P-values Range Research Articles

Age-associated alterations in thalamocortical structural connectivity in youths with a psychosis-spectrum disorder

Psychotic symptoms typically emerge in adolescence. Age-associated thalamocortical connectivity differences in psychosis remain unclear. We analyzed diffusion-weighted imaging data from 1254 participants 8–23 years old (typically developing (TD):N = 626, psychosis-spectrum (PS): N = 329, other psychopathology (OP): N = 299) from the Philadelphia Neurodevelopmental Cohort. We modeled thalamocortical tracts using deterministic fiber tractography, extracted Q-Space Diffeomorphic Reconstruction (QSDR) and diffusion tensor imaging (DTI) measures, and then used generalized additive models to determine group and age-associated thalamocortical connectivity differences. Compared to other groups, PS exhibited thalamocortical reductions in QSDR global fractional anisotropy (GFA, p-values range = 3.0 × 10–6–0.05) and DTI fractional anisotropy (FA, p-values range = 4.2 × 10–4–0.03). Compared to TD, PS exhibited shallower thalamus-prefrontal age-associated increases in GFA and FA during mid-childhood, but steeper age-associated increases during adolescence. TD and OP exhibited decreases in thalamus-frontal mean and radial diffusivities during adolescence; PS did not. Altered developmental trajectories of thalamocortical connectivity may contribute to the disruptions observed in adults with psychosis.

Preseason Measures of Cervical Spine Function, Vestibulo-Ocular Reflex, Dynamic Balance, and Divided Attention in Youth Ice Hockey Players.

OBJECTIVES: Report typical scores and examine preseason cervical spine, vestibulo-ocular reflex, dynamic balance, and divided attention measures in competitive youth ice hockey players aged 10 to 18 years with and without a previous concussion history. DESIGN: Cross-sectional secondary analysis. METHODS: The exposure of interest was self-reported history of concussion. The main outcomes were cervical spine measures (Cervical Flexor Endurance [CFE; seconds], Cervical Flexion-Rotation Test [normal/abnormal], Anterolateral Cervical Spine Strength [kilograms], Head Perturbation Test (/8), and Joint Position Error [JPE; centimeters]), vestibulo-ocular reflex (Dynamic Visual Acuity [logMAR], Head Thrust Test [Positive/Negative]), dynamic balance (Functional Gait Assessment [/30]) and divided attention (Walking While Talking Test [seconds]). Multivariable linear or logistic regression, adjusted for age-group, sex, level of play, and clustered by team, were used to assess potential differences by concussion history. RESULTS: We included data from 2311 participants in this study (87.2% male, 12.8% female, 39.0% reported a previous concussion). No differences by concussion history were found across any of the measures (P values range: 0.17-0.99). Measures of cervical spine function and divided attention differed by age group (eg, Median Left Anterolateral Cervical Spine Strength [kilograms] for males: U13 = 7.46, U15 = 9.10, U18 = 9.67). CONCLUSION: Clinical outcomes scores in youth ice hockey players did not differ by concussion history. Performance on cervical spine strength, CFE, and JPE test outcomes may improve with age, highlighting the importance of developmental considerations when interpreting test scores. J Orthop Sports Phys Ther 2024;54(3):1-11. Epub 30 November 2023. doi:10.2519/jospt.2023.11958.

Comparing the applicability of temporal gait symmetry, variability and laterality in bilateral gait conditions: A feasibility study of healthy individuals and people with diabetic neuropathy

BackgroundGait symmetry is used to measure pathological gait but is usually applied to unilateral pathology. This study aims to investigate bilateral impairment using existing and new gait symmetry methods. Methods15 healthy volunteers and 14 people with diabetes and distal symmetrical polyneuropathy participated in this study. Three temporal parameters (combined step, stance phase and double stance), expressed as a percentage, were extracted for comparing gait symmetry between healthy volunteers and patients using in-shoe measurements (Pedar-X). Three indices were calculated, including the widely used Symmetry Index; the well-established Variability Index; and the newly developed Laterality Index, that calculates how well distributed a condition is across both legs. FindingsIn all three parameters, Symmetry and Variability Index proved to be significantly greater in the diabetic cohort (p-values range < 0.001–0.0226). The Laterality Index was significantly greater in the diabetic cohort for the stance and double stance phases (p-values 0.03 and < 0.001), but not for the combined step (p-value 0.3953). In both cohorts, Laterality Index <1 (fractional laterality) was associated with small Symmetry Index data, whereas in large Symmetry Index data, the Laterality Index was 1 (unilateral condition). InterpretationsGait symmetry and variability are useful tools for quantifying locomotion and the effects of aging and diseases. We have shown the ability of these two indices in differentiating two extreme groups of individuals. For cases with small Symmetry Index, the current method of using an arbitrary value is not ideal. The newly developed Laterality Index can be used to decide on the cut-off between symmetrical and asymmetrical gait.

Association of MTHFR and TYMS gene polymorphisms with the susceptibility to HCC in Egyptian HCV cirrhotic patients.

Identification of host genetic factors influencing the risk of developing hepatocellular carcinoma (HCC) in patients with chronic hepatitis C virus (HCV) infection may help to refine patients' selection to benefit from specific preventative measures and/or adapted screening policies. Thus, this study aimed to investigate the association of MTHFR c.677C > T and c.1298A > C in addition to TYMS 3'-UTR 6-bp ins/del polymorphisms with the susceptibility to HCV-related HCC in an Egyptian population. Polymerase chain reaction-restriction fragment length polymorphism was performed to genotype the polymorphisms in 194 HCV-infected patients subdivided into liver cirrhotic (LC, n = 104) and HCC (n = 90) patients as well as 100 healthy subjects. In healthy controls, the MTHFR c.677C > T polymorphism under the homozygous and recessive models (p = 0.005) and the c.1298A > C polymorphism under all the tested genetic models (p-values range from < 0.001 to 0.007) were associated with an increased risk of HCC. In LC patients, the MTHFR c.677C > T polymorphism under the homozygous, dominant, and recessive models (p-values range from 0.001 to 0.007), as well as MTHFR c.1298A > C under the homozygous model only (p = 0.014), increased the susceptibility to HCC. The C/C and T/C haplotypes of MTHFR c.677C > T and MTHFR c.1298A > C polymorphisms were contributed to an increased risk of healthy subjects to develop HCC (p-values range from < 0.001 to 0.015), while only the T/C haplotype was associated with the progression of HCC in LC patients (p = 0.001). In conclusion, MTHFR c.677C > T and c.1298A > C in addition to their haplotypes may contribute to the development of HCV-related HCC in an Egyptian population. These findings may aid in the early diagnosis and management of HCC.

Associations between Genetically Predicted Circulating Protein Concentrations and Endometrial Cancer Risk.

Simple SummaryEndometrial cancer is the leading female reproductive tract cancer in developed countries. Discovering new biomarkers is critical for understanding the etiology this cancer and identifying women with a higher risk of this cancer from the general population. Several blood protein biomarkers have been linked to endometrial cancer in previous studies, but these studies have assessed only a limited number of biomarkers usually among a small number of participants. The current study aimed at identifying novel circulating protein biomarkers of endometrial cancer by using the largest available dataset to date. Our finding suggested nine proteins to be associated with endometrial cancer risk, and five of the identified associations showed suggestive associations with risk of non-endometrioid EC, a much more lethal subtype. If validated by additional studies, our findings may contribute to understanding the pathogenesis of endometrial tumor development and facilitating the risk assessment of endometrial cancer.Endometrial cancer (EC) is the leading female reproductive tract malignancy in developed countries. Currently, genome-wide association studies (GWAS) have identified 17 risk loci for EC. To identify novel EC-associated proteins, we used previously reported protein quantitative trait loci for 1434 plasma proteins as instruments to evaluate associations between genetically predicted circulating protein concentrations and EC risk. We studied 12,906 cases and 108,979 controls of European descent included in the Endometrial Cancer Association Consortium, the Epidemiology of Endometrial Cancer Consortium, and the UK Biobank. We observed associations between genetically predicted concentrations of nine proteins and EC risk at a false discovery rate of <0.05 (p-values range from 1.14 × 10−10 to 3.04 × 10−4). Except for vascular cell adhesion protein 1, all other identified proteins were independent from known EC risk variants identified in EC GWAS. The respective odds ratios (95% confidence intervals) per one standard deviation increase in genetically predicted circulating protein concentrations were 1.21 (1.13, 1.30) for DNA repair protein RAD51 homolog 4, 1.27 (1.14, 1.42) for desmoglein-2, 1.14 (1.07, 1.22) for MHC class I polypeptide-related sequence B, 1.05 (1.02, 1.08) for histo-blood group ABO system transferase, 0.77 (0.68, 0.89) for intestinal-type alkaline phosphatase, 0.82 (0.74, 0.91) for carbohydrate sulfotransferase 15, 1.07 (1.03, 1.11) for D-glucuronyl C5-epimerase, and 1.07 (1.03, 1.10) for CD209 antigen. In conclusion, we identified nine potential EC-associated proteins. If validated by additional studies, our findings may contribute to understanding the pathogenesis of endometrial tumor development and identifying women at high risk of EC along with other EC risk factors and biomarkers.

Quality of Life and Glycemic Control in Saudi Children with Type 1 Diabetes at Different Developmental Age Groups.

Background:Children with type 1 diabetes (T1D) at different stages of development have age-specific needs, which can influence their perception of quality of life (QoL). In our study, we aimed to emphasize these age-specific needs and assess the perception of QoL in Saudi children with T1D, as well as their parents correlating QoL scores with children’s glycemic control.Methods:This is a cross-sectional study in which children with T1D and their parents from 2 tertiary institutes in Saudi Arabia have answered a standard diabetes-specific QoL questionnaire (PedsQL™ 3.0 diabetes module, translated in Arabic). We also reported glycated hemoglobin (HbA1c) results for these children within a month of completing the questionnaire. The QoL total aggregate and domain scores for self (children) and proxy (parents’) reports were compared and correlated with children’s HbA1c.Results:A sample was 288 self and proxy reports from 144 children with T1D of 3 age groups: 5 to 7 years (7%), 8 to 12 years (49%), and 13 to 18 years (44%), and their parents. QoL differed significantly between self and proxy reports in the total aggregate and domain scores (P-values range from .02 to <.001). The impact on QoL was significantly higher in female patients (P = .043). Insulin pump users had better HbA1c (P = .007), and HbA1c level was worse in those who intended to fast at Ramadan (P = .005).Conclusion:Children with T1D at different developmental age groups perceive QoL differently than their parents. Adjusting management as per age-specific challenges could potentially improve these children’s QoL and glycemic control.

Checkpoint Inhibitor Pneumonitis in Patients with Advanced NSCLC on Nivolumab Monotherapy is Underreported and Associated with Prior Radiotherapy History

For patients with advanced non-small cell lung cancer (NSCLC) treated with Immunotherapy (ImT), checkpoint inhibitor pneumonitis (CIP) is an uncommon and sometimes life-threatening adverse event that may be underreported. Recent studies suggest that radiomic analysis of pre-ImT imaging can predict CIP. We hypothesized that for patients with advanced NSCLC treated with Nivolumab monotherapy, pre-ImT radiotherapy (RT) is predictive of CIP and that radiomics features can identify CIP that has been clinically misclassified. From an IRB-approved database (DB) of 159 patients with advanced NSCLC treated with Nivolumab, chart review identified 9 patients diagnosed with CIP of any grade (6%). 40 additional patients from the same DB without diagnosis of CIP were randomly selected for analysis. For all patients, baseline characteristics including pre-ImT RT were collected for comparison between CIP and non-CIP groups. Both lungs were contoured semi-automatically through thresholding on the last pre-ImT CT imaging studies, with intrathoracic lesions subtracted from the lung volumes prior to radiomics analysis. A logistic regression model incorporating radiomics assigned a CIP probability score to every patient. Six radiomics features correlated with CIP (p-values range from 0.02 to 0.03). Each feature had an AUC of ∼0.79 (range 0.789 to 0.794) showing large effect size, with odds ratios greater than 3.50 (4 features) or less than 0.3 (2 features). While pre-ImT thoracic RT was not predictive of pneumonitis, pre-ImT RT irrespective of treatment location was borderline predictive with high effect size (p = 0.09, OR 0.27). The radiomics-based probability model assigned 7/42 patients (16.7%) without clinical diagnosis of CIP a greater than 50% probability of CIP. Chart and imaging review revealed that 6/7 “misclassified” patients exhibited symptoms or radiographic features highly suggestive of CIP. These findings originally were attributed to disease progression or clinically overshadowed by other symptoms. For patients with advanced NSCLC treated with Nivolumab, the incidence of checkpoint-inhibitor pneumonitis (CIP) is underreported and radiomics features can help identify CIP that has been clinically misclassified. Preliminary findings suggest that pre-ImT RT irrespective of treatment location may be predictive of CIP, and therefore that immunomodulatory effects of RT-ImT synergy are not restricted to the local irradiated area. Future directions include expansion of this study across the full database, correlation of radiomics features with blood and tissue biomarkers, and the inclusion of tumor burden as an additional covariate in the analysis.

Is checkpoint inhibitor pneumonitis underreported in patients with advanced non-small cell lung cancer (NSCLC) on PD-1 inhibitor monotherapy?

9579 Background: For patients with advanced non-small cell lung cancer (NSCLC), immunotherapy (ImT) has led to improvements in survival and quality of life. Checkpoint inhibitor pneumonitis (CIP) is an uncommon but sometimes life-threatening adverse event. While CIP is a diagnosis of exclusion, many oncologists believe the incidence of CIP is underreported. Radiomics, an image analysis technique that can extract imperceptible information from radiographic images, has been incorporated into predictive models for many cancers. Recent studies suggest that radiomic analysis of pre-ImT imaging can predict CIP. We hypothesized that for patients with advanced NSCLC treated with Nivolumab monotherapy, the rate of CIP is underreported and radiomics features can identify CIP that was clinically misclassified. Methods: From an IRB-approved database (DB) of 159 patients with advanced NSCLC treated with Nivolumab, chart review identified 8 patients diagnosed with CIP of any grade (5%). 42 additional patients from the same DB without diagnosis of CIP were randomly selected for analysis. For all 50 patients, uninvolved lung in the last pre-ImT CT imaging study was segmented, delineated, and analyzed for radiomics features associated with CIP. A logistic regression model incorporating radiomics assigned a CIP probability score to every patient. Results: Six radiomics features correlated with CIP ( p-values range from 0.02 to 0.03). Each feature had an AUC of ~0.79 (range 0.789 to 0.794) showing large effect size, with odds ratios greater than 3.50 (4 features) or less than 0.3 (2 features). The radiomics-based probability model assigned 7/42 patients (17.5%) without clinical diagnosis of CIP a greater than 50% probability of CIP. Chart review revealed that 6/7 “misclassified” patients exhibited symptoms or radiographic features highly suggestive of CIP within 5 months of initial immunotherapy treatment. These indications originally had been attributed to disease progression, overshadowed by more severe symptoms or simply mislabeled (e.g. a case of recall pneumonitis was described as "radiation pneumonitis"). Conclusions: For patients with advanced NSCLC treated with nivolumab, the incidence of checkpoint-inhibitor pneumonitis (CIP) is underreported and radiomics features can help identify CIP that has been clinically misclassified. Future directions include expansion of this study across the full database, correlation of radiomics features with blood biomarkers, and the inclusion of tumor burden as an additional covariate in the analysis.

Active layer and permafrost thickness in rock glaciers derived from geophysical methods in the semiarid Andes of Argentina

The Argentinean Central Andes region (31°S to 35°S) exhibits one of the largest densities of rock glaciers on Earth. However, few studies have focused on the knowledge of the internal structure of these landforms. In the present paper, a characterization of the internal structure of two rock glaciers has been achieved by using Seismic Refraction Tomography and Vertical Electrical Sounding. In one of the rock glaciers, the thickness of the active layer is quite homogeneous, while in the other said thickness diminishes towards the front. In both rock glaciers, near the top of the active layer, the P-wave velocity values vary between 350 and 600 m/s, while in the bottom of the layer the P-values range from 800 to 1700 m/s. As regards the permafrost layer, it shows an irregular thickness with values varying between 4 and 27 m approximately. In addition, P-wave values ranging from 1600 to 3300 m/s and a few kΩm values of electrical resistivity have been recorded. The increase of geophysical surveys in rock glaciers in the Andes region is expected to give a better understanding of the characteristics, distribution and origin of the ice present in these landforms. It should also allow researchers to estimate with certainty their ice content as solid-state reserves.

Tests of Return Predictability: A Comparative Study

Evidence of return predictability based on dividend yields remains inconclusive. Predictive regressions are subject to subtle econometric issues rendering standard inference inappropriate. As a consequence, there now exists a broad range of statistical tests. We review the tests from Stambaugh (1999), Lewellen (2004), Campbell and Yogo (2006), and Cochrane (2007) and complement our analysis with standard maximum likelihood as well as restricted maximum likelihood estimation as discussed by Chen and Deo (2009). When applied to two samples from the literature, we find that p-values range from almost 0% to more than 20%. We reconcile the conflicting evidence and identify two main sources: First, we attribute part of it to the two different sample periods. Second, we urge to go beyond the p-value and find that some of the tests are severely size-distorted, whereas others lack power. To demonstrate this, we use an extensive simulation study to assess the size (falsely rejecting a true null) and power (correctly rejecting a false null) of the selected tests.

Advances in gene ontology utilization improve statistical power of annotation enrichment.

Gene-annotation enrichment is a common method for utilizing ontology-based annotations in gene and gene-product centric knowledgebases. Effective utilization of these annotations requires inferring semantic linkages by tracing paths through edges in the ontological graph, referred to as relations. However, some relations are semantically problematic with respect to scope, necessitating their omission or modification lest erroneous term mappings occur. To address these issues, we created the Gene Ontology Categorization Suite, or GOcats—a novel tool that organizes the Gene Ontology into subgraphs representing user-defined concepts, while ensuring that all appropriate relations are congruent with respect to scoping semantics. Here, we demonstrate the improvements in annotation enrichment by re-interpreting edges that would otherwise be omitted by traditional ancestor path-tracing methods. Specifically, we show that GOcats’ unique handling of relations improves enrichment over conventional methods in the analysis of two different gene-expression datasets: a breast cancer microarray dataset and several horse cartilage development RNAseq datasets. With the breast cancer microarray dataset, we observed significant improvement (one-sided binomial test p-value = 1.86E-25) in 182 of 217 significantly enriched GO terms identified from the conventional path traversal method when GOcats’ path traversal was used. We also found new significantly enriched terms using GOcats, whose biological relevancy has been experimentally demonstrated elsewhere. Likewise, on the horse RNAseq datasets, we observed a significant improvement in GO term enrichment when using GOcat’s path traversal: one-sided binomial test p-values range from 1.32E-03 to 2.58E-44.

Assessing a novel way to measure three common rehabilitation outcome measures using a custom mobile phone application

BackgroundClinicians often use thirty-second-sit (chair)-to-stand (30CST), timed-up-and-go (TUG), and the five-times-sit-to-stand (5xSTS) since these outcome measures (OMs) are sensitive for strength, balance and mobility. Research Question: The purpose of this study was to validate a custom smart phone application (App) that can remotely assess the 30CST, TUG, and 5xSTS. MethodsThirty-one healthy adults (range: 22–55 y; 54.6–106.8 kg; 160–185 cm; 19 females) participated in this cross-sectional study. Each participant performed the 30CST, TUG, and 5xSTS at a slow and normal speed. They performed each OMs twice while the App collected their performance data using both an iOS and Android phone. The gold standard of each test was the average of the silent count of two investigators for the 30CST and the time recorded by two investigators using stopwatches for the TUG and 5xSTS. Investigators analyzed the data using Intraclass Correlation coefficients (ICC), Pearson R coefficients, Signed Rank Tests, and Wilcoxon Rank-Sum Tests. Results and SignificanceA significant correlation was observed between the performances recorded by the phones and the direct observation gold standard for all three OMs (r > 0.97). For 30CST, no significant mean count differences were found for the following comparisons: between phones, within phone types, or within phone-by-speed levels. (P-values range 0.06–1.00). While a statistically significant difference was found in all of the time comparisons when performing TUG and 5xSTS (p < 0.0001) except for the between phone comparison with TUG (p = 0.27). For TUG and 5xSTS, the time difference was less than a second when compared to the gold standard and ICCs showed moderate to strong agreement when comparing the phone application to the gold standard (ICCs range 0.60–0.99). These data suggested that the App could validly measure performance of these OMs.

Farmers' perceptions of agricultural land use changes in Nepal and their major drivers

Historical trends show that the total area of agricultural land in Nepal has changed markedly over time, but few studies have addressed the causative drivers underlying this change. Evaluating the perceptions of farmers is an effective tool for addressing this issue because it reflects the full range of drivers associated with changes in land use. This study utilizes historical agricultural area, population, and climate data for 1910–2010, combined with a series of applied household surveys and focus group discussions to assess farmers' perceptions of these changes and identify the major drivers. The paired t-test was employed to measure differences between various groups of drivers. The total area of agricultural land in Nepal has expanded rapidly since 1910, more intensively in the southern (Tarai) and central (Hill) ecological regions of the country, and has decreased slightly near large cities in recent decades. Farmers’ perceptions show that socioeconomic variables were considered to be the crucial drivers of changes in agricultural land use. The three other major drivers were grouped as: neighborhood, climate–topography, and policy drivers. In particular, farmers pointed to the high level of population growth (93.96%) as the main factor underlying the changes, and the majority of drivers are associated with this variable. Access to roads (77.36%), urbanization (33.77%), government policies (23.58%), and remittance impact (16.79%) are other notable triggering variables. The paired t-test results equating variables from different groups of drivers and ecological regions indicate varied significance (p-values range from 0.004 to 0.983). Our analysis confirms that the synergy between social and natural observations can be integrated to obtain research findings that identify scientific and social issues. The interplay between the drivers should be emphasized in developing plans for sustainable agricultural land use management.

Aneuploidy of chromosome 8 and mutation of circulating tumor cells predict pathologic complete response in the treatment of locally advanced rectal cancer.

Identifying patients who may or may not achieve pathologic complete response (pathCR) allows for treatment with alternative approaches in the preoperative setting. The aim of the current study was to investigate whether aneuploidy of chromosome 8 and mutations of circulating tumor cells (CTCs) could predict the response of patients with rectal cancer to preoperative chemoradiotherapy. A total of 33 patients with locally advanced rectal cancer (cT3-T4 and/or cN+) treated with neoadjuvant chemoradiotherapy between September 2014 and March 2015 were recruited. Blood samples were collected from 33 patients with pre-chemoradiotherapy rectal cancer. It was demonstrated that ≥5 copies of chromosome 8 was associated with pathCR (univariate logistic regression, P=0.042). Of the 6 patients whose CTCs had <5 copies of chromosome 8, 3 achieved pathCR (3/6, 50%), and of the 27 patients whose CTCs had ≥5 copies of chromosome 8 obtained 3 pathCR (3/27, 11.1%; Chi-square test, P=0.0255). Of the 33 patients with mutations assessed, 8 significant nonsynonymous mutations in CTCs were identified as associated with pathCR (Chi-square test, P-values range, 0.0004-0.0298; mutations in ARID1A, HDAC1, APC, ERBB3, TP53, AMER1 and AR). These results suggest that ≥5 copies of chromosome 8 and 8 nonsynonymous mutations in ARID1A, HDAC1, APC, ERBB3, TP53, AMER1 AR in CTCs were associated with pathCR. This conclusion should be validated further in larger prospective studies and the long-term follow-up survival data of this study will also be reported in the future.

Consequences of relying on statistical significance: Some illustrations.

Despite regular criticisms of null hypothesis significance testing (NHST), a focus on testing persists, sometimes in the belief to get published and sometimes encouraged by journal reviewers. This paper aims to demonstrate known key limitations of NHST using simple nontechnical illustrations. The first illustration is based on simulated data of 20000 studies that compare two groups for an outcome event. The true effect size (difference in event rates) and sample size (20-100 per group) were varied. The second illustration used real data from a meta-analysis on alpha-blockers for the treatment of ureteric stones. The simulations demonstrated the large between-study variability in P-values (range between <.0001 and 1 for most simulation conditions). A focus on statistically significant effects (P<.05), notably in small to moderate samples, led to strongly overestimated effect sizes (up to 240%) and many false-positive conclusions, that is statistically significant effects that were, in fact, true null effects. Effect sizes also exerted strong between-study variability, but confidence intervals accounted for this: the interval width decreased with larger sample size, and the percentage of intervals that contained the true effect size was accurate across simulation conditions. Reducing alpha level, as recently suggested, reduced false-positive conclusions but strongly increased the overestimation of significant effects (up to 320%). Researchers and journals should abandon statistical significance as a pivotal element in most scientific publications. Confidence intervals around effect sizes are more informative, but should not merely be reported to comply with journal requirements.

Parents' Attitudes toward Clinical Genetic Testing for Autism Spectrum Disorder-Data from a Norwegian Sample.

Clinical genetic testing (CGT) of children with autism spectrum disorder (ASD) may have positive and negative effects. Knowledge about parents’ attitudes is needed to ensure good involvement of caregivers, which is crucial for accurate diagnosis and effective clinical management. This study aimed to assess parents’ attitudes toward CGT for ASD. Parent members of the Norwegian Autism Society were given a previously untested questionnaire and 1455 answered. Linear regression analyses were conducted to evaluate contribution of parent and child characteristics to attitude statements. Provided it could contribute to a casual explanation of their child’s ASD, 76% would undergo CGT. If it would improve the possibilities for early interventions, 74% were positive to CGT. Between 49–67% agreed that CGT could have a negative impact on health insurance, increase their concern for the child’s future and cause family conflicts. Parents against CGT (9%) were less optimistic regarding positive effects, but not more concerned with negative impacts. The severity of the children’s ASD diagnosis had a weak positive association with parent’s positive attitudes to CGT (p-values range from <0.001 to 0.975). Parents prefer that CGT is offered to those having a child with ASD (65%), when the child’s development deviates from normal (48%), or before pregnancy (36%). A majority of the parents of children with ASD are positive to CGT due to possibilities for an etiological explanation.

Vehicle emission implications of drivers’ smart advisory system for traffic operations in work zones

ABSTRACTWireless communication systems have been broadly applied in various complicated traffic operations to improve mobility and safety on roads, which may raise a concern about the implication of the new technology on vehicle emissions. This paper explores how the wireless communication systems improve drivers’ driving behaviors and its contributions to the emission reduction, in terms of Operating Mode (OpMode) IDs distribution used in emission estimation. A simulated work zone with completed traffic operation was selected as a test bed. Sixty subjects were recruited for the tests, whose demographic distribution was based on the Census data in Houston, Texas. A scene of a pedestrian’s crossing in the work zone was designed for the driving test. Meanwhile, a wireless communication system called Drivers Smart Advisory System (DSAS) was proposed and introduced in the driving simulation, which provided drivers with warning messages in the work zone. Two scenarios were designed for a leading vehicle as well as for a following vehicle driving through the work zone, which included a base test without any wireless communication systems, and a driving test with the trigger of the DSAS. Subjects’ driving behaviors in the simulation were recorded to evaluate safety and estimate the vehicle emission using the Environmental Protection Agency (EPA) released emission model MOVES. The correlation between drivers’ driving behavior and the distribution of the OpMode ID during each scenario was investigated. Results show that the DSAS was able to induce drivers to accelerate smoothly, keep longer headway distance and stop earlier for a hazardous situation in the work zone, which driving behaviors result in statistically significant reduction in vehicle emissions for almost all studied air pollutants (p-values range from 4.10E-51 to 2.18E-03). The emission reduction was achieved by the switching the distribution of the OpMode IDs from higher emission zones to lower emission zones.Implications: Transportation section is a significant source of greenhouse gas emissions. Many studies demonstrate that the wireless communication system dedicated for safety and mobility issues may contribute to the induction in vehicle emissions through changing driving behaviors. An insight into the correlation between the driving behaviors and the distribution of Operating Mode (OpMode) IDs is essential to enhance the emission reduction. The result of this study shows that with a Drivers Smart Advisory System (DSAS) drivers accelerated smoothly and stopped earlier for a hazardous situation, which induce the switch of the OpMode IDs from high emission zones to lower emission zones.

Comparison of a Simplified Colonoscopy Bowel Preparation Scale With the Validated Boston Bowel Preparation Scale

Introduction: A multi-society task force suggests adequate bowel cleansing permit detection of polyps >5mm. We validated a grading scale defining Adequate as enabling detection of polyps > 5mm AND no need to shorten the interval to the next colonoscopy. We aimed to assess intra- and inter-reader agreement between this 2 category scale and the Boston Bowel Preparation Scale (BBPS). Methods: 80 de-identified complete colonoscopies were videotaped. Readers were experienced board certified GI physicians; all attended a pre-study session to review representative videos. Grading was based on optimal cleansing on withdrawal. 8 readers reviewed 40 cases total; each video was read by 4 readers. Reader panels (comprised of a combination of 4 of the 8 readers assigned to each case) were randomized. Readers read assigned cases twice (T1, T2), 4 weeks apart. This study focused on 2 readers who read their 40 assigned cases a third time (T3) using the BBPS after completing on-line training. Agreement (%) and the kappa statistic quantified intra- and inter-reader agreement between readers. Results: For all 8 readers, there were 320 readings at T1 and T2. A rating of Adequate varied between readers for the 2-category scale (range 50%-98%; p = 0.001). Intra-reader agreement ranged from 63% to 98% (median=81%) and kappa from 0.25 to 0.88 (median 0.54). Overall inter-reader kappa= 0.35 for T1 and 0.26 for T2. For the 2 readers assessing T1, T2, and T3, there were 80 readings at each timepoint. An Adequate grade occurred significantly more with the BBPS (80-83%) than the 2-category scale (38-58%) (p-values range 0.001 to 0.004). Intra-reader agreement for the 2-category scale for T1 and T2 was k=0.25 (Reader 1) and k=0.42 (Reader 2). Intra-reader agreement between the 2-category scale and BBPS for Reader 1: T1/BBPS k=0.15, T2/BBPS k=0.34; Reader 2: T1/BBPS k=0.51, T2/BBPS k=0.17. For 18 cases common to both readers, adequacy ratings were also lower with the 2-category scale (44%-67%) compared to the BBPS (67%-83%) (p=NS). Inter-reader agreement for the 2 readers at T1 was k=0.14, T2 was k=0.44, and T3 was k=0.57. Conclusion: Bowel preparation is more likely to be rated Adequate using the BBPS compared to the 2-category scale. Intra- and inter-reader agreement for the 2-category scale was fair to moderate, and agreement between this scale and the BBPS varied greatly, ranging from slight to moderate. The 2-category scale may not be appropriate for clinical practice. Funding by Ferring Pharmaceuticals.

Influence of Builders Execution and Control Tools on Building Production Performance in Nigeria: Part Two

This part two evaluates the influence of three least used builders' execution and control tools on performance of building production, with a view to enlightening stakeholders for enhanced sustainable development of the construction industry in Nigeria. The objectives are to assess the factors militating against the use of the least significant control documents observed in part one, evaluate the performance of projects with the present use of the documents and relationship between documents' usage and projects performance. A survey of 142 purposively sampled professionals resulted in 120 valid structured questionnaire used for analysis. Data were analysed using descriptive analysis, severity index, Kruskal-Wallis and Spearman correlation tests. It was concluded that some factors significantly hinder the preparation and use of the production documents. The low extent of use has resulted in moderate cost, time quality and satisfaction performance of the projects. The perception of factor influencing documents and the performance of projects managed with the production tools do not vary significantly (p-values range=0.862-0.986>0.05). Quality management plan and information requirement schedule have weak influence on cost, quality and satisfaction of projects, the low usage level of early warning system plan has no significant influence on the cost and time performance, but promotes low quality work and stakeholders dissatisfaction. The study therefore recommends the prioritization and harmonization of the factors aecting each production document during their preparation and use. All the documents should be made mandatory by development control organs, adequate retraining of personnel on the preparation and use of the documents, government should pass the bill to enforce the building code.

Evidence for homologous recombination in Chikungunya Virus

Chikungunya Virus (CHIKV), a mosquito-transmitted alphavirus, causes acute fever and joint pain in humans. Recently, endemic CHIKV infection outbreaks have jeopardized public health in wider geographical regions. Here, we analyze the phylogenetic associations of CHIKV and explore the potential recombination events on 152 genomic isolates deposited in GenBank database. The CHIKV genotypes [West African, Asian, East/Central/South African (ECSA)], and a clear division of ECSA clade into three sub-groups (I–II–III), were defined by Bayesian analysis; similar results were obtained using E1 gene sequences. A nucleotide identity-based approach is provided to facilitate CHIKV classification within ECSA clade. Using seven methods to detect recombination, we found a statistically significant event (p-values range: 1.14×10−7–4.45×10−24) located within the nsP3 coding region. This finding was further confirmed by phylogenetic networks (PHI Test, p=0.004) and phylogenetic tree incongruence analysis. The recombinant strain, KJ679578/India/2011 (ECSA III), derives from viruses of ECSA III and ECSA I. Our study demonstrates that recombination is an additional mechanism of genetic diversity in CHIKV that might assist in the cross-species transmission process.