Pearson Correlation Coefficient Research Articles

A-162 Improved Laboratory Workflow using Automated Detection of Hemolysis, Icterus, and Lipemia for Coagulation Testing

Abstract Background Managing preanalytical variables is critical to providing quality laboratory test results. However, this can be a challenge for laboratory staff, particularly with manual detection of interfering substances and complicated workflows. For coagulation testing, we assess specimen integrity and acceptability by visual checks and quantification of interfering substance on a chemistry analyzer. To improve this subjective process, we evaluated the technical performance of a new model of coagulation analyzer with automated preanalytical specimen integrity detection. Our objective was to determine if we could reduce the number of specimens requiring visual inspection/off-analyzer interference testing in order to simplify our testing workflow. Methods Citrated plasma specimens received in the Hospital Clinical Laboratory at Mayo Clinic (Rochester, MN) were tested on the TOP ACL 500 or TOP ACL 550 Series Coagulation analyzers (Werfen, Boston, MA) according to manufacturer’s instruction. Specimens tested on the TOP 500 were visually inspected for hemolysis, icterus, and lipemia (HIL). If the technologist detected a possible interferent, an aliquot of plasma was analyzed on our cobas c501 chemistry analyzer (c501) (Roche Diagnostics, Indianapolis, IN) to obtain HIL values. Laboratory-established or manufacturer-defined interference thresholds were applied in determining specimen acceptability. For samples tested on the TOP 550, specimen integrity was assessed by the instrument’s automated interference detection module. The analyzer reported HIL as an “interference cloud” or estimated range, rather than a single value like the c501. HIL values were estimated by visual assessment of the low end of the “interference cloud”. Values were confirmed on the c501 only for specimens with an “interference cloud” at/exceeding the test-specific interference thresholds. We analyzed data from a 2-month period pre- (TOP 500) and post-implementation (TOP 550). The percent of specimens requiring quantitation/confirmation on the c501 was calculated. Statistical significance was calculated using the Chi-squared test where significance was defined as p<0.01. Correlation between c501 and TOP 550 estimated HIL values was evaluated. Results A total of 2.2% (171/7605) and 1.3% (113/8983) of specimens tested on the TOP 500 and TOP 550, respectively, required HIL measurements on the c501 (p<0.001). Of those samples, 8.2% (14/171) and 14.2% (16/113) from the TOP 500 and TOP 550, respectively, had HIL values above the interference thresholds and were rejected by the laboratory. Comparison of the estimated HIL values from the “interference cloud” and from the c501 resulted in slopes (Pearson correlation coefficients) of: H 1.56 (0.77), I 0.67 (0.97), and L 1.35 (0.99). Conclusions In comparison to our workflow with visual assessment of interference, use of the automated interference detection functionality on the TOP 550 instrument resulted in a lower percentage of specimens requiring HIL measurements on the chemistry analyzer. Agreement between interference measurements obtained on the c501 and the TOP 550 was moderate where TOP 550 overestimated the degree of hemolysis and lipemia and underestimated icterus. Implementation of automated interference detection on the TOP 550 analyzer improved our workflow by eliminating the need for tedious and subjective visual checks and reducing the percentage of specimens requiring additional HIL measurements.

B-020 Study of Method Intercomparison between Atellica Solution® and CI® Analyzers for T4L, β-HCG Total, and PSA Total

Abstract Background Method intercomparison is an essential requirement in Clinical Laboratories before changing a method or instrument to verify the interchangeability of results. After validating a new Siemens device, the CI®, we conducted an intercomparison study with the Atellica Solution® for T4 free (T4L), β-HCG total, and PSA total assays. Objectives To check the interchangeability of results between the methods of T4L, β-HCG total, and PSA total, as determined on the Atellica Solution® and CI® analyzers, to evaluate the behavior of both equipment in our laboratory as a single virtual team. Methods A total of 120 serum samples from patients with T4L values between 0.41 and 7.5 ng/dL, β-HCG total between 0.5 and 1000 mIU/mL, and PSA total between 0.01 and 78.4 ng/mL were processed on both analyzers. Passing-Bablok regression, Bland-Altman analysis, and Pearson correlation coefficient were used to evaluate the sample size. Results are expressed with a 95% confidence interval. The intercomparison study was conducted using Method Validator Version 1.19. Results See table Conclusions After evaluating the results, we conclude that the Atellica Solution® and CI® analyzers behave as a single virtual team for the T4L, β-HCG total, and PSA total assays. Although there are systematic errors, they do not exceed the quality specifications established in our laboratory, based on the Total Error allowable according to Biological Variability.

A-008 Verification of Interchangeability of Results for High-Sensitivity Troponin (TNIH) Between Atellica Solution® and Atellica CI® Analyzers

Abstract Background Method intercomparison is an essential requirement that must be carried out in Clinical Laboratories before changing a method or instrument to verify the interchangeability of results. High-sensitivity troponin (TNIH) is an extraordinarily sensitive marker for detecting myocardial damage. Currently, it is determined in Atellica Solution® autoanalyzers (Siemens Healthineers) in our laboratory. After validating a new Siemens device, the Atellica CI®, it is essential to ensure the interchangeability of results in our laboratory accredited by ISO 15189: 2012. Objectives Our objective is to verify if the TNIH method in serum is interchangeable between the analyzers: Atellica Solution® and CI®. Methods A total of 77 serum samples from patients with TNIH values ranging from 2.5 to 25000 ng/L were processed by both analyzers. The statistical analysis of the results was performed using Passing-Bablok regression and Bland-Altman analysis, along with the Pearson correlation coefficient as a criterion to verify the adequacy of the sample size. Results are expressed with a 95% confidence interval. The statistical intercomparison study was conducted using Method Validator Version 1.19 Results In statistical analysis of Bland-Altman, no statistically significant differences were observed between the results obtained on both Atellica Solution® and CI 1900® analyzers since the 95% CI of the mean difference obtained includes the null value.Passing-Bablok regression shows a statistically significant, nearly negligible proportional systematic error, as the lower limit of the 95% CI is very close to 1; and a constant systematic error since the 95% CI of the intercept does not include the value 0 Conclusions Considering the 99th percentile established in our laboratory as a clinical decision value obtained after our own study of 45 ng/L, we do not exceed our quality specification for TNIH based on biological variability, which is 19.4%. Therefore, we can conclude that the determination of TNIH between both analyzers is interchangeable.

A-173 Evaluation of Artificial Intelligence (AI)-assisted Flow Cytometry Analysis for Plasma Cell Neoplasms

Abstract Background Flow cytometry plays a critical role in diagnosing hematologic disorders, yet manual analysis is time-consuming and prone to variability. Significant advancements in artificial intelligence (AI) within healthcare have occurred in recent years. Previously, we developed and evaluated an AI-assisted automated system for diagnosing acute leukemia. This study aims to assess the effectiveness of the AI system in diagnosing plasma cell neoplasms. Methods A total of 76 bone marrow samples were analyzed using a panel of antibodies (CD38, CD56, CD138, Kappa, and Lambda) to determine plasma cell percentages and immunophenotype. All samples were used for initial diagnosis of plasma cell neoplasm or therapeutic monitoring. Manual analysis using Kaluza™ software served as the gold standard. The same flow cytometry data was processed by the AI software (DeepFlow™) for comparison. Pearson correlation coefficients were used to compare AI and manual analysis for diagnosis and plasma cell count. Results Among the 76 cases, manual analysis identified 57 positive cases for monoclonal plasma cells (36 cases of CD38+/CD138+/Kappa+ and 21 cases of CD38+/CD138+/Lambda+), with 89% showing aberrant CD56 expression. AI identified 49 monoclonal cases, missing 8 cases with low plasma cell levels (<0.07%) or brighter fluorescence. AI accurately matched 97% of immunophenotypes with manual analysis. Pearson correlation coefficients demonstrated excellent correlation (r=1.0) between manual and AI plasma cell percentages. Furthermore, AI has also enhanced laboratory efficiency, reducing analysis time per case from 10 minutes with manual methods to just 3 minutes with AI analysis. Conclusions This study shows promise for AI-assisted flow software in diagnosing plasma cell neoplasms. AI has enhanced operational efficiency by reducing the manual processing and analysis time. Further training is needed to improve the identification of variations in fluorescence intensity and low plasma cell levels.

A-155 Development of drop-of-blood QATT heparinase and functional fibrinogen assays

Abstract Background Monitoring the blood coagulation status of patients with coagulopathy or on anticoagulant therapy is important for informed treatment decisions. Quasi-static acoustic tweezing thromboelastometry (QATT) can monitor changes in blood coagulation using a small blood drop. Here, we develop the heparinase and functional fibrinogen QATT assays. Methods Citrated whole blood (WB) samples were collected from 20 healthy volunteers using IRB-approved protocols No. 520566 and 944474. Half of the samples were used for fibrinogen, platelet count tests and the others were used for QATT measurements. For developing heparinase assay, WB samples from 4 healthy volunteers were randomly selected. For each volunteer sample, QATT experiments were performed for a WB sample, a WB sample spiked with 0.5 IU/mL heparin, and a WB sample spiked with heparin and then heparinase. For developing functional fibrinogen assay, QATT experiments were performed for a WB sample and a WB sample spiked with Cytochalasin-D (4 μM). Coagulation was triggered via intrinsic pathway. Pearson correlation coefficient (rp) or the Spearman rank correlation coefficient (rs) was used for correlation analysis. We focused on the following QATT parameters: CIT, MCF, and MCE. Results The heparinase assay effectively reversed heparinized samples (Fig. 1a). CIT of normal and heparinized samples treated with heparinase were within reference range (Fig. 1b). The effect of Cytochalasin-D was shown in Fig 1c. Strong correlation was found between MCE of Cyto-treated WB and fibrinogen level (rp = 0.75). MCE of the difference between normal and Cyto-treated WB, referred to as MCEplatelet, was also strongly correlated with platelet count test (rs = 0.76). The normal range for MCF of the functional fibrinogen assay is efficient in ruling out abnormal fibrinogen level (Fig. 1d). Conclusions QATT accurately predicted the inhibition of heparin by heparinase. QATT functional fibrinogen assay detected the contribution of both fibrinogen and platelets to the clot strength.

Role of Emotional Intelligence on Employee Performance in Selected Public Sector Banks in Madhya Pradesh State (Jabalpur Region)

In the wake of a seemingly rigorous recruitment process in the banking industry, where candidates' intelligence level appears to be more important than their emotional state, this study investigated how employees' emotional intelligence is related with job performance in selected banks in Madhya Pradesh state. Emotional intelligence was categorized by empathy, while employee performance was categorized by employee turnover. This study used a correlational research design. Three banks from the state of Madhya Pradesh have been selected for coverage. Pearson's Product Moment Correlation Coefficient was used for data analysis. The results revealed that empathy has a strong negative relationship with employee turnover. It is recommended that management implement policies that both ensure the employment of emotionally intelligent employees and create opportunities within the organization that improve employee relations and employee performance to reduce employee turnover.

Modification of an AIE Fluorescent Probe for Monitoring the Polarity of Lipid Droplets Based on a Series of Synthesized Aryl Naphthalizes.

Lipid droplets (LDs) are subcellular organelles that are dynamic and play a central role in energy homeostasis and lipid metabolism. They also contribute to the transport and maturation of cellular proteins and are closely associated with several diseases. The important role of the cellular microenvironment in maintaining cellular homeostasis. Changes in cell polarity, particularly in organelles, have been found to be strongly linked to inflammation, Alzheimer's disease, cancer, and other illnesses. It is essential to check the polarity of the LDs. A series of arylated naphthalimide derivatives were synthesized using the Suzuki reaction. Modification of synthesized aryl naphthalimides using oligomeric PEG based on intramolecular charge transfer (ICT) mechanism. A series of fluorescent probes were designed to target LDs and detect their polarity. Nap-TPA-PEG3 probe exhibited high sensitivity to polarity. The addition of oligomeric polyethylene glycol (PEG) to the probe not only significantly improved its solubility in water, but also effectively reduced its cytotoxicity. In addition, the probe exhibited excellent aggregation-induced luminescence (AIE) properties and solvent discolouration effects. Nap-TPA-PEG3 probe exhibited high Pearson correlation coefficient (0.957163) in lipid droplet co-localization in cells. Nap-TPA-PEG3 could be used as an effective hand tool to monitor cell polarity.

Comparative analysis of nasal endoscopic and radiological findings in chronic rhinosinusitis patients

Background: Chronic rhinosinusitis (CRS) is a complex inflammatory disorder causing significant reduction in quality of life and interfere in day to day activity. Accurate diagnosis is crucial for effective management, typically involving nasal endoscopy and CT imaging to assess the extent of sinus involvement. Methods: This prospective observational study was conducted at Jaipur national university institute of medical sciences and research centre from July 2022 to May 2024. It included 75 patients diagnosed with CRS. Subjective quantification of disease was done using SNOT-22 scoring system. Diagnostic evaluations were performed using nasal endoscopy and CT scans, with findings scored according to the Lund-Kennedy and Lund-MacKay systems. Results: The study highlighted a strong correlation between endoscopic and CT findings, with Pearson correlation coefficients of 0.892 and 0.909 for endoscopic vs. SNOT-22 scores and CT vs. SNOT-22 scores, respectively. Discrepancies between the two diagnostic tools were also noted, emphasizing their complementary roles in CRS management. Conclusions: Integrating nasal endoscopy and CT imaging provides a robust framework for diagnosing and managing CRS, allowing for a detailed assessment of both mucosal and anatomical changes. The combined use of these tools enhances the ability to tailor treatment plans effectively.

Knowledge, attitude, anxiety and perceived mental healthcare needs toward mpox infection among nursing students: A multi-center cross-sectional study

BackgroundDespite the crucial role of nursing students in managing public health crises, their understanding and attitudes towards monkeypox (mpox) remain underexplored. This study aims to assess nursing students' knowledge, attitudes, anxiety levels, and perceived need for mental healthcare support related to mpox across the UAE, Iraq, and Egypt. MethodsA cross-sectional survey was conducted with 1,386 nursing students from three universities using non-probability purposive sampling. Participants completed a structured questionnaire covering sociodemographic information, knowledge of mpox, attitudes towards the disease, levels of anxiety, and perceived mental healthcare needs. Knowledge was categorized into poor, fair, and good, attitudes into negative, neutral, and positive, and anxiety into low, moderate, and high levels. Data were analysed for correlations using Pearson's correlation coefficient and statistical tests. We performed multivariate regression analysis to find odd ratios of assessed parameters against several sociodemographic variables. ResultsAmong the participants, 21.8% demonstrated good knowledge of mpox, while 53.4% had moderate or fair knowledge and 24.8% had poor knowledge. Attitudes were predominantly neutral (44.7%) or negative (36%), and 57.2% reported moderate anxiety. Approximately 33% of students felt a significant need for mental healthcare support. Knowledge correlated positively with attitudes and negatively with anxiety and perceived mental healthcare needs. Attitudes also negatively correlated with perceived mental healthcare needs. ConclusionThe neutral or negative attitudes towards mpox suggest a need for enhanced educational interventions. Addressing these gaps through targeted training programs could improve knowledge, foster positive attitudes, and mitigate anxiety, thereby better preparing future healthcare professionals for emerging health threats.

A WRF-UCM-SOLWEIG framework for mapping thermal comfort and quantifying urban climate drivers: Advancing spatial and temporal resolutions at city scale

The capability to evaluate city-scale outdoor thermal comfort is crucial for understanding the public's experience of heat stress, especially during heat waves. Nevertheless, there remains a methodological gap in accurately mapping thermal comfort with high spatial and temporal resolutions in complex urban environment and in quantifying the contributions of various urban climate drivers, such as sky view factors and tree canopy fraction. To bridge this gap, we propose an innovative WRF-UCM-SOLWEIG framework that couples a mesoscale model with an urban microclimate model. Specifically, it integrates the Weather Research and Forecasting model coupled with the urban canopy model (WRF-UCM) and the Solar and Longwave Environmental Irradiance Geometry model (SOLWEIG). This framework is then applied to a densely populated tropical city in China, to quantify the impact of urban climate drivers on the Universal Thermal Climate Index (UTCI). The results reveal a significant diurnal variation in the impact of urban morphology. Notably, the most significant drivers affecting daytime UTCI are the impervious surface fraction and the tree canopy fraction, with maximum Pearson's correlation coefficients of 0.80 and -0.70, respectively. These findings suggest that urban heat mitigation strategies should prioritize on reducing impervious surfaces and enhancing shade management, alongside expanding urban forestry measures.

Aortic versus distal pressure for derivation of hyperaemic microvascular resistance: From the ILIAS registry

BackgroundIn patients with angina and non-obstructive coronary arteries (ANOCA), intracoronary function testing typically involves assessing the minimal microvascular resistance. This can be derived from the coronary flow and the distal pressure (Pd) during maximal hyperaemia. Theoretically, in ANOCA patients, resistance and pressure have minimal impact along the epicardial vessel, suggesting the possibility of deriving hyperaemic microvascular resistance (HMR) using aortic pressure (Pa) instead of Pd, but this has not been studied previously. Methods and resultsData from the ILIAS registry, a global multicentre registry pooling lesion-level coronary pressure and flow data, were used to compare HMR calculated with Pa versus Pd. A total of N = 1321 evaluated vessels were included. The study population consisted predominantly of men (68 %) with a mean age of 62 ± 10 years, and stable anginal symptoms (93 %). The overall correlation between HMR calculated with Pa and with Pd was good (Pearson's correlation coefficient: 0.84, p ≤0.005). The Bland-Altman plot showed a mean difference between HMR based on Pa and Pd of 0.53 (limits of agreements ±1.35). An adjusted Bland-Altman showed that the difference between HMR based on Pa and Pd was significantly related to the functional severity of the epicardial lesion (R2 = 0.71, coef.: −4.5, p < 0.005). In patients with a FFR >0.80 there were no considerable outliers, and with a FFR <0.80 outliers increased significantly. ConclusionsIn ANOCA patients, defined by a FFR above 0.80, HMR can be accurately measured with aortic pressure instead of distal pressure. However, in patients with a FFR below 0.80, there is a significant difference between HMR measured with Pa and Pd.

Association between Changes in Menarcheal Age and Adolescent Idiopathic Scoliosis: An Analysis of 38,879 Patients over 20 Years.

Menarche has a significant impact on the progression of adolescent idiopathic scoliosis (AIS); however, studies in this area are insufficient. This study used large-scale school screening data to investigate the relationship between menarcheal age and AIS, especially the severity of scoliosis. Of 2,326,577 students who participated in school screening for scoliosis (SSS) in South Korea from 2001 to 2021, 38,879 girls with AIS, who experienced menarche, were included. Data including the patient's demographics, such as menarcheal age, Cobb angle, Risser stage, and the interval between menarche and the time of screening were retrieved from the SSS database. Pearson correlation coefficient was used to identify the changes in menarcheal age according to the birth year and to investigate the relationship between menarcheal age and each variable of interest. Based on the birth year, the mean menarcheal ages in girls with AIS from 1988 to 2008 demonstrated a steadily decreasing trend over time (r = -0.857, p < 0.001). Girls with AIS and late menarche demonstrated a higher Cobb angle at the time of screening (r = 0.095, p < 0.001). Other variables did not significantly correlate with menarcheal age. Based on the SSS, a large-scale school screening dataset, menarcheal age in girls with AIS demonstrated an ongoing downward trend in the recent 20 years in South Korea. Notably, girls with AIS and late menarche had a higher Cobb angle at screening. Our findings indicate the need for earlier screening of AIS in girls who have not undergone menarche.

Reliability and validity of facial expression recognition in the screening of generalized anxiety disorder

IntroductionAnxiety disorder is one of the most prevalent mental disorders in China. However, there are obvious subjective factors in the current assessment of anxiety disorders, which may lead to certain diagnostic errors. The identification and diagnosis of anxiety disorders can be further improved if objective biological indicators are added in the assessment process. The current research validates facial expression recognition as a screening tool to assist in detecting generalized anxiety disorder. MethodsBased on the International Affective Picture System, we constructed an aided diagnostic experimental paradigm and recorded their facial expression. The split-half reliability was displayed by the Pearson correlation heatmap. The paradigm, GAD-7 and HAMA scales were administered to 60 generalized anxiety disorder patients and 60 matched healthy controls to evaluate the criterion-related validity. Additionally, we conducted a diagnostic study by using MINI as a gold standard and calculated ROC analysis to examine the screening performance of the facial expressions. ResultsThe heatmap showed very high correlations (r > 0.60, PS < 0.05) along the diagonal of the square heatmap (from the bottom left corner to the top right). The Pearson correlation coefficients between the GAD-7, HAMA and seven facial expressions ranged from −0.35(neutral, P < 0.01) to 0.34(angry, P < 0.01). The intergroup effects of neutral, anger and fear emotions were statistically significant (F = 18.893, P < 0.001; F = 20.535, P < 0.001; F = 9.091, P = 0.003). ROC analysis showed AUC for neutral, angry and scared facial expressions were 0.723, 0.792 and 0.727 respectively. ConclusionThis study constructed a tool for auxiliary screening of GAD patients and provided an objective automatic facial expression recognition method to assist psychological diagnosis.

Prostate volume on computed tomography correlates well with magnetic resonance imaging measurements and is reproducible across rater training levels.

Data are lacking for the accuracy of computed tomography (CT) in measuring prostate size, which can streamline care and prevent invasive procedures. We evaluate agreement and intra/inter-observer variability in prostate sizing between CT and magnetic resonance imaging (MRI) planimetry for a wide range of gland sizes. We retrospectively reviewed 700 patients who underwent MRI fusion biopsy at a single institution and identified 89 patients that had a CT within 2years of the MRI. Six reviewers from different training levels were categorized as student, resident, or attending and each measured prostate size on CT by the prolate ellipse method. Bland-Altman analysis determined the degree of agreement between CT and MRI. Inter- and intra-observer reliability was calculated for CT. Mean CT volume was higher than MRI volume in the < 60g group (51.5g vs. 44.5g, p = 0.004), but not in the ≥ 60g group (101g vs. 100g, p = 0.458). The bias for overestimation of prostate volume by CT was 4.1g across prostate volumes, but the proportional agreement between modalities improved with size. The Pearson correlation coefficient between CT/MRI and inter/intra-rater reliability for CT increased in the ≥ 60g vs. the < 60g group for all training levels. Our data show that there is greater clinical utility for prostate size estimation by CT than previously established, particularly for larger glands where accurate size estimation may influence therapeutic decisions. In larger glands, prostate size estimation by CT is also reproducible across various training levels.

CIRCULATING HEPARAN SULFATE PROFILES IN PEDIATRIC ACUTE RESPIRATORY DISTRESS SYNDROME.

Introduction: Sepsis-induced degradation of endothelial glycocalyx heparan sulfate (HS) contributes to the pulmonary microvascular endothelial injury characteristic of acute respiratory distress syndrome (ARDS) pathogenesis. Our objectives were to (1) examine relationships between plasma indices of HS degradation and protein biomarkers of endothelial injury and (2) identify patient subgroups characterized by distinct profiles of HS degradation in children with ARDS. Methods: We analyzed prospectively collected plasma (2018-2020) from a cohort of invasively mechanically ventilated children (aged >1 month to <18 years) with ARDS. Mass spectrometry characterized and quantified patterns of HS disaccharide sulfation. Protein biomarkers reflective of endothelial injury (e.g., angiopoietin-2, vascular cell adhesion molecule-1, soluble thrombomodulin) were measured with a multiplex immunoassay. Pearson correlation coefficients were used to construct a biomarker correlation network. Centrality metrics detected influential biomarkers (i.e., network hubs). K-means clustering identified unique patient subgroups based on HS disaccharide profiles. Results: We evaluated 36 patients with pediatric ARDS. HS disaccharide sulfation patterns, 6S, NS, and NS2S, positively correlated with all biomarkers of endothelial injury (all P < 0.05) and were classified as network hubs. We identified three patient subgroups, with cluster 3 (n = 5) demonstrating elevated levels of 6S and N-sulfated HS disaccharides. In cluster 3, 60% of children were female and nonpulmonary sepsis accounted for 60% of cases. Relative to cluster 1 (n = 12), cluster 3 was associated with higher oxygen saturation index (P = 0.029) and fewer 28-day ventilator-free days (P = 0.016). Conclusions: Circulating highly sulfated HS fragments may represent emerging mechanistic biomarkers of endothelial injury and disease severity in pediatric ARDS.

Zynq FPGA for Hardware Co-simulation of Takagi-Sugeno Neuro-Fuzzy for MPPT Algorithm Incorporating Sensorless Wind Speed Estimation in Grid-Connected Wind System

This paper presents a hardware implementation on the Field Programmable Gate Array (FPGA) Zed-Board of a Maximum Power Point Tracking (MPPT) incorporating pitch angle control system and sensorless wind speed estimation using the Takagi-Sugeno (TS) Adaptive Neuro-Fuzzy Inference System (ANFIS). The described approach is applied specifically to a grid-connected Permanent Magnet Synchronous Generator-based Variable Speed Wind Turbine (VSWT). Firstly, the paper proposes an estimator-based TS-ANFIS model for real-time wind speed estimation, addressing challenges with conventional anemometers, such as precision, and susceptibility to adverse weather conditions. The estimated wind speed guides the calculation of an optimized mechanical speed for MPPT control. Secondly, an MPPT-based TS-ANFIS controller is introduced to achieve the maximum power point, integrating pitch angle control to prevent turbine failures in high wind speeds. Finally, the paper emphasizes the hardware implementation on the FPGA Zed-Board, leveraging its parallel processing capabilities to enhance control system quality by reducing sampling periods and loop delays. Validation includes simulations in Matlab/Simulink using the Xilinx system generator and hardware co-simulation on the FPGA Zed-Board. A comparative analysis highlights the contributions and advancements of the proposed models and controllers compared to recent schemes in the field. Indeed, the proposed MPPT-based TS-ANFIS approach effectively maximizes the power extracted from the VSWT, achieving an estimated average efficiency of 99.84%. In contrast, PID methods show average efficiencies of 92.63%. Additionally, compared to other published works, the proposed MPPT-based TS-ANFIS method demonstrates a rapid response time of 0.001s and lower static error at 0.02%. Furthermore, the proposed WSE-based TS-ANFIS model exhibits superior performance and effectiveness, yielding a root mean squared error (RMSE) of 0.0085381, a determination coefficient (R2) value of 0.99985, and a Pearson correlation coefficient (r) value of 0.99996. Moreover, the proposed hardware implementation of these approaches maintains lower power usage, operating at a high frequency of 80.38MHz and achieving a high throughput of 2,572.16 Mbps.

Enhanced diagnostics for generalized anxiety disorder: leveraging differential channel and functional connectivity features based on frontal EEG signals

Generalized Anxiety Disorder (GAD) is a chronic anxiety condition characterized by persistent excessive worry, anxiety, and fear. Current diagnostic practices primarily rely on clinicians’ subjective assessments and experience, highlighting a need for more objective and reliable methods. This study collected 10-minute resting-state electroencephalogram (EEG) from 45 GAD patients and 36 healthy controls (HC), focusing on six frontal EEG channels for preprocessing, data segmentation, and frequency band division. Innovatively, this study introduced the “Differential Channel” method, which enhances classification performance by enhancing the information related to anxiety from the data, thereby highlighting signal differences. Utilizing the preprocessed EEG signals, undirected functional connectivity features (Phase Lag Index, Pearson Correlation Coefficient, and Mutual Information) and directed functional connectivity features (Partial Directed Coherence) were extracted. Multiple machine learning models were applied to distinguish between GAD patients and HC. The results show that the Deep Forest classifier achieves excellent performance with a 12-second time window of DiffFeature. In particular, the classification of GAD and HC was successfully obtained by combining OriFeature and DiffFeature on Mutual Information with a maximum accuracy of 98.08%. Furthermore, it was observed that undirected functional connectivity features significantly outperformed directed functional connectivity when fewer frontal channels were used. Overall, the methodologies developed in this study offer accurate and practical identification strategies for the early screening and clinical diagnosis of GAD, offering the necessary theoretical and technical support for further enhancing the portability of EEG devices.

Full head-to-head comparison of ultrasonography and CT scan in volumetric quantification of pleural effusion: a systematic review and meta-analysis.

Pleural effusion is a very common clinical finding. Quantifying pleural effusion volume and its response to treatment over time has become increasingly important for clinicians, which is currently performed via computed tomography (CT) or drainage. To determine and compare ultrasonography (US), CT, and drainage agreements in pleural effusion volumetry. Protocol pre-registration was performed a priori at ( https://osf.io/rnugd/ ). We searched PubMed, Web of Science, Embase, and Cochrane Library for studies up to January 7, 2024. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2), QUADAS-C, and Consensus-based Standards for the selection of health Measurement Instruments (COSMIN). Volumetric performances of CT, US, and drainage in assessment of pleural effusion volume were evaluated through both aggregated data (AD) and individual participant data (IPD) analyses. Certainty of evidence was evaluated using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Six studies were included with 446 pleural effusion lesions. AD results showed a perfect level of agreement with pooled Pearson correlation and intraclass correlation coefficient (ICC) of 0.933 and 0.948 between US and CT. IPD results demonstrated a high level of agreement between US and CT, with Finn's coefficient, ICC, concordance correlation coefficient (CCC), and Pearson correlation coefficient values of 0.856, 0.855, 0.854, and 0.860, respectively. Also, both results showed an overall perfect level of agreement between US and drainage. As for comparing the three combinations, US vs. CT and US vs. drainage were both superior to CT vs. drainage, suggesting the US is a good option for pleural effusion volumetric assessment. Ultrasound provides a highly reliable, to-the-point, cost-effective, and noninvasive method for the assessment of pleural effusion volume and is a great alternative to CT or drainage.

Identification of complex co-occurring symptom burden in persons with cancer through multisite implementation of health-related social needs assessment in community oncology settings.

306 Background: Health related social needs (HRSN) impact cancer outcomes and patient experience, but their integration into routine cancer care is highly variable. To expand the implementation-centered evidence base for effective HRSN assessments, we studied a scalable HRSN screening tool to identify distress and complex symptom burden in patients with cancer. Methods: We prospectively tracked HRSN screenings (using the National Comprehensive Cancer Network [NCCN] Distress Thermometer [DT]) of patients at varying points during their cancer care between 07/2023-12/2023 at seven multi-site community oncology practices within the US Oncology Network. DT responses were used to evaluate the positive finding rate, types of distress reported, and correlations between distress areas and concerns reported. Results: Overall, 219,720 unique patients with cancer received 269,666 HRSN screenings using the NCCN DT; 27% had a distress score ≥1 and 38.5% reported a concern (of whom, 58.2% reported &gt;1). Co-occurring concerns that were most correlated (Pearson correlation coefficient) were emotional &amp; practical concerns in 49% of screenings, physical &amp; practical 44%, emotional &amp; social 37% and social &amp; practical concerns 36%. Emotional symptoms most frequently reported together were sadness/depression + worry/anxiety 47%, loss of interest + sadness/depression 44%, and loneliness &amp; sadness/depression 38.5%. Regarding complex symptom burden, the physical and psychosocial symptoms that were most correlated were fatigue &amp; sleep 43%, pain &amp; fatigue 40%, pain &amp; sleep 38%, anxiety/worry &amp; fatigue 37%, anxiety/worry &amp; sleep 36%. Fatigue and pain, the two most frequently reported concerns were strongly correlated with emotional and practical concerns like sleep, worry or anxiety, memory or concentration, loss or change of physical abilities, sadness or depression, loss of interest or enjoyment, changes in eating, ability to take care of self, feelings of worthlessness or being a burden, etc. Concerns with the strongest correlations are reported in the table. Conclusions: Distress and its components impact multiple cancer outcomes making their rapid identification and consequent action key to high-quality cancer care. The findings highlight the NCCN DT as a scalable approach to integrate HRSN screening and to identify complex symptom burden in the real-world practice. Co-occurring physical and psychosocial concerns. Concern 1 Concern 2 Correlation r Sadness or depression Worry or anxiety 47.3% 0.5 Loss of interest or enjoyment Sadness or depression 44.3% 0.4 Fatigue Sleep 42.5% 0.4 Pain Fatigue 40.0% 0.4 Loneliness Sadness or depression 38.5% 0.4 Pain Sleep 37.8% 0.4 Worry or anxiety Fatigue 36.7% 0.4 Worry or anxiety Sleep 36.1% 0.4 Taking care of myself Taking care of others 35.9% 0.4

Comprehensive evaluation of bioavailable phosphorus in biochar synthesized by co-pyrolysis of sewage sludge and straw ash

The world's phosphorus (P) resources are gradually depleting. Sewage sludge is an important secondary P resource, and sludge-derived biochar for land use is an effective way to achieve P recovery. However, P in biochar synthesized by direct pyrolysis of sludge usually shows comparatively low bioavailability. In this study, biomass ash from different types of straw was used as an additive for co-pyrolysis with sludge. The distribution of different P fractions in the obtained co-pyrolyzed biochar was investigated. The P bioavailability of the co-pyrolyzed biochar was comprehensively evaluated by three methods, including chemical extraction, diffusive gradients in thin films (DGT) technology and pot experiments. The results indicate that the bioavailable P in co-pyrolyzed biochar is significantly positively correlated with the contents of K, Ca, and Mg elements in straw ash, which facilitate the transformation of P in sludge into forms that are more easily utilized by plants, including monetite (CaHPO4), hydroxyapatite (Ca5(PO4)3OH) and pyrocoproite (K2MgP2O7). Moreover, pot experiments show that the P contents in ryegrass shoots and roots cultivated in co-pyrolyzed biochar-added soils increased by 11.98–114.97 % and 28.90–69.70 %, respectively, compared to the control soil. The DGT technology could better reflect the uptake of P by plants with a Pearson correlation coefficient as high as 0.94. This study provides references for P resource recovery, and the collaborative reutilization of sewage sludge and straw ash.