Score Test Research Articles

EFFECTIVENESS OF GRATITUDE INTERVENTIONS IN SCHOOLS TO INCREASE SENSE OF SCHOOL BELONGING TO HIGH SCHOOL STUDENTS

A sense of school belonging that tends to be low has an impact on problematic behavior at school, so effective psychological intervention is needed. One form of intervention carried out is gratitude intervention. This study aims to determine the effectiveness of gratitude interventions in increasing the sense of school belonging of high school students. This study uses a quantitative approach with the type of experimental research, and the design used is a pre-experimental one group pretest-posttest design. The research was conducted on students of SMA Negeri 5 Soppeng with 34 students. The determination of research participants was using the purposive sampling technique. Data were obtained by filling out the Psychological Sense of School Membership (PSSM) scale before and after the gratitude intervention. The validity of the PSSM scale was calculated using the Aiken's V test and obtained a coefficient of 0.88, while the reliability test used Cronbach's Alfa, with a reliability coefficient value of 0.86. The data analysis technique uses the N-Gain score test. The results showed that the average score of sense of school belonging before the intervention was 40.15, while after the intervention it increased to 73.5, the results of the hypothesis test using the difference index (N Gain Score) recorded an increase of 55.9. Thus, the hypothesis in this study is accepted, which means that gratitude interventions in schools are quite effective in increasing the sense of school belonging of high school students.

Abstract A055: Neighborhood Deprivation and Oncotype DX Recurrence Scores among Black and White Women: the interplay between race, place, and tumor biology

Abstract Background: Breast cancer (BC) mortality disparities have persisted between non-Hispanic Black (NHB) and non-Hispanic White (NHW) women, even those diagnosed with prognostically favorable BC. The Oncotype Dx Recurrence score (ODX) test is a gene expression panel that can be used to identify estrogen receptor (ER)-positive BC with aggressive tumor biology. Previous studies have found that Black women are more likely to have higher ODX scores than White women and socioeconomic factors (e.g., area-level income, urbanicity) are associated with higher ODX scores. We explored race-stratified associations of neighborhood deprivation and ODX to help elucidate the interplay between race, place, and tumor biology. Methods: Neighborhood deprivation was examined in relation to ODX scores among 7,100 NHB and NHW women diagnosed with ER-positive BC (stage I–IIIA and ≤3 lymph nodes) between 2010–2017, followed through 2022, and identified by the Georgia Cancer Registry. The neighborhood deprivation index (NDI) was used to characterize neighborhood deprivation. Principal component analysis of block group-level American Community Survey data representing six domains (poverty, income, occupation, housing, employment, and education) was used to derive the NDI composite score. NDI was assessed in quartiles and linked to patient residence at the time of diagnosis. Three cut-points were used for ODX scores (low <18, intermediate 18–30, high ≥31). Prevalence ratios (PR) and 95% confidence intervals (CI) were calculated to determine the prevalence of ODX scores based on NDI by race/ethnicity. Results: This study included 1651 NHB and 5449 NHW women. There were 4152 (58.5%) with a low ODX Score and 514 (7.2%) with a high ODX score; 2773 (39.1%) resided in the least deprived neighborhoods (NDI quartile 1) and 928 (13.1%) resided in the most deprived neighborhood (NDI quartile 4). Living in the most deprived neighborhood was associated with an increased prevalence of high ODX scores in models adjusted for age, race, and stage (PR=1.23, 95% CI 0.97–1.62). Stratification by race showed associations were stronger among NHW women (PR=1.41, 95% CI 1.02–1.95) but null among NHB women (PR= 0.91, 95% CI 0.59-1.39). Overall, NHB women were more likely to have a high ODX compared to NHW women. The highest prevalence of a high ODX was observed among NHB women living in the least deprived neighborhoods (PR=1.92, 95% CI 1.34–2.77). Conclusions: Findings from this study suggest that living in a deprived neighborhood increases the prevalence of high ODX among NHW women but not NHB women. NHB women in the least deprived neighborhoods had the greatest prevalence of high ODX scores. The intersection between race, neighborhood, and tumor biology needs more nuanced investigation of the social-structural drivers of disparate BC outcomes. Citation Format: Jasmine M. Miller-Kleinhenz, Lauren E. Barber, Lindsay J. Collin, Maret L. Maliniak, Demetria J. Smith-Graziani, Lauren E. McCollough. Neighborhood Deprivation and Oncotype DX Recurrence Scores among Black and White Women: the interplay between race, place, and tumor biology [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A055.

Functional outcome and quality of life index after endonasal versus external dacryocystorhinostomy

Abstract Purpose: To compare the functional outcome and quality of life (QOL) index following non-endoscopic endonasal dacryocystorhinostomy (NEN-DCR) and external dacryocystorhinostomy (EXT-DCR). Methods: Patients were prospectively allocated to two groups. All adult patients presenting with primary nasolacrimal duct obstruction (PANDO) undergoing EXT-DCR and NEN-DCR at a tertiary eye care center were included. Patients in one group underwent EXT-DCR and others NEN-DCR. Functional outcomes were measured by Munk Score and fluorescein dye disappearance test (FDDT). A validated quality of life questionnaire (EQ-5D-3L) in the local language (Odiya) was used to measure health status (social impact score) before and 1 day, 2 weeks, 6 weeks, and 3 months after surgery. The primary outcome measure was the functional outcome–Munk Score and secondary outcome measures included the QOL index and the FDDT. Results: A total of 110 patients were recruited and equally distributed (n = 55) in both groups. The mean age of the population was 47.6 years (SD = 14.02; range 20–79 years). The majority (71%, 79/110) were female. When longitudinally followed over time, functional outcome and QOL index showed reasonably rapid and marked improvement in both groups after surgery compared to baseline scores. The Munk score (P = 0.037) and QOL index (P = 0.007) were marginally better on the first postoperative day for the NEN-DCR group compared to EXT-DCR but comparable at all subsequent visits. At a median follow-up of 9 weeks (range: 0.5–24 weeks), the anatomical outcome was comparable between both groups. Conclusion: Our results demonstrate that functional outcome and QOL index show rapid and marked improvement in both NEN-DCR and EXT-DCR after surgery. NEN-DCR outcomes were marginally better on the first postoperative day but comparable to EXT-DCR thereafter.

Repeated intrathecal injections of peripheral nerve-derived stem cell spheroids improve outcomes in a rat model of traumatic brain injury

BackgroundTraumatic brain injury (TBI) is a major cause of disability and mortality worldwide. However, existing treatments still face numerous clinical challenges. Building on our prior research showing peripheral nerve-derived stem cell (PNSC) spheroids with Schwann cell-like phenotypes can secrete neurotrophic factors to aid in neural tissue regeneration, we hypothesized that repeated intrathecal injections of PNSC spheroids would improve the delivery of neurotrophic factors, thereby facilitating the restoration of neurological function and brain tissue repair post-TBI.MethodsWe generated PNSC spheroids from human peripheral nerve tissue using suspension culture techniques. These spheroids were characterized using flow cytometry, immunofluorescence, and reverse-transcription polymerase chain reaction. The conditioned media were evaluated in SH-SY5Y and RAW264.7 cell lines to assess their effects on neurogenesis and inflammation. To simulate TBI, we established a controlled cortical impact (CCI) model in rats. The animals were administered intrathecal injections of PNSC spheroids on three occasions, with each injection spaced at a 3-day interval. Recovery of sensory and motor function was assessed using the modified neurological severity score (mNSS) and rotarod tests, while histological (hematoxylin and eosin, Luxol fast blue staining) and T2-weighted magnetic resonance imaging analyses, alongside immunofluorescence, were conducted to evaluate the recovery of neural structures and pathophysiology.ResultsPNSC spheroids expressed high levels of Schwann cell markers and neurotrophic factors, such as neurotrophin-3 and Ephrin B3. Their conditioned medium was found to promote neurite outgrowth, reduce reactive oxygen species-mediated cell death and inflammation, and influence M1-M2 macrophage polarization. In the CCI rat model, rats receiving repeated triple intrathecal injections of PNSC spheroids showed significant improvements in sensory and motor function, with considerable neural tissue recovery in damaged areas. Notably, this treatment promoted nerve regeneration, axon regrowth, and remyelination. It also reduced glial scar formation and inflammation, while encouraging angiogenesis.ConclusionOur findings suggest that repeated intrathecal injections of PNSC spheroids can significantly enhance neural recovery after TBI. This effect is mediated by the diverse neurotrophic factors secreted by PNSC spheroids. Thus, the strategy of combining therapeutic cell delivery with multiple intrathecal injections holds promise as a novel clinical treatment for TBI recovery.

EFEKTIVITAS MEDIA ULAR TANGGA EDUKASI TERHADAP HASIL BELAJAR DALAM PEMBELAJARAN IPAS PADA KELAS IV SD ATTIN NAMOSAIN

This research is a quantitative research, this research aims to determine the effect of the effectiveness of snakes and ladders media on the learning outcomes of class IV students in science and science learning at Attin Namosain Elementary School. The type of Quasi Experimental Design approach is Pretest Posttest Nonequivalent Control Group Design. This research used a population and sample, namely all class IV students consisting of 44 students (22 control class students and 22 experimental class students). The data collection techniques used were test techniques and observation sheets for the implementation of learning media. Based on the analysis of the data results, it shows that the sig (2-tailed) value is 0.000<0.005, with a significance level = 0.05(5%). Furthermore, the results of the N-Gain Score test in the experimental class which applied snakes and ladders media was 71.16% and was included in the effective category. There is a significant influence of snakes and ladders media on the learning outcomes of class IV students in science learning at Attin Namosain Elementary School.

CCL5 is essential for axonogenesis and neuronal restoration after brain injury

BackgroundTraumatic brain injury (TBI) causes axon tearing and synapse degradation, resulting in multiple neurological dysfunctions and exacerbation of early neurodegeneration; the repair of axonal and synaptic structures is critical for restoring neuronal function. C-C Motif Chemokine Ligand 5 (CCL5) shows many neuroprotective activities.MethodA close-head weight-drop system was used to induce mild brain trauma in C57BL/6 (wild-type, WT) and CCL5 knockout (CCL5-KO) mice. The mNSS score, rotarod, beam walking, and sticker removal tests were used to assay neurological function after mTBI in different groups of mice. The restoration of motor and sensory functions was impaired in CCL5-KO mice after one month of injury, with swelling of axons and synapses from Golgi staining and reduced synaptic proteins-synaptophysin and PSD95. Administration of recombinant CCL5 (Pre-treatment: 300 pg/g once before injury; or post-treatment: 30 pg/g every 2 days, since 3 days after injury for 1 month) through intranasal delivery into mouse brain improved the motor and sensory neurological dysfunctions in CCL5-KO TBI mice.ResultsProteomic analysis using LC-MS/MS identified that the “Nervous system development and function”-related proteins, including axonogenesis, synaptogenesis, and myelination signaling pathways, were reduced in injured cortex of CCL5-KO mice; both pre-treatment and post-treatment with CCL5 augmented those pathways. Immunostaining and western blot analysis confirmed axonogenesis and synaptogenesis related Semaphorin, Ephrin, p70S6/mTOR signaling, and myelination-related Neuregulin/ErbB and FGF/FAK signaling pathways were up-regulated in the cortical tissue by CCL5 after brain injury. We also noticed cortex redevelopment after long-term administration of CCL5 after brain injury with increased Reelin positive Cajal-Rerzius Cells and CXCR4 expression. CCL5 enhanced the growth of cone filopodia in a primary neuron culture system; blocking CCL5’s receptor CCR5 by Maraviroc reduced the intensity of filopodia in growth cone and also CCL5 mediated mTOR and Rho signalling activation. Inhibiting mTOR and Rho signaling abolished CCL5 induced growth cone formation.ConclusionsCCL5 plays a critical role in starting the intrinsic neuronal regeneration system following TBI, which includes growth cone formation, axonogenesis and synaptogensis, remyelination, and the subsequent proper wiring of cortical circuits. Our study underscores the potential of CCL5 as a robust therapeutic stratagem in treating axonal injury and degeneration during the chronic phase after mild brain injury.Graphical

Development and validation of a nomogram for predicting critical respiratory events during early anesthesia recovery in elderly patients

BackgroundElderly patients undergoing recovery from general anesthesia face a heightened risk of critical respiratory events (CREs). Despite this, there is a notable absence of effective predictive tools tailored to this specific demographic. This study aims to develop and validate a predictive model (nomogram) to address this gap. CREs pose significant risks to elderly patients during the recovery phase from general anesthesia, making it an important issue in perioperative care. With the increasing aging population and the complexity of surgical procedures, it is crucial to develop effective predictive tools to improve patient outcomes and ensure patient safety during post-anesthesia care unit (PACU) recovery.MethodsA total of 324 elderly patients who underwent elective general anesthesia in a grade A tertiary hospital from January 2023 to June 2023 were enrolled. Risk factors were identified using least absolute shrinkage and selection operator (LASSO) regression. A multivariate logistic regression model was constructed and represented as a nomogram. Internal validation of the model was performed using Bootstrapping. This study followed the TRIPOD checklist for reporting.ResultsThe indicators included in the nomogram were frailty, snoring, patient-controlled intravenous analgesia (PCIA), emergency delirium and cough intensity at extubation. The diagnostic performance of the nomogram model was satisfactory, with AUC values of 0.990 and 0.981 for the training set and internal validation set, respectively. The optimal cutoff value was determined to be 0.22, based on a Youden index of 0.911. The F1-score was 0.927, and the MCC was 0.896. The calibration curve, Brier score (0.046), and HL test demonstrated acceptable consistency between the predicted and actual results. DCA revealed high net benefits of the nomogram prediction across all threshold probabilities.ConclusionsThis study developed and validated a nomogram to identify elderly patients in the PACU who are at higher risk of CREs. The identified predictive factors included frailty condition, snoring syndrome, PCIA, emergency delirium, and cough intensity at extubation. By identifying patients at higher risk of CREs early on, medical professionals can implement targeted strategies to mitigate the occurrence of complications and provide better postoperative care for elderly patients recovering from general anesthesia.

Validity of Wagner, SINBAB, PEDIS, and WIFI Scoring Systems to Assess Risk of Amputation in Patients with Diabetic Foot Ulcers

Aim: This study aims to determine validity of the Wagner, SINBAD, PEDIS, and WIFI scoring systems in assessing the risk of amputation in patients with diabetic foot ulcers at Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar. Methods: This research is an observational study of diagnostic tests with a cross-sectional design. The sample in this study was selected by consecutive sampling from 1 January 2022 to 31 December 2022 with total of 72 respondents.Results: Wagner score test obtained sensitivity 77.2%, specificity 80.0%, PPV 93.6%, NPV 48%, accuracy 77.7%, and RR 1.8. PEDIS score test results obtained sensitivity 82.5%, specificity 86.7%, PPV 95.9%, NPV 56.5%, accuracy 83.3%, and RR 2.2. The results of the SINBAD test score obtained sensitivity 78.9%, specificity 66.7%, PPV 90.0%, NPV 45.5%, accuracy 76.3%, and RR 1.6. WIFI score test obtained sensitivity 89.5%, specificity 66.7%, PPV 91.1%, NPV 62.5%, accuracy 84.7%, and RR 2.4. Conclusion: The WIFI score has better sensitivity and accuracy compared to score Wagner, SINBAD, and PEDIS so it is recommended to use the WIFI score to assess the risk of amputation in diabetic foot ulcer patients.

Impact of Overweight on Response to Dupilumab Treatment in Chronic Rhinosinusitis with Nasal Polyps.

Chronic rhinosinusitis with nasal polyps (CRSwNP) significantly impacts quality of life and often presents therapeutic challenges, with biologics like dupilumab showing promise in managing severe, uncontrolled cases. The aim of this study was to assess the influence of overweight on the effectiveness of dupilumab in patients with uncontrolled CRSwNP. This retrospective study analyzed treatment outcomes of 75 CRSwNP patients receiving dupilumab, categorizing them into underweight/normal-weight (BMI ≤ 24.9 kg/m2) and overweight/obese (BMI ≥ 25 kg/m2) groups. Outcome measures included changes in nasal polyp score (NPS) and sinonasal outcome test (SNOT-22) scores. Results demonstrated that the underweight/normal-weight group experienced significantly greater improvements in NPS and a higher rate of total NPS improvement compared to the overweight/obese group. While SNOT-22 scores improved in both groups, no significant differences were observed. Among patients with comorbid asthma, the underweight/normal-weight subgroup also showed significantly better outcomes, including greater reductions in both NPS and SNOT-22 scores. Multiple regression analysis identified BMI as an independent prognostic factor for NPS outcomes. The findings suggest that overweight/obesity adversely affects the response to dupilumab in CRSwNP, emphasizing the need for personalized treatment strategies considering BMI.

The Effects of Instructional Approaches and Motivation on Students’ Reading Comprehension at MTS’s Amal Shaleh Simalingkar

Reading comprehension is a fundamental skill that serves as the foundation for effective learning and intellectual growth. GSSR's comprehensive approach extends beyond the classroom, fostering a lifelong appreciation for reading. A significant area of focus in educational psychology is the relationship between motivation and reading comprehension. This relationship has been shown to influence student engagement, perseverance, and, ultimately, academic achievement. The objective of this study was to ascertain whether the GSSR approach is more effective than the non-GSR treatment. Additionally, the study aimed to determine whether students with high levels of motivation demonstrate superior reading comprehension skills compared to those who are less motivated. Finally, the study sought to investigate whether there is a relationship between teaching the GSSR approach versus the conventional approach and the level of motivation on students' reading comprehension. This study employed a quantitative research design. The study was conducted at MTS Amal Saleh. The study sample consisted of 62 students from grades 8A, 8B, and 8C. The data analysis employed descriptive analysis, the Wilcoxon test, and the N-gain Score test. The findings indicated that the GSSR approach was more effective than the conventional method in enhancing students' reading comprehension. The success rate for the former was 55%, while the latter was 81.81%. Additionally, the students' mean scores were 70.25 and 77.75, respectively, for classes 8B and 8C. The enhancement of students' reading comprehension with high motivation yields superior outcomes compared to the improvement of students' reading comprehension with low motivation. This was demonstrated by the fact that the GSSR + Motivation method resulted in a 76.81% increase in the pass rate and a 38.44-point increase in the average score.

Anti-infectivity efficacy and pharmacokinetics of WHO recommended single low-dose primaquine in children with acute Plasmodium falciparum in Burkina Faso: study protocol

BackgroundPrimaquine (PQ) has activity against mature P. falciparum gametocytes and proven transmission blocking efficacy (TBE) between humans and mosquitoes. WHO formerly recommended a single transmission blocking dose of 0.75 mg/kg but this was little used. Then in 2012, faced with the emergence of artemisinin-resistant P. falciparum (ARPf) in SE Asia, the WHO recommended a lower dose of 0.25 mg/kg to be added to artemisinin-based combination therapy in falciparum-infected patients in low transmission areas. This dose was considered safe in glucose-6-phosphate dehydrogenase deficiency (G6PDd) and not requiring G6PD testing. Subsequent single low-dose primaquine (SLDPQ) studies have demonstrated safety in different G6PD variants. Dosing remains challenging in children under the age of 5 because of the paucity of PQ pharmacokinetic (PK) data. We plan to assess the anti-infectivity efficacy of SLDPQ using an allometrically scaled, weight-based regimen, with a target dose of 0.25 mg/kg, in children with acute uncomplicated falciparum malaria.MethodsThis study is an open label, randomised 1:1, phase IIb study to assess TBE, tolerability, pharmacokinetics and acceptability of artesunate pyronaridine (ASPYR) administered alone or combined with SLDPQ in 56 Burkinabe children aged ≥ 6 months– < 5 years, with uncomplicated P. falciparum and a haemoglobin (Hb) concentration of ≥ 5 g/dL. We will assess TBE, using direct membrane feeding assays (DMFA), and further investigate PQ pharmacokinetics, adverse events, Hb dynamics, G6PD, sickle cells, thalassaemia and cytochrome 2D6 (CYP2D6) status, acceptability of flavoured PQ [CAST—ClinSearch Acceptability Score Test®], and the population’s knowledge, attitude and practices on malaria.Expected results and discussionWe expect children to accept tablets, confirm the TBE and gametocytocidal effects of SLDPQ and then construct a PK infectivity model (including age, sex, baseline Hb, G6PD and CYP2D6 status) to define the dose response TBE relationship that may lead to fine tuning our SLDPQ regimen. Our study will complement others that have examined factors associated with Hb dynamics and PQ PK. It will provide much needed, high-quality evidence of SLDPQ in sick African children and provide reassurance that SLDPQ should be used as a strategy against emerging ARPf in Africa.Trial registrationISRCTN16297951. Registered on September 26, 2021

Melatonin alleviates heme-induced ferroptosis via activating the Nrf2/HO-1 pathway in neurons.

Ferroptosis of neurons is a significant cause of brain injury following intracerebral hemorrhage (ICH). As an iron-containing compound in hemoglobin, heme contributes to nerve injury post-ICH. Melatonin has been shown to mitigate the effects of ICH, yet its specific functions remain largely elusive. In this study, we aimed to explore the roles and mechanisms of melatonin in heme-induced ferroptosis subsequent to ICH. C57BL/6 mice were intracranially injected with heme and then treated with melatonin. Behavior tests [modified neurological severity score (mNSS), forelimb placing, and corner turn tests], H&E staining, Nissl staining, and Prussian blue staining were used to evaluate mouse brain tissue injury. In vitro, HT-22 cells were stimulated with heme and cell viability was determined by crystal violet staining. The iron contents were determined in heme-treated brains and cells, and the levels of 4-hydroxynonenal (4-HNE) and malonaldehyde (MDA) were assessed by ELISA. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to investigate the mRNA levels of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1). Immunoblotting was used to analyze the protein expression of glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), Nrf2, and HO-1. Finally, small interfering RNA (siRNA) was used to knock down Nrf2 in HT-22 cells. Melatonin treatment alleviated heme-induced injuries to neural function, as indicated by improved behavior in the mice. Moreover, melatonin decreased cell death and iron concentrations, increased MDA and 4-HNE levels, and reversed the decreases in GPX4, SLC7A11, Nrf2, and HO-1 induced by heme in vitro and in vivo. These results indicated that melatonin could improve the ferroptosis induced by heme. In addition, we found that Nrf2 knockdown attenuated the therapeutic effect of melatonin on neuronal ferroptosis induced by heme. In general, melatonin alleviates heme-induced ferroptosis by activating the Nrf2/HO-1 pathway, which implies that melatonin is a promising treatment for ferroptosis in ICH.

Avoiding Treatment in Hospital With Subcutaneous Furosemide for Worsening Heart Failure: A Pilot Study (AT HOME-HF)

BackgroundTherapies are needed to address worsening congestion, without hospitalization, in patients with chronic heart failure (HF). ObjectivesThis pilot study assessed outcomes of a novel subcutaneous (SC) furosemide formulation compared to usual care in outpatients with worsening congestion. MethodsParticipants with chronic HF and worsening congestion were randomized open-label 2:1 to SC furosemide compared to usual care (UC). Decongestion was estimated by tracking body weight. The primary endpoint was a win ratio of a 30-day hierarchical composite of cardiovascular death, HF events, and change in N-terminal pro–B-type natriuretic peptide. Secondary endpoints included dyspnea severity, functional capacity, and quality of life. ResultsThirty-four participants were randomized to SC furosemide and 17 to UC. SC furosemide caused greater reduction in body weight: between-group difference in least square mean change was −2.02 kg at day 3 (95% CI: −3.9 to −0.14; P = 0.035). SC furosemide-to-UC win ratio was 1.11 (95% CI: 0.48-2.50; P = 0.806). Significant between-group least square mean differences favoring SC furosemide occurred in 7-point dyspnea score (P = 0.017) and 6-minute walk test (P = 0.032), with trend in Kansas City Cardiomyopathy Questionnaire (KCCQ)-12 Overall Summary Score of 9.15 (95% CI: 1.95-20.3; P = 0.106). The most common related adverse event with SC furosemide was mild infusion site pain (11.8%). ConclusionsSC furosemide augmented weight loss in patients with HF and worsening congestion. The composite primary endpoint was not statistically significant in this pilot investigation. However, findings of improved dyspnea scores and functional capacity, with favorable trend in KCCQ-12 score, warrant additional investigation to further document the clinical value of SC furosemide as an alternative to hospitalization (AT HOME-HF [Avoiding Treatment in the Hospital With Furoscix for the Management of Congestion in Heart Failure—A Pilot Study]; NCT04593823)

Homogeneity Test of Ratios of Two Proportions in Stratified Bilateral and Unilateral Data

In paired-organ studies such as ophthalmology, otolaryngology, and rheumatology, etc., various approaches take highly correlated bilateral data into account for homogeneity tests but are less likely to focus on combined bilateral and unilateral data structures. Also, it is necessary and important to adjust the effect of confounders on stratified combined bilateral and unilateral data since, in these data structures, ignoring intra-class correlation and confounding effects can cause biased statistical inference. This article derived three homogeneity tests (the likelihood ratio test, the Wald test, and the score test) concerning these cooperative structure data to detect if ratios of proportions retain consistency across strata. Simulation shows that the score test provides a robust Type I error rate and satisfactory power performance. Finally, a real example is applied to demonstrate the application of these three proposed tests.

Exact interval estimation for three parameters subject to false positive misclassification

SummaryBinary data subject to one type of misclassification exist in various fields. It is collected in a double‐sampling scheme that includes a gold standard test and a fallible test. The main parameter of interest for this type of data is the positive probability of the gold standard test. Existing intervals are unreliable because the given nominal level is not achieved. In this paper, we construct an exact interval by inverting the E+M score tests and improve it by the general ‐function method. We find that the total length of the improved interval is shorter than the exact intervals that are also the improved intervals when we apply the ‐function to several existing approximate intervals, including the score and Bayesian intervals. Therefore, it is recommended for practice. We are also interested in two other parameters: —the difference between the two positive rates for the fallible and gold standard tests—and —the false positive rate for the fallible test. To the best of our knowledge, the research on these two parameters is limited. For , we find that any interval for can be converted to an interval for . So, the interval converted from the aforementioned recommended interval for is recommended for inferring . For , the improved interval by the ‐function method over the E+M score interval is derived. We use an example to illustrate how the intervals are computed and provide a real data analysis.

Development of Etno-STEM Integrated Bioentrepreneur Electronic LKPD PjBL on Technology Innovation Material to Improve Creative Thinking Abilities and Entrepreneurial Interests of High School Students

This development research aims to produce an ethno-STEM integrated PjBL bioentrepreneur electronic worksheet that is feasible, practical and effective for use in improving creative thinking abilities and entrepreneurial interest. This type of research is Research and Development R&amp;D with the ADDIE model (Analysis, Design, Development, Implement, and Evaluate). The subjects in this research were expert lecturers, teachers and students. The instruments in this research are interview instruments, needs questionnaires, feasibility questionnaires, practicality questionnaires, learning implementation sheets, teaching module validation questionnaires, test instruments, and entrepreneurial interest questionnaires. The instrument will be validated by experts and then tested. Data analysis using Manova and N-gain score tests. The results of this research show that the ethno-STEM integrated bioentrepreneur PjBL electronic worksheet is very feasible with a feasibility score for material experts of 84% and media experts of 94%, very practical with a practicality score for teachers of 100% and students of 89%, and effective as seen from The N-gain test value for creative thinking ability for the experimental class was 0.57 and the control class was 0.47 in the medium category and the N-gain test for entrepreneurial interest in the experimental class was 0.40 and the control class was 0.30 in the medium category. The Manova test obtained sig. hotteling's trace 0.00 &lt; 0.05. The results of the Manova and N-gain tests show that the ethno-STEM integrated bioentrepreneur PjBL electronic LKPD is effective in increasing creative thinking abilities and entrepreneurial interest

Nonlinear Analysis of Machine Learning Applicability for Survival Analysis of Lung Cancer Patients

This study about looks into how nonlinear machine learning (ML) can be utilized to foresee the survival of lung cancer patients in arrange to create expectations more exact and make strides understanding comes about. Lung cancer is still one of the foremost deadly types of cancer within the world, so better approaches ought to be found to precisely analyze and arrange medicines. Whereas conventional measurements strategies have made a difference us get it survival examination, they aren't continuously great at catching the complicated, nonlinear connections that exist in organic information. The think about looks at how to combine diverse machine learning models, like Irregular Woodlands, Slope Boosting Machines, and Neural Systems, to see at nonlinear designs and connections in DNA and clinical datasets of lung cancer cases. A part of consideration is paid to methods for choosing highlights and utilizing progressed arrangement strategies to bargain with expansive sums of information and lower clamor. We utilize strict cross-validation strategies and comparison investigation to check how well ML models work compared to conventional factual strategies. To see how well a demonstrate can anticipate how long a understanding will live, measurements just like the Concordance File, Brier Score, and Log-Rank Test are utilized. The comes about appear that machine learning models, particularly those that are great at recognizing nonlinearities, do much way better than standard strategies, making gauges that are more exact and dependable. The comes about appear that machine learning has the ability to alter the way survival analysis is worn out cancer by giving personalized data around forecast and making it easier to select centered treatments. Within the future, analysts will center on combining information from numerous omics and making machine learning models that can be caught on. This will make these progressed examination devices indeed more valuable in clinical settings and boost believe in them. This work includes to the developing sum of information that machine learning is an vital device for moving forward cancer inquire about and quiet care.

CytoKernel: Robust kernel embeddings for assessing differential expression of single cell data.

High-throughput sequencing of single-cell data can be used to rigorously evlauate cell specification and enable intricate variations between groups or conditions. Many popular existing methods for differential expression target differences in aggregate measurements (mean, median, sum) and limit their approaches to detect only global differential changes. We present a robust method for differential expression of single-cell data using a kernel-based score test, cytoKernel. cytoKernel is specifically designed to assess the differential expression of single cell RNA sequencing and high-dimensional flow or mass cytometry data using the full probability distribution pattern. cytoKernel is based on kernel embeddings which employs the probability distributions of the single cell data, by calculating the pairwise divergence/distance between distributions of subjects. It can detect both patterns involving aggregate changes, as well as more elusive variations that are often overlooked due to the multimodal characteristics of single cell data. We performed extensive benchmarks across both simulated and real data sets from mass cytometry data and single-cell RNA sequencing. The cytoKernel procedure effectively controls the False Discovery Rate (FDR) and shows favourable performance compared to existing methods. The method is able to identify more differential patterns than existing approaches. We apply cytoKernel to assess gene expression and protein marker expression differences from cell subpopulations in various publicly available single-cell RNAseq and mass cytometry data sets. The methods described in this paper are implemented in the open-source R package cytoKernel, which is freely available from Bioconductor at http://bioconductor.org/packages/cytoKernel.

Assessment of accuracy of liver fluke diagnostic tests using the gold standard of total worm counts

In many regions of New Zealand liver fluke is endemic, infecting most grazing ruminants, including cattle, sheep, and deer. Restricting the economic losses and welfare costs associated with liver fluke relies on accurately identifying those animals with a production limiting infection. This has proven a difficult goal and although several antemortem quantitative tests are available, including faecal egg counts (FEC), serum ELISA and copro-antigen ELISA, none can be considered a gold standard test of liver fluke infection. The accepted gold standard test for fascioliasis is the total fluke count, which is both laborious and can only be completed at post-mortem. This study aimed to compare the performance of four liver fluke diagnostic tests, against the results of a gold standard total fluke count test. Two groups of cattle were selected, 29 culled mixed age beef cows (MAC) and ten 30-month-old steers. The cattle were blood sampled and faecal sampled prior to slaughter and their whole livers recovered post slaughter at the abattoir. Liveweight was also recorded at slaughter. After collection, each liver was weighed, scored for gross pathology, then serum, faeces and livers were frozen at −20 °C for later analysis. Faecal egg counts and F. hepatica copro-antigen ELISA tests were completed on the faecal samples and total fluke counts were completed on the livers. Fasciola hepatica antibody concentration in serum samples were quantified using a commercial ELISA test. Poisson regression models were built to model the association between each diagnostic test and the total fluke count, and a linear regression model was built to examine the relationship between each diagnostic test and live weight at slaughter.The median fluke count was significantly higher in MAC than steers (p = 0.01), and F. hepatica eggs were present in 100% steers and 66% MAC. There was a significant effect of copro-antigen ELISA value on total fluke count (p < 0.0001), with a coproantigen ELISA value = 20.1 predicting 10 flukes and a value = 44.8 predicting 30 flukes. There was also a significant effect of FEC on total fluke count (p = 0.002) but the R-squared value for this model was lower. There was no association between liver fibrosis score or antibody ELISA test and total fluke count (p = 0.95, p = 0.73, respectively). There was a significant effect of total fluke count (p = 0.03) on liveweight at slaughter, with liveweight falling 20.4 kg for each unit increase in loge (total fluke count). There was no effect of FEC (p = 0.11), antibody ELISA (p = 0.55) or copro-antigen ELISA value (p = 0.16) on liveweight at slaughter. Taken together, these results show that the coproantigen ELISA test is the better test for estimating the true liver fluke burden and that the number of flukes in the liver has a negative effect on cattle live weights at slaughter.

Effect of improving asymmetry through self-myofascial release in adolescent soccer player with hypomobility syndrome hip: A randomized controlled trial.

Hypomobility syndrome (HMS), or limited hip range of motion (ROM), is often reported in adolescents who train heavily. This study was aimed to investigate the impact of traditional static stretching (STR) and self-myofascial release (MFR) in adolescents with HMS hip. This study was a randomized controlled trial. Adolescent athletes with HMS hip were grouped as 23 STR and 23 MFR. Foam rolling was employed as the training method for MFR. Both interventions were performed twice a day for 20 minutes in 6 weeks. The training was filmed and distributed via the mobile video. Self-assessed Copenhagen Hip & Groin Outcome Score, ROM, strength, and hop tests were measured before and after the interventions. The healthy side without limitations was designated as non-HMS (nHMS) and taken as reference value. The study participants had limitations in flexion (FLX), abduction (ABD), internal rotation (IR), and external rotation (ER). The ROM of STR group was recovered to nHMS level. The FLX and ABD of MFR group was also recovered, however the IR and ER had lower angles compared to nHMS. MFR FLX, ABD, ER strength, and single hop test were restored like that of nHMS, however STR group was substantially lower than nHMS despite the improvements. Both groups depicted lower pre-intervention Copenhagen Hip & Groin Outcome Score subscale activities daily living, sport, and physical activity compared to nHMS. Activities daily living and physical activity were improved to healthy levels after the intervention, however sport was lower than that of nHMS. Both STR and MFR had impact on hip mobility and hip self-assessment score. Furthermore, MFR had strength improvements in FLX, ABD, and ER. However, the improvements in MFR group regarding triples, crossover hops, and self-assessed sports were limited. Therefore, STR and MFR are effective in improving not only ROM but also muscle function asymmetry in HMS hip.