Percent Chance Research Articles

Additional Relevant Intracranial Findings in Persons Screened with MR for Intracranial Aneurysms

BackgroundRadiological screening for intracranial aneurysms (IAs) may identify other relevant intracranial findings. We investigated their prevalence on MR in persons screened for IAs. MethodsWe included all persons who were screened for the presence of IAs with brain MRI/MRA between 1996 and 2022 because of a family history of aneurysmal subarachnoid haemorrhage (aSAH) or autosomal dominant polycystic kidney disease (ADPKD). We reviewed radiology reports of initial and repeated brain MR to identify additional intracranial findings that needed follow-up or treatment, or carried a risk of becoming symptomatic. ResultsWe included 766 persons (positive family history of aSAH: n = 681; ADPKD: n = 85) who had 1446 MRI/MRAs. At initial screening, 49 additional relevant intracranial findings were reported in 47 persons (6.1%, 95% CI 4.7–8.1%). Of all included persons, 338 (44%) underwent one (n = 154) or more (n = 184) follow-up screenings (total MRI/MRAs at follow-up: n = 680). In 15/338 persons (4.4%, 95% CI 2.7–7.2%), 16 new additional relevant findings were reported at a median follow-up duration of 10 years (IQR 5–12). ConclusionsPersons who are counselled for screening for IAs should be informed that there is a six percent chance of identifying an additional finding that requires follow-up or treatment, or may become symptomatic. Additionally, after 10-year follow-up screening there is a four percent chance of identifying a new additional relevant finding. The impact of such findings on quality of life needs further study.

Forecast of the Fuyao Groups Share Certificate

The article forecasts the price of share certificate of the Fuyao glass Industry Group Co., Ltd. As the Fuyao glass Industry Group Co., Ltd is the largest company in China that produces automotive glass and it has developed rapidly in recent times, it is meaningful to research its shock certificate and it will also be helpful for studying the trend of the entire industry. Both nave model and the ARIMA model could forecast the price of the Fuyaos share certificate well and have a low residual. The two models suggest that the price of the shock certificate will keep stable in 2024 and will maintain around 39 yuan per share. There is a 95 percent chance that the price will stay between 58 yuan and 19 yuan in Dec 2024. The chance that the price will stay between 51 yuan and 26 yuan in Dec 2024 will be 80 percent. This means that the company's development will become stable in 2024.

Economic expansion and innovation: A comprehensive analysis of Pakistan's path to technological excellence.

To encourage technological and industrial innovation, nations worldwide implement "re-industrialization" and "manufacturing return." This study investigates the relationship between GDP growth, expenditure on research and development, and medium- to high-tech as a percentage of manufactured exports on technological innovation in Pakistan. We evaluated long-run and short-run causal relationships using the ARDL, bound-F test, and ECM regression. The study found a positive relationship between GDP growth and technological innovation in the short and long run. In the short run, with a one-year lag, the analysis reveals a positive and statistically significant relationship between technological innovation, medium-high-tech exports, and GDP growth. In the long run, R&D is positive and significant, while economic growth and technological innovation are positive but not statistically significant. There is a 0.38 percent chance that exogenous shocks will eventually lead to equilibrium in the long run. Based on the findings of this study, it is recommended to allocate resources to research and development, promoting collaborative initiatives, ensuring intellectual property rights, and developing a skilled workforce.

Life cycle assessment of fibre metal laminates: An ecodesign approach

Despite the extensive research on renewable resources (RR) and their potential applications in composite materials and sandwich structures, there remains a significant dearth of life cycle assessment (LCA) studies that comprehensively evaluate the efficacy of RR in mitigating environmental impacts (EI). To bridge this gap, the present study aims to investigate twelve different designs of sandwich panels, specifically referred to as Fibre Metal Laminates (FML). These FML combine aluminium skins (2024-T3 and 1200-H14), polymer matrices (Epoxy, Polyester, and Castor oil Bio-PU), natural fibres (Sisal, Coir, and Cynodon spp.), surface treatments for aluminium skins (sanding, NaOH, and Washprimer), and treatments for natural fibres (Ground, NaOH-treatment and untreated). A cradle-to-gate LCA is conducted, and the inventories are modelled using the OpenLCA 1.6.3 and ecoinvent 3.9 cut-off regionalized database. EI are evaluated in twelve categories, including climate change, fossil and nuclear energy use, freshwater (acidification, ecotoxicity and eutrophication), human toxicity (cancer and non-cancer), mineral resources use, ozone layer depletion, particulate matter formation, photochemical oxidant formation, and terrestrial acidification. Impact World+ method for Latin America version 1.251 is employed to calculate EI. Nine Eco-efficiency indicators and trade-off analyses are evaluated to gain insights into design decision outcomes. Among the various panels considered, FML12, manufactured with aluminium alloy 1200-H14 treated only with sanding, castor oil biopolymer and untreated coir fibres, present the most consistent eco-efficiency indicators. The reference scenario considers the average characteristics of FML (both environmental and mechanical) for trade-off analysis. Despite the fifty percent chance of better performance, FML12 is the only panel that shows higher mechanical performance and lower EI compared to the reference scenario. The importance of this article lies in the novel results obtained using the proposed eco-efficiency indicators, which can be expanded in further studies on the topic.

Application of Electrochemical Method to Evaluate the Corrosion Conditions of Steel Bars

The purpose of this research is to use an electrochemical method to evaluate corrosion conditions of steel bars in concrete. According to the description of ASTM C876, when the corrosion potential measurement values of the steel bar are below -350 mV, there may be a greater than 90 percent chance of corrosion. If the current impedance of the concrete is below 10 kΩ-cm, there is a possibility of corrosion in the steel bar. The test plan is as follows: to use concrete with different concentrations of chloride ions or applying an electric current to the steel bars to accelerate the corrosion reaction. In addition, we plan to use a solution of chloride ions to simulate sea tidal erosion on reinforced concrete structures by spraying. According to the experimental observations, concrete containing chloride ions is very likely to cause internal corrosion of the steel bar. The current impedance of the concrete can be used as the basis for assessing the internal humidity and moisture content of concrete. With an increase in curing time, the concrete's resistance correspondingly increases.

The BRCA1 c.4096+1G>A Is a Founder Variant Which Originated in Ancient Times.

Approximately 30-50% of hereditary breast and ovarian cancer (HBOC) is due to the presence of germline pathogenic variants in the BRCA1 (OMIM 113705) and BRCA2 (OMIM 600185) onco-suppressor genes, which are involved in DNA damage response. Women who carry pathogenic BRCA1 variants are particularly likely to develop breast cancer (BC) and ovarian cancer (OC), with a 45-79 percent and 39-48 percent chance, respectively. The BRCA1 c.4096+1G>A variant has been frequently ascertained in Tuscany, Italy, and it has also been detected in other Italian regions and other countries. Its pathogenetic status has been repeatedly changed from a variant of uncertain significance, to pathogenic, to likely pathogenic. In our study, 48 subjects (38 of whom are carriers) from 27 families were genotyped with the Illumina OncoArray Infinium platform (533,531 SNPs); a 20 Mb region (24.6 cM) around BRCA1, including 4130 SNPs (21 inside BRCA1) was selected for haplotype analysis. We used a phylogenetic method to estimate the time to the most recent common ancestor (MRCA) of BRCA1 c.4096+1G>A founder pathogenic variant. This analysis suggests that the MRCA lived about 155 generations ago-around 3000 years ago.

133 A review of analgesia prescription in patients admitted with Neck of Femur Fractures

Abstract Background Analgesics are amongst the most commonly prescribed drugs within a hospital setting. Often prescribed based on clinical judgement and perceived pain, without formal evaluation. They are integral to patients comfort and experience. A study in 2008 showed that when patients had moderate to severe pain, they had only about a 50 percent chance of obtaining adequate pain relief, while another study in 2010 showed that the average cost per patient for readmission due to pain was $1,869 (≈£1,571) per visit. Aim Methods Review of drug charts of all the neck of femur patients admitted from 04/10/2022 to 22/10/2022 (30 in total). Recorded patient pain score extracted from admission clerking. Results Conclusion Pain score tends not to be recorded at the time of admission and analgesia is prescribed based on clinical judgement. Therefore, a poster of new Trust guidelines for patients admitted with Neck of Femur Fractures (NOF) was circulated amongst Orthopaedics department and A&E in Watford General Hospital, United Kingdom.

Prediction of stability coefficient of open-pit mine slope based on artificial intelligence deep learning algorithm

The mining of open pit mines is widespread in China, and there are many cases of landslide accidents. Therefore, the problem of slope stability is highlighted. The stability of the slope is a factor that directly affects the mining efficiency and the safety of the entire mining process. According to the statistics, there is a 15 percent chance of finding landslide risk in China’s large-scale mines. And due to the expansion of the mining scale of the enterprise, the problem of slope stability has become increasingly obvious, which has become a major subject in the study of open-pit mine engineering. In order to better predict the slope stability coefficient, this study takes a mine in China as a case to deeply discuss the accuracy of different algorithms in the stability calculation, and then uses a deep learning algorithm to study the stability under rainfall conditions. The change of the coefficient and the change of the stability coefficient before and after the slope treatment are experimentally studied with the displacement of the monitoring point. The result shows that the safety coefficient calculated by the algorithm in this paper is about 7% lower than that of the traditional algorithm. In the slope stability analysis before treatment, the safety factor calculated by the algorithm in this paper is 1.086, and the algorithm in this paper is closer to reality. In the stability analysis of the slope after treatment, the safety factor calculated by the algorithm in this paper is 1.227, and the stability factor meets the requirements of the specification. It also shows that the deep learning algorithm effectively improves the efficiency of the slope stability factor prediction and improves security during project development.

Subtotal gland resection for MR negative Cushing disease with no detectable tumor on gland exploration: operative video

MRI–Negative Cushing disease is a very difficult disease to treat medically and surgically. In the past, after negative gland exploration, hemihypophysectomy was commonly performed on the localizing side of inferior petrosal sampling. However, this generally resulted in 50% remission/cure rates. Therefore, other techniques have arisen based on the percent chance of microadenoma tumor being present in the gland. Subtotal gland resection is a technique aimed at removing 75% of the gland that results in a similar chance of remission and a 10% chance of pituitary dysfunction. In this video, the authors demonstrate this important technique for MRI–Negative Cushing disease. The video can be found here: https://thejns.org/doi/abs/10.3171/2023.4.FOCVID2320

MP43-15 MICROSURGICAL VARICOCELE REPAIR IMPROVES SPERM CAPACITATION AND PROBABILITY OF GENERATING A PREGNANCY, AS MEASURED BY PRE- AND POST-OPERATIVE TESTING WITH CAP-SCORE

You have accessJournal of UrologyCME1 Apr 2023MP43-15 MICROSURGICAL VARICOCELE REPAIR IMPROVES SPERM CAPACITATION AND PROBABILITY OF GENERATING A PREGNANCY, AS MEASURED BY PRE- AND POST-OPERATIVE TESTING WITH CAP-SCORE Muhamed Qalawena, Eric Seaman, Jared Johnson, Ahmed El-Sakka, and Joshua Bodie Muhamed QalawenaMuhamed Qalawena More articles by this author , Eric SeamanEric Seaman More articles by this author , Jared JohnsonJared Johnson More articles by this author , Ahmed El-SakkaAhmed El-Sakka More articles by this author , and Joshua BodieJoshua Bodie More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003289.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Infertility is a worldwide problem, with up to 40-50% of cases involving male infertility. Varicocele represents the most common correctable cause of male infertility. While semen analysis (SA) remains the primary diagnostic tool of infertility, it does not provide information about sperm function. The Cap-Score is designed to assess sperm capacitation via localization patterns of ganglioside GM-1, which has been shown to be a viable surrogate of capacitation-competent human sperm. The predicted probability of generating a pregnancy (PGP) is a validated metric based on semen volume, concentration, and Cap-Score. PGP is defined as the percent chance of obtaining a pregnancy within three consecutive rounds of intrauterine insemination (IUI). The objective of this study was to determine the effect of microscopic varicocelectomy on sperm capacitation and the probability of generating a pregnancy. METHODS: Data were collected prospectively of 40 consecutive adult men who presented with infertility confirmed by SA and found to have a varicocele on exam or ultrasound who underwent unilateral or bilateral subinguinal microscopic varicocelectomy. We recorded pre and post-operative SA, Cap-Score, and PGP with a 3-month follow up. Values were compared using paired t-test and Wilcox rank-sum test. RESULTS: Of the 40 men enrolled, 29 (72.5%) demonstrated improved Cap-Score with an average increase of 4% (p=0.001). The absolute change in probability of generating a pregnancy was 6% higher (p=0.001) after varicocelectomy, which represents a 25% relative increase in PGP. The change in Cap-Score was not associated with the grade of varicocele (p=0.0703) or whether the patient had a unilateral or bilateral repair (p=0.9682). There were no differences in semen volume (p=0.061) or morphology (p=0.091), however, there was improvement in sperm motility (p=0.021), total sperm count (p=0.030) and concentration (p=0.004). CONCLUSIONS: It is known that varicocelectomy improves semen parameters and chances of conception in the majority of cases, including pregnancies via intercourse or via assisted reproduction. This study confirms that varicocelectomy augments male fertility by improving sperm capacitation, and that varicocele repair improves the probability of generating an IUI pregnancy to a statistically-significant degree. The improvement in sperm capacitation ability may explain how varicocele repair may improve the chance of pregnancy, regardless of standard semen parameter improvements. Source of Funding: This study did not receive industry support. The only external funding for the study came from doctor M. Qalawena, a scholar visiting the University of Minnesota from the faculty of Medicine Suez Canal University, Egypt, whose personal educational grant by the Egyptian ministry of higher education funded the sixteen tests for the eight patients contributed from the University of Minnesota. Patients from the New Jersey site had received Cap-Score testing by Androvia LifeSciences Lab at patient expense. Physicians received no funding from Androvia for running the study, and the Androvia Labs did not have editorial control of the study results © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e607 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Muhamed Qalawena More articles by this author Eric Seaman More articles by this author Jared Johnson More articles by this author Ahmed El-Sakka More articles by this author Joshua Bodie More articles by this author Expand All Advertisement PDF downloadLoading ...

Homeopathic Management of Lumbar DiscHerniation

Lumbar disc herniation is a common cause of chronic or recurrent low back pain. It is most likely to occur at the L4-L5 and L5-S1 levels and upper lumbar levels are involved occasionally. The incidence of a herniated disc is about 5 to 20 cases per 1000 adults annually and is most common in people in their third to the fifth decade of life, with a male to female ratio of 2:1. The estimated prevalence of symptomatic herniated disc of the lumbar spine is about 1-3 percent of patients. The prevalence is most significant among 30-50-year-olds. The patients between 25-55 years old have an approximately 95 percent chance of herniated discs occurring either at L4-L5 or L5-S1. Disc disease is the underlying etiology in less than five percent of patients with back pain.

Inappropriate use of statistical power

We are pleased to add this typescript, Inappropriate use of statistical power by Raphael Fraser to the BONE MARROW TRANSPLANTATION Statistics Series. The authour discusses how we sometimes misuse statistical analyses after a study is completed and analyzed to explain the results. The most egregious example is post hoc power calculations.When the conclusion of an observational study or clinical trial is negative, namely, the data observed (or more extreme data) fail to reject the null hypothesis, people often argue for calculating the observed statistical power. This is especially true of clinical trialists believing in a new therapy who wished and hoped for a favorable outcome (rejecting the null hypothesis). One is reminded of the saying from Benjamin Franklin: A man convinced against his will is of the same opinion still.As the authour notes, when we face a negative conclusion of a clinical trial there are two possibilities: (1) there is no treatment effect; or (2) we made a mistake. By calculating the observed power after the study, people (incorrectly) believe if the observed power is high there is strong support for the null hypothesis. However, the problem is usually the opposite: if the observed power is low, the null hypothesis was not rejected because there were too few subjects. This is usually couched in terms such as: there was a trend towards… or we failed to detect a benefit because we had too few subjects or the like. Observed power should not be used to interpret results of a negative study. Put more strongly, observed power should not be calculated after a study is completed and analyzed. The power of the study to reject or not the null hypothesis is already incorporated in the calculation of the p value.The authour use interesting analogies to make important points about hypothesis testing. Testing the null hypothesis is like a jury trial. The jury can find the plaintiff guilty or not guilty. They cannot find him innocent. It is always important to recall failure to reject the null hypothesis does not mean the null hypothesis is true, simply there are insufficient evidence (data) to reject it. As the author notes: In a sense, hypothesis testing is like world championship boxing where the null hypothesis is the champion until defeated by the challenger, the alternative hypothesis, to become the new world champion.The authour include a discussion of what is a p-value, a topic we discussed before in this series and elsewhere [1, 2]. Finally, there is a nice discussion of confidence intervals (frequentist) and credibility limits (Bayesian). A frequentist interpretation views probability as the limit of the relative frequency of an event after many trials. In contrast, a Bayesian interpretation views probability in the context of a degree of belief in an event . This belief could be based on prior knowledge such as the results of previous trials, biological plausibility or personal beliefs (my drug is better than your drug). The important point is the common mis-interpretation of confidence intervals. For example, many researchers interpret a 95 percent confidence interval to mean there is a 95 percent chance this interval contains the parameter value. This is wrong. It means, if we repeat the identical study many times 95 percent of the intervals will contain the true but unknown parameter in the population. This will seem strange to many people because we are interested only in the study we are analyzing, not in repeating the same study-design many times.We hope readers will enjoy this well-written summary of common statistical errors, especially post hoc calculations of observed power. Going forth we hope to ban statements like there was a trend towards… or we failed to detect a benefit because we had too few subjects from the Journal. Reviewers have been advised. Proceed at your own risk. Robert Peter Gale MD, PhD, DSc(hc), FACP, FRCP, FRCPI(hon), FRSM, Imperial College London, Mei-Jie Zhang PhD, Medical College of Wisconsin.

The Negro Leagues Newly Incorporated into Major League Baseball: An Examination of Their Strength and an Evaluation of the Unification

The Negro Leagues Newly Incorporated into Major League BaseballAn Examination of Their Strength and an Evaluation of the Unification William Wise (bio) 1. introduction In December 2020 Major League Baseball (MLB) acknowledged that seven of the Negro Leagues were, indeed, major leagues. The seven specific leagues and their active years are as follows: 1. Negro National League I (NNLI) 1920– 31 2. Eastern Colored League (ECL) 1923– 28 3. American Negro League (ANL) 1929 4. Negro Southern League (NSL) 1932 season 5. Negro East- West League (NEWL) 1932 6. Negro National League II (NNLII) 1933– 48 7. Negro American League (NAL) 1937– 48 This study explores the strength of the Negro Leagues incorporated into MLB versus that of the National League (NL) and the American League (AL). To this end two methods are employed: (1) a statistical comparison of eleven seasons between the two sets of leagues and (2) an examination of one hundred and three specific games played between teams from the two sets of leagues. Though nonnumeric evidence is scrutinized the aforementioned points show that Negro Leagues were justifiably incorporated into MLB. 2. a multiyear statistical comparison of negro leagues versus the national league and the american league Based on the idea of Puerzer (2020)1 this section compares the overall records of the Negro Leagues that played between 1920 and 1948 to the National League [End Page 60] (NL) and the American League (AL).2,3 Statistics are pulled from eleven of the most significant seasons of Negro League Baseball between the years of 1920 and 1948. The years examined in the study are 1920, 1924, 1925, 1926, 1927, 1929, 1932, 1937, 1938, 1943, and 1947. The years 1920 and 1932 have significant data for them, so high- level “independent” teams are also included in the analyses. 2.1 Batting Statistics Nineteen twenty- four is the first season explored without considering independent teams. The Seamheads website has statistics for 967 games played by teams in the Negro National League I (NNLI) and the Eastern Colored League (ECL), which is 39.3 percent of the total number of the 2,462 NL and AL games played that season. Following Puerzer (2020) the batting averages (BAs) of the players with at least forty plate appearances are first inspected. In the NNLI and ECL in 1924 there were a total of 217 such players while in the NL and AL the total was 328 players.4 For the 217 NNLI/ECL players the average BA was .262875, and the equivalent average for the NL/AL was .263649. The standard deviations (SDs), a measure of the spread of the data, of the two sets of BAs are 0.058566 and 0.057854, respectively. The t-distribution is used to compare the two BA averages. See the appendix for a short description of statistical tests and those used in this paper. Welch’s t-test results conclude that there is no significant difference (at a 10 percent level) between the two averages of BAs. Another way of thinking of the outcome is that if one decides that there is a difference between the two BA averages there is a greater than 10 percent chance of being wrong.5 Thus the conclusion is that there is no such difference. See tables 1 and 2 for the results for all years and tests performed for batting statistics. To further compare the NNLI and ECL with the NL and AL the slugging percentages (SLGs) for the 217 and 328 players are investigated next. The averages of the two sets of SLGs are .353521 and .354217, respectively, whereas the two SDs are 0.108773 and 0.100458, respectively. As with the BAs, the outcome of Welch’s t-test shows there is no significant difference (at a 10 percent level) between the two averages of SLGs. The t-distribution is not the only statistical test that can be utilized. A two- tailed Z-test can be employed to compare BAs because they are proportions. For this test, rather than the average of the 217 and 328 BAs, the test considers the total overall BA of each set of players. For the 217 players in the...

Direct healthcare costs of non-metastatic castration-resistant prostate cancer in Italy.

The management of non-metastatic castration-resistant prostate cancer (nmCRPC) is rapidly evolving; however, little is known about the direct healthcare costs of nmCRPC. We aimed to estimate the cost-of-illness (COI) of nmCRPC from the Italian National Health Service perspective. Structured, individual qualitative interviews were carried out with clinical experts to identify what healthcare resources are consumed in clinical practice. To collect quantitative estimates of healthcare resource consumption, a structured expert elicitation was performed with clinical experts using a modified version of a previously validated interactive Excel-based tool, EXPLICIT (EXPert eLICItation Tool). For each parameter, experts were asked to provide the lowest, highest, and most likely value. Deterministic and probabilistic sensitivity analyses (PSA) were carried out to test the robustness of the results. Ten clinical experts were interviewed, and six of them participated in the expert elicitation exercise. According to the most likely estimate, the yearly cost per nmCRPC patient is €4,710 (range, €2,243 to €8,243). Diagnostic imaging (i.e., number/type of PET scans performed) had the highest impact on cost. The PSA showed a 50 percent chance for the yearly cost per nmCRPC patient to be within €5,048 using a triangular distribution for parameters, and similar results were found using a beta-PERT distribution. This study estimated the direct healthcare costs of nmCRPC in Italy based on a mixed-methods approach. Delaying metastases may be a reasonable goal also from an economic standpoint. These findings can inform decision-making about treatments at the juncture between non-metastatic and metastatic prostate cancer disease.

Modeling the Water Balance of Agricultural Land in the Determination of the Growing Season in Buru Regency

This study aims to determine the value of surplus and water deviation of agricultural land in Namlea District, Buru Regency. The study was conducted in Namlea Subdistrict, Buru Regency, Maluku Province. Materials used, questionnaires, climate data, air temperature, precipitation, humidity, solar rays 10-20 years. Tools used, computer equipment, writing stationery and location maps. To obtain the surplus value and water deficit of the land used data on the average amount of monthly precipitation and the average monthly temperature using the calculation of the Thornthwaite method. The calculation of the groundwater balance is carried out using a bookkeeping system. The data used are monthly potential evapotranspiration values, climate station data, monthly average rainfall, and rainfall at a 50 percent chance level. The observation parameters calculated in this study are rainfall, evapotranspiration, and determination of land water balance. The results of this study showed that the difference in rainfall and evapotranspiration in Namlea District was highest in June at 85.40 mm, and the lowest in October at -99.83 mm. This value indicates that the evapotranspiration value is greater than the average monthly rainfall value during the period 2010 – 2019. Namlea Subdistrict experienced potential water loss for evaporation (APWL) in May of 35.30 mm, in August to November of August of 65.26 mm, in September of 156.24 mm, in October of 256.07 mm and in November of 303.45 mm. The land water balance in Namlea Subdistrict, namely rainwater deviation, occurs in May, then August to November, while the water surplus occurs in December to July, and continues in June and July. Namlea district annual runoff is 854.01 mm. Regarding agricultural irrigation development policies, this study recommends that it is necessary to pay attention to weaknesses in each food crop sub-sector.

Transgender Adults Have Higher Rates Of Disability Than Their Cisgender Counterparts.

In the US population, the burden of disability among transgender adults compared with their cisgender peers is largely unknown. This study used seven years of pooled cross-sectional data from the Behavioral Risk Factor Surveillance System to examine how disability varies by gender across age groups. I present a series of nested logistic regression models to show the adjusted probability of disability among adults. Transgender adults have a higher probability of reporting a disability compared with cisgender men and women. After confounders are controlled for, transgender adults have a 27percent chance of having at least one disability at age twenty and a 39percent chance at age fifty-five, which is nearly twice the rate of their cisgender counterparts at both ages. The findings show the importance of considering disability from a life-course perspective, the effect of intersectional identities on disability risk, and the urgency of targeted health interventions for transgender people in the US.

Communicating Uncertainty Information in a Dynamic Decision Environment

Abstract The likelihood of threatening events is often simplified for members of the public and presented as risk categories such as the “watches” and “warnings” currently issued by National Weather Service in the United States. However, research (e.g., Joslyn and LeClerc) suggests that explicit numeric uncertainty information—for example, 30%—improves people’s understanding as well as their decisions. Whether this benefit extends to dynamic situations in which users must process multiple forecast updates is as yet unknown. It may be that other likelihood expressions, such as color coding, are required under those circumstances. The experimental study reported here compared the effect of the categorical expressions “watches” and “warnings” with both color-coded and numeric percent chance expressions of the likelihood of a tornado in a situation with multiple updates. Participants decided whether and when to take shelter to protect themselves from a tornado on each of 40 trials, each with seven updated tornado forecasts. Understanding, decision quality, and trust were highest in conditions that provided percent chance information. Color-coded likelihood information inspired the least trust and led to the greatest overestimation of likelihood and confusion with severity information of all expressions.

Risk Factors for Partial Flap Loss in a Free Flap: A 12-Year Retrospective Study of Anterolateral Thigh Free Flaps in 303 Lower Extremity Cases.

Despite remarkable improvements in free flap procedures, partial flap losses in perforator flaps still occur. This study aimed to analyze partial necrosis cases that underwent reconstruction of the lower extremities using anterolateral thigh free flaps and to identify risk factors causing the occurrence of partial necrosis. From January of 2005 to February of 2017, 303 anterolateral thigh free flaps were analyzed retrospectively. After collecting patient data, receiver operating characteristic curve analysis was conducted to find the critical distance between the perforator and the flap margin that distinguishes partial necrosis. Also, the rate of partial losses was calculated for each section after dividing the distance from the perforator to the flap margin into 1-cm sections. Lastly, logistic regression analyses were performed to identify the risk factors. Forty-three cases had partial flap loss (14.19 percent). Flaps with supradeep fat layer elevation showed the highest rate of partial necrosis (25.53 percent), with statistical significance ( p = 0.0001). In receiver operating characteristic curve analysis, the cutoff distance was 10.25 cm. In addition, flap tissues 8 cm away from the perforator have a 10.3 percent chance of necrosis, whereas those 12 cm away from the perforator have a 22.9 percent chance. Lastly, supradeep fat layer elevation (OR, 3.952) and large flap size (OR, 1.041) were risk factors for partial flap necrosis on multivariate analysis. The distance from the perforator to the flap margin, the flap elevation layer, and the flap size affected the occurrence of partial necrosis. Taking these into consideration, anterolateral thigh free flaps of appropriate size and thickness should be harvested. Risk, III.

Inter-individual Differences In Anxiety As A Result Of Aerobic Exercise In Adults With Fibromyalgia: Meta-analysis

It is unknown whether true inter-individual response differences (IIRD) exist with respect to changes in anxiety as a result of aerobic exercise training in adults with fibromyalgia (FM). PURPOSE: Determine whether true IIRD exist with respect to changes in anxiety as a result of aerobic exercise training in adults with FM. METHODS: Data from a previous as well as updated meta-analytic database of randomized controlled trials of exercise in adults with arthritis and other rheumatic diseases were sourced. Randomized controlled trials limited to aerobic exercise training on anxiety in adults >18 years of age with FM were included. Change outcome standard deviations treated as point estimates for anxiety were used to calculate true IIRD from each study. In addition, treatment effect data were extracted. The inverse variance heterogeneity (IVhet) model was used to pool all results. RESULTS: For the five studies and 321 participants in which results were pooled, statistically significant treatment effect reductions in anxiety were observed (Mean, -0.77 points, 95% CI, -1.25 to -0.77). However, no significant IIRD were found (Mean, 0.6 points, 95% confidence interval, -1.2 to 1.5). The 95% prediction interval for true IIRD in a future study was -1.7 to 0.8. The percent chance, i.e., probability, of a clinically meaningful difference in variability, i.e., IIRD, was 61.5% (only possibly clinically important). CONCLUSION: While aerobic exercise is associated with reductions in anxiety among adults with fibromyalgia, there is currently a lack of convincing evidence to support the notion that true IIRD exist. Therefore, a search for potential mediators and moderators associated with aerobic exercise and changes in anxiety among adults with FM may not be warranted. However, additional research is needed before any true level of certainty can be established. This includes (1) the assessment of IIRD in future randomized controlled trials, (2) randomized controlled trials of longer duration, and (3) an increase in the proportion of men included in randomized controlled trials.

Ectopic Pregnancy in A 28-year-old Woman with CuT IUCD in Situ – A Case Report

Background: There is a 3–4 percent chance of all pregnancies being ectopic in location. The risk of ectopic pregnancy to a woman using an Intrauterine Contraceptive Device (IUCD) is lower than that in a woman using no form of birth control. However if awoman gets pregnant whiles using the IUCD, the chances of having ectopic is more than 4 percent. Data on the occurrence of ectopic gestation with IUCD in situ is scanty, with no report of any such case in Ghana or West Africa. The objective of this report is therefore to contribute to knowledge on the subject with the view to bring it to attention among clinicians.Case: A 28year old woman (G3P1A+1) who has had copper IUCD in situ for over two years, reported to a health facility in Accra after missing her period for two weeks. She had performed a home-based urine pregnancy test on three separate occasions, and theywere all positive. A trans-vaginal ultrasound scan showed a small cystic lesion in the right adnexa with moderate fluid in the pouch of Douglas. A right tubal abortion was found at laparotomy.Conclusion: Ectopic pregnancy in women with an IUCD is an important major potential complication that can be life-threatening.Adequate counselling by clinicians would create awareness among clients for early reporting of amenorhoea and prompt intervention for desirable outcome.