Score Method Research Articles

Impact of post-disaster federal assistance on the national flood insurance program

This research tested the hypothesis that post-disaster federal relief program crowds out the demand for flood insurance in the U.S. To do that, this research has collected historical data between 2016 and 2020, and conducted propensity score-based analysis to understand the causality between post-disaster federal assistance and flood insurance enrollment in the flood affected counties in the U.S. In the first part, the treatment variable has been considered as binary to compare the effect of the availability of federal assistance to that of non-availability of federal assistance in a flood affected county by using propensity score matching method. It was found that the availability of the federal payout in a county in a year increased the number of flood insurance policies by 5.2 % and the total insured value of the policies by 4.6 % in the following year. Next, the treatment variable was considered continuous and was used in a generalized propensity score method to develop a dose response function, i.e., a function that depicts the changes in the outcome variables based on different levels of treatment. It was found that for each 1000 households in a county that received federal assistance, the percentage increase in the number of flood insurance policies was 3.41 %. On the other hand, for each million-dollar of federal assistance in a county, the total insured value of the flood insurance policies increased by 1.96 %. Therefore, this research has concluded that, contrary to the hypothesis, the availability of post-disaster federal assistance increased the flood insurance enrollment in the U.S.

MAGIC: Malware behaviour analysis and impact quantification through signature co-occurrence and regression

Malware poses risks by compromising both data integrity and system security. Proactive defense efforts have led to the adoption of malware scoring, allowing analysts to assess the severity and develop countermeasures. These scores indicate the degree of malware maliciousness based on triggered signatures. However, current scoring methods do not precisely depict the true extent of malware's maliciousness. This inaccuracy is attributed to an inadequate assessment of the impact of behaviour corresponding to signatures on both system and network resources. To address this limitation, the paper proposes a novel scoring approach that accurately quantifies the impact of signatures triggered by malware through co-occurrence analysis. The method assesses the ensemble behaviour of signatures across two phases. In the first phase of signature scoring, an impact score quantification algorithm initializes each signature to predefined severity score bands based on the studied severity and frequency. The second phase refines initial scores iteratively, considering mutual information among signatures co-occurring in the malware's execution. Experimental results validate the proposed method's ability to accurately reflect signature maliciousness. This novel scoring method enhances malware analysis platforms in generating more precise scores compared to traditional methods, thereby improving resilience against evolving malware threats in the dynamic cybersecurity landscape.

Concordance among three programmed death-ligand 1 (PD-L1) scoring methods and their association with clinical outcomes of tislelizumab (TIS) monotherapy in esophageal squamous cell carcinoma (ESCC).

390 Background: Multiple scoring methods and cutoffs have been developed to evaluate tumor PD-L1 expression status in patients with ESCC, and PD-L1 expression level has been associated with the degree of response to anti-programmed cell death protein 1 (PD-1)/PD-L1 therapy. Here, we retrospectively investigated concordance between three PD-L1 scoring methods and their association with clinical outcomes in RATIONALE-302, a phase 3 study of the anti-PD-1 antibody TIS vs investigator-chosen chemotherapy (ICC) as second-line treatment for advanced unresectable/metastatic ESCC (NCT03430843). Methods: Patients enrolled in RATIONALE-302 with evaluable PD-L1 expression by the tumor area positivity (TAP) score (based on visual estimation of positive tumor cells [TCs] and tumor-associated immune cells [ICs]) using the VENTANA PD-L1 (SP263) assay were categorized at a 10% cutoff. Stained slides from those patients were rescored post hoc using both combined positive score (CPS; based on counting positive TCs and ICs) at cutoff 10 and TC (based on counting positive TCs only) score at a 1% cutoff, thresholds currently used in ESCC for anti-PD-(L)1 therapy. Concordance at these thresholds was investigated. Clinical efficacy (overall survival [OS]) for PD-L1 subgroups was assessed. Results: Of 512 pts enrolled, 364 had evaluable TAP scores (TIS, n=180; ICC, n=184), of whom 355 had evaluable post-hoc CPS and TC scores (TIS, n=175; ICC, n=180). TAP score and CPS showed high concordance in terms of overall percentage agreement (OPA; 90% [95% confidence interval (CI): 86, 93]) and Cohen’s Kappa (0.79 [95% CI: 0.72, 0.85]), while TAP and TC scores had lower concordance (OPA: 78% [95% CI: 73, 82]; Cohen’s Kappa: 0.56 [95% CI: 0.47, 0.64]). OS benefit with TIS vs ICC in PD-L1 subgroups defined by TAP, CPS, and TC score cutoffs were generally similar (Table). Conclusions: OS subgroup analysis showed comparable treatment effect by TAP score at 10% cutoff, CPS at cutoff 10, and TC score at 1% cutoff based on SP263 staining. TAP score and CPS at these cutoffs exhibited substantial concordance. The results indicate that the less time-consuming, visually estimated TAP score and CPS may be interchangeable for clinical measurement of PD-L1 expression in patients with ESCC. Clinical trial information: NCT03430843 . [Table: see text]

Factors associated with trajectories of bone marrow lesions over 4years: data from the Osteoarthritis Initiative.

To identify bone marrow lesion (BML) trajectories over 4years and their demographic and structural predictors in middle-aged and older adults with or at increased risk of knee osteoarthritis (OA). A total of 614 participants (mean age 61years, 62% female) from the Osteoarthritis Initiative cohort (OAI) were included. BMLs in 15 anatomical locations of the knee were measured annually from baseline to 4years using the Magnetic Resonance Imaging Osteoarthritis Knee Score (MOAKS) method. BML trajectories were determined using latent class mixed models (LCMMs). Multinomial logistic regression was used to examine baseline characteristics that predicted BML trajectories. Three distinct BML trajectories were identified: "Mild-stable BMLs" (25.9%), "Moderate-stable BMLs" (66.4%), and "Rapid-rise BMLs" (7.7%). Compared to the "Mild-stable BMLs" trajectory, current smokers were more likely to be in the "Moderate-stable BMLs" (odds ratio [OR] 2.089, P < 0.001) and "Rapid-rise" (OR 2.462, P < 0.001) trajectories. Moreover, female sex and meniscal tears were associated with an increased risk of being in the "Rapid-rise BMLs" trajectory (OR 2.023 to 2.504, P < 0.05). Participants who had higher education levels and drank more alcohol were more likely to be in the "Rapid-rise BMLs" trajectory (OR 1.624 to 3.178, P < 0.05) and less likely to be in the "Moderate-stable BMLs" trajectory (OR 0.668 to 0.674, P < 0.05). During the 4-year follow-up, most participants had relatively stable BMLs, few had enlarged BMLs, and no trajectory of decreased BMLs was identified. Sociodemographic factors, lifestyle, and knee structural pathology play roles in predicting distinct BML trajectories.

CREDIT RISK MANAGEMENT OF “HALYK BANK” JSC: PROBLEMS AND SOLUTIONS

The purpose of the research work is to reveal the essence of the credit risk system, study the causes of its occurrence, and conduct a detailed analysis of the loan portfolio and credit risk management methods on the example of the commercial bank "Halyk Bank of the Republic of Kazakhstan" JSC. The authors analyze the loan portfolio of the bank using CAMELS, Z - score methods and build a regression analysis using R-studio, identify the main problems in credit risk management in a commercial bank and propose some solutions. In this article such problems in credit risk management as incomplete credit risk assessment, weak credit risk monitoring, insufficient collateral assessment, improper risk diversification, insufficient credit risk management policy are identified, and several solutions and methods for their improvement are proposed. The informational approach to solving the set goals is formed based on existing scientific research, published periodicals, scientific articles and financial statements of the bank, and its statistical data is used as material for writing a research paper.

Evaluation of a hybrid-polymer pervious mortar and optimization of its mix design

The utilization of permeable pavement has notably increased in urban areas. However, the conventional bonding layer composed of ordinary mortar or coarse sand can lead to challenges such as easy-loosening and a pseudo-permeable effect. To tackle this problem, this study utilized a hybrid polymer additive (HPA) to develop a novel hybrid-polymer pervious mortar (HPPM). An orthogonal experiment with the Composite Scoring Method (CSM) was conducted to determine the optimal mix design for HPPM, and the effect of the HPA content water-to-binder (W/B) ratio on the mechanical and bonding properties was analyzed. The CSM result revealed that the HPA content presented a higher significant impact than the W/B ratio, and the optimal combination was B3A2 - HPA content of 6 % (B3) and W/B of 0.3 (A2). Under this optimal combination, HPPM was able to enhance the compressive strength, flexural strength, tensile bond strength, and workability compared with the pervious mortar without HPA. Simultaneously, this study revealed that HPPM exhibited a higher ratio of interconnect voids compared to ordinary mortar, and demonstrated HPPM was able to achieve a good permeable function. In addition, according to the life-cycle cost and eco-efficiency analysis, the cost of permeable pavement using HPPM was lower than that of ordinary mortar, while HPPM represented savings in resource consumption and in energy consumption. Consequently, these results demonstrated the feasibility of using HPPM as an eco-friendly alternative to mitigate the pseudo-permeable issue of permeable pavement.

Impaired humoral immunity following COVID-19 vaccination in HTLV-1 carriers

BackgroundWhether human T-lymphotropic virus type 1 (HTLV-1) carriers can develop sufficient humoral immunity after coronavirus disease 2019 (COVID-19) vaccination is unknown.MethodsTo investigate humoral immunity after COVID-19 vaccination in HTLV-1 carriers, a multicenter, prospective observational cohort study was conducted at five institutions in southwestern Japan, an endemic area for HTLV-1. HTLV-1 carriers and HTLV-1-negative controls were enrolled for this study from January to December 2022. During this period, the third dose of the COVID-19 vaccine was actively administered. HTLV-1 carriers were enrolled during outpatient visits, while HTLV-1-negative controls included health care workers and patients treated by participating institutions for diabetes, hypertension, or dyslipidemia. The main outcome was the effect of HTLV-1 infection on the plasma anti-COVID-19 spike IgG (IgG-S) titers after the third dose, assessed by multivariate linear regression with other clinical factors.ResultsWe analyzed 181 cases (90 HTLV-1 carriers, 91 HTLV-1-negative controls) after receiving the third dose. HTLV-1 carriers were older (median age 67.0 vs. 45.0 years, p < 0.001) and more frequently had diabetes, hypertension, or dyslipidemia than did HTLV-1-negative controls (60.0% vs. 27.5%, p < 0.001). After the third dose, the IgG-S titers decreased over time in both carriers and controls. Multivariate linear regression in the entire cohort showed that time since the third dose, age, and HTLV-1 infection negatively influenced IgG-S titers. After adjusting for confounders such as age, or presence of diabetes, hypertension, or dyslipidemia between carriers and controls using the overlap weighting propensity score method, and performing weighted regression analysis in the entire cohort, both time since the third dose and HTLV-1 infection negatively influenced IgG-S titers.ConclusionsThe humoral immunity after the third vaccination dose is impaired in HTLV-1 carriers; thus, customized vaccination schedules may be necessary for them.

The use of 12-item General Health Questionnaire (GHQ-12) in Ukrainian refugees: translation and validation study of the Ukrainian version

Following the Russian-Ukrainian conflict, the well-being of millions of Ukrainians has been jeopardised. This study aims to translate and test the psychometric features of the Ukrainian version of the General Health Questionnaire 12 (GHQ-12). The study included Ukrainian refugees housed in Verona (Italy) between November/2022 and February/2023. The Ukrainian translation was obtained through a ‘forward-backward’ translation. Questionnaire was completed by 141 refugees (females: 78.7%). Median age was 36 years (IQR 23–43). Individuals with a score suggestive of psychological distress were 97 (68.8%). Cronbach’s coefficient was 0.84 (0.95CI 0.80–0.88). According to confirmatory factor analysis, both single- (modelB1) and two-factor (model B2) structures with bimodal scoring method fitted the data satisfactorily. The two factors of model B2 had a 0.88 correlation. Pearson coefficient showed a positive significant correlation between the GHQ-12 and International Trauma Questionnaire scores (ρ = 0.53, 0.95CI 0.40–0.64, p < 0.001). The GHQ-12 Ukrainian translation showed good psychometric features being a reliable and valid instrument to assess Ukrainian refugees’ general well-being.

Bidirectional Mendelian randomization analysis investigating the genetic association between primary breast cancer and colorectal cancer.

With the advancement in early diagnosis and treatment, the prognosis for individuals diagnosed with breast cancer (BC) has improved significantly. The prognosis of primary breast cancer (PBC) survivors can be significantly influenced by the occurrence of colorectal cancer (CRC) as a secondary primary cancer (SPC). The objective of this study is to explore the possible genetic association between PBC and CRC, aiming to lay a groundwork for the development of preventive strategies against SPC-CRC following BC surgery. We employed a bidirectional two-sample Mendelian randomization (MR) approach to thoroughly examine genetic instrumental variables (IVs) derived from genome-wide association studies (GWAS) conducted on PBC and CRC. And applied inverse variance weighted (IVW) and multiple other MR methods (weighted median, simple median, MR-PRESSO and MR-RAPS) to evaluate the association between the two cancers (PBC and CRC) at genetic level. Furthermore, the robustness of the findings was further confirmed through the utilization of the genetic risk score (GRS) method in a secondary analysis. Forward MR analysis, a total of 179 BC genetic IVs, 25 estrogen receptor-negative (ER-) genetic IVs and 135 ER-positive (ER+) genetic IVs were screened. Reverse MR analysis, 179 genetic IVs of CRC, 25 genetic IVs of colon cancer, 135 genetic IVs of rectal cancer, 25 genetic IVs of left colon cancer and 135 genetic IVs of right colon cancer were screened. IVW and other MR methods found no significant genetic association between PBC and CRC (P > 0.05). Subgroup analysis also showed that ER- BC and ER+ BC were not correlated with the occurrence of CRC (P > 0.05). The findings of the secondary analysis using GRS were consistent with those obtained from the primary analysis, thereby confirming the robustness and reliability of this study. Our findings do not provide any evidence supporting the association between PBC and CRC at the genetic level. Further large-scale prospective studies are warranted to replicate our findings.

Assessment of strategic healthcare purchasing and financial autonomy in Tanzania: the case of results-based financing and health basket fund.

Low-and middle-income countries (LMICs) are implementing health financing reforms toward Universal Health Coverage (UHC). In Tanzania direct health facility financing of health basket funds (DHFF-HBF) scheme was introduced in 2017/18, while the results-based financing (RBF) scheme was introduced in 2016. The DHFF-HBF involves a direct transfer of pooled donor funds (Health Basket Funds, HBF) from the central government to public primary healthcare-PHC (including a few selected non-public PHC with a service agreement) facilities bank accounts, while the RBF involves paying providers based on pre-defined performance indicators or targets in PHC facilities. We consider whether these two reforms align with strategic healthcare purchasing principles by describing and comparing their purchasing arrangements and associated financial autonomy. We used document review and qualitative methods. Key policy documents and articles related to strategic purchasing and financial autonomy were reviewed. In-depth interviews were conducted with health managers and providers (n = 31) from 25 public facilities, health managers (n = 4) in the Mwanza region (implementing DHFF-HBF and RBF), and national-level stakeholders (n = 2). In this paper, we describe and compare DHFF-HBF and RBF in terms of four functions of strategic purchasing (benefit specification, contracting, payment method, and performance monitoring), but also compare the degree of purchaser-provider split and financial autonomy. Interviews were recorded, transcribed verbatim, and analyzed using a thematic framework approach. The RBF paid facilities based on 17 health services and 18 groups of quality indicators, whilst the DHFF-HBF payment accounts for performance on two quality indicators, six service indicators, distance from district headquarters, and population catchment size. Both schemes purchased services from PHC facilities (dispensaries, health centers, and district hospitals). RBF uses a fee-for-service payment adjusted by the quality of care score method adjusted by quality of care score, while the DHFF-HBF scheme uses a formula-based capitation payment method with adjustors. Unlike DHFF-HBF which relies on an annual general auditing process, the RBF involved more detailed and intensive performance monitoring including data before verification prior to payment across all facilities on a quarterly basis. RBF scheme had a clear purchaser-provider split arrangement compared to a partial arrangement under the DHFF-HBF scheme. Study participants reported that the RBF scheme provided more autonomy on spending facility funds, while the DHFF-HBF scheme was less flexible due to a budget ceiling on specific spending items. Both RBF and DHFF-HBF considered most of the strategic healthcare purchasing principles, but further efforts are needed to strengthen the alignment towards UHC. This may include further strengthening the data verification process and spending autonomy for DHFF-HBF, although it is important to contain costs associated with verification and ensuring public financial management around spending autonomy.

Comparative analysis of soil quality indexing techniques for various tree based land use systems in semi-arid India

Inappropriate management of land use systems is one of the main factors that leads to soil quality degradation and its quantification is crucial to their sustainable utilization planning. The objective of the research is to evaluate how various land-use systems, viz., natural forest, tree plantations of Tectona grandis, Terminalia bellirica, Swietenia macrophylla, Artocarpus hirsutus, Melia dubia based agroforestry system, horticulture (Mangifera indica) and agriculture systems impact the soil physicochemical and biological characteristics in semi-arid climatic conditions of India. Principal component analysis followed by linear and non-linear scoring methods was employed to compute the soil quality index (SQI). The soil attributes viz., dehydrogenase activity, acid phosphatase activity, soil available nitrogen, potassium, calcium, porosity, and soil available iron emerged as significant indicators for assessing the soil quality. Among different SQIs, non-linear weighted SQI can efficiently assess soil quality. Based on the non-linear weighted SQI, the order of the systems studied was natural forest (0.973) &amp;gt; Swietenia macrophylla (0.756) &amp;gt; agroforestry (0.737) &amp;gt; agriculture (0.556) &amp;gt; Tectona grandis (0.416) &amp;gt; Terminalia bellirica (0.373) &amp;gt; Artocarpus hirsutus (0.343) &amp;gt; Mangifera indica (0.208). The study concludes that converting natural forests into different land-use systems deteriorated the soil quality. Identifying soil indicators will help rapidly diagnose soil degradation, assess soil-based ecosystem services, and design appropriate land management practices in the future.

POTENTIAL OF RED OKRA (Abelmoschus esculentus (L.) Moench) ETHANOL EXTRACT TO PROTECT AGAINST 7, 12-DIMETHYLBENZ[A]ANTHRACENE-INDUCED DAMAGE IN RAT’S (Rattus norvegicus) Liver

Highlights: Red okra pods have a potential antioxidant to protect against DMBA-induced damage in a rat’s liver. The liver protection with ROE decreased reversible and irreversible cellular damage from 51.8% to 35%, 27.3%, and 18.9%. Abstract Background: Okra (Abelmonchus esculentus (L.) Moench) is a plant that has potential for humans and health because it contains high antioxidants such as polyphenols. Objective: This study aimed to analyze the red okra pods’ ethanol extract (ROE) antioxidant potential to protect rat (Rattus norvegicus L.) liver against damage by induction of 7, 12-dimethyl-benz[a]anthracene (DMBA). Material and Method: The material used was various doses of red okra pods with ethanol as solvent. Twenty-five female rats (4 weeks, body weight 140—150 g) were divided into five groups: negative control (receiving a single dose of 0.5 mL corn oil as DMBA solvent), positive control (receiving a single dose induction of DMBA 80 mg/kg BW dissolved in 0.5 mL corn oil), and treatment groups 1, 2, 3 (receiving a single dose of DMBA 80 mg/kg BW dissolved in 0.5 mL corn oil and ROE of 50, 100, and 200 mg/kg BW, respectively, daily for 35 days). On day 36, the livers were removed and prepared for histopathological observation using hematoxylin-eosin staining. The method of histopathological score was determined using an ordinal score. Result: The data were analyzed statistically (p&gt;0.05). All ROE doses showed a significant decrease in the histopathological score of rats’ liver damage caused by DMBA-induced. The liver protection with ROE reduced the percentages of reversible and irreversible cellular damage from 51.8% to 35%, 27.3%, and 18.9%, respectively. Conclusion: The red okra pod ethanol extract can protect against DMBA-induced liver damage in rats.

An improved method for extracting essay tangency features in intelligent scoring of English essays

With the continuous improvement of teaching quality in China's colleges and universities, English teaching has received more and more attention, and the automatic scoring system for English composition has begun to be gradually applied in English teaching in colleges and universities, but the system can only score compositions objectively, which is difficult to meet the actual teaching needs. Therefore, this study first proposes a topic richness based approach for analyzing composition cut points, and then proposes a combination based automatic grading method for English compositions. Based on the above, an intelligent grading improvement method based on composition tangent feature extraction is proposed to improve the efficiency of the English composition grading system and reduce the teaching burden on teachers. The traditional grading method is to grade grammar or essays by introducing Analytic Hierarchy Process, artificial neural networks, or combining machine learning theory with multi feature fusion. However, based on the characteristics of single semantic similarity and keyword alignment, the comprehensiveness of the grading is insufficient, making it difficult to analyze the correlation between essay sentences and the overall theme. The experimental results show that the topic decision-making model proposed in this study has better deep learning performance, and its scoring accuracy shows an upward trend with the increase of the sample data size of the essay, increasing from 40.05% to 91.46%. And the main content of the learned is the irrelevant information of the first sentence of a new topic and the truncation point, which can effectively distinguish whether a sentence is a topic segmentation point, and effectively identifies whether two sentences belong to the same topic; the proposed topic segmentation model has better practicality and its ability to segment topics is stronger; the combined method proposed in this study The overall performance of the model is better than the composition scoring methods based on RNN and BiLSTM models. Under the same semantic vectorization processing operation, the per values present in the composition sets are all different, and this result indicates that the writers' ability and the difficulty of writing on the topics are all different. It is hoped that this study can provide some solution ideas for the research of intelligent scoring feature extraction methods in English.

Comparison of Parkin Score and New Ballard Score for Gestational Age Assessment in Newborns with Ultrasound Scan as the Standard Reference

Objective: To compare the assessment of gestational age (GA) in newborns using the Parkin Scoring and the New Ballard Scoring methods with the Ultrasound Scan Method as the Standard Reference, conducted at a peripheral military setup.&#x0D; Methodology: A descriptive, cross-sectional study was conducted at the Pediatrics department of Combined Military Hospital (CMH), Abbottabad from July 2019 to June 2020. A total of 102 newborns were recruited from the CMH Nursery. GA was assessed using ultrasound scan, Parkin Score (PS), and the New Ballard Score (NBS). Pearson correlation coefficient statistics were calculated to evaluate the strength of associations among the three methods. The significance level (p value) was set at 0.05.&#x0D; Results: The study included 47 (46.1%) females and 55 (53.9%) males. The highest GA (days) was calculated by ultrasound scan (268.76 ± 0.83), followed by PS GA (266.65 ± 1.00) and NBS (264.38 ± 1.05). There was no significant difference in GA assessment between PS and the ultrasound scan (2.32 ± 1.37 days; p = 0.208). The GA assessment between NBS and the ultrasound scan was found to be significant (4.38 ± 1.37 days; p = 0.004). However, this difference is not clinically significant. The NBS and PS GA assessment had a strong positive correlation (Pearson Coefficient = 0.80).&#x0D; Conclusions: The PS is a reliable method for assessing GA in newborns and is comparable to the NBS. Further research with a larger sample size should be conducted to validate these findings.

Modifying the walk score based on daily social activities: residential neighborhood in Egypt as a case study

Walkability has been linked to quality of life in many ways. The Walk Score is one of several methodologies aimed at assisting people in evaluating walkability. Despite the validation of this method, the amenity schedule around the day and the occupancy percentage in each amenity are not included in the calculation of the Walk Score, resulting in reduced accuracy. The research aims to improve the Walk Score methodology by inserting the amenity schedule around the day and the occupancy percentage in each amenity in the calculating method of the walk score, as the amenities do not have the same occupancy throughout the day. The research proposes a new method to calculate the Walk Score according to the time and occupancy for each amenity at the residential neighborhood level in Egypt. The research uses Salam New City as a case study to apply the new method to a residential neighborhood using the Urban Modelling Interference (Umi) plugin. Finally, the research proposes the Walk Score Model of Salam New City to calculate the Walk Score around the day. The new Walk Score model helps urban planners improve urban space design and the distribution of amenities.

The Probability of Stroke Based on Clinical Decision Support System (CDSS) using the Framingham Risk Score Method in Hospital

Stroke is the main cause of death in Indonesia. Identification of stroke risk factors can use the Clinical Decision Support System (CDSS). Researchers have designed and developed a CDSS using the Framingham Risk Score (FRS) method to identify stroke in patients. The study aims to identify stroke risk factors using CDSS with the Framingham Risk Score method in dr Soebandi Hospital.This research was an analytic observational study using secondary data from medical record documents of neurology patients. . The sampling technique used was incidental sampling that met the inclusion criteria and exclusion criteria. The inclusion criteria used in selecting medical records were medical records that had complete data regarding gender, age, systolic blood pressure, total cholesterol, HDL, smoking behavior, history of diabetes mellitus, and the patient's stroke incidence thus obtaining 14 patient medical records.. Data were analyzed using the FRS method. Based on the research results, it can be concluded that there were 8 patients with high risk and 6 patients with low risk. However, further research needs to be carried out on the relationship between variables so that they can contribute in more detail to efforts to reduce the prevalence of stroke in society.

Comparing quality indicator rates for home care clients receiving palliative and end-of-life care before and during the Covid-19 pandemic

BackgroundThe consensus among Canadians with regards to end-of-life preferences is that with adequate support the majority prefer to live and die at home.PurposeTo compare quality indicator (QI) rates for home care clients receiving palliative and end-of-life care prior to and after the onset of the COVID-19 pandemic.MethodsA retrospective population-based cohort design was used. Sixteen QIs informed by existing literature and a preliminary set of QIs recently evaluated by a modified Delphi panel were compared. Data were obtained from the interRAI Palliative Care instrument for Ontario home care clients for two separate cohorts: the pre-COVID (January 14, 2019 to March 16, 2020) and COVID cohort (March 17, 2020 to May 18, 2021). A propensity score analysis was used to match (using nearest neighbour matching) on 21 covariates, resulting in a sample size of 2479 unique interRAI Palliative Care assessments in each cohort. Alternative propensity score methods were explored as part of a sensitivity analysis.ResultsAfter matching the pre-COVID and COVID cohorts, five of the 16 QIs had statistically significant differences in the QI rates (change from pre-COVID to COVID): decrease in prevalence of severe or excruciating daily pain (p = 0.03, effect size=-0.08), decrease in prevalence of caregiver distress (p = 0.02, effect size=-0.06), decrease in prevalence of negative mood (p = 0.003, effect size=- 0.17), decrease in prevalence of a delirium-like syndrome (p = 0.001, effect size=-0.25) and decrease in prevalence of nausea or vomiting (p = 0.04, effect size=-0.06). While the alternative propensity score methods produced slightly different results, no clinically meaningful differences were seen between the cohorts when effect sizes were examined. All methods were in agreement regarding the highest QI rates, which included the prevalence of shortness of breath with activity, no advance directives, and fatigue.ConclusionThis study is the first to examine differences in QI rates for home care clients receiving palliative and end-of-life care before and during COVID in Ontario. It appears that QI rates did not change over the course of the pandemic in this population. Future work should be directed to understanding the temporal variation in these QI rates, risk-adjusting the QI rates for further comparison among jurisdictions, provinces, and countries, and in creating benchmarks for determining acceptable rates of different QIs.

Clinical outcomes of sentinel node navigation surgery in patients with preoperatively estimated stage IA endometrial cancer and evaluation of validity for continuing sentinel node navigation surgery based on dispersion of recurrence probability.

To evaluate the feasibility of the use and continuation of sentinel lymph node navigation surgery (SNNS) as an alternative to pelvic lymph node dissection (PLND) for patients with preoperatively estimated stage IA endometrial cancer. This retrospective study selected the electronic medical records of all patients who had received CT scans and MRI imaging before surgery from April 1, 2009 to March 31, 2021. Sentinel lymph nodes (SLNs) were detected by administrating 99mTc-phytate and/or indocyanine green into the cervix, and the clinical outcomes of the patients who underwent SNNS or PLND were evaluated. Furthermore, in case of nodal recurrence, a new procedure to determine whether the facility should continue with SNNS or not was developed that compares the maximum likelihood hypothesis and an alternative one based on recurrence rates. Among 137 patients, SLN biopsies with ultrastaging were performed on 91 patients. The SLN detection rate was 95.6%. Over a 59-month median observation period, no statistically significant differences were shown in overall survival, disease-specific survival and disease-free survival between the SNNS and PLND groups when introducing the propensity score method (p-values: 0.06, 0.153, and 0.625, respectively). Our procedure demonstrated that, in our department without recurrence up to the 65th attempt, it was possible to continue SNNS if a recurrence occurs at the 66th attempt. This study suggests the validity of SNNS as an alternative to PLND. Even in the absence of evidence from randomized controlled trials, we can confirm the validity of continuing SNNS using our procedure.

Interval estimation of common risk difference for stratified unilateral and bilateral data✩

ABSTRACT In clinical trials, unilateral or bilateral data can usually be encountered if a subject contributes one or both of paired organs. For the bilateral data, responses from two paired body parts are correlated. In this paper, we study various confidence intervals of common risk difference in stratified unilateral and bilateral data based on the Dallal’s model. Simulation results show that the score method outperforms other methods and provides coverage probability close to the nominal level and satisfactory coverage width. Hence, the method is recommended. In addition, the inverse hyperbolic tangent Wald-type become as optimal as the score method with the increase of sample sizes. An otolaryngology example is used to demonstrate the proposed methods.

Future changes in compound drought events and associated population and GDP exposure in China based on CMIP6

Compound drought events, in which several types of drought occur at the same time, usually causes more harm to human society than just one type of drought event on its own. In this study, skill scoring methods are used to evaluate models, and then several drought indices are calculated to characterize meteorological, agricultural, and hydrological droughts, separately. Finally, the projected future changes in compound drought events, and associated population and GDP exposure to them, are further studied based on CMIP6. The results show that the frequency of compound drought events is likely to increase in northern Northwest China, Southwest China, and South China, but decrease in North and Northeast China. The projected changes in duration and severity are similar to those of frequency, i.e., mainly increasing in a few parts of northern Northwest and South China, but decreasing in Northeast and North China. The population exposure to compound drought events is expected to increase greatly in the area south of the Yangtze River Basin, slightly in Northwest China, and decrease greatly in the northeast of the Yangtze River Basin. Both climate and population have important effects on the change in population exposure. Due to the expected rapid growth in GDP, the exposure of GDP to compound drought events in almost all regions of China is projected to increase in the future, especially in eastern China, and the relative contribution of the GDP effect to the change in GDP exposure will be the largest.摘要相较于一种类型的干旱, 几种类型的干旱同时发生的复合型干旱事件对人类社会造成的危害更加严重. 本研究采用CMIP6资料, 研究中国复合型干旱事件及其相关社会经济暴露度的未来变化. 结果表明, 西北北部, 西南和华南地区复合型干旱事件频次, 持续时间和严重程度增加, 而华北和东北地区则减少. 复合型干旱事件的人口暴露度在长江流域南部大幅增加, 在长江流域以北的东部大幅减少, 其中气候和人口均对人口暴露度的变化有重要影响. 由于GDP的快速增长, 中国未来几乎所有地区复合型干旱事件的GDP暴露度增加, 特别是在中国东部, GDP效应对GDP暴露度变化的相对贡献最大.