quartile. Decline in lung function was estimated using a linear mixed model with patient-specific random effect. Increase in dyspnea score was estimated using a general mixed logistic regression model. We did not find an association between elevated SDC1 or TM and an excess decline in neither FEV1: SDC1: 4.5 mL/year (95% CI: -3.9-12.9, p = 0.30), TM: 2.2 mL/year (95% CI: -6.0-10.4, p = 0.60) nor FVC: SDC1: 4.1 mL/year (95% CI: -6.0-14.2, p = 0.42), TM: 1.4 mL/year (95% CI: -8.3-11.1, p = 0.78). A subgroup analysis of never-smokers was consistent with the main analysis.Likewise, we did not find any association between elevated SDC1 and TM and increase in dyspnea score: SDC1: OR 1.43 (95% CI: 0.89-2.30, p = 0.14), TM: OR 1.05 (95% CI: 0.65-1.71, p = 0.26). We did not find a significant association between elevated biomarkers of endothelial injury and decline in lung function nor dyspnea.

The significance of delivery methods and fetal gender in reducing stillbirth rate: Using the generalized regression model

AimDespite stillbirth being a significant burden for maternal lives, families, and communities worldwide, it is often neglected and overlooked in many countries. The fetal gender and the delivery method are two interaction factors that directly impact the stillbirth rate. This study aimed to identify the impact of fetal gender on stillbirth delivery methods, either cesarean section or vaginal delivery. MethodThe current research analyzed the stillbirths recorded over ten years between January 1st, 2008, and December 31st, 2017, obtained from the Maternity Teaching Hospital in Erbil City, the capital of the Kurdistan Region of Iraq. ResultsThe results showed that stillbirths remain a significant public health concern in the region, with 11.7 stillbirths occurring for every 1000 deliveries. The generalized regression model for each normal, beta, and gamma distribution was used to determine the best fit of the data. The study found that for fetal males, vaginal delivery reduced the stillbirth rate by 4.2 % and the cesarean section rate by 3.6 % while for fetal females, vaginal delivery reduced the stillbirth rate by 4.7 % and the cesarean section rate by 6 %. ConclusionThe findings suggest that healthcare in the region should prioritize reducing the incidence of stillbirths during pregnancy and delivery, considering factors such as fetal gender and delivery mode.

The glue that binds us: The positive relationships between whanaungatanga (belonging), the wellbeing, and identity pride for takatāpui who are trans and non-binary.

This article explores how belonging can enhance well-being for takatāpui (a traditional Māori term that embraces all Māori with diverse genders, sexualities and sex characteristics) who are trans and non-binary across a range of contexts. We drew data from the 2018 Counting Ourselves, a nationwide community-based survey of trans and non-binary people in Aotearoa (New Zealand) (N = 1178); of which 161 (13.7%) identified as Māori, the Indigenous people of Aotearoa. Based on generalised regression models, feelings of belonging with friends, takatāpui communities, Māori communities, and work communities were correlated to higher feelings of life satisfaction, life worthwhileness, and identity pride for takatāpui who are trans and non-binary. In Te Ao Maōri (the Māori worldview), such concepts of belonging and relationships are collectively known as whanaungatanga. Our findings affirm whanaungatanga as foundational to well-being among trans Māori people, enabling them to locate themselves within nurturing and supportive networks. SO WHAT?: Whanaungatanga is a key policy agenda, alongside other system-level change, that is needed to buffer takatāpui who are trans and non-binary from poverty, stigma, and racism they face. This will require changes to the current policy and practice context. We argue that whanaungatanga, while an important strategy of well-being for trans and non-binary people, must also occur alongside wider system transformations to address transphobia, racism, and cisheteronormativity.

Land cover fraction mapping across global biomes with Landsat data, spatially generalized regression models and spectral-temporal metrics

Mapping land cover in highly heterogeneous landscapes is challenging, and classifications have inherent limitations where the spatial resolution of remotely sensed data exceeds the size of small objects. For example, classifications based on 30-m Landsat data do not capture urban or other heterogeneous environments well. This limitation may be overcome by quantifying the subpixel fractions of different land cover types. However, the selection process and transferability of models designed for subpixel land cover mapping across biomes is yet challenging. We asked to what extent (a) locally trained models can be used for sub-pixel land cover fraction estimates in other biomes, and (b) training data from different regions can be combined into spatially generalized models to quantify fractions across global biomes. We applied machine learning regression-based fraction mapping to quantify land cover fractions of 18 regions in five biomes using Landsat data from 2022. We used spectral-temporal metrics to incorporate intra-annual temporal information and compared the performance of local, spatially transferred, and spatially generalized models. Local models performed best when applied to their respective sites (average mean absolute error, MAE, 9–18%), and also well when transferred to other sites within the same biome, but not consistently so for out-of-biome sites. However, spatially generalized models that combined input data from many sites worked very well when analyzing sites in many different biomes, and their MAE values were only slightly higher than those of the respective local models. A weighted training data selection approach, preferring training data with a lower spectral distance to the image data to be predicted, further enhanced the performance of generalized models. Our results suggest that spatially generalized regression-based fraction models can support multi-class sub-pixel fraction estimates based on medium-resolution satellite images globally. Such products would have great value for environmental monitoring in heterogeneous environments and where land cover varies along spatial or temporal gradients.

Tricks with metrics: combining statistics for improved inference in regression analysis

. In maximum likelihood methods, the three classical tests statistics are often unreliable for inference in small samples, even under the correct model specification. In this article, I discuss how likelihood ratio and Wald test statistics can be combined to obtain highly improved parameter inference in regression models with small samples. I consider modifications obtained from both the Barndorff-Nielsen and the Lugannani and Rice likelihood approximations, and I show how they can produce highly accurate parameter inference in a general (possibly non linear) regression model with possibly non spherical disturbances. I discuss the underlying theory and provide Monte Carlo simulations demonstrating the superior accuracy of the proposed procedures over the first-order classical likelihood methods (i.e., the signed log-likelihood ratio test and the Wald test). An empirical application to a regression model of mobile money (“M-pesa”) adoption in Kenya is provided as an illustration of the usefulness of these methods in practice.

The interplay between ADHD and school shift on educational outcomes in children and adolescents: A cross-sectional and longitudinal analysis.

Many countries implement a double-shift schooling system, offering morning or afternoon shifts, driven by diverse factors. Young people with ADHD may face educational problems attending morning shifts compared to afternoon shifts. To investigate this, we used data from a Brazilian school-based cohort (n = 2.240, 6-14 years old, 45.6% female; 50.2% in the morning shift; 11.2% with ADHD). ADHD was determined by child psychiatrists using semi-structured interview. Educational outcomes were measured cross-sectionally and three years later (80% retention) and included reading and writing ability, performance in school subjects, and any negative school events (repetition, suspension, or dropout). Generalized regression models tested the interaction between ADHD and school shift and were adjusted for age, sex, race/ethnicity, intelligence, parental education, socioeconomic status, and site. Attrition was adjusted with inverse probability weights. We used two dimensional measures of attentional problems as sensitivity analysis. ADHD and morning shift were independently associated with lower reading and writing ability and with higher odds for negative school events cross sectionally. ADHD independently predicted lower performance in school subjects and higher negative school events at follow-up. Interaction was found only at the cross-sectional level in a way that those studying in the afternoon present better educational outcomes compared with those studying in the morning only if they have lower ADHD symptom. Thus, ADHD was not associated with poorer educational outcomes among those studying in the morning. However, participants studying in the afternoon with lower levels of attentional problems presented better educational, despite these associations fade away over time.

Ocrelizumab and ofatumumab comparison: an Italian real-world propensity score matched study

BackgroundThe management of Multiple Sclerosis (MS) has undergone transformative evolution with the introduction of high-efficacy disease-modifying therapies (DMTs), specifically anti-CD20 monoclonal antibodies, such as ocrelizumab (OCR) and ofatumumab (OFA).Materials and methodsThis is an independent retrospective cohort study in Relapsing MS (RMS) patients followed at eight Italian MS centers who initiated treatment with OCR or OFA in the participating centers and with at least 12 months on therapy. A generalized linear regression model inverse probability of treatment weight (IPTW) PS-adjusted was performed to evaluate the relationship between annualized relapse rate (ARR) and treatment groups. No evidence of disease activity-NEDA-3 at 12-month score was also collected. Safety profile of the investigated DMTs was recorded.ResultsA total cohort of 396 RMS patients fulfilled the required criteria and were enrolled in the study. Out of them, 216 had a prescription of OCR and 180 of OFA. The mean follow-up was 13.2 ± 1.9 months. The estimated means for ARR did not show differences between the two groups, 0.059 for patients on OCR and 0.038 for patients on OFA (p = 0.185). The generalized regression model IPTW PS-adjusted did not reveal differences between patients on OCR and OFA (ExpBOFA 0.974, 95%CI 934–1.015, p = 0.207). NEDA-3 at 12 months was experienced by 199(92.1%) patients on OCR and 170(94.4%) patients on OFA (p = 0.368). Generally, both therapies exhibit good tolerability.ConclusionsThe treatment with OCR and OFA resulted in comparable control of disease activity with good safety profile. Our results need further validation in larger multicentre studies with long-term follow-up.

ПРОГНОЗЫ ГОДОВОГО СТОКА Р. ЖАЙЫК (УРАЛ) С УЧЕТОМ АВТОКОРРЕЛЯЦИОННЫХ МОДЕЛЕЙ ЕГО МНОГОЛЕТНИХ КОЛЕБАНИЙ ЗА ОТДЕЛЬНЫЕ МЕСЯЦЫ

The study is devoted to the development and application of autocorrelation and general regression models for long-term forecasting of the Ural (Zhaiyk) River flow based on the analysis of multi-year fluctuations. The Ural River is an important water resource of the Russian Federation and the Republic of Kazakhstan, demonstrating significant variability in annual runoff, which affects various sectors of economic activity. In the course of the study, annual and monthly series of the river flow for the period from 1943 to 2010 were estimated using the autocorrelation method of Y.M. Alekhin. Based on these data, forecasts were made for the period from 2011 to 2015. The results show that autocorrelation models provide more accurate forecasts compared to models based on average values of series. The general regression model integrating monthly and annual data showed the best results, confirming the effectiveness of the combined approach in predicting hydrological characteristics. The scientific significance of the work is to improve the accuracy and reliability of the Ural River flow forecasts, which contributes to more effective water resources management in this region.

The effect of the COVID-19 pandemic on TOM in the housing market

Purpose The COVID-19 pandemic, a sudden and disruptive external shock to the USA and global economy, profoundly affected various operations. Thus, it becomes imperative to investigate the repercussions of this pandemic on the US housing market. This study investigates the impact of the COVID-19 pandemic on a crucial facet of the real estate market: the Time on the Market (TOM). Therefore, this study aims to ascertain the net effect of this unprecedented event after controlling for economic influences and real estate market variations. Design/methodology/approach Monthly time series data were collected for the period of January 2010 through December 2022 for statistical analysis. Given the temporal nature of the data, we conducted the Durbin–Watson test on the OLS residuals to ascertain the presence of autocorrelation. Subsequently, we used the generalized regression model to mitigate any identified issues of autocorrelation. However, it is important to note that the response variable derived from count data (specifically, the median number of months), which may not conform to the normality assumption associated with standard regression models. To better accommodate this, we opted to use Poisson regression as an alternative approach. Additionally, recognizing the possibility of overdispersion in the count data, we also explored the application of the negative binomial model as a means to address this concern, if present. Findings This study’s findings offer an insightful perspective on the housing market’s resilience in the face of COVID-19 external shock, aligning with previous research outcomes. Although TOM showed a decrease of around 10 days with standard regression and 27% with Poisson regression during the COVID-19 pandemic, it is noteworthy that this reduction lacked statistical significance in both models. As such, the impact of COVID-19 on TOM, and consequently on the housing market, appears less dramatic than initially anticipated. Originality/value This research deepens our understanding of the complex lead–lag relationships between key factors, ultimately facilitating an early indication of housing price movements. It extends the existing literature by scrutinizing the impact of the COVID-19 pandemic on the TOM. From a pragmatic viewpoint, this research carries valuable implications for real estate professionals and policymakers. It equips them with the tools to assess the prevailing conditions of the real estate market and to prepare for potential shifts in market dynamics. Specifically, both investors and policymakers are urged to remain vigilant in monitoring changes in the inventory of houses for sale. This vigilant approach can serve as an early warning system for upcoming market changes, helping stakeholders make well-informed decisions.

Anxiety Levels in Brazilian Women with Metastatic Breast Cancer Undergoing Palliative Chemotherapy: A Prospective Study.

This study aimed to assess anxiety levels among women with metastatic breast cancer undergoing palliative chemotherapy. A descriptive, prospective study was conducted at an oncology hospital in southern Brazil from September 2021 to October 2022. A total of 123 adult women receiving outpatient palliative chemotherapy were included in the study. Anxiety levels were evaluated using the State-Trait Anxiety Inventory at baseline, the fifth week, and the eleventh week of treatment. Data were analyzed using Kruskal-Wallis, Mann-Whitney, and Multiple General Regression Models. Women with advanced breast cancer had an average trait-anxiety score of 48.24±5.92. A progressive improvement in anxiety scores was observed throughout the treatment evaluation stages (44.90±5.89; 43.37±5.34; 42.58±5.75), with a significant difference between the evaluations (p=0.008). Significant correlations were found between trait-anxiety and work situation (p=0.010) and ovarian metastasis (p=0.022). The adjusted general regression model also showed statistical significance for baseline evaluation with offspring (p=0.045) and education level (p=0.041). Women with breast cancer undergoing palliative chemotherapy exhibited high trait-anxiety scores, which decreased significantly over the course of treatment.

Normal weight obesity is associated with lower AFC and adverse IVF outcomes.

Body weight could be classified into underweight, normal weight and overweight according to percentage of body fat (%BF), and normal weight obesity (NWO) is defined as a normal BMI but a high %BF. While the impact of NWO in women fecundity remain unknow. Therefore, this study aimed to investigate the associations between %BF and reproductive outcomes among in vitro fertilization (IVF) women with normal BMI. A total of 469 women were included in this study and were classified into low %BF, normal %BF and high %BF according to previous study. Multivariate generalized regression models were employed to evaluate the associations of %BF with ovarian reserve parameters, IVF outcomes and early pregnancy outcomes. We further run sensitivity analyses by restricted the analysis to young women and those only with tubal factor, respectively. About 32.2% of normal BMI women were misclassified according %BF, with 16.4% of them were low %BF and 15.8% were high %BF. The high %BF group had significantly lower antral follicle count (AFC) than normal %BF groups, and the AFC showed a tendency of decrease as %BF increased. In sensitivity analysis in young women, high %BF group also had significantly lower number of good-quality embryos when compared to normal %BF groups. The results expanded to all IVF outcomes when analysis restricted to tubal factor women. In summary, misclassifications of body weight status based on BMI are common according to %BF, and NWO is associated with adverse reproductive outcomes.

Using External Information for More Precise Inferences in General Regression Models

Empirical research usually takes place in a space of available external information, like results from single studies, meta-analyses, official statistics or subjective (expert) knowledge. The available information ranges from simple means and proportions to known relations between a multitude of variables or estimated distributions. In psychological research, external information derived from the named sources may be used to build a theory and derive hypotheses. In addition, techniques do exist that use external information in the estimation process, for example prior distributions in Bayesian statistics. In this paper, we discuss the benefits of adopting generalized method of moments with external moments, as another example for such a technique. Analytical formulas for estimators and their variances in the multiple linear regression case are derived. An R function that implements these formulas is provided in the supplementary material for general applied use. The effects of various practically relevant moments are analyzed and tested in a simulation study. A new approach to robustify the estimators against misspecification of the external moments based on the concept of imprecise probabilities is introduced. Finally, the resulting externally informed model is applied to a dataset to investigate the predictability of the premorbid intelligence quotient based on lexical tasks, leading to a reduction of variances and thus to narrower confidence intervals.

Рrоjeсt Management Рrосess and Рerfоrmаnсe of Feeder Rоаds Соnstruсtiоn Рrоjeсts in Rwаndа

This reseаrсh exаmined the influenсe оf рrоjeсt mаnаgement рrосess оn рerfоrmаnсe оf feeder rоаds соnstruсtiоn рrоjeсts in Rwаndа. Feeder rоаds соnstruсtiоn рrоjeсts exрerienсe сhаllenges thаt hаmрer them frоm being effeсtively соmрleted within the аllосаted budget, timelines аnd tо the desired quаlity. This study sрeсifiсаlly investigаted hоw рrоjeсt initiаtiоn, рrоjeсt рlаnning, рrоjeсt implementation аnd рrоjeсt mоnitоring аnd соntrоl influenсe the рerfоrmаnсe оf feeder rоаds соnstruсtiоn рrоjeсts. The study was соnduсted in аll the 10 Distriсts feeder rоаds соnstruсtiоn рrоjeсts in Rwаndа. These feeder rоаds рrоjeсts аre аt vаriоus stаges оf соmрletiоn. The number оf seleсted resроndents was 84 respondents from all 84 employees аnd cencus was used from which 77 responses were received. The study used desсriрtive reseаrсh designs аnd аррlying questiоnnаire in соlleсtiоn оf dаtа. Thrоugh quаntitаtive аnаlysis, the study fоund оut that рrоjeсt initiаtiоn, рrоjeсt рlаnning, рrоjeсt exeсutiоn аnd рrоjeсt mоnitоring аnd соntrоl hаve а significant relаtiоnshiр with feeder roads рrоjeсts рerfоrmаnсe. Moreover, it was estаblished оut аt whiсh extent thоse рrоjeсt mаnаgement рrосess рhаses аre being аrrаnged in the feeder rоаd рrоjeсts under study. The study emрlоyed multiрle lineаr regressiоn mоdel fоr dаtа аnаlysis аnd it соnсluded that рrоjeсt mаnаgement рrосess рhаses influenсed the рerfоrmаnсe оf feeder rоаds соnstruсtiоn рrоjeсts. The R-squared (R2) equals to 0.880 (or 88.8%) and adjusted R-squared equals to 0.873 (or 87.3%); the results show the goodness of fit of the estimated model. Up to 88.8% of long-run appreciation in performance is influenced by changes in project initiation process; project planning process; project implementation process and project monitoring &amp; control process as implemented by FRCP. The other remaining 11.2% can be explained by other factors not examined in this study. The results of ANOVA as p-value is less than 5%, this specifies that the performance of FRCP was significantly driven by at least one independent variable under this study. Therefore, the calculated F-value equals to 131.960 and this is greater than critical F-Value which is 2.499. Consequently, the general regression model is significant. Оverаll соnсlusiоns аnd reсоmmendаtiоns were shарed in оrder tо helр рrоjeсt mаnаgers, оrgаnizаtiоns, аnd future reseаrсhers. Keywords: Project Management Process, Construction Project, Project Performance, Feeder Rоаds Соnstruсtiоn Рrоjeсts Rwanda.