Nonparametric Research Articles

Discovery of the Lipopeptides Albubactins A-H from Streptomyces albidoflavus RKJM0023 via Chemical Elicitation with Rhamnolipids and Synthesis of Albubactin A.

The marine tunicate-derived Streptomyces albidoflavus RKJM0023 was cultured in the presence of a rhamnolipid mixture in an effort to elicit the production of silent natural products. MS/MS-based molecular networking analysis enhanced with nonparametric statistics highlighted the upregulation of a molecular cluster (Kruskal-Wallis p = 1.6 e-6 for 1) in which no MS/MS features had library matches. Targeted isolation of these features resulted in the discovery of nine new N-acylated lipopeptides, albubactins A-H (1-8) each containing a unique glutamine tripeptide and a C-terminal ethyl ester moiety. Three related albubactin acids A-C (9-11) lacking the ethyl ester were also identified. NMR spectroscopy and UPLC-HR-ESI-MS/MS demonstrated that the albubactins were obtained as mixtures that shared a common m/z and differed only in their acylated terminal groups. Due to the complex spectroscopic elucidation with many overlapping shifts, a total synthesis of albubactin A (1) was completed and used to determine the absolute configuration of the new albubactins.

Quality of nutritional uptake of community-dwelling, care-dependent older adults in Zurich

Objective: This study evaluated the quality of nutritional uptake of the care-dependent, community-dwelling older adults.Methods: Community-dwelling care-dependent elders were recruited in this study. The food items along with their nutritional content were extracted from the participants’ refrigerators and categorized according to the NOVA classification (G1: unprocessed/minimally processed; G2: processed culinary ingredients; G3: processed; G4: ultra-processed). The nutritional information of the food items was entered into a dietary analysis software that analyzed the content. Data was verified for a normal distribution and non-parametric tests were applied for statistical analysis (p < 0.05).Results: 100 subjects (mean age = 81.1±9.5 y; mean MMSE: 26.6±6.8) participated in this study. The participants had significantly more G1 than G2, G3 or G4 (p < 0.001) foods. Women had more G1 items in their refrigerators than men (rs = 0.372, p < 0.001). Higher socio-economic status indicated a presence of more G1 (rs = 0.313, p = 0.002), G2 (rs = 0.342, p < 0.001) and G4 (rs = 0.237, p = 0.024) foods.Higher cognitive scores revealed an increase in presence of G4 (rs = 0.238, p = 0.023) items. Participants with an increased need for assistance had less G2 (rs = -0.332, p = 0.001), and G4 (rs = -0.215, p = 0.041) foods; age had no influence.Conclusion: The findings of this study confirm that the majority of care-dependent, community-dwelling adults procured healthy dietary aliments for their daily living; however, whether this correlated to the actual nutritional state of these older adults needs to be further investigated. This highlights the need for further investigation and tailored interventions to ensure good nutrition, emphasizing regular assessments and comprehensive support beyond just food access.Clinical relevance: Clinicians must recognize that access to healthy food alone may not ensure good nutrition in older adults. Regular nutritional assessments, personalized dietary interventions, and additional support services like meal preparation assistance, nutritional counseling, and tailored programs are essential to address specific dietary needs and preferences.

Effects of AR-HMD Interactive Interface Layout on Usability and Obstacle Avoidance in Subway Overhauls

The maintenance and overhaul of rail transit vehicle frames are vital for ensuring the safe and reliable operation of equipment. AR-based maintenance has been proven to be cost-reducing and effective. Few studies explored the application of AR-based maintenance on subway overhaul. In this study, 74 participants were selected to conduct the underground maintenance AR recognition and obstacle avoidance experiment. And two-factor ANOVA, independent samples t-test, and non-parametric test were used for data statistics. The results show that a high-opacity AR interface has better recognition but affects obstacle avoidance. Facing different types of obstacles, AR interfaces with different layouts have significant differences in terms of recognizability and obstacle avoidance effects. Compared with the list layout, the matrix layout AR interface will make more effort for workers. The findings provide useful references for designing the visual information layout of AR interfaces and conducting usability testing of AR interfaces in complex scenarios such as underground maintenance. Highlights This study assessed the effects of the AR-HMD interface on workers’ recognition of and ability to safely avoid obstacles in a subway maintenance environment. A high-opacity AR interface leads to better recognition but affects obstacle avoidance. List AR interfaces lead to better recognition but increase the probability of obstacle avoidance failure by 50% under block obstacles. For linear obstacles, layout has no significant effect on recognition or obstacle avoidance. A matrix layout AR interface is more effortful than the list layout AR for the workers.

Analyzing the Evolution of Needle and Ultrasound Probe Manipulation Skills of Interventional Radiology Trainees With Time and Experience.

To test the hypothesis that hand motion analysis can measure the progression of needle and ultrasound probe manipulation skills of interventional radiology trainees in central venous line placement. An expert cohort of 6 interventional radiologists and 4 anesthesiologists and a trainee cohort of 6 novice trainees (<50 central lines) and 5 experienced trainees (>50 central lines) performed simulated central venous access. Four novices and 1 experienced trainee repeated the task 1 year later. An electromagnetic motion tracking system tracked the needle hand and ultrasound probe. Path length, translational, and rotational movements were calculated separately for the needle hand and probe sensor. These metrics were used to calculate motion metrics based scores on a scale of 0 to 3 for each sensor. Nonparametric statistics were used, and the data are reported as median ± interquartile range. Comparing novice and experienced trainees, there was a significant difference in probe scores (experienced vs. novice: 1 ± 2 vs. 0 ± 0, P = 0.04) but not in needle-hand scores (1 ± 1.5 vs. 0 ± 1, P = 0.26). Trainees showed a significant increase in probe scores at the 1-year follow-up (baseline vs. follow-up: 0 ± 1 vs. 2.5 ± 1.8, P = 0.003), but no significant difference was observed in the needle manipulation metrics. Experts differed significantly from experienced trainees for all metrics for both sensors (P < 0.05), with the exception of the path length of the probe. Acquisition of improved dexterity of the probe may occur before improvement in the dexterity with the needle hand for interventional radiology trainees.

Exploring the content of epilepsy fellowship program websites: an analysis of information available to applicants

BackgroundProgram websites are essential resources in the process of residency and fellowship application. We evaluated the information furnished on these resources by Epilepsy fellowship programs. The extent of information provided was compared across geographic zones, academic affiliation, and national ranking.MethodsA list of Epilepsy fellowship programs was derived from the Fellowship and Residency Electronic Interactive Database (FREIDA). Links to program websites were obtained directly from FREIDA or using Google’s search engine. Online data was categorized to reflect program information, education, recruitment, compensation, epilepsy center-specific information, and social media presence. Data points under each category were collected to develop a standardized scoring system. The frequency of criterion present was compared across geographic zones, academic affiliation, and national ranking using parametric and non-parametric statistical tests. Significance was determined at a p-value ≤ 0.05 for all cases. The study utilized IBM SPSS version 28 and Python 3.11.3.ResultsWe analyzed 80 Epilepsy fellowship programs. The most reported feature was the program director’s name and email (100.0%). The least reported features included board pass rates (1.3%), preparatory boot camp (8.8%), and post-fellowship placements (11.3%). Programs were found to be well-represented on X (88.8%), Facebook (81.3%), and Instagram (71.3%). Most (85.0%) of the programs were searchable through Google. The scores for program information, education, recruitment, compensation, epilepsy center-specific information, and social media visibility did not significantly vary based on location, academic affiliation, or rank status.ConclusionsOur results demonstrate that despite an online presence, there is much room for improvement in the content available to the applicant. To improve the Match process and attract a roster of well-informed fellows, Epilepsy fellowship programs should furnish program websites with up-to-date information relevant to program information, education, recruitment, compensation, and epilepsy center-specific information.

Analysis of lymph node metastasis and survival prognosis in early gastric cancer patients: A retrospective study.

Early gastric cancer (EGC) is a common malignant tumor of the digestive system, and its lymph node metastasis and survival prognosis have been concerning. By retrospectively analyzing the clinical data of EGC patients, we can better understand the status of lymph node metastasis and its impact on survival and prognosis. To evaluate the prognosis of EGC patients and the factors that affect lymph node metastasis. The clinicopathological data of 1011 patients with EGC admitted to our hospital between January 2015 and December 2023 were collected in a retrospective cohort study. There were 561 males and 450 females. The mean age was 58 ± 11 years. The patient underwent radical gastrectomy. The status of lymph node metastasis in each group was determined according to the pathological examination results of surgical specimens. The outcomes were as follows: (1) Lymph node metastasis in EGC patients; (2) Analysis of influencing factors of lymph node metastasis in EGC; and (3) Analysis of prognostic factors in patients with EGC. Normally distributed measurement data are expressed as mean ± SD, and a t test was used for comparisons between groups. The data are expressed as absolute numbers or percentages, and the chi-square test was used for comparisons between groups. Rank data were compared using a nonparametric rank sum test. A log-rank test and a logistic regression model were used for univariate analysis. A logistic stepwise regression model and a Cox stepwise regression model were used for multivariate analysis. The Kaplan-Meier method was used to calculate the survival rate and construct survival curves. A log-rank test was used for survival analysis. Analysis of influencing factors of lymph node metastasis in EGC. The results of the multifactor analysis showed that tumor length and diameter, tumor site, tumor invasion depth, vascular thrombus, and tumor differentiation degree were independent influencing factors for lymph node metastasis in patients with EGC (odds ratios = 1.80, 1.49, 2.65, 5.76, and 0.60; 95%CI: 1.29-2.50, 1.11-2.00, 1.81-3.88, 3.87-8.59, and 0.48-0.76, respectively; P < 0.05). Analysis of prognostic factors in patients with EGC. All 1011 patients with EGC were followed up for 43 (0-13) months. The 3-year overall survival rate was 97.32%. Multivariate analysis revealed that age > 60 years and lymph node metastasis were independent risk factors for prognosis in patients with EGC (hazard ratio = 9.50, 2.20; 95%CI: 3.31-27.29, 1.00-4.87; P < 0.05). Further analysis revealed that the 3-year overall survival rates of gastric cancer patients aged > 60 years and ≤ 60 years were 99.37% and 94.66%, respectively, and the difference was statistically significant (P < 0.05). The 3-year overall survival rates of patients with and without lymph node metastasis were 95.42% and 97.92%, respectively, and the difference was statistically significant (P < 0.05). The lymph node metastasis rate of EGC patients was 23.64%. Tumor length, tumor site, tumor infiltration depth, vascular cancer thrombin, and tumor differentiation degree were found to be independent factors affecting lymph node metastasis in EGC patients. Age > 60 years and lymph node metastasis are independent risk factors for EGC prognosis.

Correction to: Integrated statistical and graphical non-parametric trend analysis of annual and seasonal rainfall in the Shire River Basin, Malawi

Correction to: Integrated statistical and graphical non-parametric trend analysis of annual and seasonal rainfall in the Shire River Basin, Malawi

Radiologists’ perceptions on AI integration: An in-depth survey study

PurposeTo assess the perceptions and attitudes of radiologists toward the adoption of artificial intelligence (AI) in clinical practice. MethodsA survey was conducted among members of the SIRM Lombardy. Radiologists’ attitudes were assessed comprehensively, covering satisfaction with AI-based tools, propensity for innovation, and optimism for the future. The questionnaire consisted of two sections: the first gathered demographic and professional information using categorical responses, while the second evaluated radiologists’ attitudes toward AI through Likert-type responses ranging from 1 to 5 (with 1 representing extremely negative attitudes, 3 indicating a neutral stance, and 5 reflecting extremely positive attitudes). Questionnaire refinement involved an iterative process with expert panels and a pilot phase to enhance consistency and eliminate redundancy. Exploratory data analysis employed descriptive statistics and visual assessment of Likert plots, supported by non-parametric tests for subgroup comparisons for a thorough analysis of specific emerging patterns. ResultsThe survey yielded 232 valid responses. The findings reveal a generally optimistic outlook on AI adoption, especially among young radiologist (<30) and seasoned professionals (>60, p<0.01). However, while 36.2 % (84 out 232) of subjects reported daily use of AI-based tools, only a third considered their contribution decisive (30 %, 25 out of 84). AI literacy varied, with a notable proportion feeling inadequately informed (36 %, 84 out of 232), particularly among younger radiologists (46 %, p < 0.01). Positive attitudes towards the potential of AI to improve detection, characterization of anomalies and reduce workload (positive answers > 80 %) and were consistent across subgroups. Radiologists’ opinions were more skeptical about the role of AI in enhancing decision-making processes, including the choice of further investigation, and in personalized medicine in general. Overall, respondents recognized AI’s significant impact on the radiology profession, viewing it as an opportunity (61 %, 141 out of 232) rather than a threat (18 %, 42 out of 232), with a majority expressing belief in AI’s relevance to future radiologists’ career choices (60 %, 139 out of 232). However, there were some concerns, particularly among breast radiologists (20 of 232 responders), regarding the potential impact of AI on the profession. Eighty-four percent of the respondents consider the final assessment by the radiologist still to be essential. ConclusionOur results indicate an overall positive attitude towards the adoption of AI in radiology, though this is moderated by concerns regarding training and practical efficacy. Addressing AI literacy gaps, especially among younger radiologists, is essential. Furthermore, proactively adapting to technological advancements is crucial to fully leverage AI’s potential benefits. Despite the generally positive outlook among radiologists, there remains significant work to be done to enhance the integration and widespread use of AI tools in clinical practice.

Spatiotemproal changes and hot spots of UTCI index over Iran

In this study, the Universal Thermal Climate Index (UTCI) gridded data from ECMWF (European Centre for Medium-Range Weather Forecasts) database was applied to assess the spatiotemproal changes in thermal comfort in Iran for 1990–2021. This index's monthly changes and trends have been determined, using the Mann-Kendall nonparametric test. Moran's I was used to compute the index's spatial autocorrelation, and the Getis-Ord Gi* statistic was used to calculate the index's hot and cold spots. The findings indicated that the majority of the country experiences thermal comfort condition from June to October. Furthermore, no location of Iran has recorded very hot or very strong heat stress. Moderate and strong heat stress has only been recorded in a few areas along the southern coasts from May to November. Most of the country experiences strong, moderate, or slight cold stress from January to May, as well as November and December. According to the Moran I autocorrelation index, the spatial pattern of UTCI in Iran is cluster throughout the year. Significant hot spots have also formed throughout the country's southern coasts, with limited spatiotemproal variability. Significant cold spots have also formed, with more temporal and spatial variability, along the Alborz and Zagros mountain ranges.

Detecting drug-resistant human cytomegalovirus mutations in liver transplant recipients: A study of the UL97 gene

Human cytomegalovirus (HCMV or HHV-5) is a member of the beta herpesvirus family and remains dormant for life after the initial infection. However, if conditions such as immunosuppression occur, the virus can become active again and lead to severe diseases. The incidence of disease in solid organ transplant (SOT) recipients is reduced by prophylactic use of ganciclovir (either intravenously or orally). This study aimed to determine the pattern of clinical mutations associated with the cytomegalovirus UL97 gene after treatment with ganciclovir and the effect of these mutations on disease progression in liver transplant recipients infected with Iranian HCMV strains. Six HCMV-positive liver transplant recipients were enrolled, comprising 3 (50.0 %) males and 3 (50.0 %) females. Sequence analysis and mutation detection were performed using Finch software (version 1.4.0) and the NCBI Nucleotide Blast database, whereas phylogenetic analysis was performed using MEGA X (version 10.0.5). Mann-Whitney U nonparametric test, Chi-square test, Spearman's correlation coefficient analysis, were employed for statistical analysis. The results of the study showed that two samples from two patients had mutations in the UL97 gene, and the viral load of the mutated samples decreased after administering antiviral medications. Furthermore, the phylogenetic tree demonstrated a close relationship between the Iranian HCMV strains and global reference sequences.

Vulnerability factors of snake bite patients in China

ObjectiveTo analyze the vulnerability factors of snakebite patients in China.MethodsMulti-stage random sampling was used as the main sampling method and snowball sampling as the auxiliary sampling method. The knowledge, attitude and behavior of snakebite among Chinese residents were investigated. Non-parametric test was used to compare the percentage differences in residents’ knowledge, attitude and behavior of snakebite, and generalized linear regression analysis was used to analyze the influencing factors, and the vulnerability factors of snakebite patients were comprehensively analyzed.ResultsA total of 6338 subjects were included in this study, of which 68.4% were males, and 58.6% were farmers, workers and service personnel. The median total score of knowledge, attitude, and behavior was 26 (22,36). The patients who were improperly treated after injury were ligation proximal to the affected area (23.43%), squeezing (21.82%), and oral and suction wounds (8.74%). Did not go to hospital due to poverty (1351 cases) and did not receive antivenom (2068 cases). There were 21.32% and 32.63%, respectively. Among 4270 patients injected with antivenom 30.7% were vaccinated within 2 h. Among the patients who went to the hospital for treatment (4987), 75.0% arrived at the hospital within 6 h; Among the 4,761 patients who made emergency calls, 37.4% were treated within 0.5 h.ConclusionsSnakebite patients in China have weak knowledge about snakebite, low awareness of medical treatment, lack of correct prevention and emergency treatment measures, dependence on folk remedies, poor housing and so on. In addition, there are low availability of antivenoms and unreasonable distribution of medical resources in some areas of China. Multisectoral and multidisciplinary cooperation should be developed to prevent and control snakebites in order to reduce the burden caused by snakebites.

Quality of life in children with erythropoietic protoporphyria: a case-control study.

Erythropoietic protoporphyria (EPP) is an inherited metabolic disease that causes painful phototoxic reactions, starting in childhood. Studies have shown a reduced quality of life (QoL) in adults with EPP, however, data on children with the disease are lacking. Since treatment for EPP is currently not registered for children, knowledge about their QoL is of crucial importance. In this prospective, case-control study, we included children from the Netherlands and Belgium diagnosed with EPP and matched to healthy controls. Previously collected EPP quality of life (EPP-QoL) data from matched adults with EPP were used. QoL scores, utilizing the Pediatric Quality of Life Inventory (PedsQL) and the disease-specific EPP-QoL, were collected. Scores range from 0 to 100, with higher scores indicating a higher QoL. Non-parametric tests were used to compare groups. A total of 15 cases, 13 matched healthy control children, and 15 matched adults with EPP were included. Children with EPP exhibited lower median scores in the PedsQL in both physical (cases: 87.5 (interquartile range [IQR] 77.7-96.1), controls: 99.2 [IQR 94.9-100.0], p = 0.03) and social (cases: 77.5 [IQR 69.4-86.3], controls: 97.5 [IQR 78.8-100.0], p = 0.04) domains compared to healthy children, although these differences were not statistically significant after correcting for multiple testing. The overall median EPP-QoL score for children was similar to adults with EPP (children: 44.4 [IQR 25.0-54.2], adults: 45.8 [IQR 25.7-68.1], p = 0.68). However, within the EPP-QoL subdomain on QoL, children were found to have significantly lower median scores (children: 16.7 [IQR 0.0-33.3], adults: 33.3 [IQR 33.3-62.5], p < 0.01). In conclusion, children with EPP experience a reduced QoL compared to both healthy children and adults with EPP. Ensuring treatment availability for this patient group is crucial for improving their QoL. We advocate the inclusion of children in safety and efficacy studies, to ensure availability of treatment in the future.

Factors influencing the occurrence of the House Sparrow Passer domesticus (Linnaeus, 1758) (Aves: Passeriformes: Passeridae) in Bhavnagar, Gujarat, India

The present study aims to understand key factors influencing the House Sparrow population across different habitat scales in Bhavnagar, Gujarat, India. Correspondingly, different variables such as changes in habitat composition, sound levels, and density of mobile phone base stations were considered with reference to the occurrence of the House Sparrows across the study area. During the study period (December 2016 to November 2018), the number of House Sparrows was recorded through point count without distance estimate method. Non-parametric tests were employed to assess variations in different variables and their correlation with the presence of House Sparrows, revealing that changes in local habitat composition significantly influence their occurrence. Shrubby vegetation, cowsheds, and old/traditional structures emerged as crucial predictors positively impacting House Sparrow’s presence, particularly in urban areas where suitable habitat patches are scarce due to urbanization and modern lifestyles. The decline in these habitats has significantly impacted House Sparrow populations. To counter this decline, implementing strategies like providing artificial nest sites is being considered. However, it’s crucial to ensure that there are adequate shelter and food resources available to effectively conserve the species.

Relationship of Demographic Profile to Satisfaction in Interprofessional Collaboration among Medical-Surgical Ward Nurses in Selected Hospitals of Shandong, China: A Cross-Sectional Study

With the spread of the concept of team medicine, active nurse-doctor collaboration is closely related to nursing quality. Nursing standards recognize that collaborative practice is a necessary condition for high-quality patient care, but many nurses are often reluctant to participate in interprofessional teams, indicating that challenges in nurse-doctor collaboration still exist. This study aimed to investigate the relationship between demographic data and nurse interprofessional satisfaction of medical and surgical nurses in tertiary hospitals in Shandong Province, and to provide a reference direction for improving teamwork. Methods: The research method was a cross-sectional study. Medical and surgical nurses in three tertiary hospitals in Shandong Province were surveyed. Medical and surgical nurses who were officially registered in the hospital and had been engaged in internal medicine or surgery for at least one year were selected. They were aged 18 to 45 years. The researchers used SPSS software to analyze the data, and descriptive statistics (frequency percentage distribution, mean score, and standard deviation) were used to present the satisfaction scores. If the data did not follow a normal distribution, nonparametric tests were used. Results: The average scores of the interprofessional collaboration satisfaction scale for the participating nurses were: "overall expectation" 2.67; "perception dimension of professional collaboration" 3.78; "The overall relationship satisfaction of professional cooperation" 3.83; "Communication and tolerance of interprofessional collaboration" 3.80; "Equality of interprofessional collaboration" 3.81; "Satisfaction with interprofessional collaboration" 2.98. The results of non-parametric tests showed that there was a significant difference between marriage and nurses' satisfaction with interprofessional collaboration (P&lt;0.05). Conclusion: The overall satisfaction of nurses with interprofessional collaboration in three tertiary hospitals in Shandong Province was generally average. The three hospitals should improve the management model and care about the mental health of nurses according to factors such as the marital status of nurses. Nurses should make a good distinction and plan between work and life to promote interprofessional collaboration.

Exploring Stroke Patients' Needs: A Cultural Adaptation and Validation of the Modified Needs Assessment Questionnaire in a Greek Context.

Stroke survivors often face diverse unmet needs highlighting the significance of identifying and addressing these needs to enhance rehabilitation outcomes and overall quality of life. This study aimed to validate the modified Needs Assessment Questionnaire (mNAQ) as a reliable and valid tool for assessing the needs of stroke patients in the Greek context. Additionally the research sought to identify potential differences in the assessment of stroke patients' needs based on their stroke phase and National Institutes of Health Stroke Scale (NIHSS) scores. A sample of 71 adult stroke survivors adhering to World Health Organization guidelines and providing autonomous consent participated in the study. The mNAQ comprising 141 items across 12 domains was utilized to evaluate stroke patients' needs. The NIHSS and Barthel Index (BI) were employed for functional independence and mobility assessment. Data analysis incorporated confirmatory factor analysis, exploratory factor analysis and Cronbach's reliability analysis to establish construct validity and internal consistency. Concurrent and known-groups validity analyses were conducted; and Spearman's rho correlation explored the relationship between mNAQ and BI scores. Non-parametric analyses were applied to identify differences based on stroke phase and NIHSS scores. The study revealed that the mNAQ initially lacked satisfactory psychometric properties in the Greek context. Subsequent modifications guided by confirmatory and exploratory factor analyses resulted in a refined three-factor scale encompassing 31 items in the domains of communication, mobility, and social functioning needs. This adapted measure effectively differentiated between acute and chronic stroke patients and those with minor and moderate strokes. In conclusion, the validated 31-item Greek mNAQ emerges as a crucial tool for comprehensively assessing the needs of stroke patients. Its application holds promise for optimizing post-stroke care improving functional outcomes and ultimately enhancing the overall well-being and quality of life for stroke survivors.

Should Hypervascular Incidentalomas Detected on Per-Interventional Cone Beam Computed Tomography during Intra-Arterial Therapies for Hepatocellular Carcinoma Impact the Treatment Plan in Patients Waiting for Liver Transplantation?

Current guidelines do not indicate any comprehensive management of hepatic hypervascular incidentalomas (HVIs) discovered in hepatocellular carcinoma (HCC) patients during intra-arterial therapies (IATs). This study aims to evaluate the prognostic value of HVIs detected on per-interventional cone beam computed tomography (CBCT) during IAT for HCC in patients waiting for liver transplantation (LT). In this retrospective single-institutional study, all liver-transplanted HCC patients between January 2014 and December 2018 who received transarterial chemoembolization (TACE) or radioembolization (TARE) before LT were included. The number of ≥10 mm HCCs diagnosed on contrast-enhanced pre-interventional imaging (PII) was compared with that detected on per-interventional CBCT with a nonparametric Wilcoxon test. The correlation between the presence of an HVI and histopathological criteria associated with poor prognosis (HPP) on liver explants was investigated using the chi-square test. Tumor recurrence (TR) and TR-related mortality were investigated using the chi-square test. Recurrence-free survival (RFS), TR-related survival (TRRS), and overall survival (OS) were assessed according to the presence of HVI using Kaplan-Meier analysis. Among 63 included patients (average age: 59 ± 7 years, H/F = 50/13), 36 presented HVIs on per-interventional CBCT. The overall nodule detection rate of per-interventional CBCT was superior to that of PII (median at 3 [Q1:2, Q3:5] vs. 2 [Q1:1, Q3:3], respectively, p < 0.001). No significant correlation was shown between the presence of HVI and HPP (p = 0.34), TR (p = 0.095), and TR-related mortality (0.22). Kaplan-Meier analysis did not show a significant impact of the presence of HVI on RFS (p = 0.07), TRRS (0.48), or OS (p = 0.14). These results may indicate that the treatment plan during IAT should not be impacted or modified in response to HVI detection.

An extended event study methodology and its application in the HNA group's overseas market contraction

This paper introduces a novel framework for analyzing the performance of cross-border merger and acquisition (M&A) activities in international business. It investigates whether the contraction of overseas market activities can mitigate financial crises, using the case study of a Chinese multinational enterprise (MNE). Traditional event study methodology, commonly used for assessing business performance changes, relies on assumptions of normality and homoscedasticity in data. However, real financial data often exhibits high volatility and non-normal distribution, rendering traditional methods inadequate for estimation. To address this limitation, we propose an enhanced analytical framework integrating the Shapiro–Wilk test, event studies, quantile regression, and nonparametric rank tests. This approach provides more robust estimates, facilitating a more accurate and comprehensive analysis of business performance changes under specific events. Applying this methodology to assess the short-term performance of HNA Group, a cross-border airline in China, during its financial crisis, we find that while overseas market contraction events generate overall positive short-term value for enterprises, the impact varies depending on the assets sold. However, given HNA Group's substantial debt burden, the positive effect is minimal, indicating that overseas market contraction alone is insufficient as a "self-help" strategy in addressing corporate financial crises.

THE EFFECT OF NATURAL MUSIC ON REDUCING STRESS LEVELS IN COLLEGE STUDENTS

College students are a transition period from adolescence to early adulthood. At that time, students had to be clever in adapting to their environment. College students who fail to adapt can experience anxiety, lack of self-expression and face obstacles and obstacles in the academic field. The aim of this research is to see whether or not there is an effect of natural music therapy on reducing stress levels in students. This research is a type of experimental research to observe the effects of changes before and after treatment. The sampling technique used was the purposive sampling method. The criteria for this research were 2022 psychology college students at the Padang campus who were/had experienced stress. The total sample consisted of 10 colege students. The measuring instrument in this study used the Depression Anxiety Stress Scale (DASS) 21. The data was processed using the SPSS version 26.0 for Windows application using non-parameter statistical tests using the Wilcoxon test to test the difference between the DASS 21 scores before being given treatment and after being given treatment. Based on the results, the Asymp Sig (2 Tailed) (0.015) &lt; (0.05) results show that there is a significant difference between college students' stress levels before being treated and after being treated.

Seasonality and relative abundance within an elasmobranch assemblage near a major biogeographic divide.

Nearshore waters are utilized by elasmobranchs in various ways, including foraging, reproduction, and migration. Multiple elasmobranch species have been previously documented in the nearshore waters of North Carolina, USA, which has a biogeographic break at Cape Hatteras on the Atlantic coast. However, comprehensive understanding of the elasmobranch community in this region is still lacking. Monthly year-round trawling conducted along two ocean transects (near Cape Lookout and Masonboro Inlet in 5 to 18 m depth) in Onslow Bay, North Carolina provided the opportunity to examine the dynamics and seasonal patterns of this community using a multivariate approach, including permutational multivariate analysis of variance and nonparametric BIO-ENV analysis. From November 2004 to April 2008, 21,149 elasmobranchs comprised of 20 species were caught, dominated by spiny dogfish (Squalus acanthias) and clearnose skate (Rostroraja eglanteria). All species exhibited seasonal variation in abundance, but several key species contributed the most to seasonal differences in species composition within each transect. Spiny dogfish was most abundant in the winter at both locations, comprised mainly of mature females. Although clearnose skate was caught in all seasons, the species was most abundant during the spring and fall. Atlantic sharpnose (Rhizoprionodon terraenovae) was one of the most abundant species in the summer, and two distinct size cohorts were documented. Temperature appeared to be the main abiotic factor driving the community assemblage. The extensive year-round sampling provided the ability to better understand the dramatic seasonal variation in species composition and provides new information on the relative abundance of several understudied elasmobranch species that may be of significant ecological importance. Our results underscore the importance of inner continental shelf waters as important elasmobranch habitat and provide baseline data to examine for future shifts in timing and community structure at the northern portion of the biogeographic break at Cape Hatteras.

Lipopolysaccharide-binding protein in Crohn's disease patients: a promising noninvasive biomarker monitoring disease activity.

Following STRIDE-II recommendations, the discovery of novel noninvasive biomarkers, beyond the use of C-reactive protein (CRP) and fecal calprotectin, remains a medical need to further improve the monitoring of patients with inflammatory bowel disease (IBD). This study aims to evaluate the potential of serum lipopolysaccharide-binding protein (LBP) in monitoring IBD activity. This retrospective cross-sectional study included 69 IBD patients (43 Crohn's disease and 26 ulcerative colitis) and 82 controls. Serum LBP levels were measured by ELISA. Clinical, biological and endoscopic parameters were analyzed for IBD patients with no reports of missing data. Statistical tests, including nonparametric tests and receiver operating characteristic (ROC) curve analysis, were used to evaluate the diagnostic accuracy of LBP. IBD patients displayed a significantly higher LBP median [29.6 μg/ml (19.8-38.8) in Crohn's disease and 22.8 (13.7-38.8) in ulcerative colitis] than controls [5.8 (4.7-7.3), P < 0.001] with little overlapping distributions. In Crohn's disease patients, LBP levels gradually increased with endoscopic activity scores demonstrating a 1.7-fold rise in active patients compared to remitter patients ( P = 0.02). LBP level exhibited a positive correlation with CRP ( ρ = 0.75, P < 0.001) as well as fecal calprotectin ( ρ = 0.42, P < 0.01), both of which further increased when excluding cases that did not match endoscopic activity. LBP might be a promising noninvasive biomarker for monitoring disease activity, especially in Crohn's disease patients. In clinical situations where current biomarkers lack sensitivity, LBP could be discriminative and help filling the gap for reliable therapeutic decisions.