Rank Correlation Research Articles

Relationships between survival and real-world recurrence-free survival or distant metastasis-free survival among patients with completely resected stage IIB or IIC melanoma.

Long follow-up time is needed for overall survival (OS) data to mature for early-stage melanoma. This retrospective study aimed to describe the relationships between OS and two intermediate endpoints - real-world recurrence-free survival (rwRFS) and real-world distant metastasis-free survival (rwDMFS) - for patients with stage IIB or IIC melanoma that was completely resected from 1 January 2008 to 31 December 2017, with follow-up to 31 December 2020. We used three different approaches to describe the relationships: estimates of correlation using Kendall τ rank correlation; comparisons of all-cause survival with/without recurrence or distant metastasis using adjusted Cox proportional hazard models; and landmark analyses of all-cause survival stratified by recurrence status at 1-5 years. During a 39-month median follow-up from surgical resection, 223/567 patients (39%) experienced recurrence, among whom 171/567 patients (30%) developed distant metastasis. Median OS from surgical resection was 117.6 months [95% confidence interval (CI), 104.7-not reached], median rwRFS was 49.8 months (95% CI, 39.6-61.0), and median rwDMFS was 70.9 months (95% CI, 58.4-89.1). We observed strong correlations between rwRFS and OS, and between rwDMFS and OS (Kendall τ of 0.73 and 0.82, respectively). Risk of death was significantly greater after recurrence (all-cause survival adjusted hazard ratio [HR], 7.48; 95% CI, 4.55-12.29) or distant metastasis (adjusted HR, 11.00; 95% CI, 6.92-17.49). Risk of death remained significantly elevated with recurrence or distant metastasis by landmark years 1, 3, and 5 after surgical resection. These findings support the use of recurrence/rwRFS and distant metastasis/rwDMFS as surrogate endpoints for OS after complete resection of stage IIB or IIC melanoma.

Comparison of qualitative and fully automated quantitative tools for classifying severity of white matter hyperintensity

Objectives: In this study, we aimed to compare the Fazekas scoring system and quantitative white matter hyperintensity volume in the classification of white matter hyperintensity severity using a fully automated analysis software to investigate the reliability of quantitative evaluation.Materials and Methods: Patients with suspected cognitive impairment who underwent medical examinations at our institution between January 2010 and May 2021 were retrospectively examined. White matter hyperintensity volumes were analyzed using fully automated analysis software and Fazekas scoring (scores 0–3). Using one-way analysis of variance, white matter hyperintensity volume differences across Fazekas scores were assessed. We employed post-hoc pairwise comparisons to compare the differences in the mean white matter hyperintensity volume between each Fazekas score. Spearman's rank correlation test was used to investigate the association between Fazekas score and white matter hyperintensity volume.Results: Among the 839 patients included in this study, Fazekas scores 0, 1, 2, and 3 were assigned to 68, 198, 217, and 356 patients, respectively. White matter hyperintensity volumes significantly differed according to Fazekas score (F=623.5, p<0.001). Post-hoc pairwise comparisons revealed significant differences in mean white matter hyperintensity volume between all Fazekas scores (p<0.05). We observed a significantly positive correlation between the Fazekas scores and white matter hyperintensity volume (R=0.823, p<0.01).Conclusions: Quantitative white matter hyperintensity volume and the Fazekas scores are highly correlated and may be used as indicators of white matter hyperintensity severity. In addition, quantitative analysis may be more effective in classifying advanced white matter hyperintensity lesions than the Fazekas classification.

Optimizing wireless sensor networks using centrality metrics: a strategic approach

This research paper presents a methodology for improving wireless sensor network (WSN) performance by leveraging centrality measures, including degree, betweenness, closeness, eigenvector, and Katz centrality. Employing a random walk graph model, this study constructs networks with 30 and 50 nodes to investigate the impact of these centrality metrics on routing decisions to optimize energy efficiency, minimize latency, and enhance overall network reliability. Additionally, the paper provides a comprehensive analysis of the relationships among these centrality measures through various correlation techniques, such as Pearson correlation, Kendall rank correlation, and Spearman correlation, offering insights into how these metrics can effectively improve WSN operations.

Evaluation of birth outcomes, congenital anomalies and neonatal complications of singletons born to infertile women treated with letrozole: A retrospective cohort study.

At present, safety of letrozole administration as an ovulation-inducing drug still remains controversial. Investigation of the safety of letrozole use for the induction of ovulation in the Chinese population is scant. The present study aimed to fill this gap. Data concerning mothers using letrozole and birth outcomes of their singleton offspring were collected as the letrozole group (n=194), equivalent data from mothers using non-letrozole drugs and their singleton offspring were included as the non-letrozole group (control, n=154). Birth outcomes, congenital anomalies and neonatal complications were compared and analyzed between the two groups. Univariate analysis, Spearman's rank correlation analysis and the logistic regression model were utilized. For birth outcomes, the percentage of caesarean section deliveries in the letrozole group was lower than the non-letrozole group (43.8 vs. 56.4%, P=0.019). For congenital anomalies, no significant difference was found between the two groups (all P>0.05). The statistical P-value for the correlation between the maternal use of letrozole and neonatal complications was marginal (P=0.051). Results from the logistic regression analysis confirmed that maternal use of letrozole was not a significant contributor for neonatal complications, independent of statistical adjustment [crude odds ratio (OR), 1.436; 95% confidence interval (CI), 0.803-2.569; P=0.223 vs. adjusted OR, 1.406; 95% CI, 0.748-2.643; P=0.290). The results of the present study suggested that maternal use of letrozole for ovulation induction does not associate with poorer birth outcomes or increased risk of congenital anomalies and neonatal complications.

Motivasi dan Kinerja Peternak Kaitannya dengan Keberlanjutan Usaha Sapi Perah

This study aims to analyze the motivation and performance of dairy farmers and their relationship with the sustainability of the dairy farming business. The research was conducted at Putra Saluyu 1, which included a multi-purpose cooperative Tandangsari with a survey method. The sample used in this study consisted of 60 farmers selected through Simple Random Sampling. The study results showed that the motivation was classified as high (65.0%), and the performance was classified as high (70.0%). There was a significant correlation between motivation and business sustainability with a Spearman's rank correlation coefficient value (rS = 0.464). Moreover, a significant correlation exists between performance and business sustainability with Spearman's rank correlation coefficient value (rS = 0.462).

Effect of patellofemoral joint overstuffing following total knee arthroplasty without patella resurfacing on clinical efficacy and related factors analysis

ObjectiveTo analyze the influencing factors for patellofemoral joint (PFJ) overstuffing following total knee arthroplasty (TKA) without patella resurfacing, and explore the effect of PFJ overstuffing on clinical efficacy.MethodsA retrospective analysis was conducted on 168 patients with end-stage knee osteoarthritis who underwent TKA without patella resurfacing at our hospital between Match 2019 and September 2021. The clinical data of these patients were retrospectively analyzed. In this study, PFJ overstuffing was defined as a postoperative PFJ distance greater than 1 mm compared to the preoperative measurement. The occurrence of postoperative PFJ overstuffing was counted. The patients were divided into the overstuffing group (n = 109) and the non-overstuffing group (n = 59) to count the patellar thickness and thickness of femoral anterior condyle in all patients before and after surgery, and analyze the influencing factors for postoperative PFJ overstuffing in such patients. Patients were followed up for 2 years to compare the recovery time of postoperative pain, score of visual analogue scale (VAS) and flexion activity between the two groups.ResultsThere was no significant difference in patellar thickness between preoperative and postoperative measurements of the patients (P > 0.05). However, the thickness of the femoral anterior condyle and the PFJ distance after surgery increased significantly compared with those before surgery (P < 0.05). Among the 168 patients, 109 cases (64.88%) experienced PFJ overstuffing. The risk of PFJ overstuffing was higher in female patients than in male (P < 0.05). The preoperative thickness of the femoral anterior condyle in the overstuffing group was significantly smaller compared to the non-overstuffing group (P < 0.001). Compared with the non-overstuffing group, the overstuffing group had longer recovery time of postoperative pain (P < 0.05), and had lower flexion activity at 2 years after surgery (P < 0.001). However, no significant difference was found in VAS score between the overstuffing group and the non-overstuffing group at 2 years after surgery (P > 0.05). Spearman rank correlation analysis indicated females tend to have a lower preoperative thickness of the femoral anterior condyle (r=-0.424, P < 0.001), as well as a positive postoperative PFJ overstuffing (r = 0.237, P < 0.05). Furthermore, there was a negative correlation between preoperative thickness of the femoral anterior condyle and postoperative PFJ overstuffing (r=-0.540, P < 0.001).ConclusionFollowing TKA without patella resurfacing, there is a high risk of PFJ overstuffing, particularly among female patients and those with a small thickness of the femoral anterior condyle. Therefore, special attention should be given to these high-risk groups during clinical treatment.

Analysis of Risk Factors Related to Nurses' Attitudes and Patient Safety Culture Implementation

Patient safety is a critical global concern, with millions of adverse events occurring annually. Nurses' attitudes towards patient safety culture are pivotal in its successful implementation. This study aimed to assess the risk factors related to nurses' attitudes towards patient safety culture and its relationship with the implementation of patient safety culture in a public hospital dr. H. Moch. Ansari Saleh in Banjarmasin, Indonesia. A cross-sectional study was conducted among nurses working in a public hospital dr. H. Moch. Ansari Saleh in Banjarmasin, Indonesia. Data were collected using a questionnaire adapted from the National Patient Safety Guidelines and the AHRQ Hospital Survey on Patient Safety. The questionnaire assessed nurses' attitudes towards patient safety, the implementation of patient safety culture, and potential risk factors such as age, gender, years of experience, and workload. Data were analyzed using descriptive statistics, Spearman's rank correlation coefficient, and multivariate logistic regression. A total of 85 nurses participated in the study. The majority of nurses (81.2%) exhibited a moderate attitude towards patient safety, while 83.5% reported a moderate level of patient safety culture implementation. Spearman's rank correlation analysis revealed a weak positive correlation (rho = 0.417, p = 0.01) between nurses' attitudes and the implementation of patient safety culture. Multivariate logistic regression analysis identified age (OR = 1.12, 95% CI = 1.01-1.24) and workload (OR = 1.18, 95% CI = 1.05-1.33) as significant risk factors associated with a less positive attitude towards patient safety culture. In conclusion, while there is a positive relationship between nurses' attitudes and patient safety culture implementation, the relationship is weak. Age and workload were identified as significant risk factors for a less positive attitude towards patient safety culture. These findings highlight the need for targeted interventions to address these risk factors and enhance nurses' attitudes, thereby strengthening patient safety culture in the hospital.

The impact of pregnancy on sexual functioning in Polish women.

Sexual life of pregnant women alters during pregnancy due to the physiologic,' anatomic and hormonal changes in her body. Therefore, the aim of this study was to evaluate female sexual functioning after becoming pregnant. A prospective survey study including 148 pregnant women. An anonymous questionnaire including 60 inquiries concerning intimate relationship before and during pregnancy was performed. The following statistical test were used: Chi-square test of independence, Spearman's rank correlation coefficient and Wilcoxon test. The significance level of p = 0.05 was assumed. Most of the respondents were between 31 and 40years old (55%). Majority of them were married (86%). During pregnancy, slightly more than half of women had a moderate need for sexual intercourse (51%), a large percentage of them had a low need (32%), a high need for intercourse was declared by 17% of women. The correlation analysis showed a statistically significant relationship between women's education and the need for sex before pregnancy (p = 0.049). Respondents with higher degrees of education more often felt the need for intercourse before pregnancy. No correlation was found between education and the need for intercourse after pregnancy (p = 0.107). After becoming pregnant, 51% of women had less need for intercourse, 7% more, and 42% the same as before pregnancy, and these differences were statistically significant (p < 0.001). Also, a decreased satisfaction with sexual intercourse was reported during pregnancy (p < 0.001). After getting pregnant, the average number of intercourses decreased in majority (71%) of respondents, and differences in the number of intercourses before and during pregnancy were statistically significant (p < 0.001). Pregnancy has significant impact on woman's sexuality. After becoming pregnant majority of women declare less need for sexual intercourses, decreased number of intercourses with less satisfaction.

Criterion-related Validity of the Cognitive Function Score with the Revised Hasegawa's Dementia Scale and the Bedriddenness Rank with the Barthel Index and the Katz Index: A Multi-center Retrospective Study

Introduction The Cognitive Function Score (CFS) is a public scale for assessing the activities of daily living (ADL) in older adults with dementia in Japan. In contrast, the scores of the revised Hasegawa's dementia scale (HDS-R), an easy-to-use dementia screening tool developed in Japan, are significantly correlated with mini-mental state examination scores and are widely utilized in various countries. This novel study aimed to elucidate the previously unexplored criterion-related validity of the CFS and HDS-R and the Bedriddenness Rank (BR), Barthel Index (BI), and Katz Index (KI). Methods This was a multicenter retrospective study and a secondary analysis of our previous study. The study included patients aged ≥ 20 years hospitalized in chronic care settings between April 1, 2018, and March 31, 2021. We collected data from medical charts on admission, including age, sex, the BR, CFS, BI, KI, and HDS-R scores. Correlations between the CFS and HDS-R score, as well as between the BR and BI or KI, were analyzed using Spearman's rank correlation coefficients. Results A total of 749 participants were included in the analysis of criterion-related validity between the CFS and HDS-R. In the CFS cohort analysis, 202 patients (27.0%) were categorized as having a normal CFS, and the median HDS-R score was 18 (range: 6–26). The correlation coefficient between the CFS and HDS-R scores was -0.834 (p &amp;lt; 0.001). The correlation coefficient between BR and BI was -0.741 (p &amp;lt; 0.001), BR and KI was -0.740 (p &amp;lt; 0.001). Conclusion The CFS revealed significant criterion-related validity compared with the established cognitive assessment scale, the HDS-R. The BR also demonstrated significant criterion-related validity with the BI and KI.

Alcohol Abuse and Emotional Intelligence among adults of Karnataka

Emotional intelligence is the capacity of a person to successfully and appropriately react to a wide range of emotional inputs that are generated from the inner self and immediate environment. The present study was an attempt to examine the impact alcohol abuse on emotional intelligence among adults situated at Karnataka State. The research instruments used were Alcohol use disorder identification test and emotion quotient test. The statistical techniques used were Spearman’s Rank correlation and Mann Whitney U Test. The findings showed a positive link between the EI dimensions. There is a significant negative association between alcohol abuse and competency dimension of EI. The studies result indicates that there was no significant association between alcohol abuse and emotional intelligence. There is a significant difference in alcohol abuse-based on the level of education but no significant difference in Emotional intelligence based on the education level.

Comparison of Scheimpflug Imaging (Pentacam HR) and Swept-Source Optical Coherence Tomography (CASIA2) in Eyes With Macular Corneal Dystrophy.

Assessment of tomographic characteristics and interdevice comparability between Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany) and swept-source optical coherence tomography (CASIA2, Tomey Corp., Nagoya, Japan) in eyes with macular corneal dystrophy (MCD). Eyes with MCD were examined by Pentacam HR and CASIA2. Interdevice comparison was performed using a Wilcoxon matched pairs test and Bland-Altman plots with 95% limit of agreement. A Spearman rank correlation coefficient was used for correlating indices of both devices. This retrospective study included 31 eyes of 18 patients (mean age: 32.1 ± 10.7 years). Eyes with MCD demonstrated a moderate astigmatism with a Cylinder anterior of 2.56 ± 1.50 D (Pentacam HR) and 2.52 ± 1.57 D (CASIA2) without a difference between both devices. CASIA2 (0.34 ± 0.14 D) measured lower values of Cylinder posterior compared with Pentacam HR (0.96 ± 0.66 D) (P < 0.0001). Comparison of pachymetry (Pentacam HR vs. CASIA2) showed higher values of the central corneal thickness (619 ± 227 μm vs. 445 ± 67 μm, P = 0.0001) and the thinnest corneal thickness (499 ± 165 μm vs. 430 ± 60 μm, P = 0.0167) for Pentacam HR. Corneal densitometry measurement revealed that increasing gray scale units caused a greater interdevice difference for pachymetry values, as Pentacam HR measured higher than CASIA2 for more opaque corneas. Eyes with MCD tend to have thinner corneas and a higher amount of corneal astigmatism than healthy eyes. In advanced MCD, Scheimpflug technology may mistakenly overestimate corneal thickness. The pachymetry measurement of the optical coherence tomography should be used when planning corneal surgery such as excimer laser-assisted phototherapeutic keratectomy to determine the ablation depth.

Comparison of the measurement properties and consistency between the EQ-5D-3L and EQ-5D-Y-3L in adolescents aged 15–17 in China

ObjectiveTo evaluate and compare the measurement properties and consistency between the Chinese versions of EQ-5D-3L and EQ-5D-Y-3L among Chinese adolescent populations aged 15–17 years.MethodsChinese adolescents aged 15–17 studying in high school were recruited through online survey. Social-demographic characteristics and self-reported EQ-5D-3L and EQ-5D-Y-3L responses were collected in the survey. The consistency of responses between the two measures was assessed using redistribution property, and the consistency of utility values was assessed by intraclass correlation coefficients (ICC). Convergent validity and known-group validity were examined using Spearman’s rank correlation, F-test and effect sizes, respectively. Sensitivity was compared using relative efficiency (RE).Results762 respondents (48.8% male; age 15–17 years;) were recruited. The EQ-5D-3L showed a more severe ceiling effect than EQ-5D-Y-3L (78.2% vs. 66.0%). Respondents reported higher proportions of having problems in four dimensions using the EQ-5D-Y-3L than using the EQ-5D-3L. The consistency of corresponding dimensions between the two measures was relatively good, while non-negligible proportions of inconsistency were observed in “pain/discomfort” (11.4%) and “anxiety/depression” (15.7%) dimensions. The ICC of the utility values between the EQ-5D-3L and EQ-5D-Y-3L was 0.852 (p < 0.001). The Spearman’s rank correlation (range: 0.385–0.620) indicated an acceptable convergent validity between the correlative dimensions of the EQ-5D-3L and EQ-5D-Y-3L. The EQ-5D-Y-3L had a higher efficiency than the EQ-5D-3L at detecting differences across EQ VAS subgroups (ES = 1.793 for EQ-5D-3L, ES = 1.920 for EQ-5D-Y-3L). Mixed results were observed in sensitivity.ConclusionsBoth the EQ-5D-3L and EQ-5D-Y-3L are demonstrated to be valid and generally consistent for measuring HRQoL among adolescents aged 15–17 years in China. Respondents reported higher proportions of having problems using the EQ-5D-Y-3L than using the EQ-5D-3L. More research is warranted to compare the discriminant validity and test-retest reliability between the two measures.

Efficiency evaluation of 28 health systems by MCDA and DEA

BackgroundPolicymakers, who are constantly discussing growing health expenditures, should know whether the health system is efficient. We can provide them with such information through international health system efficiency evaluations. The main objectives of this study are: (a) to evaluate the efficiency of health systems in 28 developed countries by multiple-criteria decision analysis (MCDA) and data envelopment analysis (DEA) and (b) to identify reasonable benchmark countries for the Czech Republic, for which we collect information on the relative importance of health system inputs and outputs.MethodsWe used MCDA and DEA to evaluate the efficiency of the health systems of 28 developed countries. The models included four health system inputs (health expenditure as a relative share of GDP, the number of physicians, nurses, and hospital beds) and three health system outputs (life expectancy at birth, healthy life expectancy, and infant mortality rate). The sample covers 27 OECD countries and Russia, which is also included in the OECD database. To determine the input and output weights, we used a questionnaire sent to health policy experts in the Czech Republic.ResultsWe obtained subjective information on the relative importance of the health system inputs and outputs from 27 Czech health policy experts. We evaluated health system efficiency using four MCDA and two DEA models. According to the MCDA models, Turkey, Poland, and Israel were found to have efficient health systems. The Czech Republic ranked 16th, 19th, 15th, and 17th. The benchmark countries for the Czech Republic’s health system were Israel, Estonia, Luxembourg, Italy, the UK, Spain, Slovenia, and Canada. The DEA model with the constant returns to scale identified four technically efficient health systems: Turkey, the UK, Canada, and Sweden. The Czech Republic was found to be one of the worst-performing health systems. The DEA model with the variable returns to scale identified 15 technically efficient health systems. We found that efficiency results are quite robust. With two exceptions, the Spearman rank correlations between each pair of models were statistically significant at the 0.05 level.ConclusionsDuring the model formulation, we investigated the pitfalls of efficiency measurement in health care and used several practical solutions. We consider MCDA and DEA, above all, as exploratory methods, not methods providing definitive answers.

Community perceptions towards the ecosystem services of urban forests in Mekelle, Tigray, Ethiopia

Urban forests are crucial providers of ecosystem services, delivering significant benefits to residents and the environment. This study aimed to investigate how residents in Mekelle, Tigray, Ethiopia, perceive the ecosystem services provided by urban forests. Understanding these perceptions is essential, particularly in developing countries and the study area, where little research has been conducted on this topic. To achieve this objective, a questionnaire-based survey was conducted among randomly selected household heads from two sub-cities within Mekelle. The collected data were analyzed using both descriptive and inferential statistics, including Spearman rank correlation and ordinal regression analysis. These analyses helped identify the factors influencing inhabitants’ perceptions of ecosystem services. The findings revealed that residents placed a high value on the regulating ecosystem services provided by urban forests. In contrast, provisioning, supporting, and cultural ecosystem services were perceived at a medium level. Additionally, the analysis indicated that the level of education and age of respondents were significant factors influencing their overall perception of these ecosystem services. Higher educational attainment and older age were associated with a greater appreciation of the ecosystem services offered by urban forests. This study has important implications for urban forest management and policy. It highlights the necessity of incorporating community perceptions of ecosystem services into urban planning and management efforts. Moreover, the study recommends the need for local governments to focus on raising community awareness about the ecosystem services provided by urban forests. This can ensure more effective and inclusive urban forest management strategies that align with community values and needs.

Simplifying venous outflow: Prolonged venous transit as a novel qualitative marker correlating with acute stroke outcomes.

Prolonged venous transit (PVT), defined as presence of time-to-maximum 10 s within the superior sagittal sinus (SSS) and/or torcula, is a novel, qualitatively assessed computed tomography perfusion surrogate parameter of venous outflow with potential utility in pretreatment acute ischemic stroke imaging for neuroprognostication. We aim to characterize the correlation between PVT and neurological functional outcomes in thrombectomy-treated patients. A prospectively-collected database of large vessel occlusion acute ischemic stroke patients treated with thrombectomy was retrospectively analyzed. Spearman's rank correlation coefficient and point-biserial correlations were performed between PVT status (i.e., no region, either SSS or torcula, or both), 90-day modified Rankin score (mRS), mortality (mRS 6), and poor functional outcome (mRS 4-6 vs 0-3). Of 128 patients, correlation between PVT and 90-day mRS ( = 0.35, p < 0.0001), mortality (r = 0.26, p = 0.002), and poor functional outcome (r = 0.27, p = 0.002) were significant. There is a modest, significant correlation between PVT and severity of neurological functional outcome. Consequently, PVT is an easily-ascertained, qualitative metric that may be useful as an adjunct for anticipating a patient's clinical course. Future analyses will determine the significance of incorporating PVT in clinical decision-making.

Construction of New Bivariate Semilinear Copulas Based on the Ali–Mikhail–Haq, Farlie–Gumbel–Morgenstern and Plackett Families

Copulas are quite a popular, flexible, and useful tool for multivariate modeling in many fields of applications, including finance and insurance, actuarial sciences, biomedical studies, geostatistics, and hydrology. In this paper, we use the concept of diagonal function to build new bivariate copulas based on the well known and important Ali–Mikhail–Haq (AMH), Farlie–Gumbel–Morgenstern (FGM) and Plackett families. We also study some dependence properties of the newly constructed semilinear copulas, namely, the Spearman’s [Formula: see text] coefficient. In particular, we find that the range of this rank correlation coefficient varies between weak and moderate values for the transformed AMH and FGM families, although it varies between moderate and strong values for the transformed Plackett families. Moreover, in all cases, the Spearman’s [Formula: see text] coefficient reaches negative and positive values. Finally, we present a synthetic data generation algorithm, as well as a classical method of estimation of the copula association parameter [Formula: see text] for each of the six transformed bivariate families.

Alanine, a potential amino acid biomarker of pediatric sepsis: a pilot study in PICU

Sepsis is characterized by a metabolic disorder of amino acid occurs in the early stage; however, the profile of serum amino acids and their alterations associated with the onset of sepsis remain unclear. Thus, our objective is to identify the specific kinds of amino acids as diagnostic biomarkers in pediatric patients with sepsis. Serum samples were collected from patients with sepsis admitted to the pediatric intensive care unit (PICU) between January 2019 and December 2019 on the 1st, 3rd and 7th day following admission. Demographic and laboratory variables were also retrieved from the medical records specified times. Serum amino acid concentrations were detected by UPLC-MS/MS system. PLS-DA (VIP > 1.0) and Kruskal-Wallis test (p < 0.05) were employed to identify potential biomarkers. Spearman’s rank correlation analysis was conducted to find the potential association between amino acid levels and clinical features. The diagnostic utility for pediatric sepsis was assessed using receiver operating characteristic (ROC) curve analysis. Most of amino acid contents in serum were significantly decreased in patients with sepsis, but approached normal levels by the seventh day post-diagnosis. Threonine (THR), lysine (LYS), valine (VAL) and alanine (ALA) emerged as potential biomarkers related for sepsis occurrence, though they were not associated with PELOD/PELOD-2 scores. Moreover, alterations in serum THR, LYS and ALA were linked to complications of brain injury, and serum ALA levels were also related to sepsis-associated acute kidney injury. Further analysis revealed that ALA was significantly correlated with the Glasgow score, serum lactate and glucose levels, C-reactive protein (CRP), and other indicators for liver or kidney dysfunction. Notably, the area under the ROC curve (AUC) for ALA in distinguishing sepsis from healthy controls was 0.977 (95% CI: 0.925-1.000). The serum amino acid profile of children with sepsis is significantly altered compared to that of healthy controls. Notably, ALA shows promise as a potential biomarker for the early diagnosis in septic children.

The prognostic role of mitosis index, stage and grade of endometrial cancer in Dr. Soetomo General Academic Hospital Surabaya, Indonesia, in 2018-2020

HIGHLIGHTS 1. Mitotic index and grade are prognostic factors for endometrial cancer, but both are independent.2. Stage and mitotic index associated with cell proliferation affect the prognosis of endometrial cancer. ABSTRACT Objective: This study aimed to analyze the correlation between the mitotic index and the stage and grade of endometrial cancer. Materials and Methods: We collected pathology reports of endometrial cancer from the Pathology Laboratory at Dr. Soetomo General Hospital in Surabaya, Indonesia, covering cases diagnosed between 2018 and 2020. A total of 106 cases of endometrial cancer were included in this study. For each case, detailed records of the cancer stage, grade, and mitotic index were recorded. The mitotic index, an indicator of cell proliferation, was quantified, and its correlation with cancer stage and grade was assessed. To determine the strength and direction of these relationships, we performed a Spearman rank correlation statistical analysis for non-parametric data. Results: Our findings indicated a significant positive correlation between the mitotic index and the stage of endometrial cancer. An increase in the mitotic index, reflecting a higher proliferation rate of cancer cells, was associated with a more advanced cancer stage, suggesting that the mitotic index could potentially serve as a prognostic marker for assessing tumor progression in endometrial cancer. However, our analysis revealed no significant correlation between the mitotic index and the histological grade of endometrial cancer, implying that the grade, which typically reflects the differentiation status and morphological characteristics of the tumor cells, is independent of the proliferation rate as measured by the mitotic index. Conclusion: The mitotic index is positively correlated with the stage of endometrial cancer but does not show a correlation with the histological grade. These findings highlight the potential use of the mitotic index in staging endometrial cancer.

Developing a Methodology to Assess Pedestrian Walkability in the City Markets Using Multi-Attribute Decision-Making Techniques

City markets are one of the busiest urban areas in India and experience heavy pedestrian footfall. This study uses multi-attribute decision-making (MADM) techniques to rank market roads based on the existing condition of pedestrian infrastructure. A set of seven key attributes was identified containing 28 sub-attributes influencing pedestrian walkability. Videography and photographic surveys were conducted at selected roads of Aminabad Market (AM) in Lucknow, and Silchar Market (SM) in Silchar. Attribute weights were calculated using the entropy weight method, and the roads were ranked using the analytical hierarchy process, the technique for order of preference by similarity to ideal solution, and a novel walkability metric called the Market Walkability Index. Spearman’s rank correlation coefficient was found to be more than 0.9 among all three methods, indicating conformity in ranking. Internal or minor roads of both the market areas (AM and SM) were observed to be the most used roads of the market areas for pedestrian movement. Still, they were not safe and walkable for pedestrian movement, indicating that more emphasis is required on these roads to improve the overall quality of the pedestrian walking environment. Research findings are expected to be essential inputs for rational decision-making about pedestrian infrastructure improvement in developing countries, which could contribute to a safer and more efficient environment for pedestrian movement.

Factors Affecting ERP System Implementation Among Selected Organizations: A Proposed Operational Strategies

The successful implementation of Enterprise Resource Planning (ERP) systems relies heavily on the interplay between management-specific factors and operational-specific factors. This study investigates these critical success factors, focusing on their impact on organizational performance. Management-specific factors, including top management support, package selection, and organizational fit, provide strategic direction and resources, ensuring alignment with operational goals. The research employed a quantitative approach to gather data from employees of selected organizations that have implemented ERP systems. The survey targeted employees from selected organizations who use ERP systems. The responses were analyzed using statistical techniques such as frequency analysis, mean, standard deviation, Spearman’s rank correlation, and multiple regression to identify the relationships and impacts of various CSFs on ERP implementation success. The study reveals that effective project management significantly enhances package selection, while comprehensive training improves organizational fit. Communication emerges as a pivotal element, influencing all aspects of ERP implementation. These findings underscore the necessity for a balanced approach that integrates both management and operational strategies to achieve optimal ERP outcomes and organizational efficiency.