Kendall's Tau-b Correlation Research Articles

Ortodontik Tedavi Görmek İsteyen Bireylerde Kaygı Düzeyleri, Temporomandibular Eklem Disfonksiyonu Skorları ve Ortodontik Maloklüzyon Arasındaki İlişkinin Değerlendirilmesi

Amaç: Ortodontik tedavi görme isteğiyle başvuran genç yetişkin bireylerde Beck Anksiyete İndeksi (BAI)
 ile belirlenen kaygı düzeyleri ve Fonseca Anamnestik İndeksi (FAI) ile belirlenen Temporomandibular
 Eklem Disfonksiyonu (TMD) prevalansı ile Sınıf I, Sınıf II ve Sınıf III ortodontik maloklüzyonlar arasındaki
 ilişkinin değerlendirilmesidir.
 Gereç ve Yöntemler: Maloklüzyonlarının düzeltilmesi için ardışık olarak başvuran, 14-24 yaş arası
 genç yetişkinlerden oluşan 120 katılımcı çalışmamızın gerecini oluşturmuştur. Yapılan klinik muayene
 sonucunda dental maloklüzyonlarına göre bireyler Angle Sınıf I, II ve III olarak 3 gruba ayrılmıştır. Her
 grup kendi içinde kadın ve erkek bireyler olarak iki alt gruba ayrılmış ve sonuçta her bir grupta 20 birey
 olacak şekilde 6 grup oluşturulmuştur. Hastalara rutin ortodontik muayenenin yanı sıra TMD prevalansı
 ve şiddetini değerlendirmek amacıyla FAI ve kaygı düzeylerini belirlemek amacıyla da Beck Anksiyete
 BAI uygulanmıştır. Verilerin istatistiksel değerlendirmesi için Fischer’s Exact, Mann-Whitney U ve
 Kruskal Wallis testleri kullanılmıştır. BAI ve FAI arasındaki ilişkiyi değerlendirmek için Kendall Tau-b
 korelasyon testi kullanılmıştır. Anlamlılık düzeyi p

Correlation between Skeletal Maturation and Developmental Stages of Canines and Second Molars among Iranian Population.

Statement of the Problem: Growth assessment has become an important issue in many medical and dental fields. Determining the stages of dental development and skeletal maturation are essential methods in evaluation of growth phases.Purpose: This study aimed to assess the relationship between developmental stages of maxillary and mandibular canines and second molars by Nolla’s method and skeletal maturation stages by cervical vertebral maturation. In addition, diagnostic performances of dental developmental stages were evaluated to identify growth phases.Materials and Method: In this descriptive-analytical study, 201 digital panoramic and lateral cephalometry of children referred to the Orthodontic Department of Babol Dental School (8 to 15 years) were examined. The stages of dental development were determined by Nolla’s method, and the stages of skeletal development were determined by cervical vertebral maturation stages (CVMs). Positive likelihood ratio (LHR+) was used to determine the diagnostic performances to identify growth phases. The Kendall's Tau-b correlation coefficient was used to measure the association between the CVM stages and dental calcification stages. In this study, p ≤ 0.05 was considered significant.Results: The relationship between dental development and skeletal maturation in different teeth was significant (p ≤ 0.05). Kendall's Tau-b correlation coefficient between the stages of dental development and skeletal maturity in girls ranged from 0.578 - 0.634 and in boys ranged from 0.588 - 0.655. The right second molar in maxilla presented the highest correlation coefficient. The right and left second molars in maxilla and left second molar in mandible in stage 5 had the highest LHR+ to identify the pre-pubertal growth phase.Conclusion: Despite the high correlation coefficient between dental development and skeletal maturity, the LHR+ for determining growth stages in only a small number of teeth was more than 10.

Application of the Polar Coordinate Technique in the Study of Technical-Tactical Scoring Actions in Taekwondo.

The objective of this study was to design, validate and update an observation tool to analyse the technical-tactical actions by which taekwondo players win points. An ad hoc observational tool was developed for subsequent use in HOISAN software by viewing seven finals (14 viewings) in the Rome 2019 Grand Prix, collecting data (1,382 technical/tactical actions) from both winners and losers (women, n = 3; men, n = 4). An observational methodology based on a nomothetic, follow-up and multidimensional (N/F/M) observational design was used. In the statistical analysis, to check the validity of the generalizability analysis, the Category/Observer (C/O) and Observer/Category (O/C) models were employed, and to determine reliability between observations (intra- and interobserver), the Pearson, Spearman, Kendall's tau-b and Cohen's kappa correlation coefficients were applied. One point were awarded for every penalty given against the opponent. Two points were obtained for a circular technique to the trunk protector (in winners) or by scoring a point for a punch plus a penalty against the opponent, three points in melee actions, anticipatory actions with the left side (winners), or after a punch action, and circular technique (losers). Four and five points were only obtained by winners, in a direct attack with the right leg, turning (five points) or simultaneous (four points). The results of this study provide information on the most effective technical-tactical actions in taekwondo for scoring points in a contest.

RETRACTED ARTICLE: Assessment of the Dutch Healthy Diet index 2015 in the Lifelines cohort study at baseline.

Dietary indices are useful measures to investigate associations between dietary intake and disease development. The Dutch Healthy Diet index 2015 (DHD2015-index), a measure of diet quality, assesses adherence to the 2015 Dutch dietary guidelines. We assessed the DHD2015-index in the Lifelines cohort study, and compared calculations from basic and detailed dietary intake data. Dietary intake was assessed with a specially developed Food Frequency Questionnaire (FFQ) called Flower-FFQ, which consists of one main questionnaire (heart-FFQ), which asks for intakes of major food groups, and three complementary questionnaires (petal-FFQs), which ask for detailed information on food types within major food groups of the heart-FFQ. The DHD2015-index was assessed using data from the total Flower-FFQ (for 56,982 participants), and using data from the heart-FFQ only (for 129,030 participants). Agreement between the two indices was assessed with correlation and cross-classification. The median (25th-75th percentile) DHD2015-index score was 70 (60-80) for men and 76 (65-86) for women based on the Flower-FFQ, and 68 (58-78) for men and 73 (63-83) for women based on the heart-FFQ. The Kendall's tau-b correlation coefficient between the two scores was 0.66. Cross-classification into quartiles of the DHD2015-index showed that 59-60% of participants were classified in the same quartile, 37% in the adjacent, and 4% in the non-adjacent. Dietary data from the Flower-FFQ provide the most optimal information to assess the DHD2015-index. However, the DHD2015-index from the heart-FFQ showed good agreement with the index from the Flower-FFQ of ranking participants according to diet quality, and can be used when the DHD2015 index from the Flower-FFQ is not available.

The Validity of Cepstral Analysis to Distinguish Between Different Levels of Perceptual Dysphonia in the Persian Vocal Tasks

The validity of cepstral analysis (Cepstral Peak Prominence [CPP] and Cepstral Peak Prominence-Smoothed [CPPS]) as an indicator of perceptual dysphonia was investigated in the Persian language STUDY DESIGN: Cross-sectional study. A total of 223 participants (159 with and 64 without dysphonia) uttered vowels /a/ and /i/, six standard sentences, and non-standard connected speech. All vocal samples were perceptually evaluated by three raters on a visual analog scale and put into four groups (normal voice, mild, moderate, and severe perpetual dysphonia). CPP and CPPS of sustained vowel /a/, reading the second standard sentence, and a sentence extracted from non-standard connected speech were established using "Praat" software. Statistical analysis involved a one-way factorial analysis of variance (ANOVA), Kruskal-Wallis H, Kendall's Tau-b correlation, t test, and receiver operating characteristics (ROC) curve. The results showed that CPP of sustained vowels and reading the standard sentence and CPPS of sustained vowel differed significantly (P < 0.05), except between the normal voice and mild perpetual dysphonia groups (P > 0.05). The CPP of non-standard connected speech, CPPS of reading the standard sentence, and non-standard connected speech differed significantly between all groups (P < 0.05). The mean of cepstral analysis of all tasks, "averaged CPP," and "averaged CPPS" were significantly different between two groups of the normal voice and perceptual dysphonia (P < 0.05). Correlation between the cepstral analysis and the perceptual ratings demonstrated that the correlation coefficients for CPP and CPPS were between 0.4 and 0.6 (P < 0.05). ROC curve analysis revealed that the area under the ROC curve for "averaged CPP" and "averaged CPPS" was greater than 0.8 (P < 0.05). The values of 22.11 and 12.29 were determined as cut-off scores of "averaged CPP" and "averaged CPPS," respectively. Cepstral analysis was known as useful clinical tool for diagnosis of perpetual dysphonia and determining its severity level in the Persian language.

A comparative study of orthorexia between premenopausal, perimenopausal, and postmenopausal women.

Studies suggested that menopause is a period of vulnerability for disordered eating behaviors, but whether menopause could be linked to orthorexia nervosa (ON) remains unexplored. A sample composed of 709 women aged between 30 and 71years (mean age = 43.08years, SD = 9.24) answered self-administered questionnaires assessing ON (Düsseldorfer Orthorexia Skala, DOS), body image, self-esteem, and psychopathological symptoms. The sample included a Premenopause group of 441 women reporting regular menses, a Perimenopause group of 94 women reporting the recent onset of amenorrhea or menstrual irregularities, and a Postmenopause group of 174 women reporting amenorrhea of natural onset for more than 12months. Group comparison using analysis of covariance with age as covariate showed that ON scores were statistically higher in the two groups of participants dealing with menopause (Peri- and Postmenopause) when compared with women not yet concerned by menopause (Premenopause). A Kendall's tau-b correlation performed between the menopausal status (Pre, Peri, or Postmenopause) and DOS categories (No ON; At risk of ON; Presence of ON) showed a weak but statistically significant positive correlation between the menopausal group and DOS categories (tau-b = 0.136, p < 0.001). In addition, Fisher's exact tests indicated that the percentages of participants in the "At risk of ON" and "Presence of ON" categories were statistically higher in the Postmenopause group in comparison with the Premenopause group (p < 0.001). Depressive symptoms were statistically higher in the Peri- and Post-groups, while anxiety symptoms were stronger in the Peri-group when compared with the Pre-group. This study shows an increase of ON in women concerned with menopause, suggesting the existence of a relationship between menopause and ON. Further studies are necessary to identify factors involved in this association. Descriptive (cross-sectional) study, level V.

Injection of Leukocyte-Poor Platelet-Rich Plasma for Moderate-to-Large Rotator Cuff Tears Does Not Improve Clinical Outcomes but Reduces Retear Rates and Fatty Infiltration: A Prospective, Single-Blinded Randomized Study

To determine whether leukocyte-poor platelet-rich plasma (Lp-PRP) reduced retear rates, reduced fatty infiltration, and improved functional outcomes in patients with degenerative moderate-to-large rotator cuff tears. This was a randomized controlled study at a single center. A consecutive series of 104 patients with moderate-to-large rotator cuff tears was enrolled and randomly allocated to a control group (double-row suture-bridge arthroscopic rotator cuff repair alone, n= 52) and a study group (double-row suture-bridge repair followed by 3 Lp-PRP injections at the tendon repair site during surgery, at days 7 and 14 after surgery, n= 52). All patients were followed up for 27.2 months (range 24-36 months), with University of California at Los Angeles (UCLA) shoulder rating scale, the Constant score, and a visual analog scale (VAS) evaluated respectively. The integrity and fatty infiltration of repaired tissue were assessed by magnetic resonance imaging using the Sugaya classification and Goutallier grade classification at 24 months after surgery. Statistical analysis was performed based on the t test, χ2 test, and the Kendall tau-b correlation coefficient. Four patients refused follow-up, and 11 patients had incomplete data. Eventually, a total of 89 patients were available for 24 months follow-up. The mean UCLA score increased from 14.80 ± 2.53 to 29.37 ± 2.06 in control group and from 13.74 ± 3.30 to 30.14 ± 2.32 in study group (P= .103). The mean Constant score increased from 46.56 ± 5.90 to 86.83 ± 4.94 in control group and from 44.37 ± 7.92 to 88.80 ± 4.92 in study group (P= .063). The VAS score decreased from 3.22 ± 1.24 to 0.97 ± 1.12 in control group and in 3.49 ± 1.52 to 1.16 ± 0.99 in study group (P= .41). All differences in UCLA score, Constant score, and VAS between pre- and postoperation achieved minimal clinically important differences proposed for arthroscopic rotator cuff repair. Of the 89 patients, 76 had magnetic resonance imaging performed at 24 months after surgery. The retear rate was 17.6% in study group, which was lower than that in control group (38.1%, P= .049). In addition, the Goutallier grade was found to be significant difference between groups postoperatively (Kendall tau-b -0.24, P= .03) but no significant difference preoperatively (Kendall tau-b -0.18, P= .11). There were no complications in the patients. Our procedures involving repeated injections of Lp-PRP during surgery and at days 7 and 14, as described in this study, have positive effects on reducing retear rate and promoting Goutallier grade in patients following arthroscopic rotator cuff repair and could also provide substantial clinical outcomes that reach the minimal clinically important difference for surgical treatment. However, given the numbers available for analysis, it did not promote better clinical results when compared with the control group. II, randomized controlled study.

Validating Automatic Diadochokinesis Analysis Methods Across Dysarthria Severity and Syllable Task in Amyotrophic Lateral Sclerosis.

Oral diadochokinesis (DDK) is a standard dysarthria assessment task. To extract automatic and semi-automatic DDK measurements, numerous DDK analysis algorithms based on acoustic signal processing are available, including amplitude based, spectral based, and hybrid. However, these algorithms have been predominantly validated in individuals with no perceptible to mild dysarthria. The behavior of these algorithms across dysarthria severity is largely unknown. Likewise, these algorithms have not been tested equally for various syllable types. The goal of this study was to evaluate the performance of five common DDK algorithms as a function of dysarthria severity, considering syllable types. We analyzed 282 DDK recordings of /ba/, /pa/, and /ta/ from 145 participants with amyotrophic lateral sclerosis. Recordings were stratified into mild, moderate, or severe dysarthria groups based on individual performance on the Speech Intelligibility Test. Analysis included manual and automatic estimation of the number of syllables, DDK rate, and cycle-to-cycle temporal variability (cTV). Validation metrics included Bland-Altman mixed-effects limits of agreement between manual and automatic syllable counts, recall and precision between manual and automatic syllable boundary detection, and Kendall's tau-b correlations between manual and algorithm-detected DDK rate and cTV. The amplitude-based algorithm (absolute energy) yielded the strongest correlations with manual analysis across all severity groups for DDK rate (τ b = 0.7-0.84) and cTV (τ b = 0.7-0.84) and the narrowest limits of agreement (-5.92 to 7.12 syllable difference). Moreover, this algorithm also provided the highest mean recall and precision across severity groups for /ba/ and /pa/, but with significantly more variation for/ta/. Algorithms based on signal energy analysis appeared to be the most robust for DDK analysis across dysarthria severity and syllable types; however, it remains prone to error against severe dysarthria and alveolar syllable context. Further development is needed to address this important issue.

Long noncoding RNA CCAT2 reduces chemosensitivity to 5-fluorouracil in breast cancer cells by activating the mTOR axis.

Breast cancer (BC) is the most prevalent cancer in women and the second leading cause for cancer‐related death in women. LncRNA CCAT2 is involved in BC cell drug sensitivity. Drug resistance of BC cells after chemotherapy is the main obstacle to therapeutic effects. This study explored whether BC cell drug sensitivity to 5‐Fu was related to lncRNA CCAT2‐regulated mTOR pathway. Normal breast tissues and BC tissues before/after neoadjuvant chemotherapy were collected, and CCAT2 expression was detected by RT‐qPCR. Correlation between CCATA2 expression and neoadjuvant chemotherapy efficacy was analysed using the Kendall's tau‐b correlation analysis. Normal breast epithelial cells and BC cell lines were cultured. BC cell lines were treated with 5‐Fu, and CCAT2 mRNA level in cells was detected. The 5‐Fu‐resistant MCF‐7/5‐Fu and MDA‐MB‐231/5‐Fu cells were treated with CCAT2 overexpression/knockdown or CCI‐779 (the mTOR pathway inhibitor). The mTOR pathway levels were detected. Expression of apoptosis‐related factors was identified. A subcutaneous xenograft model was carried out. High CCAT2 expression was detected in BC tissues and BC drug‐resistant cells after neoadjuvant chemotherapy, and a negative link was revealed between CCAT2 expression and efficacy of neoadjuvant chemotherapy. p‐mTOR/mTOR in 5‐Fu‐resistant BC cells with inhibited CCAT2 was decreased, while CCAT2 overexpression activated the mTOR pathway. IC50 value, proliferation, cells in S phase increased and apoptosis reduced after CCAT2 overexpression. After si‐CCAT2 or CCI‐779 treatment, the growth rate of transplanted tumours was inhibited, while promoted after CCAT2 overexpression. CCAT2 may reduce BC cell chemosensitivity to 5‐Fu by activating the mTOR pathway.

Assessment of Eyelid Pressure Using a Novel Pressure Measurement Device in Patients With Moderate-to-Severe Dry Eye Disease.

ObjectiveTo assess a novel eyelid pressure measurement device and study the relationship between eyelid pressure and ocular surface parameters of moderate-to-severe dry eye disease (DED).MethodsThe present study included 70 eyes of 35 moderate-to-severe DED patients. All subjects were subjected to the following examinations for DED assessment: Ocular Surface Disease Index (OSDI) questionnaire, tear meniscus height (TMH), lipid layer thickness (LLT), number of partial blink (PB), total blink (TB) and partial blink rate (PBR), fluorescein tear breakup time (FBUT), corneal fluorescein staining (CFS), lid margin abnormality, meibum expression assessment (meibum score), meibomian gland dropout (MGd) and Schirmer I test. Pressure of the upper eyelid was measured thrice with the novel pressure measurement device. Repeatability of the device was evaluated by intraclass correlation coefficient (ICC). Safety of the device was evaluated by observing ocular adverse reactions of each subject prior to measurement, at day 1 and day 7 following measurement. Correlations between eyelid pressure and ocular surface parameters of moderate-to-severe DED were analyzed by using Pearson correlation coefficient and Kendall's tau-b correlation coefficient.ResultsICC of the measurement results in our study was 0.86. There was no abnormality presenting in all subjects recorded prior to measurement, 1 and 7 days following measurement. The eyelid pressure was significantly correlated with PBR (r = 0.286, P = 0.016), FBUT (r = −0.331, P = 0.005), CFS (r = 0.528, P = 0.000), lid margin abnormality (r = 0.408, P = 0.011) and MGd (r = 0.226, P = 0.016) in moderate-to-severe DED patients, but not significantly correlated with OSDI score (r = 0.016, P = 0.912), TMH (r = −0.002, P = 0.988), meibum score (r = −0.196, P = 0.317), LLT (r = 0.114, P = 0.346), PB (r = 0.116, P = 0.338), TB (r = 0.074, P = 0.544), meibum score (r = −0.196, P = 0.317) and Schirmer I test (r = 0.028, P = 0.821).ConclusionThe novel pressure measurement device exhibited good repeatability and safety in measuring eyelid pressure. Significant correlations were noted between the eyelid pressure and PBR, FBUT, CFS, lid margin abnormality and MGd in moderate-to-severe DED. The measurement of eyelid pressure combined with ocular surface parameters may be valuable for the assessment of DED.

HUBUNGAN TITER WIDAL DENGAN JUMLAH LIMFOSIT PADA KASUS DEMAM TIFOID DI WILAYAH KERJA PUSKESMAS SAWOO

Typhoid fever is a systemic infection that is still a global problem, especially in Indonesia. This disease is caused by Salmonella bacteria. The Widal test is used to detect antibodies to Salmonella bacteria based on agglutination reactions between bacterial antigens and antibodies called agglutinins. Routine blood tests be used to see the body's defense mechanism against infection. Lymphocytes are produced by bone marrow, the presence of bacterial endotoxin causes inhibition of the formation of lymphocytes, so that in some cases of typhoid fever, low lymphocyte counts are often found. The purpose of this study was to determine the relationship between Widal titer and lymphocyte count in patients with suspected typhoid fever. The Widal test was examined using a microscope to see the agglutination formed, while the number of lymphocytes was calculated using a hematology analyzer. The results of the Widal test with a titer of 1/160 were 63.3% with normal lymphocyte counts and 10% with low lymphocytes. While the titer 1/320 obtained 10% of respondents with normal lymphocyte count and 16.7% with low lymphocyte count. The research design used was analytic observation with the type of cross sectional study. Statistical analysis using Kendall's Tau-b correlation test with SPSS. From the correlation test, the significance value is 0.009, and the correlation coefficient is -0.404**, which means that there is a relationship between the Widal titer and the number of lymphocytes with sufficient closeness.

HUBUNGAN PROGRAM GERAKAN LITERASI SEKOLAH (GLS) DENGAN LITERASI BACA-TULIS SISWA KELAS VIII SMP NEGERI 1 TARAKAN

This study aims to determine the relationship and closeness between the School Literacy Movement Program (GLS) on the Reading and Writing Literacy of Class VIII Students of SMP Negeri 1 Tarakan and the implementation of the GLS Program at SMP Negeri 1 Tarakan. This type of research is descriptive quantitative. The population in the study were all class VIII students of SMP Negeri 1 Tarakan in the 2020/2021 academic year, totaling 345 students. Samples were taken based on the Simple Random Sampling technique. Based on the results of data analysis, 69 of 86 students showed a supportive attitude in the GLS and Literacy and Literacy Program at school and based on the results of Kendall's Tau-B correlation test at a significant level of 5% (N = 86) obtained a p-value of less than 0.05 ( 0.000 0.05) means that there is a relationship between the GLS Program and Literacy. Then, the result of Z count is greater than Z table (4,972 1.65). This shows that there is a significant and strong relationship between the GLS Program and the Literacy and Literacy of students in schools. Thus, it can be concluded that "There is a significant and strong relationship between the School Literacy Movement Program (GLS) and the Literacy of Class VIII Students of SMP Negeri 1 Tarakan".Keywords: Literacy Movement, GLS, Read and Write Literacy

Mutual relationships between SARS-CoV-2 test numbers, fatality and morbidity rates

BackgroundThe number of SARS-CoV-2 tests conversely to other factors, such as age of population or comorbidities, influencing SARS-CoV-2 morbidity and fatality rates, can be increased or decreased by decision makers depending on the development of the pandemic, operational capacity, and financial restraints. The key objective of this study is to identify and describe, within the probabilistic approach, the relationships between SARS-CoV-2 test numbers and the mortality and morbidity rates.MethodsThe study is based on a statistical analysis of 1058 monthly observations relating to 107 countries, from six different continents, in an 11-month period from March 2020 to January 2021. The variable utilised can be defined as the number of tests performed in a given country in 1 month, to the number of cases reported in a prior month and morbidities and mortalities per 1 million population. The probabilities of different mortality and morbidity rates for different test numbers were determined by moving percentiles and fitted by the power law and by the three-segment piecewise-linear approximation based on Theil Sen trend lines.ResultsWe have identified that for a given probability the dependence of mortality and morbidity rates on SARS-CoV-2 test rates follows a power law and it is well approximated by the three Theil Sen trend lines in the three test rate ranges. In all these ranges Spearman rho and Kendall tau-b rank correlation coefficients of test numbers and morbidity with fatality rates have values between − 0.5 and − 0.12 with p-values below 0.002.ConclusionsAccording to the ABC classification: the most important, moderately important, and relatively unimportant ranges of test numbers for managing and control have been indicated based on the value of the Theil Sen trend line slope in the three SARS-CoV-2 test rate ranges identified. Recommendations for SARS-CoV-2 testing strategy are provided.

Concordance of multiple methods to define resiliency and vulnerability to sleep loss depends on Psychomotor Vigilance Test metric.

Sleep restriction (SR) and total sleep deprivation (TSD) reveal well-established individual differences in Psychomotor Vigilance Test (PVT) performance. While prior studies have used different methods to categorize such resiliency/vulnerability, none have systematically investigated whether these methods categorize individuals similarly. Forty-one adults participated in a 13-day laboratory study consisting of two baseline, five SR, four recovery, and one 36 h TSD night. The PVT was administered every 2 h during wakefulness. Three approaches (Raw Score [average SR performance], Change from Baseline [average SR minus average baseline performance], and Variance [intraindividual variance of SR performance]), and within each approach, six thresholds (±1 standard deviation and the best/worst performing 12.5%, 20%, 25%, 33%, and 50%) classified Resilient/Vulnerable groups. Kendall's tau-b correlations examined the concordance of group categorizations of approaches within and between PVT lapses and 1/reaction time (RT). Bias-corrected and accelerated bootstrapped t-tests compared group performance. Correlations comparing the approaches ranged from moderate to perfect for lapses and zero to moderate for 1/RT. Defined by all approaches, the Resilient groups had significantly fewer lapses on nearly all study days. Defined by the Raw Score approach only, the Resilient groups had significantly faster 1/RT on all study days. Between-measures comparisons revealed significant correlations between the Raw Score approach for 1/RT and all approaches for lapses. The three approaches defining vigilant attention resiliency/vulnerability to sleep loss resulted in groups comprised of similar individuals for PVT lapses but not for 1/RT. Thus, both method and metric selection for defining vigilant attention resiliency/vulnerability to sleep loss is critical.

Raw scores on subjective sleepiness, fatigue, and vigor metrics consistently define resilience and vulnerability to sleep loss.

Although trait-like individual differences in subjective responses to sleep restriction (SR) and total sleep deprivation (TSD) exist, reliable characterizations remain elusive. We comprehensively compared multiple methods for defining resilience and vulnerability by subjective metrics. A total of 41 adults participated in a 13-day experiment: 2 baseline, 5 SR, 4 recovery, and one 36 h TSD night. The Karolinska Sleepiness Scale (KSS) and the Profile of Mood States Fatigue (POMS-F) and Vigor (POMS-V) were administered every 2 h. Three approaches (Raw Score [average SR score], Change from Baseline [average SR minus average baseline score], and Variance [intraindividual SR score variance]), and six thresholds (±1 standard deviation, and the highest/lowest scoring 12.5%, 20%, 25%, 33%, and 50%) categorized Resilient/Vulnerable groups. Kendall's tau-b correlations compared the group categorization's concordance within and between KSS, POMS-F, and POMS-V scores. Bias-corrected and accelerated bootstrapped t-tests compared group scores. There were significant correlations between all approaches at all thresholds for POMS-F, between Raw Score and Change from Baseline approaches for KSS, and between Raw Score and Variance approaches for POMS-V. All Resilient groups defined by the Raw Score approach had significantly better scores throughout the study, notably including during baseline and recovery, whereas the two other approaches differed by measure, threshold, or day. Between-measure correlations varied in strength by measure, approach, or threshold. Only the Raw Score approach consistently distinguished Resilient/Vulnerable groups at baseline, during sleep loss, and during recovery‒‒we recommend this approach as an effective method for subjective resilience/vulnerability categorization. All approaches created comparable categorizations for fatigue, some were comparable for sleepiness, and none were comparable for vigor. Fatigue and vigor captured resilience/vulnerability similarly to sleepiness but not each other.

Differentiation of Hydrogen and Oxygen Isotopes in the Water Source Treatment Wetlands of Stream Networks

To explore the isotopic distribution and differentiation of water along the hydraulic flow gradients and plant-bed/ditch systems in constructed root-channel wetlands, surface and subsurface water samples were collected from four ecological wetlands, namely Shijiuyang and Guanjinggang in Jiaxing, as well as Changshuitang and Taishangang in Haining. All samples were collected along water flow pathways during the wet and rainy summer season in August 2019, except for those from Taishangang, which were collected within the plant-bed/ditch system during the dry and cold winter season in January 2020. The abundance of deuterium (δD) and δ18 O was determined in each functional area of the wetlands to assess the influence of wetlands on water differentiation. Stable isotope technology and mathematical statistics were used to analyze the distribution of δD and δ18 O in constructed root-channel wetlands and to reveal the influence of plant-bed/ditch systems on stable isotopes of water. A variety of data mining methods were used to examine the differentiation of stable isotopes of water, at various dimensions and scales, including nonparametric Kendall's tau-b correlation, stepwise regression, gray relational analysis, and machine learning (random forest) combined with scatter diagrams and model hypothesis diagnosis analysis. The main results were as follows:① The spatiotemporal variations in water isotopes of stream networks were largely affected by different water supply and evaporation enrichment effects. The slope and intercept of the wetland water line in Jiaxing were both significantly lower than the regional precipitation line of the adjacent Changshu Station (CHNIP). This showed that the wetlands area had undergone hydrogen and oxygen isotope enrichment. The δD values in Shijiuyang wetland water ranged from -52.2‰ to -49.4‰, and δ18 O values ranged from -7.6‰ to -6.9‰. In Guanjinggang wetland water samples, δD ranged from -48.1‰ to -45.1‰, and δ18 O ranged from -6.8‰ to -5.8‰. The δD values in Changshuitang wetland water ranged from -49.8‰ to -48.4‰, and δ18 O ranged from -7.2‰ to -6.6‰. The δD values in Taishangang wetland water ranged from -55.3‰ to -51.6‰, and δ18 O ranged from -7.8‰ to -7.2‰. ② Hydrogen and oxygen isotope abundance and composition of water showed complex nonlinear changes in the vertical and horizontal dimensions at different scales. At the regional scale, water level elevation in the vertical dimension had a greater impact on water isotope distribution than the length of the hydraulic flow pathway in the horizontal dimension. Water isotopes tended to be enriched in low-lying areas with low water levels. At the local scale, the influence of hydraulic process often played a greater role in determining water isotope distributions. The spatial variations of water isotopes were comprehensively determined by the evaporation of regional water and meandering hydraulic processes inside the wetland. ③ Compared with other wetland functional areas, the central constructed root-channel area (middle treatment zone) was more enriched in water isotopes. ④ The underground macropore network formed by plants with developed rhizomes or roots (e.g., Phragmites communis Trin. and Typha orientalis Presl), mineral-rich substrate soil, and aquatic plants in the plant bed had a significant influence on the abundance of hydrogen and oxygen isotopes in the plant-bed/ditch system. Therefore, when water passed through the plant-bed/ditch system, the values of δD and δ18 O in the lower ditch (outlet) were lower than those in the higher ditch (inlet). ⑤ The abrupt change in isotopic contents of the plant-bed/ditch system might indicate an inflection point in water quality purification. ⑥ The deuterium excess (d-excess) in subsurface water of the plant-bed/ditch system was significantly higher than that in ditch water, and the coefficient of variation in subsurface water was considerably greater than that in ditch water. The d-excess in the wetland root-channel ecological purification zone showed significant temporal differences and was negative in the summer and positive in the winter, which reflected the seasonal variation in water vapor sources and the spatial variation in isotope fractionation behavior in wetlands. These results provide some understanding of the distribution of water isotopes in constructed wetlands, which will strengthen their operation and management. This study also provides some ideas regarding new technologies for water quality improvement and shows that water isotope technology may be a reliable method for analyzing wetland hydrology.

Experiences of racial discrimination in the medical setting and associations with medical mistrust and expectations of care among black patients seeking addiction treatment

IntroductionExperiences of racial discrimination in the medical setting are common among Black patients and may be linked to mistrust in medical recommendations and poorer clinical outcomes. However, little is known about the prevalence of experiences of racial mistreatment by healthcare workers among Black patients seeking addiction treatment, or how these experiences might influence Black patients' medical mistrust or expectations of care. MethodsParticipants were 143 Black adults recruited consecutively from two university addiction treatment facilities in Columbus, Ohio. All participants completed validated surveys assessing perceptions of prior racial discrimination in the medical setting and group-based medical mistrust. Participants were also asked a series of questions about their expectations of care with regard to racial discrimination and addiction treatment. Descriptive analyses were used to characterize the sample with regard to demographics, perceived racial discrimination and medical mistrust. Kendall tau-b correlations assessed relationships between racial discrimination, mistrust and expectations of care. ResultsSeventy-nine percent (n = 113) of participants reported prior experiences of racial discrimination during healthcare. Racial discrimination in the medical setting was associated with greater mistrust in the medical system and worse expectations regarding racial discrimination in addiction treatment including delays in care-seeking due to concern for discrimination, projected non-adherence and fears of discrimination-precipitated relapse. ConclusionsBlack patients seeking addiction treatment commonly report experiencing racial discrimination by healthcare workers which may be associated with mistrust in the medical system and expectations of care. Strategies to eliminate and mitigate experiences of racial discrimination may improve addiction treatment receptivity and engagement.

Minimal Clinically Important Difference (MCID) for the Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire – IUGA Revised (PISQ-IR)

BackgroundTo put statistically significant changes in patient reported outcome measurement (PROM) questionnaires into a clinical perspective, the concept of the minimal clinically important difference (MCID) can be used. AimTo determine the MCID for the summary score for sexually active (SA) women of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR), a validated instrument which assesses sexual functioning (SF) for patients suffering from a symptomatic pelvic floor disorder. MethodsPatients participating in a multicentre prospective cohort study comparing pessary therapy with surgery for a symptomatic pelvic organ prolapse (POP) filled in the PISQ-IR at baseline and 12 months’ follow-up. We used both an anchor-based as well as a distribution-based method to calculate the MCID for both treatment groups. The Patient Global Impression of Improvement (PGI-I) questionnaire and PISQ-IR question 19a about satisfaction with sexual functioning were used as anchors. For the distribution-based approach we used the effect size (ES). OutcomesMCID for the SA summary score of the PISQ-IR. ResultsData of 243 women were used to calculate the MCID. In the pessary group, Kendall's tau-b correlation coefficients between the PISQ-IR summary score and both anchors were below the cut-off of 0.21, which implies the anchors cannot be used to calculate an MCID. In our surgery group, the PISQ-IR question 19a met the anchor criteria and 0.31 points increase in the PISQ-IR summary score was equal to an improvement of 1 point on question 19a about satisfaction with sexual functioning. Clinical implicationsFuture research on this subject should focus on clinical relevance of results rather than statistical significance only. Strengths & LimitationsOur main strength is the fact that we used both anchor-based and distribution-based methods to determine our MCID. Secondly, we set out to determine an MCID for both treatment groups separately, which relatively enhances the generalisability of our results. A limitation is that we were not able to estimate an MCID for the pessary group.Pruijssers B, van der Vaart L, Milani F, et al. Minimal Clinically Important Difference (MCID) for the Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire – IUGA Revised (PISQ-IR). J Sex Med 2021;18:1265–1270. ConclusionWe estimated the MCID for the PISQ-IR SA summary score to be 0.31 in our surgery group.

Pacing behaviour of middle-long distance running & race-walking athletes at the IAAF U18 and U20 World Championship finals

ABSTRACT The current study analysed the pacing behaviour of athletes competing in the middle-long track event finals of the IAAF Under 18 and Under 20 World Championships between 2015 and 2018. Official finishing times, 1000-m split times and positioning data of 116 female and 153 male athletes, competing in the middle-long distance running (3000 m, 5000 m and 10,000 m) and race walking (5000 m and 10,000 m) events, were gathered. Repeated measures analysis of variance, with 1000-m speed as within-subjects factor and final ranking (medallist, Top 8 or Top 12, rest of the field) as between-subjects factor, was performed to compare the pacing behaviour between athletes. Positioning of the athletes was analysed by Kendall tau-b (Tb) correlation between the intermediate position and final position. Overall, medallists increased their speed throughout a race, with the exception of the 5000 m running event, in which a parabolic pacing behaviour was exhibited. The 1000-m segment in which a significant (P > 0.05) difference in speed was exhibited between differently ranked athletes coincided with a strong (Tb > 0.7) correlation between intermediate and final positioning. These combined results point towards a separation between the athletes during the race, as the Top 8 or Top 12 and the rest of the field are unable to match the speed of the medallists. The distance, discipline, sex, age category and behaviour of competitors all influence the pacing behaviour of young track athletes during international level competition, emphasising the importance and complexity of developing adequate pacing behaviour in track athletes. Highlights The distribution of effort over an exercise task (i.e. pacing) is an important factor in endurance exercise competition. The pacing behaviour of athletes is determined by many aspects, such as the biomechanical characteristics of the task, the exercise environment and the age of the athlete Sport specific competition data from youth athlete sports events can provide insight into the pacing behaviour of developing athletes. These insights could assist in the optimalisation of the development of pacing behaviour of young athletes in the future. The current study analysed the 1000-m split times and positioning data of athletes competing in the running (3000 m, 5000 m and 10,000) and racewalking (5000 m and 10,000m) finals of the U18 and U20 IAAF world-championship. The difference in final ranking impacted the pacing behaviour of the athletes, with the medallists increasing their speed throughout the race and the other athletes separating from the medallists either early (rest of field) or later in the race (Top 8 or Top 12 athletes).

Effects on Children’s Health by Excessive Use of Online Devices: A Study from the Parents Perspectives

This paper aims to identify the patterns of excessive use of online devices by children and its physical and behavioural impact on children's health of five different age groups: 0- less than 3, 3-7, 7-10, 10- 13 and over 13years of age. A survey was conducted with 42 respondents by using an on-line Google form in Pokhara. The purposive sampling method was used to select the sample and an online questionnaire was used to accumulate data from the parents. The target sample groups are parents who have children with age below 14 years. It is not a surprising matter that children have become good operators of any online devices these days. Therefore, this research paper attempts to find out any relationships that exist between online device user children and physical problems that they suffer. So a hypothesis has been developed to test whether “excessive online devices uses affects children’s health?” A hypothesis was tested through Kendall's tau-b (τb) correlation coefficient, a non-parametric test. This paper concludes that the time is managed by the parent to their children for the use of the internet. Due to this effort of the parents, there is no serious physical health problem arising in the children and the parents are also not worried about their excessive engagement on electronic gadgets.