Interval Measurement Research Articles

Vocalic and intervocalic intervals in the speech of educated Idoma speakers of English

The measurement of vocalic and intervocalic intervals, which has been proposed as a more reliable acoustic correlate of rhythm than inter-stress intervals or syllable duration, is usually not included in the description of the rhythm of Nigerian English, and little is known about how this contributes to the impression of rhythm in the speech of educated Idoma speakers of English. This study therefore investigated the speech rhythm of educated Idoma speakers of English by measuring vocalic and intervocalic intervals as acoustic correlates of speech rhythm. A carefully selected passage, read by 50 educated Idoma speakers of English, was analysed acoustically and statistically. The normalised pairwise variability index (nPVI) was employed to account for vocalic and intervocalic intervals in the speech of the participants in order show how this contributes to the impression of rhythm in their speech. The study indicated that there was no durational variability between successive vowels, in addition to low variability index values for vocalic and intervocalic intervals. These results showed syllable-timing rhythm. However, patterns from female participants along the continuum were less syllable timed than the male participants. There were also indications of sentence type variations with compound sentences, in some cases, less syllable timed than simple sentences.

A Multi-Sample Comparison and Rasch Analysis of the Evaluation of Children's Listening and Processing Skills Questionnaire.

Assessing listening difficulties and associated complaints can be challenging. Often, measures of peripheral auditory functions are within normal ranges, making clinicians feel unsure about proper management strategies. The range and nature of observed or experienced difficulties might be better captured using a qualitative measure. The Evaluation of Children's Listening and Processing Skills (ECLiPS) questionnaire was designed to broadly profile the auditory and cognitive problems often present in children with listening difficulties. This 38-item questionnaire was initially standardized in British children aged 6 to 11 years, was subsequently modified for use with North-American children, and was recently translated into Flemish-Dutch. This study aimed to compare typical scores of the Flemish version with the UK and US versions, and to evaluate and compare its psychometric quality based on Rasch analysis. We selected 112 Flemish children aged 6 to 11 years with verified normal hearing and typical development, and asked two caregivers of every child to fill out the ECLiPS. Data from two comparator samples were analyzed, including responses for 71 North-American children and 650 British children. Typical values for ECLiPS factors and aggregates were determined as a function of age and gender, and meaningful differences across samples were analyzed. Rasch analyses were performed to evaluate whether ECLiPS response categories work as intended, and whether item scores fit a linear equal interval measurement scale that works the same way for everyone. Item and person metrics were derived, including separation and reliability indices. We investigated whether items function similarly across linguistically and culturally different samples. ECLiPS scores were relatively invariant to age. Girls obtained higher scores compared with boys, mainly for items related to memory and attention, and pragmatic and social skills. Across ECLiPS versions, the most pronounced differences were found for items probing social skills. With respect to its psychometric quality, ECLiPS response categories work as intended, and ECLiPS items were found to fit the Rasch measurement scale. Cultural differences in responses were noted for some items, belonging to different factors. Item separation and reliability indices generally pointed toward sufficient variation in item difficulty. In general, person separation (and reliability) metrics, quantifying the instrument's ability to distinguish between poor and strong performers (in a reproducible manner), were low. This is expected from samples of typically developing children with homogeneous and high levels of listening ability. Across the languages assessed here, the ECLiPS caregiver questionnaire was verified to be a psychometrically valid qualitative measure to assess listening and processing skills, which can be used to support the assessment and management of elementary school children referred with LiD.

Using Fuzzy Ranking Technique to Find the Best Traits and Peak Age Group of Electors in an Election

Objective: To predict the peak-age of age group of voters who turn the table of election results and also to rank the attribute which people look from their candidates. Methods: Improved CETD matrix has been used in the sample size of nearly 150 through unsupervised method. Findings: This study provides: 1. Ordering or ranking of age groups; 2. Identifying the best attribute for the leaders to possess to win the election. Novelty: To get accurate result, the researchers have structured the normalization through max-max (min-min) for improved CETD and rank identification through TOPSIS method. This method enhances the normality of interval measure to lie between [0, 1]. Keywords: ATD, RTD, CETD, Attributes, ∝ cut, TOPSIS

Value of basal HV Interval prior TAVR as predictor of permanent pacemaker implantation

Abstract Background/Introduction Transfemoral aortic valve replacement (TAVR) is an effective and safe treatment for severe aortic stenosis (SAoS) even in low risk patients (1,2). As population ages, the volume of TAVR procedure increases and although improvements in technology and technique, new onset persistent disturbances in the electrocardiogram (ECG) are present up to 34,8% of patients at hospital discharge(3) and the secondary need of permanent pacemaker implantation (PPM) remains high, being of 4-24% with balloon-expanding valves (BEV) and 14.7-26.7% with self-expanding valves (SEV)(3). According to ESC guidelines, an electrophyisiologic study (EPS) centered in HV interval measure with a cutoff of ≥70ms is a useful tool to assess the risk of progression to high auriculoventricular block (HAVB) in specific groups with persistent ECG abnormalities to consider PPM(4-5), but this only applies in post TAVR scenario. Measuring HV interval at the intervention day prior procedure could help optimize and assess risk for PPM post TAVR. Purpose To measure basal HV interval prior TAVR and correlate it to risk of PPM implantation before discharge and 30 days after discharge. Methods Single-center prospective cohort study, patients with SAoS scheduled for TAVR, sinus rhythm at intervention day, without PPM or history of PPM indication were included. At time of TAVR, a tetrapolar catheter was placed at the septal aspect of tricuspid valve. A mobile polygraph was used to measure ECG parameters and HV interval before TAVR. Then, tetrapolar catheter was advanced to ventricle to perform rapid stimulation as part of habitual valve implantation protocol. After procedure, a rhythm monitorization for >48-72 hrs, was made to decide, PPM, HV interval measure or clinical daily ECG vigilance with posterior discharge was performed. A 30-day post discharge follow up was expected. Results 38 patients were enrolled, median age 83.5 ± 5.5 years, 23 females (60,5%). 37 patients had SEV implanted and 1 patient had BEV implanted. Median HV interval was 54.4ms. 18 patients (47.4%) had a mild abnormal HV interval, of whom 11 had a narrow QRS. Post TAVR procedure, 15 patients (39.5%) persisted with "de novo" LBB at discharge. 5 women and 7 men, had PPM implanted before discharge. 1 woman was implanted 6 days after discharge due to HAVB (66ms HV interval prior TAVR). In a multivariate analysis including sex, age, PR, QRS and HV interval >55ms, the RR (IC 95% 1.9-70.3) risk of PPM was 13.42 folds higher (p=0.008). At a bivariate quantitative HV analysis, a higher HV period persisted significantly related to PPM outcome (p=0.001). Conclusions In our study population, a pre-existing mild to moderate prolongation of HV interval prior TAVR substantially elevates the risk of requiring PPM before discharge. 61.1% of these basal mild prolongation HV interval patients had a narrow QRS prior TAVR.HV measure prior TAVR in narrow QRSTable 1

Use of portable single-lead electrocardiogram device as an alternative for QTc monitoring in critically ill patients.

Acquired QT prolongation is frequent and leads to a higher mortality rate in critically ill patients. KardiaMobile 1L® (KM1L) is a portable, user-friendly single lead, mobile alternative to conventional 12-lead electrocardiogram (12-L ECG) that could be more readily available, potentially facilitating more frequent QTc assessments in intensive care units (ICU); however, there is currently no evidence to validate this potential use. We conducted a prospective diagnostic test study comparing QT interval measurement using KM1L with conventional 12-L ECG ordered for any reason in patients admitted to an ICU. We compared the mean difference using a paired t-test, agreement using Bland-Altman analysis, and Lin's concordance coefficient, numerical precision (proportion of QT measurements with <10 ms difference between KM1L and conventional 12-L ECG), and clinical precision (concordance for adequate discrimination of prolonged QTc). We included 114 patients (61.4% men, 60% cardiovascular etiology of hospitalization) with 131 12-L ECG traces. We found no statistical difference between corrected QT measurements (427 ms vs. 428 ms, p = .308). Lin's concordance coefficient was 0.848 (95% CI 0.801-0.894, p = .001). Clinical precision was excellent in males and substantial in females (Kappa 0.837 and 0.781, respectively). Numerical precision was lower in patients with vasoactive drugs (-13.99 ms), QT-prolonging drugs (13.84 ms), antiarrhythmic drugs (-12.87 ms), and a heart rate (HR) difference of ≥5 beats per minute (bpm) between devices (-11.26 ms). Our study validates the clinical viability of KM1L, a single-lead mobile ECG device, for identifying prolonged QT intervals in ICU patients. Caution is warranted in patients with certain medical conditions that may affect numerical precision.

Current status and applications of time-to-digital converters

Time-to-Digital Converter (TDC) is widely used to realize time interval measurement. The high-precision time measurement technique has important applications in the fields of laser ranging, particle identification, and radioactive nuclear medicine engineering. Based on the existing literature research and data, this paper studies the application areas of TDC in the present development and analyzes the future prospects of TDC applications. The research results showed that: TDC, based on signal screening, realizes time interval measurement as the ultimate purpose of building the system and, at the same time, completes the function of multi-pulse time interval measurement, which can meet the needs of more diversified measurements in the experiments. In the circuit structure, it can identify the feedback output in the all-digital phase-locked loop (ADPLL) and the reference clock phase and frequency information between the feedback output and the reference clock in an ADPLL. It is also promising for use in other areas of high-precision time measurement and processing of circuit signals.

Research on Radial Double Velocity Measurement Method of Laser Tracker

For the dynamic problem that the low-speed sliding table is unable to meet the radial measuring speed of the laser tracker, this paper takes the sliding table of the indoor large-length standard device as the moving object to double the measuring distance by adding a pyramid prism, thereby doubling the radial speed of the laser tracker. In this paper, the measurement data are analyzed through equal interval measurement experiments, equal sampling frequency experiments and repeatability measurement experiments using a pyramid prism to obtain the following conclusions, respectively: Firstly, the stability of the actual interval of the laser tracker is optimal when the rated speed of the sliding table is 50 mm/s. When the pyramid prism is not used, the minimum standard deviation obtained by the laser tracker at a sampling interval of 5 mm is 0.0158 mm. Secondly, during the equal sampling frequency measurement, the stability of the laser interferometer is better than that of the laser tracker when the pyramid prism is not used. With two instruments at a sampling frequency of 10 Hz, the standard deviations of the local velocity of the laser interferometer are 0.1466 mm/s, 0.0693 mm/s and 0.1106 mm/s, respectively. The standard deviations of the laser tracker are 0.1582 mm/s, 0.1033 mm/s and 0.2008 mm/s, respectively. The same conclusion is obtained at a sampling frequency of 20 Hz. The stability of the laser tracker is better than that of the laser interferometer when the pyramid prism is used. Thirdly, the stability and reliability of the local velocity of the laser tracker are better than that of the laser interferometer. For example, at 10 Hz, the standard deviations of the local velocity of the laser tracker are 0.2745 mm/s and 0.2097 mm/s, respectively, and the repeatability of the local velocity is 0.9140 mm/s. The standard deviations of the local velocity of the interferometer are 0.6141 mm/s and 0.6368 mm/s, respectively, and the repeatability of the local velocity is 1.4886 mm/s. And the local velocity of the two measuring instruments is more reliable and stable at a low frequency (10 Hz). This experimental scheme provides a way to measure the high speed of a laser tracker using a sliding table at low speed.

Unravelling temperature-dependent molecular changes in hydrated wheat and maize starches using 1H time-domain NMR

This study proved that time-domain NMR (TD-NMR) experiments can accurately demonstrate the interaction between starch (wheat and maize) and water and the distribution of water molecules in starch-water systems during heating. Molecular properties in starch-water systems at 50% moisture content were monitored by Rhim and Kessemeier – Radiofrequency Optimized Solid-Echo (RK-ROSE) and Carr-Purcell-Meiboom-Gill (CPMG) pulse sequences at frequent (2 °C intervals) measurements during heating (55–80 °C). Starch-like and water-like phases were obtained by RK-ROSE and CPMG pulse sequences, respectively. The second moment, M2, along with the relaxation times of the populations, associated with fast-decaying protons, provided information on the crystal structure state during heating and the extent of gelatinisation. The relaxation times of the most abundant population from the CPMG signal decreased during heating due to strong interactions between starch and water. Temperature of stabilisation of this population aligned with the associated findings from the differential scanning calorimetry and rheological measurements.

Improving the measurement properties of the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R): deriving a valid measurement total for the calculation of change

Background The Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) total score is a widely used measure of functional status in Amyotrophic Lateral Sclerosis/Motor Neuron Disease (ALS), but recent evidence has raised doubts about its validity. The objective was to examine the measurement properties of the ALSFRS-R, aiming to produce valid measurement from all 12 scale items. Method Longitudinal ALSFRS-R data were collected between 2013-2020 from 1120 people with ALS recruited from 35 centers, together with other scales in the Trajectories of Outcomes in Neurological Conditions-ALS (TONiC-ALS) study. The ALSFRS-R was analyzed by confirmatory factor analysis (CFA), Rasch Analysis (RA) and Mokken scaling. Results No definite factor structure of the ALSFRS-R was confirmed by CFA. RA revealed the raw score total to be invalid even at the ordinal level because of multidimensionality; valid interval level subscale measures could be found for the Bulbar, Fine-Motor and Gross-Motor domains but the Respiratory domain was only valid at an ordinal level. All four domains resolved into a single valid, interval level measure by using a bifactor RA. The smallest detectable difference was 10.4% of the range of the interval scale. Conclusion A total ALSFRS-R ordinal raw score can lead to inferential bias in clinical trial results due to its non-linear nature. On the interval level transformation, more than 5 points difference is required before a statistically significant detectable difference can be observed. Transformation to interval level data should be mandatory in clinical trials.

The Danish Nationwide Electrocardiogram (ECG) Cohort

The electrocardiogram (ECG) is a non-invasive diagnostic tool holding significant clinical importance in the diagnosis and risk stratification of cardiac disease. However, access to large-scale, population-based digital ECG data for research purposes remains limited and challenging. Consequently, we established the Danish Nationwide ECG Cohort to provide data from standard 12-lead digital ECGs in both pre- and in-hospital settings, which can be linked to comprehensive Danish nationwide administrative registers on health and social data with long-term follow-up. The Danish Nationwide ECG Cohort is an open real-world cohort including all patients with at least one digital pre- or in-hospital ECG in Denmark from January 01, 2000, to December 31, 2021. The cohort includes data on standardized and uniform ECG diagnostic statements and ECG measurements including global parameters as well as lead-specific measures of waveform amplitudes, durations, and intervals. Currently, the cohort comprises 2,485,987 unique patients with a median age at the first ECG of 57 years (25th–75th percentiles, 40–71 years; males, 48%), resulting in a total of 11,952,430 ECGs. In conclusion, the Danish Nationwide ECG Cohort represents a novel and extensive population-based digital ECG dataset for cardiovascular research, encompassing both pre- and in-hospital settings. The cohort contains ECG diagnostic statements and ECG measurements that can be linked to various nationwide health and social registers without loss to follow-up.

Clinical practice competence and associated factors among undergraduate midwifery and nursing sciences students at Bahir Dar city, Northwest Ethiopia

Background: Competence describes actions that will be demonstrated or observed and assessed while competency refers to the skill itself. Following appropriate theoretical and practical training, clinical experience is required to achieve the highest level of clinical competence. It is estimated that many women and newborns die each year due to a lack of qualified health professional around the world. As a result, the purpose of this study was to determine the prevalence and factors influencing clinical competency in the study area. Methods: An Institutional-based cross-sectional study was conducted from 12 August to 12 September 2022, among 403 undergraduate health sciences students of Bahir Dar University. Participants were approached through simple random sampling technique. Data were collected using a pre-tested structured questionnaire through a face-to-face interview, and entered into Epidata version 3.1 and analyzed using SPSS version 22. The prevalence was reported using proportion with 95% CI and summary measures. Predictors were assessed using a multivariable logistic regression analysis model and reported using an adjusted odds ratio (AOR) with 95% CI. Statistical significance was declared at P value less than 0.05. Results: Overall, the prevalence of clinical practice competency was 36.5% [95% CI; 33.5, 39.1]. Students who were provided a logbook (AOR=5.40, 95% CI 2.91, 10.02), adequate clinical cases in the clinical practice placement (AOR=2.72, 95% CI 1.60, 4.60), preceptor show different procedures (AOR=2.50, 95% CI 1.33, 4.71), student’s confidence during conducting procedure (AOR=4.16, 95% CI 1.67, 10.35) and the suitability of the way of teaching to the learning styles of students during skills demonstration (AOR=2.10, 95% CI 1.00, 4.40) were factors statistically associated with clinical practice competence. Conclusions: According to this study, more than three out of every five participants were found to be clinically incompetent. Providing logbooks, adequate clinical cases, preceptors showing different procedures, students’ confidence, and suitability of the way of teaching to the learning styles of students were significantly associated with clinical practice competence. Implementing logbooks, selecting clinical sites, enhancing the confidence of students, preferred teaching/learning styles, and clinical preceptor support were important to improve the clinical competence of students.

Compensation of Accuracy Error for Time Interval Measurements

Abstract A method of accuracy error compensation for the time interval is examined, allowing to decrease the dependence of accuracy error on the duration of measured intervals and minimising the influence of destabilising factors – ambient temperature changes and the initial deviation of the meter clock generator frequency from the nominal value. The compensation method is based on a calibration procedure that measures precise time intervals under conditions of changing ambient temperature. Then the dependence of the accuracy error on temperature for a particular meter is recorded. Based on these data, a correction table is compiled containing correction factors and temperature values at which these factors were determined. Under real measurement conditions, the correction factor corresponding to the current temperature is determined from the table for measured result correction. The table with correction factor values could be stored in the memory of the meter or processing computer. Experimental verification of the method showed that applying a correction for a meter with a standard XO class clock generator (certificated instability of ±50 ppm) could obtain an equivalent clock generator instability of ±0.15 ppm. The application of the method is efficient in cases where the use of high-end clocking to ensure the required measurement accuracy is not economically feasible.

Laparoscopic vs. ultrasound-guided transversus abdominis plane (TAP) block in colorectal surgery: a systematic review and meta-analysis of randomized trials.

The transversus abdominis plane block (TAPB) is effective for postoperative pain management in patients undergoing colorectal surgery. However, evidence regarding the optimal delivery method, either laparoscopic (L-TAPB) or ultrasound-guided (U-TAPB) is lacking. Our study aimed to compare the effectiveness of these delivery methods. We carried out a literature search of PubMed, Cochrane Library, Web of Science, and Google Scholar databases to include randomized studies comparing patients receiving either L-TAPB or U-TAPB during minimally invasive colorectal surgery. The primary endpoint was opioid consumption in the first 24h after surgery. Risk of bias was assessed with the RoB-2 tool. Effect size was estimated for each study with 95% confidence interval and overall effect measure was estimated with a random effect model. The literature search revealed 294 articles, of which four randomized trials were eligible. A total of 359 patients were included, 176 received a L-TAPB and 183 received a U-TAPB. We established the non-inferiority of L-TAPB, as the absolute difference of - 2.6 morphine-mg (95%CI - 8.3 to 3.0) was below the pooled non-inferiority threshold of 8.1 morphine-mg (low certainty level). No difference in opioid consumption was noted at 2, 6, 12, and 48h (low to very low certainty level). Postoperative pain, nausea and vomiting were similar between groups at different timepoints (low to very low certainty level). No TAPB-related complications were recorded. Finally, the length of hospital stay was similar between groups. For postoperative multimodal analgesia both L-TAPB and U-TAPB may result in little to no difference in outcome in patients undergoing colorectal surgery. Registration Prospero CRD42023421141.

Inter-Beat Interval Estimation with Tiramisu Model: A Novel Approach with Reduced Error

Inter-beat interval (IBI) measurement enables estimation of heart-tare variability (HRV) which, in turn, can provide early indication of potential cardiovascular diseases (CVDs). However, extracting IBIs from noisy signals is challenging since the morphology of the signal gets distorted in the presence of noise. Electrocardiogram (ECG) of a person in heavy motion is highly corrupted with noise, known as motion-artifact, and IBI extracted from it is inaccurate. As a part of remote health monitoring and wearable system development, denoising ECG signals and estimating IBIs correctly from them have become an emerging topic among signal-processing researchers. Apart from conventional methods, deep-learning techniques have been successfully used in signal denoising recently, and diagnosis process has become easier, leading to accuracy levels that were previously unachievable. We propose a deep-learning approach leveraging tiramisu autoencoder model to suppress motion-artifact noise and make the R-peaks of the ECG signal prominent even in the presence of high-intensity motion. After denoising, IBIs are estimated more accurately expediting diagnosis tasks. Results illustrate that our method enables IBI estimation from noisy ECG signals with SNR up to -30 dB with average root mean square error (RMSE) of 13 milliseconds for estimated IBIs. At this noise level, our error percentage remains below 8% and outperforms other state-of-the-art techniques.

Self-image-guided ultrasonic transceiver design for reliably powering mm-sized implants

This paper presents the design of a self-image-guided ultrasonic (SIG-US) transceiver for reliable wireless power transmission (WPT) to miniaturized biomedical implants. In the receiver (RX) mode, this paper proposes a method for high precision time interval measurement (TIM) between two signals independent of their amplitudes. In the transmitter (TX) mode, a 15 V Class-DE driver by stacking 3.3 V transistors of 180 nm standard CMOS technology is designed to drive a 32-element linear array. The designed TX efficiency is 90.93%. The post-layout and the Matlab k-Wave toolbox simulation results show that the designed system is capable of transmitting power to the implant with less than 0.9% reduction compared to the ideal SIG-US system over the ±45° steering range. Considering the mismatch effect between transistors, the power reduction is less than 2% in the worst case. The RX with a power consumption of 628.83 μW from a nominal supply voltage of 1.8 V, is capable of detecting time delays between two signals over the input range of 1 mV to 10 mV, with high accuracy.

From Waves to Diagnoses: Decoding Electrocardiogram for Improved Cardiac Care

The electrocardiogram (ECG) is a fundamental tool in cardiology, providing invaluable insights into cardiac physiology and detecting various abnormalities. This review article presents a comprehensive overview of ECG interpretation, focusing on the procedure, application, and methodology. The placement of electrodes, ECG paper speed, and measurements of intervals and blocks are discussed in detail. The article emphasizes the importance of a systematic approach to ECG interpretation, highlighting six main sections: determination of heart rhythm, calculation of heart rate, assessment of intervals and blocks, analysis of atrial depolarization patterns, assessment of ventricular depolarization complexes, and delving into the intricate characteristics of ST segments and exploration of the electrocardiographic T-wave manifestations. Specific criteria for identifying abnormalities in each section are provided, along with their associated etiologies and clinical implications. Furthermore, the limitations of ECG as a diagnostic tool are acknowledged, emphasizing the need for clinical correlation and consideration of additional tests. The abstract encapsulates the breadth and depth of the review, conveying the relevance and the profound significance of ECG interpretation in the realm of clinical practice and scientific inquiry.

Latest ALICE results on charm and beauty hadronisation in hadronic collisions

The study of heavy-flavour mesons and baryons in hadronic collisions provides unique access to the properties of heavy-quark hadronisation in the presence of large partonic densities, where new mechanisms of hadron formation beyond in-vacuum fragmentation can emerge. Performing these measurements in intervals of charged-particle multiplicities across different collision systems provides sensitivity to understand whether different hadronisation mechanisms are at play in small and large hadronic colliding systems. In this contribution, a selection of the latest charm and beauty production measurements in proton–proton (pp) collisions is presented, which can shed light on the modification of the heavy-quark hadronisation mechanisms with respect to leptonic collisions. New published results of the production of all prompt charm ground states in pp collisions at √S = 13 TeV, which allowed us to measure the charm fragmentation fractions and the total cc production cross section at midrapidity, will be shown. The new final measurement of non-prompt (i.e. originating from beauty-hadron decays) Λc+ baryons in the same collisions system will be discussed to provide a quantitative comparison between the hadronisation properties of beauty and charm hadrons. New measurements of Ξc0 production as a function of charged-particle multiplicity in pp collisions at √S = 13, and of Ξc0 production in p–Pb collisions at √SNN = 5.02 TeV, will be also presented, shedding further light on the hadronisation of charm-strange baryons in different colliding systems.

Two out of every three pregnant women who gave birth in public health facilities of Tullo Woreda were dissatisfied with deliveries services, Eastern Ethiopia.

The level of maternal satisfaction with delivery services significantly affects health service utilization among women. Ethiopia's healthcare system and health facilities' quality have not much improved, which may contribute to women's generally poor levels of satisfaction and there was a limited study about client satisfaction on delivery services in the study area. Thus, the purpose of this study was to assess level of maternal satisfaction with delivery service and its associated factors among women who gave birth in Tullo Woreda public health facilities, Eastern Ethiopia. A facility-based cross-sectional study was conducted from 1 to 30 September 2020 among 355 women who gave birth in Tullo Woreda public health facilities, Eastern Ethiopia Data were collected using a pretested structured questionnaire through a face-to-face interview and entered into Epidata version 3.1 and analyzed using statistical package for the social sciences (SPSS) version 25. The prevalence was reported using a 95% confidence interval and summary measures. Predictors were assessed using a multivariable logistic regression analysis model and reported using an adjusted odds ratio with 95% CI. Statistical significance was declared at a p-value of <0.05. The overall satisfaction of mothers on delivery service was 33.5% (95% CI: 27.81, 39.13). Factors such as having no antenatal care (ANC) for the index pregnancy (AOR = 0.33; 95% CI: 0.19, 0.56), women who came to health centers on foot (AOR = 0.17; CI: 0.04, 0.74) and by auto-rickshaw (AOR = 0.16; 95 % CI: 0.04, 0.64), mothers who did not satisfied with toilet service at the delivery room (AOR = 0.49; 95% CI: 0.12, 0.86) and who were not satisfied with maternal drugs availability (AOR = 0.65; 95% CI: 0.11, 0.95) were predictors of maternal satisfaction. This study pointed out that only 33.5% of women were satisfied with delivery care services provided in public health facilities of the study area. Factors such as not having ANC, using foot and auto-rickshaw as means of transportation, availability of drugs, and toilets were predictor of maternal satisfactions. Awareness creation for the benefit of ANC follow-up and delivery in the health facilities and providing safe transportation during referral time may help mothers get a timely healthcare service, which may increase client satisfaction. The concerned entities must pay attention in timely availability of drugs and improving the toiles, which play a role in shaping and molding level of satisfaction of women.

Transcending Patient Morphometry: Acromiohumeral Interval to Glenoid Ratio as a Universal Diagnostic Tool for Massive Rotator Cuff Tears.

Morphological differences among various ethnicities can significantly impact the reliability of acromiohumeral interval (AHI) measurements in diagnosing massive rotator cuff tears. This variation raises questions about the generalizability of AHI studies conducted in Western populations to the Asian population. Consequently, the primary objective of this study was to develop a novel parameter that can enhance the diagnosis of massive rotator cuff tears, irrespective of morphometric disparities between individuals of different ethnic backgrounds. A 10-year retrospective analysis of shoulder arthroscopic surgery patients was conducted, categorizing them into 3 groups based on intraoperative findings: those without rotator cuff tears, those with non-massive tears, and those with massive tears. AHI-glenoid ratio (AHIGR) was measured by individuals with varying academic backgrounds, and its diagnostic performance was compared to AHI. Sensitivity, specificity, accuracy, and intra- and inter-rater reliability were evaluated. AHIGR exhibited significantly improved sensitivity, specificity, and accuracy as a diagnostic tool for massive rotator cuff tears, compared to AHI. A proposed cut-off point of AHIGR ≤ 0.2 yielded comparable results to AHI < 7 mm. Intra- and inter-rater reliability was excellent among different observers. AHIGR emerges as a promising diagnostic tool for massive rotator cuff tears, offering improved sensitivity and specificity compared to AHI. Its reproducibility among diverse observers underscores its potential clinical utility. While further research with larger and more diverse patient cohorts is necessary, AHIGR offers significant potential as a reference for enhancing the assessment of massive rotator cuff tears.

Inverse two-stage data envelopment analysis with interval measures for resource planning

PurposeAssessing inputs and outputs is a significant aspect of taking decisions while there are complex and multistage processes in many examinations. Due to the presence of interval performance measures in various real-world studies, the purpose of this study is to address the changes of interval inputs of two-stage processes for the perturbations of interval outputs of two-stage systems, given that the overall efficiency scores are maintained.Design/methodology/approachActually, an interval inverse two-stage data envelopment analysis (DEA) model is proposed to plan resources. To illustrate, an interval two-stage network DEA model with external interval inputs and outputs and also its inverse problem are suggested to estimate the upper and lower bounds of the entire efficiency and the stages efficiency along with the variations of interval inputs.FindingsAn example from the literature and a real case study of the banking industry are applied to demonstrate the introduced approach. The results show the proposed approach is suitable to estimate the resources of two-stage systems when interval measures are presented.Originality/valueTo the best of the authors’ knowledge, there is no study to estimate the fluctuation of imprecise inputs related to network structures for the changes of imprecise outputs while the interval efficiency of network processes is maintained. Accordingly, this paper considers the resource planning problem when there are imprecise and interval measures in two-stage networks.