Nonparametric Research Articles

The impact of a lifestyle promotion program on anthropometric and clinical manifestations in adolescents with polycystic ovarian syndrome: a randomized controlled trial

BackgroundLifestyle modification can have beneficial effects on improving symptoms of ovary syndrome and anthropometric changes, particularly in obese individuals… However, it is not clear whether these affects in obese adolescents with PCOS are the same as non-PCOS adolescents. We had a study question” Can lifestyle promotion programs, which focus on changing behavioral habits, have an effect on anthropometric parameters and the manifestation of polycystic ovary syndrome (PCOS) in adolescents?”MethodsThis was a cluster randomized trial (CRT) that started from January 2021 and follow-up ended in March 2022. 128 participants included adolescent girls (from 14 to 18 years old). The status of PCOS was determined for the participants, following which both the PCOS-afflicted and non-PCOS cohorts were subjected to randomization to either partake in a lifestyle promotion program or to proceed without it. This program included eight sessions that were designed to be implemented for two months. This intervention provides recommendations for a balanced diet and regular exercise, as well as advice on behavior change for adolescents, including those with PCOS, regardless of their weight. All participants were followed up for 12 months and were evaluated at three time points: baseline, 6 and 12 months. Outcomes included changes in the anthropometric indices (weight, hip and waist circumstance), regularity of menstrual cycle, hirsutism score by the modified-Ferriman-Gallwey scale, acne score by the Investigator’s Global Assessment Scale, hair loss scores by the Sinclair Graphic Instrument and then physical activity by the Caspian tool and dietary intake status by the Food Frequency Questionnaire. Data was analyzed using the non-parametric Mann-Whitney test for variables with two-time point assessments and generalized estimation equations (GEE) for variables with three time point assessments.ResultsIn the study, the intervention group of girls with PCOS exhibited a significant reduction in weight and waist circumference, with an average decrease of 3.14 kg and 4.68 cm, respectively (P < 0.001), compared to the PCOS control group. Similarly, the non-PCOS intervention group showed a decrease in these factors by 2.60 kg and 4.95 cm (P < 0.001) when compared to the non-PCOS control group. After 12 months of intervention, the odds ratio (OR) for menstrual regularity in the PCOS intervention group increased to 3.30 (95% CI: 2.06, 5.25), and the acne score significantly decreased with an OR of 0.46 (95% CI: 0.31, 0.70). In contrast, the non-PCOS intervention group experienced an increase in the OR for menstrual regularity to 2.45 (95% CI: 1.33, 4.25) and an improved in acne score with an OR of 0.44 (95% CI: 0.28, 0.69). No notable differences were observed in the nutritional status among all groups post-intervention. However, a significant increase in physical activity levels, measured in metabolic equivalent minutes per week (met/min/week), was recorded in both intervention groups (p < 0.05).ConclusionManifestations of PCOS in adolescents are improved by a lifestyle promotion program and high schools are considered an appropriate setting to identify those with PCOS and the implementation of a lifestyle modification program. This program was also shown to promote healthy lifestyles for non-PCOS adolescents.Trial registrationTrial registration number: irct.ir number: IRCT20200114046123N1.

"Let's get PrEP'd" - A pilot service evaluation of the LVNDR health digital pre-exposure prophylaxis pathway for HIV prevention.

Despite the availability of PrEP, 2023 data have demonstrated an increase in new HIV diagnoses. LGBTQ + individuals are disproportionately affected by HIV. PrEP access is crucial but limited due to high demand on sexual health services. Additional modalities of PrEP access may help to address this unmet need. LVNDR Health, a digital solution for LGBTQ + care, sought to evaluate its PrEP pathway. We conducted a retrospective cross-sectional service evaluation of users accessing the LVNDR digital PrEP pathway between December 2022-April 2023. Operational data (e.g., appointment attendance) were derived from the clinical dashboard. Service-user feedback (e.g., service experience) was sought using a bespoke questionnaire. Descriptive statistics are reported for socio-demographic information. Non-parametric between-group analyses are reported. In total, 90 users completed the end-to-end pathway and received PrEP. Average time for pathway completion was 2.7weeks. A survey response rate of 71.0% was achieved. Users reported significantly higher service satisfaction, inclusivity, and accessibility, compared to their most recent experience accessing PrEP (p < .01). Up to 89% of users strongly agreed they would switch to a digital PrEP service if made available. Digital PrEP shows acceptability among LGBTQ + populations. More research is needed to assess scalability, digital equity, and cost-effectiveness.

Dietetic Students' Perceived Anxiety towards Simulation Activities: A Mixed-methods Pilot Study.

Purpose: To assess dietetic students' anxiety levels before and after a series of simulations and to document students' perceived sources of anxiety while completing simulation-based learning activities.Methods: A mixed-method convergent pilot study was conducted. Students enrolled in a Nutrition Assessment course that included a series of four simulations were invited to participate. Students completed an online pre-post simulation survey and engaged in individual interviews and a focus group discussion. The questionnaires included demographic questions and the French State-Trait Anxiety Inventory. Nonparametric tests and thematic analysis were used to examine data.Results: Fourteen students participated in the study's quantitative component and seven in the qualitative component. There was a significant decrease in trait (44.5 ± 13.8 vs 32.0 ± 14.0, P = 0.01) and state (47.0 ± 11.2 vs 33.0 ± 18.0, P = 0.05) anxiety from pre- to post-simulations. Individual factors influencing students' anxiety levels were stress and self-confidence. External factors influencing students' anxiety levels were unknown situations, observers, patient profiles, observers' feedback, preparation level, and academic setting.Conclusions: Our findings suggest that ensuring the educator is not present during simulations, advance preparation, and reassurance that simulations are a learning and not an evaluation activity may be effective pedagogical strategies for dietetic educators to reduce learners' anxiety and facilitate competency development.

Exploring the Neurodiversity of Lithuanian College Students and Its link to Learning Difficulties and Supporting Measures

&lt;p dir="ltr"&gt;&lt;span&gt;Enhancing the inclusion of neurodiverse students in higher education institutions represents a significant and evolving challenge for educators. Recognizing learning difficulties and equipping teachers with the knowledge and skills to effectively work with and communicate with neuro-diverse students are crucial steps toward achieving social inclusion. Aim – to explore the neurodiversity of Lithuanian college students and its link to learning difficulties and supporting measures. Two developmental adult disorders were presented to illustrate the expression of neurodiversity including attention deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD). A cross-sectional survey included 512 students from Kauno Kolegija Higher Education Institution. The survey assessed 39 attributes related to students’ learning difficulties and supporting measures. The nine scales, consisting of 39 items, demonstrated good internal consistency, with a Cronbach's alpha coefficient of 0.76. Due to the unequal and smaller sample sizes of attention deficit hyperactivity and autism spectrum disorders having students, non-parametric statistics (Kruskal-Wallis) were used. Spearman's correlation coefficient (R²) was used for correlation analysis. Results. Nearly a quarter of the students associate their neurodiversity with ADHD, with 22.3 % suspecting they have the condition and 2 % noted that this is confirmed. 4.7% of students consider themselves to be on the autism spectrum disorder (ASD), with 0.6% having a confirmed diagnosis. Statistically significant differences were identified in the relationship between ADHD and attention difficulties at home, college, sensory sensitivity and specific learning difficulties (p ≤ 0.05). ADHD and ASS suspected of having students tend to have lower grade point average (GPAs). Students who suspect or confirm having ADHD express a higher preference for organizational tools compared to those without ADHD, with a significant difference (p ≤ 0.05). Preferences for explanations and illustrations are higher among those suspecting ADHD (p ≤ 0.05). The analysis of expectations from lecturers and organization concerning ASD shows minimal variation among groups (p≥0.05). Conclusions. Neurodiversity among students is a relevant phenomenon that is associated with learning difficulties that interfere with achieving good learning outcomes. However, the role of the teacher and organization is exclusively relevant for the ADHD student group. For ASD students and neurotypical students, universal approaches are appropriate.&lt;/span&gt;&lt;/p&gt;&lt;div&gt;&lt;span&gt;&lt;br /&gt;&lt;/span&gt;&lt;/div&gt;

Individualized metering and the influence of other endogenous and exogenous factors on water consumption in social housing

ABSTRACT Individual water metering allows consumers to pay for the water volume actually consumed, promoting the efficient use of water resources. This case study aims to evaluate the impact of consumption billing based on individual water meters in a social housing complex in the city of Joinville, southern Brazil. The residential complex under study consists of 20 four-story buildings with four units per floor, each with a floor area of 40.17 m2. Statistical analyses were conducted in 158 households, whose residents agreed to participate in the interview stage. Data were collected over a period of 1,429 days and until 21 August 2020. The water billing system was initially based on a collective consumption meter, with subsequent apportionment of the consumption charges between the households. An individual billing system was then implemented, using one water consumption meter per household. The impact of individual water billing on the water consumption data from the households in the sample was analyzed using descriptive statistics, Wilcoxon–Mann–Whitney nonparametric test, and Prais–Winsten regression model. The results showed that the water billing system influences the per capita water consumption in the social housing complex under analysis.

Optimising Physical Training in DanceSport by Using HIIT Training and Smart Devices for Monitoring Physical Activity

&lt;p dir="ltr"&gt;&lt;span&gt;This study investigates the effectiveness of High-Intensity Interval Training (HIIT), specifically for Tabata, combined with smart monitoring devices on adult dancesport practitioners' physical fitness and performance. The primary objective was to assess the impact of these interventions on key physical parameters and overall performance. Forty participants were divided into two groups: an experimental group (n=20) that engaged in Tabata training three times a week while using smart devices to monitor their activity, and a control group (n=20) that continued with their regular training routines. The experimental group showed significant improvements in aerobic and anaerobic capacity, agility, and overall motor performance throughout the study. These enhancements were measured using standardized physical assessments and the Mann-Whitney non-parametric test, confirming statistically significant progress in the experimental group compared to the control group. Integrating smart devices was crucial in maintaining and enhancing participant motivation, providing real-time feedback, facilitating goal-setting, and allowing for progress tracking, contributing to increased responsibility and engagement in physical activity. Participant feedback highlighted the motivational benefits of smart technology, consistent with existing literature. The immediate performance data and synchronization with fitness apps enhanced the training experience, promoting continuous improvement and long-term commitment. The findings indicate that combining Tabata training with smart monitoring devices effectively improves the physical and technical performance of adult dancesport practitioners. This dual approach enhances physical conditioning and also ensures training relevance to the specific demands of dancesport, maintaining both aesthetic and functional performance aspects. In conclusion, using HIIT, specifically Tabata, alongside smart devices, offers a powerful methodology for optimizing dancers' physical preparation. Future research should investigate the long-term impacts of these training programs, integrate different forms of HIIT, and include a broader participant demographic to validate and expand these findings.&lt;/span&gt;&lt;/p&gt;&lt;div&gt;&lt;span&gt;&lt;br /&gt;&lt;/span&gt;&lt;/div&gt;

Plasma ferritin, C-reactive protein, and adenosine deaminase levels in tuberculous lymphadenitis and pleuritis and their role in monitoring treatment response

BackgroundWe aimed to assess the plasma levels of ferritin, C-reactive protein (CRP), and adenosine deaminase (ADA) at baseline and their utility as biomarkers to monitor response to treatment in extrapulmonary tuberculosis (EPTB) patients.MethodsProspective measurements of ferritin, CRP, and ADA were done in unstimulated plasma samples of 92 EPTB (49 TB lymphadenitis and 43 TB pleuritis) patients registered for anti-TB treatment. Blood samples were taken at the start, 2, and 6 months of treatment, plasma levels of ferritin and CRP were measured by the enzyme-linked immunosorbent assay and ADA levels by kinetic chemistry method at each time point. Data was analyzed using SPSS version 22. Non-parametric tests were used for paired analysis and two groups’ comparison. Spearman’s rank test was used for correlation analysis. A Chi-square test was used for categorical variables. A p-value < 0.05 was considered statistically significant.ResultsBefore the start of treatment, plasma levels of ferritin were raised in 13% and 45%, CRP in 21% and 64%, and ADA in 70% and 60% of TB lymphadenitis and pleuritis cases respectively. Levels of all three biomarkers with raised values at baseline decreased significantly with treatment at both 2 and 6 months in all patients. [Ferritin (2 months p = 0.001, 6 months p < 0.001), CRP (2 months p < 0.001, 6 months p < 0.001), ADA (2 months p = 0.039, 6 months p < 0.004)]. Plasma levels of ferritin (median 300 ng/ml range = 145–758 ng/ml) and CRP (median 11.73 mg/L, range = 10.45–17.84 mg/L) were significantly higher in TB pleuritis patients, while the levels of ADA were not significantly different among the two groups. Biosignatures generated by different combinations showed that a combination of all three biomarkers could predict treatment response in 83% and 100% of all patients at 2 and 6 months of treatment respectively.ConclusionA combination of serum ferritin, CRP, and ADA shows a promising role in monitoring response to treatment in TB lymphadenitis and TB pleuritis patients. Similar studies in larger cohorts are needed to establish a definite role of these biomarkers in EPTB patients.

Psychological Symptom Cluster Severity Profiles Are Associated With Higher Levels of Stress and Worse Quality of Life in Postmenopausal Women With Breast Cancer.

Although common, the severity of the psychological symptom cluster (PSC) (ie, co-occurrence of anxiety, depression, fatigue, sleep disturbance) varies among women with breast cancer. In addition, the impact of various types of stress and other risk factors on its severity are understudied, and the influence of the PSC on quality of life (QOL) outcomes remains poorly characterized. To identify subgroups of postmenopausal women with breast cancer with distinct PSC severity profiles following surgery and evaluate whether these subgroups differed in terms of demographic and clinical characteristics, symptoms, social and posttraumatic stress, and QOL. Following surgery, 159 postmenopausal women with early-stage, hormone receptor-positive breast cancer completed assessments of anxiety, depression, fatigue, sleep disturbance, cognitive function, physical symptoms, stress, and QOL. Latent profile analysis was used to identify subgroups of women based on the severity of the prespecified PSC. Parametric and nonparametric tests were used to evaluate for subgroup differences. Three distinct PSC severity subgroups were identified (ie, Lower [71.7%], Moderate [23.9%], Higher [4.4%]). Compared with the Lower subgroup, the Moderate subgroup was less likely to have received prior radiation, and the Moderate and Higher subgroups had worse perceived cognitive function, higher symptom burden, higher posttraumatic stress, and lower QOL. Clinically relevant sleep disturbance was common across PSC subgroups. PSC severity is associated with higher posttraumatic stress and poorer QOL following breast surgery. Sleep disturbance is a common problem and may be undertreated. Assessments of posttraumatic stress and sleep disturbance are needed for timely intervention.

Effects of Medical Material-Based Play Therapy on Pain Levels in Hospitalized Preschool Children Aged 3-6 Years

Introduction: Pain is a stressor of hospitalization that, if not managed properly, can have physical and psychological impacts on children. One intervention that can be provided to reduce pain in preschool-aged children is play therapy. Objective: This study aims to determine the effect of play therapy using medical materials on the pain levels of hospitalized preschool-aged children. Method: This study uses a pre-experimental design with a one group pretest-posttest design approach. The number of respondents in this study was 25 preschool-aged children who were treated in the Dahlia Pediatric Ward at TK. II R. W. Mongisidi hospital Manado, selected using purposive sampling based on inclusion criteria. Pain measurement was carried out using the Wong Baker FACES Pain Rating Scale. Data analysis was performed using the Nonparametric Wilcoxon test. Results: The Wilcoxon statistical test results showed a p-value of 0.000 (p&lt;0.05), indicating a significant difference in pain levels before and after the play therapy intervention using medical equipment. Conclusion: Based on the analysis, it can be concluded that there is an effect of play therapy using medical materials on the pain levels of hospitalized preschool-aged children. Future researchers interested in this study are encouraged to use a quasi-experimental method with a two-group pretest-posttest design.

Comparative Evaluation of Multi‐Criteria Decision Making Methods for River Hydromorphology Assessment: Case Study of the Saz‐Çayırova Basin, Türkiye

ABSTRACTHydromorphology plays a crucial role in the sustainable management of water resources. It relies on numerous measures based on both qualitative and quantitative observations. The density of data complicates the decision‐making and evaluation processes concerning hydromorphological alterations. This study aims to develop a hydromorphological monitoring methodology for the sustainable management of a river basin subjected to industrial and urban density by analytically evaluating decision‐making approaches. Multi‐criteria decision‐making approaches have been designed to gather and consistently evaluate expert opinions, facilitating the examination of various external factors that impact hydromorphology and integrating these into the decision‐making processes. In this study, three important multi‐criteria decision‐making approaches were compared: the analytical hierarchy process, the best–worst method, and the Fuzzy analytical hierarchy process. Minimum violation, total deviation, and nonparametric tests were used to determine statistically significant differences among the three approaches and to identify the most effective method. Their impacts on hydromorphology were tested on a river network experiencing industrial and urban pressures. Although the results were similar in representing hydromorphology, the best–worst method proved to be statistically more consistent than the other two approaches.

In vivo reduction of biofilm seeded on orthopaedic implants.

Electromagnetic induction heating has demonstrated in vitro antibacterial efficacy over biofilms on metallic biomaterials, although no in vivo studies have been published. Assessment of side effects, including thermal necrosis of adjacent tissue, would determine transferability into clinical practice. Our goal was to assess bone necrosis and antibacterial efficacy of induction heating on biofilm-infected implants in an in vivo setting. Titanium-aluminium-vanadium (Ti6Al4V) screws were implanted in medial condyle of New Zealand giant rabbit knee. Study intervention consisted of induction heating of the screw head up to 70°C for 3.5 minutes after implantation using a portable device. Both knees were implanted, and induction heating was applied unilaterally keeping contralateral knee as paired control. Sterile screws were implanted in six rabbits, while the other six received screws coated with Staphylococcus aureus biofilm. Sacrifice and sample collection were performed 24, 48, or 96 hours postoperatively. Retrieved screws were sonicated, and adhered bacteria were estimated via drop-plate. Width of bone necrosis in retrieved femora was assessed through microscopic examination. Analysis was performed using non-parametric tests with significance fixed at p ≤ 0.05. The width of necrosis margin in induction heating-treated knees ranged from 0 to 650 μm in the sterile-screw group, and 0 to 517 μm in the biofilm-infected group. No significant differences were found between paired knees. In rabbits implanted with sterile screws, no bacteria were detected. In rabbits implanted with infected screws, a significant bacterial load reduction with median 0.75 Log10 colony-forming units/ml was observed (p = 0.016). Induction heating was not associated with any demonstrable thermal bone necrosis in our rabbit knee model, and might reduce bacterial load in S. aureus biofilms on Ti6Al4V implants.

Analysing inflammatory responses after mandibular third molar extraction: a comparison of suture-less and multiple suture techniques.

This study aims to compare the outcomes of suture-less and multiple suture closure methods on postoperative pain, swelling, and trismus, and associated complications. This prospective, randomized clinical trial was conducted at the Department of Oral & Maxillofacial Surgery, Goa Dental College & Hospital. Inclusion criteria encompassed subjects aged between 17 and 55 years, classified as American Society of Anaesthesiologists (ASA) I, with asymptomatic impacted third molars falling within the moderately difficult impaction range (Pederson's difficulty index: 5-7). Study excluded individuals classified as ASA II, III, or IV, those with known or suspected allergies to the anaesthetic solution, immunocompromised patients, and individuals taking medications that could affect healing. Pregnant or lactating females and those with a history of bleeding disorders were also excluded. Wound closure methods were compared: Group A underwent primary closure with silk sutures, while Group B had suture-less closure. Subjects were allocated to the specific groups using a simple randomization method. This involved using a lottery-based random sequence to assign each participant to either Group A or Group B. Pain intensity, facial swelling, and trismus were key outcomes. Secondary outcomes included lingual nerve sensation and postoperative complications. Demographics factors, surgical details, radiographic and perioperative data, and physiological parameters were considered. Non-parametric tests and parametric test (repeated measure ANOVA) were employed. Statistical significance was set at P < 0.05. Among 101 participants, both closure techniques exhibited similar outcomes in pain, swelling, and lingual nerve function. However, suture-less closure resulted in significantly less trismus and fewer cases of delayed wound healing. Suture-less method after surgical removal of third molar may reduce trismus compared to multiple sutures. While pain, swelling, and lingual nerve function management were comparable.

Trend analysis of hydrometeorological parameters and reservoir level of Tarbela reservoir, Pakistan

This study identified the trends in monthly temperature, precipitation, &amp; evaporation for Astore, Darosh, Gilgit, Gupis and Skardu and trends in inflow, outflow and reservoir level for Tarbela reservoir. Two non-parametric tests i.e. Man-Kendall and Sen’s Slope and Innovative Trend Analysis (ITA) were used to determine the trend. The first Mann-Kendall test with a significance level 5% was applied to 33-year data of five selected areas from 1990-2022. The results showed an increasing trend in temperature in March for all selected areas. No significant trend was observed in precipitation except negative trends for Darosh in March, May and December and positive trend for Gilgit in January and September. It has been observed that the trend direction given by ITA and Mann-Kendall is similar. Inflows to reservoir were found directly related to the temperature because of glacier melt in rising temperature, thus increasing the inflow, although the precipitation was found decreasing with increase in temperature. Altered snowmelt patterns can influence weather systems, potentially contributing to more extreme weather events.

Combination of granulocyte–monocyte apheresis and ustekinumab: Multicentre and retrospective study

ObjectiveGranulocyte–monocyte apheresis (GMA) has shown to be safe and effective in ulcerative colitis (UC), also in combination with biologics, mainly with anti-TNF. The aim of this study was to evaluate the efficacy and safety of combining GMA after primary non-response (PNR) or loss of response (LOR) to ustekinumab (UST) in patients with UC. Patients and methodsA retrospective study was performed in 12 IBD Units, including all patients with refractory UC or unclassified IBD (IBD-U) who received combined GMA plus UST. The number and frequency of GMA sessions, filtered blood volume and time of each session were registered. Efficacy was assessed 1 and 6 months after finishing GMA by partial Mayo score, C-reactive protein (CRP) and fecal calprotectin (FC). Descriptive statistics and non-parametric tests were used in the statistical analysis. ResultsSeventeen patients were included (15 UC, 2 IBD-U; median age 47 years [IQR, 35–61]; 59% male; 53% E3). Most patients (89%) had prior exposure to anti-TNF agents and 53% to vedolizumab; 65% were also receiving steroids at baseline. Median partial Mayo score at baseline was 6 (IQR, 5–7) and it significantly decreased after 1 and 6 months (p=0.042 and 0.007, respectively). Baseline FC significantly decreased after 6 months (p=0.028) while no differences were found in CRP. During follow-up, 18% patients started a new biologic therapy and 12% required surgery; 64% of patients under steroids were able to discontinue them. Adverse events were reported in one patient. ConclusionGMA can recapture the response to UST in selected cases of UC after PNR or LOR to this drug.

The Effectiveness of Focus of Attention in Static Balance and Functional Ability of Chronic Ankle Instability: A Pilot Study

Objectives: The focus of patients’ attention during the physiotherapy program has been reported to affect the rehabilitation goals. The study aimed to investigate the effectiveness of an external focus of attention (EFA) on static balance and functional ability in individuals with chronic ankle instability (CAI). Methods: Fourteen subjects with CAI, aged from 19 to 25 years, were randomly assigned to two groups: external and internal focus of attention (IFA) group. The outcome measures of the study were static balance and functional ability. A pre-intervention evaluation was performed. Following instructions to an external or an IFA, subjects practiced on a balance board 3 times per week for 4 weeks. At the end of each week, they performed evaluation tests, including a time balance test, foot lift test, side hop test, figure-8 test, and star excursion balance test (SEBT). Parametric (mixed analysis of variance) and non-parametric analysis (the Mann–Whitney and Friedman tests) were performed between measurements and groups. Results: The intervention program showed a statistically significant improvement in static balance and functional ability in both groups. The results indicated the main effect of time (F(2.488, 29.855)=43.880, P&lt;0.001). For the time in balance test, analysis of variance revealed a main effect of time (F(2.571, 30.855)=11.188, P&lt;0.001). Regarding the SEBT, every direction indicated a main effect of time for both groups. No significant differences between the two groups were found in static balance and functional ability. Discussion: Even though there were no statistically significant differences between the two groups, both types of focus of attention contributed to the improvement of static balance and functional ability, which may reveal an increase in motor control and neuromuscular ability of the subjects with CAI.

The dynamic connectedness between oil price shocks and emerging market economies stock markets: Evidence from new approaches

This paper uses the dynamic connectedness framework to investigate the interrelationship between the decomposed oil supply, demand and risk shocks that Ready (2018) developed and the stock market returns of emerging market economies. For this purpose, we use daily data from 11 October 2001 to 5 April 2021. Novel empirical methodologies, including wavelet quantile correlation (WQC), cross-quantilogram analysis, nonparametric causality-in-quantile approaches, contemporaneous R2 connectedness approach and generalized R2 connectedness approaches, are employed. The results show that oil price fluctuations significantly impact the economic performance of emerging market economies, reflecting historical events. Demand price shocks are regarded as net transmitters within the system, whereas supply and risk price shocks are net receivers of spillovers. Concurrently, our findings indicate a considerable degree of dynamic connectedness among the stock markets of emerging market economies. In particular, the stock markets of Brazil, Mexico, and Argentina have been identified as net transmitters of spillovers. In contrast, the stock markets of Turkey, South Korea, Malaysia, Indonesia and India are classified as net receivers of spillovers. Furthermore, we examine and document the advantages of diversified portfolios that include all sector indices, including oil price shocks and emerging market economy stock markets, in terms of portfolio performance. The insights offered here are valuable for investors and policymakers striving to enhance their strategic approaches in today's interconnected global financial context. The results show that oil price fluctuations significantly impact the economic performance of emerging market economies and reflect historical events. Demand shocks affecting the stock market indices of Brazil, Argentina and Mexico tend to act as net spillover transmitters. In contrast, supply shocks affecting the stock market indices of Indonesia, South Korea, India, Turkey and Malaysia mainly act as net spillover receivers. Net pairwise interconnectedness analysis reveals that, except for crisis periods, interactions between financial markets or macroeconomic indicators are evenly distributed. Thus, systemic risk is lower, and markets act independently. Empirical findings obtained using WQC generally show the presence of negative correlations at long-time scales and low quantiles, which is considered an indicator of the safe-haven feature associated with the asset in question. The hedge feature is observed to be evident only at long time scales. The results of the cross-quantilogram analysis show mixed evidence of correlation in all stock indices, especially in the weekly lag structure, compared to daily and monthly lags. Finally, non-parametric Granger causality test results show that stock returns are insensitive to oil price fluctuations, making these markets attractive for investors seeking diversification strategies. These findings provide valuable recommendations for investors seeking sustainable equities in a volatile oil market.

Trend analysis and change-point detection of temperature and rainfall in southern Peruvian Amazon and its relation to deforestation

The study aimed to identify the change points, tendencies, and trends in climatic parameters (precipitation and temperatures) and to investigate their relationship with deforestation in the southeastern Peruvian Amazon (Tambopata). Rainfall and temperature data for the Puerto Maldonado station from 1970 to 2023 was used. Monthly, seasonal, and annual precipitation as well as temperature (maximum, minimum, and mean) were analyzed for possible trends using nonparametric Mann-Kendal statistic test, while the Pettitt test was employed to detect the abrupt change point in time series. The Spearman's correlation coefficient was used to identify the relationship between deforestation and climate parameters. The results revealed a rise in mean, minimum, and maximum temperatures. Mann Kendall and Sen’s slope revealed significant trends in the monthly, seasonal and annual temperatures in the study period. However, in contrast to the temperature variation trend, the monthly, seasonal and annual precipitation did not present a significant trend. Significant positive correlations were obtained between deforestation and temperatures but its association with precipitation was not significant.

Middle School Teachers’ Implementation and Perceptions of Automated Writing Evaluation

Despite research supporting the efficacy of Automated Writing Evaluation (AWE) in improving writing outcomes, inconsistent implementation by teachers raises concerns about the efficacy of these systems in practice. However, little is known about what factors influence teachers’ implementation and perceptions of AWE. This study examined the relationship between teachers’ implementation and perceptions of the MI Write AWE system, seeking to identify actionable factors that could enhance AWE implementation and acceptance in the future. A mixed-methods design was utilized, combining quantitative analysis of usage logs and survey data with qualitative insights from focus groups and interviews with 19 teachers who participated in a randomized controlled trial (RCT) testing the efficacy of MI Write on students’ writing outcomes. Quantitative data were subjected to descriptive and non-parametric statistical analyses, while qualitative data underwent a deductive coding process, offering an integrated view of MI Write's use and educators’ perceptions. Teachers implemented MI Write variably and not to the extent expected of them within the RCT, but they did report generally positive attitudes towards MI Write. Findings indicated that positive perceptions of system usability and usefulness may be insufficient to promote effective implementation. Instead, ecological factors such as curricular alignment and the challenge of incorporating AWE into existing workload, administrative support, and broader social and educational policy appeared as factors influencing implementation. Findings emphasize that teachers’ implementation and perceptions of AWE are dependent on a range of contextual elements beyond mere system functionality, suggesting that successful adoption requires addressing broader ecological considerations.

Investigation of Clinical Features, EEG Findings, and Brain Imaging in Psychiatric Patients With Epilepsy at Razi Psychiatric Hospital

Objectives: This study aimed to assess the clinical features, Electroencephalography (EEG) findings, and brain imaging results in psychiatric patients diagnosed with epilepsy at Razi Psychiatric Hospital. Methods: This retrospective descriptive-analytical study was carried out on patients with epilepsy and psychiatric disorders admitted to Razi Psychiatric Hospital over two years. A total of 94 patient files seizure and epilepsy comorbidity, recorded in the hospital’s health information system (HIS), were reviewed. Data collection involved a demographic checklist and an epilepsy scale; the latter, developed by DiIorio, Colleen, et al., encompassed personal characteristics, mental disorders, epilepsy, and seizures. The Kruskal-Wallis and Mann-Whitney non-parametric tests were utilized to compare the mean scores of variables, with SPSS software, version 21 facilitating the analysis. Results: Out of 94 patients with seizure and epilepsy, 9.6% had focal seizure, 26.6% had generalized epilepsy, 36.1% had focal-generalized seizure, and 26.8% had unknown seizure. About 12% had a structural etiology, while the remaining 88% had an etiology that remained unidentified. Conclusion: The findings indicate that epilepsy, affecting individuals from adolescence through to old age, can lead to psychiatric disorders. For many patients, the etiology of their condition remains elusive, and EEG findings and brain imaging appear normal in the majority of cases.

Circadian rhythms and objective measures of physical activity among middle-aged and older adults in Taiwan

BackgroundTo identify the association between daytime activity with objectively monitor and subjective variables at a different time-zone of day as well as the sex differences. MethodsParticipants aged 50 years and older living in the community in Taiwan were recruited. The activity was measured by wearable actigraphy devices, diaries, and self-reported questionnaires. The study used nonparametric analysis to examine the association between mean activity level and demographic and subjective measurement variables. ResultsAmong the 55 participants enrolled in the study, data of 34 (62 %) participants who meet the criteria that wore a wearable actigraphy device for at least 7 completed days were analyzed. There is no significant relationship between each demographics and subjective measurement variables. However, actigraphy counts are significantly related to female's nutrition (Z = -2.367, p = 0.017*), and male's retirement status (Z = -2.132, p = 0.033*). ConclusionsThe activity in morning is highest of the day with significant correlation to evening activities. Moreover, actigraphy counts that indicating objective measure of physical activity in female is significantly related to physiological variables (nutritional status), while male are predicted by social variables (retired status).