Scale Values Research Articles

Predictors of In-Hospital Mortality after Thrombectomy in Anterior Circulation Large Vessel Occlusion: A Retrospective, Machine Learning Study.

Despite the increased use of mechanical thrombectomy (MT) in recent years, there remains a lack of research on in-hospital mortality rates following the procedure, the primary factors influencing these rates, and the potential for predicting them. This study aimed to utilize interpretable machine learning (ML) to help clarify these uncertainties. This retrospective study involved patients with anterior circulation large vessel occlusion (LVO)-related ischemic stroke who underwent MT. The patient division was made into two groups: (I) the in-hospital death group, referred to as miserable outcome, and (II) the in-hospital survival group, or favorable outcome. Python 3.10.9 was utilized to develop the machine learning models, which consisted of two types based on input features: (I) the Pre-MT model, incorporating baseline features, and (II) the Post-MT model, which included both baseline and MT-related features. After a feature selection process, the models were trained, internally evaluated, and tested, after which interpretation frameworks were employed to clarify the decision-making processes. This study included 602 patients with a median age of 76 years (interquartile range (IQR) 65-83), out of which 54% (n = 328) were female, and 22% (n = 133) had miserable outcomes. Selected baseline features were age, baseline National Institutes of Health Stroke Scale (NIHSS) value, neutrophil-to-lymphocyte ratio (NLR), international normalized ratio (INR), the type of the affected vessel ('Vessel type'), peripheral arterial disease (PAD), baseline glycemia, and premorbid modified Rankin scale (pre-mRS). The highest odds ratio of 4.504 was observed with the presence of peripheral arterial disease (95% confidence interval (CI), 2.120-9.569). The Pre-MT model achieved an area under the curve (AUC) value of around 79% utilizing these features, and the interpretable framework discovered the baseline NIHSS value as the most influential factor. In the second data set, selected features were the same, excluding pre-mRS and including puncture-to-procedure-end time (PET) and onset-to-puncture time (OPT). The AUC value of the Post-MT model was around 84% with age being the highest-ranked feature. This study demonstrates the moderate to strong effectiveness of interpretable machine learning models in predicting in-hospital mortality following mechanical thrombectomy for ischemic stroke, with AUCs of 0.792 for the Pre-MT model and 0.837 for the Post-MT model. Key predictors included patient age, baseline NIHSS, NLR, INR, occluded vessel type, PAD, baseline glycemia, pre-mRS, PET, and OPT. These findings provide valuable insights into risk factors and could improve post-procedural patient management.

Association of Early Dexmedetomidine Utilization With Clinical Outcomes After Moderate-Severe Traumatic Brain Injury: A Retrospective Cohort Study.

Traumatic brain injury (TBI) is an expensive and common public health problem. Management of TBI oftentimes includes sedation to facilitate mechanical ventilation (MV) for airway protection. Dexmedetomidine has emerged as a potential candidate for improved patient outcomes when used for early sedation after TBI due to its potential modulation of autonomic dysfunction. We examined early sedation patterns, as well as the association of dexmedetomidine exposure with clinical and functional outcomes among mechanically ventilated patients with moderate-severe TBI (msTBI) in the United States. We conducted a retrospective cohort study using data from the Premier dataset and identified a cohort of critically ill adult patients with msTBI who required MV from January 2016 to June 2020. msTBI was defined by head-neck abbreviated injury scale (AIS) values of 3 (serious), 4 (severe), and 5 (critical). We described early continuous sedative utilization patterns. Using propensity-matched models, we examined the association of early dexmedetomidine exposure (within 2 days of intensive care unit [ICU] admission) with the primary outcome of hospital mortality and the following secondary outcomes: hospital length of stay (LOS), days on MV, vasopressor use after the first 2 days of admission, hemodialysis (HD) after the first 2 days of admission, hospital costs, and discharge disposition. All medications, treatments, and procedures were identified using date-stamped hospital charge codes. The study population included 19,751 subjects who required MV within 2 days of ICU admission. The patients were majority male and white. From 2016 to 2020, the annual percent utilization of dexmedetomidine increased from 4.05% to 8.60%. After propensity score matching, early dexmedetomidine exposure was associated with reduced odds of hospital mortality (odds ratio [OR], 0.59; 95% confidence interval [CI], 0.47-0.74; P < .0001), increased risk for liberation from MV (hazard ratio [HR], 1.20; 95% CI, 1.09-1.33; P = .0003), and reduced LOS (HR, 1.11; 95% CI, 1.01-1.22; P = .033). Exposure to early dexmedetomidine was not associated with odds of HD (OR, 1.14; 95% CI, 0.73-1.78; P = .56), vasopressor utilization (OR, 1.10; 95% CI, 0.78-1.55; P = .60), or increased hospital costs (relative cost ratio, 1.98; 95% CI, 0.93-1.03; P = .66). Dexmedetomidine is being utilized increasingly as a sedative for mechanically ventilated patients with msTBI. Early dexmedetomidine exposure may lead to improved patient outcomes in this population.

Search potential of the high energy-large hadron collider for spin-1/2 excited quarks in di-jet final state

Composite models, which suggest a possible substructure of fundamental particles, can be directly proven by the discovery of the excited quark. Higher energy and higher-luminosity particle colliders are needed to discover the composite structure predicted in the proposed models. The High Energy Large Hadron Collider (HE-LHC) has the potential to be a possible discovery machine for composite models. In this collider, with a center-of-mass energy of 27 TeV and integrated luminosity between 750 and 15000 fb\textsuperscript{-1}, we calculated the exclusion, observation, and discovery limits for the mass of spin-1/2 excited quark in the \textit{di-jet} final state, as well as the attainable compositeness scale values. In addition to these calculations, we scanned free parameters from 0.06 to 1 to determine the HE-LHC potential to reveal spin-1/2 excited quark.

Note on black holes with kilometer-scale ultraviolet regulators

Regular black hole metrics involve a universal, mass-independent regulator that can be up to O(700km) while remaining consistent with terrestrial tests of Newtonian gravity and astrophysical tests of general relativistic orbits. However, for such large values of the regulator scale, the metric describes a compact, astrophysical-mass object with no horizon rather than a black hole. We note that allowing the regulator to have a nontrivial mass dependence preserves the horizon, while allowing large, percent-level effects in black hole observables. By considering the deflection angle of light and the black hole shadow, we demonstrate this possibility explicitly.

Rebuilding the Relative Value Unit–Based Physician Payment System

This Viewpoint explores the use of relative value units assigned by the Resource-Based Relative Value Scale in US physician payment systems and the need to rebuild this scale to reflect changes in modern clinical practice.

The Effect Of Simulated Patient Education On Critical Thinking Trends In Medical School Students

Introduction &amp;Objective: Critical thinking consists of mental processes such as reasoning, analysis, and evaluation. It is an objective super-thinking way open to self-correction and change. The main component of the current education methods is the acquisition of critical thinking. Simulated patient applications in medical education is an effective method that enables the student to acquire cognitive and psychomotor behaviors with active participation in the learning process. The aim of this study is to determine the change in the critical thinking tendencies of the third-year students of Akdeniz University Faculty of Medicine before and after simulated patient applications. Method: Third-year students of Akdeniz University Faculty of Medicine in the 2018-2019 academic year participated in the study. The students were asked to apply the Critical Thinking Disposition scale forms before the simulated patient applications. In the second stage of the study, the scale was reapplied to the students. The scale consists of 49 items. In our study, the results of the change between the first and the second applications of Critical Thinking Disposition scale were compared with the Paired Sample Test. Results &amp;conclusion: A total of 345 students participated in the study. The mean score obtained from the Critical Thinking Disposition scale of the whole group was 191.63 (SD = 21.07) in the fall term and 193.69 (SD = 23.63) in the spring term. Although there was an increase in mean values of CTHD scale, the difference was not statistically significant (t(344)=-1.09, p = 0.277). The multidimensional nature of critical thinking skills and the need for continuity in order to keep this skill sharp are considered effective on this result. Different applications can be added to the training program to develop this skill.

Significance of acupuncture treatment for medical staff with low back pain: A case report

AbstractA 24‐year‐old female nurse with a 4‐month history of low back pain (LBP) was treated with acupuncture because of difficulty to her working. At the first presentation, the numerical rating scale (NRS) value was 7. After 2 weeks, the NRS value improved to 2–3, and she could bend over better, including when working night shifts. After 4 months, the NRS value remained at 1–2 so her relocating or leaving of absence from the ICU department was avoided. Acupuncture treatment for medical staff with LBP could relieve their pain and improve decreased clinical performance in hospitals or clinics.

Planar Concentration Field Measurement In A Transient Jet Using Mie Scattering

An experimental method for time resolved concentration measurements in the near field of a transient starting turbulent air jet is presented. Planar Laser Mie Scattering (PLMS) using DEHS droplets produced by a Laskin nozzle as tracers of concentration is applied on an air jet with Reynolds number of 62.000 and is recorded with 10.000 frames per second. A jet penetration of about 20 nozzle diameters into the ambient environment is resolved with more than 100 frames. A linear response between grey scale values and concentration is found for mixtures up to 13% of the air-particle flow from the Laskin nozzle mixed with clean air. The calibration is based on images with no particles and images with a homogeneous particle concentration. A correction for light scattered by particles outside the laser sheet is proposed. The experimental results agree well with mean concentration measured with other techniques.

Usefulness of Body Fat and Visceral Fat Determined by Bioimpedanciometry versus Body Mass Index and Waist Circumference in Predicting Elevated Values of Different Risk Scales for Non-Alcoholic Fatty Liver Disease.

Obesity constitutes a public health problem worldwide and causes non-alcoholic fatty liver disease (MALFD), the leading cause of liver disease in developed countries, which progresses to liver cirrhosis and liver cancer. MAFLD is associated with obesity and can be evaluated by validated formulas to assess MAFLD risk using different parameters such as the body mass index (BMI) and waist circumference (WC). However, these parameters do not accurately measure body fat. As MAFLD is strongly associated with obesity, we hypothesize that measuring body and visceral fat by electrical bioimpedance is an efficient method to predict the risk of MAFLD. The objective of our work was to demonstrate that electrical bioimpedance is a more efficient method than the BMI or WC to predict an elevated risk of MAFLD. A cross-sectional, descriptive study involving 8590 Spanish workers in the Balearic Islands was carried out. The study's sample of employees was drawn from those who underwent occupational medicine examinations between January 2019 and December 2020. Five MAFLD risk scales were determined for evaluating very high levels of body fat and visceral fat. The determination of body and visceral fat was performed using bioimpedanciometry. Student's t-test was employed to ascertain the mean and standard deviation of quantitative data. The chi-square test was used to find prevalences for qualitative variables, while ROC curves were used to define the cut-off points for body and visceral fat. The calculations included the area under the curve (AUC), the cut-off points along with their Youden index, sensitivity, and specificity. Correlation and concordance between the various scales were determined using Pearson's correlation index and Cohen's kappa, respectively. As both total body fat and visceral fat increase, the risk of MAFLD increases with a statistically significant result (p < 0.001), presenting a higher risk in men. The areas under the curve (AUC) of the five scales that assess overweight and obesity to determine the occurrence of high values of the different MAFLD risk scales were very high, most of them exceeding 0.9. These AUC values were higher for visceral and body fat than for the BMI or waist circumference. FLD-high presented the best results in men and women with the AUC at around 0.97, both for visceral fat and total body fat, with a high Youden index in all cases (women body fat = 0.830, visceral fat = 0.892; men body fat = 0.780, visceral fat = 0.881). In our study, all the overweight and obesity scales show a very good association with the scales assessing the risk of MAFLD. These values are higher for visceral and body fat than for waist circumference and the BMI. Both visceral fat and body fat are better associated than the BMI and waist circumference with MAFLD risk scales.

SRG/eROSITA 3D mapping of the interstellar medium using X-ray absorption spectroscopy

We present a detailed study of the hydrogen density distribution in the local interstellar medium (ISM) using the X-ray absorption technique. Hydrogen column densities were precisely measured by fitting X-ray spectra from coronal sources observed during the initial eROSITA all-sky survey (eRASS1). Accurate distance measurements were obtained through cross-matching Galactic sources with the third Gaia data release (DR3). Despite the absence of a discernible correlation between column densities and distances or Galactic longitude, a robust correlation with Galactic latitude was identified. This suggests a decrease in ISM material density in the vertical direction away from the Galactic plane. We have also investigated the relation between the optical extinction and the hydrogen column density. To do so, we employed multiple density laws to fit the measured column densities, revealing constraints on height scale values ($9 &lt; h_ z &lt; 14$ pc). Unfortunately, radial scales and the central density remain unconstrained due to the scarcity of sources near the Galactic center. Subsequently, a 3D density map of the ISM was computed using a Gaussian process approach, inferring hydrogen density distribution from hydrogen column densities. The results unveil the presence of multiple beams and clouds of various sizes, indicative of small-scale structures. High-density regions were identified at approximately 100 pc, consistent with findings in dust-reddening studies, and are potentially associated with the Galactic Perseus arm or the local bubble. Moreover, high-density regions were pinpointed in proximity to the Orion, Chameleon, and Coalsack molecular complex, enriching our understanding of the intricate structure of the local ISM.

Опросник академической компетентности студентов

&lt;p&gt;The results of the development and standardization of an academic competence questionnaire are presented. The method is based on the understanding of academic competence as a complex of independently developed personal qualities, abilities and skills that ensure the success of educational activities in conditions of its variability during higher education. The theoretical model includes 6 structural and content components (academic motivation, self-organization of educational activities, emotional self-regulation, skills and abilities to work with information, proficiency in oral and written language, communication skills), presented at 3 levels of generality and freedom of transformation (reproductive, reflective, functional). Based on the results of Study 1 (N=199), the preliminary version of the questionnaire was reduced from 144 to 69 items. Comparing the results of successful and unsuccessful students confirmed predictive validity. External criterion validity using the contrast group method is based on comparison of groups of undergraduate and graduate students, correlations with self-organization and academic motivation questionnaires (AMS). Study 2 (N=355) demonstrated a relatively acceptable fit of the data to the theoretical model based on confirmatory factor analysis, consistency with educational experience questionnaire scales. The internal consistency of the scales was confirmed by Cronbach's alpha indicators based on data from studies 1 and 2. Descriptive statistics for Study 2 are provided. Standardization is proposed based on percentile values, because the distributions of values for most scales differ significantly from normal.&lt;/p&gt;

A dynamically equivalent atomistic electrochemical paradigm for the larger-scale experiments.

Electrochemical systems possess a considerable part of modern technologies, such as the operation of rechargeable batteries and the fabrication of electronic components, which are explored both experimentally and computationally. The largest gap between the experimental observations and atomic-level simulations is their orders-of-magnitude scale difference. While the largest computationally affordable scale of the atomic-level computations is ∼ns and ∼nm, the smallest reachable scale in the typical experiments, using very high-precision devices, is ∼s and ∼μm. In order to close this gap and correlate the studies in the two scales, we establish an equivalent simulation setup for the given general experiment, which excludes the microstructure effects (i.e., solid-electrolyte interface), using the coarse-grained framework. The developed equivalent paradigm constitutes the adjusted values for the equivalent length scale (i.e., lEQ), diffusivity (i.e., DEQ), and voltage (i.e., VEQ). The time scale for the formation and relaxation of the concentration gradients in the vicinity of the electrode matches for both smaller scale (i.e., atomistic) equivalent simulations and the larger scale (i.e., continuum) experiments and could be utilized for exploring the cluster-level inter-ionic events that occur during the extended time periods. The developed model could offer insights for forecasting experiment dynamics and estimating the transition period to the steady-state regime of operation.

Professional Identity in Irish Certified Athletic Therapists

Professional identity is an important construct that considers an individual’s own values, beliefs, attitudes, and motives surrounding their own role in their profession. No research has examined this concept in athletic training/therapy beyond the U.S. context. We examined professional identity in Irish certified athletic therapists (n = 81) using the Professional Identity and Values Scale. Participants presented with a total Professional Identity and Values Scale score of 92.0 ± 9.9. Age (r = .26, p = .02; r = .27, p = .02) and years of experience (r = .29, p = .01; r = .32, p = .0004) were positively correlated with total Professional Identity and Values Scale score and professional development subscale score, respectively. No gender differences were observed (p &gt; .05). Despite being a new emerging profession, Irish athletic therapists presented with a strong professional identity.

Turkish psychometric characteristics of the humanistic practice ability of nursing scale: differences by education, working year, and professional satisfaction

BackgroundHumanistic nursing practices scientifically improve the knowledge structure of nursing, enrich its theoretical system and support its development. Therefore, it is crucial to evaluate the humanistic practice abilities of nurses.ObjectiveThis study aimed to test the psycholinguistic features, language and construct validity of the Humanistic Practice Ability of Nursing Scale and to examine it according to nurses’ demographic characteristics.Design and methodsThis study was a methodological type of analytical research conducted with 397 clinical nurses working in a hospital. A questionnaire including demographic information and evaluating empathy and compassion adequacy was used. Data were analyzed using explanatory and confirmatory factor analysis, Cronbach’s alpha, item-total score correlation, split-half analysis, t-test, analysis of variance and correlation analysis.ResultsThe scale consists of 29 items and four factors, explaining 61.15% of the total variance. Factor loads were > 0.30. confirmatory factor analysis results were χ2/df: 2.58, GFI: 0.86, TLI: 0.91, IFI: 0.92, CFI: 0.92, RMSEA: 0.06, and SRMR: 0.03. The Cronbach alpha value for the full scale is 0.95. A significant relationship was found between the scale and empathy and compassion proficiency. It was observed that the scale scores differed according to the nurses’ education level, working years and job satisfaction (p < 0.05).ConclusionThis study shows that the Turkish version of the HPAN scale is valid and reliable for 29 items and four factors. The humanistic practice ability of nurses differ according to postgraduate education, years of working in the profession and professional satisfaction.

Vessel Monitoring System (VMS) Technology as a Management Strategy for Longline Tuna Capture Fisheries in Benoa

Benoa Port has fishing vessel activities that are the foundation of Bali's tuna swamp fisheries (longlines). Sustainable tuna capture fisheries will be impossible to attain if the number of infractions in the marine and fisheries sectors continues to rise. The government's efforts to reduce infractions in marine and fisheries are achieved through tightening the oversight system. The Vessel Monitoring System (VMS) surveillance system was created to reduce breaches in the marine and fishery sectors. The goal of this study is to determine the monitoring and suspected indication of violations of longlines using the VMS at the Benoa PSDKP as well as to learn about the capture fisheries management strategy using VMS data on longlines at Benoa Port using an analytic hierarchy process (AHP) approach. This study used a qualitative-quantitative descriptive technique with AHP analysis to determine the value of the management priority scale. Based on the findings of monitoring longlines with web tracks from January to December 2022, the most targeted fishing area was the Indian Ocean High Seas, and the most prominent suspected indication of violation was the inactivity of VMS when the vessel was operating. The main approach for managing capture fisheries utilizing VMS data on longlines in Benoa Port with the AHP analysis is for the government to offer subsidies for installing VMS on all fishing vessels, particularly those under 30 GT.

Spectral distortions from acoustic dissipation with non-Gaussian (or not) perturbations

A well-known route to form primordial black holes in the early universe relies on the existence of unusually large primordial curvature fluctuations, confined to a narrow range of wavelengths that would be too small to be constrained by Cosmic Microwave Background (CMB) anisotropies. This scenario would however boost the generation of μ-type spectral distortions in the CMB due to an enhanced dissipation of acoustic waves. Previous studies of μ-distortion bounds on the primordial spectrum were based on the assumptions of Gaussian primordial fluctuations. In this work, we push the calculation of μ-distortions to one higher order in photon anisotropies. We discuss how to derive bounds on primordial spectrum peaks obeying non-Gaussian statistics under the assumption of local (perturbative or not) non-Gaussianity. We find that, depending on the value of the peak scale, the bounds may either remain stable or get tighter by several orders of magnitude, but only when the departure from Gaussian statistics is very strong. Our results are translated in terms of bounds on primordial supermassive black hole mass in a companion paper.

The Effect of Endorphin Massage on Reducing Back Pain in Third Trimester Pregnant Women

Every pregnant woman will experience various changes that occur in the first trimester, second trimester and third trimester. One of the discomforts experienced by third trimester pregnant women is musculoskeletal changes that cause pain in the mother's back. Pain therapy can be done pharmacologically and non-pharmacologically. One of the non-pharmacological pain therapies is endorphin massage, which is a light touch or massage technique that can stimulate the body to release endorphin compounds which are pain relievers and can create a feeling of comfort. This study aims to determine the effect of endorphin massage on reducing back pain in third trimester pregnant women. This research method uses pre experiment with pre-test post test one group using the Wilcoxon test and sampling using the total population of 15 pregnant women. The research was conducted in April-May 2023. The results of the study obtained the average value of the pain scale before being given endorphin massage is 4.93, after being given endorphin massage down to 2.60. This shows there is a significant effectiveness of endorphin massage on reducing back pain in third trimester pregnant women. The results of the Wilcoxon sign rank test Z score = -3.529 and p = 0.000 where α = 0.05 then p &lt;0.05 means there is an effect of endorphin massage on reducing the intensity of back pain in pregnant women Trimester III.

Ballistic impact wave and bulge profile propagation characteristics and blunt injury assessment of UHMWPE laminate composite

Amid escalating localized conflicts worldwide, the elucidation of the mechanisms and quantification blunt trauma the emergency services and military personnel confronted becomes imperatively. However, the understanding of bullet-induced bulge formation on the laminate's back face, impact wave propagation, and consequent trauma assessment methods remains incomplete. This study applies 3-dimension digital image correlation (3D-DIC) method to reveals these phenomena by utilizing a lead-core bullet traveling at 334.93 m/s to impact an ultra-high molecular weight polyethylene (UHMWPE) laminate. The results show that the initial transverse propagation velocity of bulge profile is 24.79% smaller than the theoretical calculation, which indicates the reduction caused by cohesive matrix. The transverse wave demonstrates a double exponential attenuation pattern, which could be decomposed into two single exponential attenuation curves. The bulge profile shows hyperbolic pattern, which reveals the stability of the bulge shape and the temporal evolution pattern. Increasing the laminate-body gap leads to a decline in Blunt Criterion (BC) and the Abbreviated Injury Scale (AIS) values reduce from 2 to 0 correspondingly. The numerical model confirms the compression wave velocity as 1447.77 ± 123.10 m/s in the thickness direction and 9542.86 ± 3087.75 m/s in the fiber direction. These findings reveals and quantified the propagation patterns of back bulge and compressive wave, and thus could provide data-driven insights to improve body armor performance and blunt trauma assessment for individual soldiers.

Colour Stability between In-House 3D-Printed Resin Brackets and Conventionally Aesthetic Brackets: An In Vitro Study

Background: To evaluate colour stability in artificial saliva by mechanically simulating brushing between in-house 3D-printed resin brackets (IH3DBs) and commercially available brackets. Methods: The samples consist of four sets of ten aesthetic brackets each supplied by four different manufacturers: clear Damon, Synovate C, Crystal and in-house 3D printed brackets (IH3DBs). The brackets were immersed in a plastic tank containing artificial saliva maintained at a constant temperature of 37 °C with a 65-minute brushing system. Staining changes at T0 (pre-brushing) and T1 (post-brushing) were measured with a spectrophotometer according to the VITA and Master scale and brightness values. Statistical analysis compared the colour changes with the Wilcoxon test and in case of significance, severity was investigated. The significance level considered was p &lt; 0.05. Results: The IH3DBs shows statistically significant differences for both scales and brightness values. The Damon and the Crystal brackets report a statistically significant difference only for brightness. The Synovate C bracket shows no statistically significant differences. Conclusions: The IH3DB produced chromaticity differences for the VITA and Master scale possibly due to the surface roughness created during the printing process. However, the IH3DBs together with Damon Clear improved brightness, due to the mechanical action of brushing.

Phát triển ngành nông nghiệp Việt Nam trong giai đoạn hiện nay

The article uses secondary data sources collected from the General Statistics Office in the period from 2010 until now and the article uses indicators to evaluate the development of the agricultural sector to evaluate the current development status of Vietnam’s agricultural industry. Research results showed that Vietnam’s agricultural sector have achieved many remarkable results in the development process, specifically the scale and production value of the agricultural sector have increased, the agricultural sector has shifted towards towards applying science and technology to production and diversifying products, contributing to increasing economic efficiency and environmental protection efficiency of the industry. Although there are many advantages, but in the process of developing the agricultural sector, there are still some limitations and difficults such as the low value of the agricultural sector’s contribution to the country’s GDP, Labor productivity of the agricultural sector is lower than that of other sectors and environmental pollution is still widespread and tends to increase. On that basis, the article presents a number of proposals to contribute to the development of Vietnam’s agricultural industry in the near future.