Significant Regression Equation Research Articles

Investigation of the relationship between the levels of public trust and corruption: A topological model and statistical methods

The article analyzes the concepts of "trust" and "corruption of society" and explores the interdependence between them using the international indexes Edelman Trust Barometer (ETB) and Corruption Perceptions Index (CPI). The research methods are: 1) the topological model proposed by the authors, based on the averaged values of these indices; 2) correlation and regression analysis; 3) interval method (studying the dependence on the selected intervals of the averaged values of ETB and CPI). The topological model uses data on the values of these indices for 28 countries and was developed in two versions for the time periods (2011–2021) and (2013–2019). In both cases, the model gives a similar picture of the points placement on the coordinate plane, which indicates the stability of the results. A comparison of empirical data over the time periods revealed countries with a relatively stable ratio of ETB and CPI indices (Germany, Indonesia, Canada, Colombia, France) and countries where this ratio is noticeably changing (Australia, Argentina, Brazil, Hong Kong, Italy, the Netherlands). The analysis of the topological model was carried out and zones of low, medium and high levels of corruption were identified. Zones are characterized by a specific type of relationship between ETB and CPI indices. The general type of dependence of the level of trust on corruption in the form of a horizontal S-shaped curve is approximately determined. Regression analysis using time series data for 28 countries was performed. Statistically significant linear regression equations (reflecting the relationship between the considered economic categories) were obtained for some countries (the Netherland, Sweden and Japan). The conclusion about the significant nonlinearity of the studied relationship is made. This is evidenced by both the visual analysis of the topological model and the results of regression analysis conducted for the selected intervals of change values of the ETB and CPI indexes.

Echocardiographic Left Ventricular Z-Score Utility in Predicting Pulmonary-Systemic Flow Ratio in Children With Ventricular Septal Defect or Patent Ductus Arteriosus.

The correlation between the Z-score of the left ventricular (LV) diameter and the LV volume-overload due to pulmonary over-circulation in children with ventricular septal defect (VSD) or patent ductus arteriosus (PDA) remains unclear.Methods and Results:The present, retrospective study enrolled 70 children (aged 0.3-16.8 years; 33 males, 37 females) with a diagnosis of isolated VSD and/or PDA who underwent cardiac catheterization (CC) between 2015 and 2019. Patients with chromosomal/genetic anomalies, growth disorder, right-ventricular enlargement or other conditions causing LV enlargement were excluded. Echocardiographic parameters were retrospectively evaluated from the medical records, converted to a Z-score, then compared with CC data. The pulmonary-systemic flow ratio on CC (cQp/Qs) correlated significantly with the Z-score of both the LV end-diastolic diameter (Zd) (r=0.698, P<0.0001) and LV end-systolic diameter (r=0.593, P<0.0001). Regression analysis and curve-fitting were used to predict the cQp/Qs based on the Zd, and a significant regression equation was found on cubic regression (R2of 0.524, P<0.0001) showing a strong correlation with the cQp/Qs (r=0.724, P<0.0001). The Z-score of the LV diameter can be a useful, non-invasive marker for evaluating LV volume overload and determining the surgical indications in children with VSD or PDA because of its strong correlation with the cQp/Qs.

Assessment of Femoral Torsion on Magnetic Resonance Imaging is More Reliable Using Axial-Oblique Sequences Compared With Standard Axial Slices in Patients With Femoroacetabular Impingement Syndrome

To determine the agreeability of femoral torsion measurements on axial and oblique axial magnetic resonance imaging (MRI) sequences in patients with femoroacetabular impingement syndrome (FAIS). Patients who underwent primary hip arthroscopy for FAIS between January 2012 to January 2019 were identified. Inclusion criteria were all patients with an MRI scan containing the pelvis and knee imaging. MRI-based measurements of femoral torsion were performed on axial and oblique-axial slices by 2 raters, and inter-rater and intrarater reliability was assessed. Bland Altman plots were constructed to evaluate the agreeability between femoral torsion measurements performed using axial and oblique-axial slices. Bivariate correlation analyses were performed to assess the relationship between measurement methods on each respective scan. A linear regression was performed between measurements performed using axial and oblique-axial sequences. A total of 164 patients were included. The mean true-axial and oblique axial femoral torsion were 12.2° ± 9.9° and 11.1° ± 9.2°, respectively. The intrarater reliability for axial and oblique-axial measurements were 0.993 and 0.997, respectively. The inter-rater reliability for axial and oblique-axial measurements were 0.925 and 0.965, respectively. The number of differences within the limits of agreement for axial and oblique-axial femoral torsion measurements was 58.54%. On Pearson correlation analysis, strong positive correlations were found between oblique-axial measurements at multiple time points (r= 0.994, P<.001), as well as axial measurements at multiple time points (r= 0.986, P < .001). A strong positive correlation was found between axial and oblique-axial measurements (r= 0.894, P < .001). A significant regression equation indicated that for each additional increase in axial femoral torsion, the oblique-axial femoral torsion increased 0.837 (95% confidence interval 0.772-0.901). Femoral torsion values measured on oblique-axial sequences are smaller than on true-axial sequences. Femoral torsion measurements on axial and oblique-axial MRI sequences exhibit poor agreement. Oblique-axial sequences demonstrated greater measurement consistency at multiple timepoints. When evaluating torsional measurements, it is important to delineate which axial sequence was used, especially inpatients with suspected severe femoral antetorsion. Standardization of MRI femoral version protocols within one'spractice can ensure more consistent decision-making, especially in patients with suspected femoral antetorsion. Retrospective cohort, level III.

Self-reported driving difficulty in patients with bilateral cataract

PurposeThe presence of cataract causes reduction in visual acuity (VA) and contrast sensitivity (CS) and thus can affect individual's daily activities. The aim of this study was to investigate self-reported driving difficulty in patients with bilateral cataract. MethodsA total of 99 participants aged 50 and above, with bilateral cataract, who possessed a valid driving license and drove regularly were chosen for this cross-sectional study that looked into their visual functions (VA and CS) and driving difficulty using the self-reported Driving Difficulty Questionnaire. ResultsThe mean age of the participants was 65.04±7.22 years old. Results showed that the mean composite driving difficulty score was 83.18±11.74 and most of the participants were having difficulty for driving in the rain (73.7%) and at night (85.9%). Furthermore, the study found that there was a significant correlation between driving difficulty score and CS (rs = 0.40, p = 0.03). However, there was no significant correlation between driving difficulty score and VA (rs = -0.14, p = 0.17). A linear regression was calculated to predict driving difficulty score based on binocular CS and a significant regression equation was found (F (1,28) = 8.115, p = 0.008) with R² of 0.225. Drivers with bilateral cataract will most likely experience some forms of difficulty, especially when driving under low contrast conditions. ConclusionThe findings of this study demand that a comprehensive eye examination should be made compulsory for older adult drivers when issuing or renewing their driving license for the safety of all road users.

Dual energy window imaging for optimisation of P/V ratios in VP SPECT

PurposeVentilation–perfusion single-photon emission computed tomography (VP SPECT) plays an important role in pulmonary embolism diagnosis. Rapid results may be obtained using same-day ventilation followed by perfusion imaging, but generally requires careful attention to achieving an optimal count rate ratio (P/V ratio) of ≥ 3:1. This study investigated whether the ratio of counts simultaneously acquired in adjacent primary and Compton scatter energy windows (Eratio) on V SPECT was predictive of final normalised perfusion count rate (PCRnorm) on P SPECT using [99mTc]Tc-macroaggregated albumin (MAA), thus allowing for optimisation of P/V ratios.MethodsSame-day VP SPECT studies acquired using standard protocols in adult patients during a 2-year period (training dataset) were assessed. Studies were included provided they were acquired with correct imaging parameters, and injection site imaging and laboratory records were available for quality control and normalised count rate corrections. Extraction of DICOM information, and linear regression were performed using custom Python and R scripts. A predictive tool was developed in Microsoft Excel. This tool was then validated using a second (validation) dataset of same-day studies acquired over a subsequent 7-month period. Accuracy of the prediction tool was assessed by calculating the mean absolute percentage error (MAPE).ResultsOf 643 studies performed, the scans of 342 participants (median age 30.4 years, 318 female) were included in the training dataset, the analysis of which yielded a significant regression equation (F(1,340) = 1057.3, p < 0.0001), with an adjusted R2 of 0.756 and MSE of 0.001089. A prediction tool designed for routine clinical use was developed for predicting final P/V ratio. Of an additional 285 studies, 198 were included in the second (validation) dataset (median age 29.7 years, 188 female). The Excel-based tool was shown to be 91% accurate (MAPE: 9%) in predicting P/V ratio.ConclusionThe relationship between the ratio of simultaneously acquired counts in adjacent energy windows on V SPECT and perfusion count rate after administration of a known activity of [99mTc]Tc-MAA can be linearly approximated. A predictive tool based on this work may assist in optimising the dose and timing of [99mTc]Tc-MAA administration in same-day studies to the benefit of patients and workflows.

Handgrip Strength Cutoff Points for Functional Independence and Wheelchair Ability in Men With Spinal Cord Injury.

To determine optimal handgrip strength (HGS) cutoff points for greater functional independence and wheelchair skills in men with spinal cord injury (SCI), and to establish predictive equations for functional independence and wheelchair ability in men with SCI, based on demographic characteristics, HGS, and functionality. In this cross-sectional study conducted at a rehabilitation hospital, 54 men with SCI were recruited and stratified into high and low paraplegia groups. All participants performed a maximum HGS test to determine cutoff points for the Spinal Cord Independence Measure (SCIM-III) and Adapted Manual Wheelchair Circuit (AMWC). The primary outcomes were the SCIM-III, AMWC, and HGS. Demographic characteristics obtained from participants' electronic medical records were the secondary outcomes, used as predictor variables of functional independence. The SCIM-III scale, performance score, and 3-minute overground wheeling test presented significant regression equations (R = 0.45, R = 0.69, and R = 0.72). The HGS showed a cutoff point of 102.5 kilogram force (kgf) to achieve a score of 70 on the SCIM-III and a 3-minute overground wheeling distance of 270 m. The HGS cutoff point to obtain a performance score of 23.7 seconds was 93.0 kgf. The HGS was a significant predictor for the SCIM-III score, AMWC performance score, and 3-minute overground wheeling test. Three significant predictive equations were established based on HGS. The cutoff points could be adopted as parameters for optimal functional independence and wheelchair skills.

Biological factors predicting the length of hospital stay in odontogenic cellulitis

ObjectiveThe purpose of this study was to assess whether common biological factors are correlated with a longer hospital stay. Study DesignAll patients having odontogenic cellulitis, treated from January 2019 to December 2019 at Lille University Hospital, and requiring surgical drainage under general anesthesia, were included, retrospectively. Data, such as length of hospital stay and biological factors, namely, C-reactive protein (CRP) level, Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score, and bacterial samples were collected. ResultsSignificant moderate-strong correlations were found between postoperative length of stay and patients’ LRINEC score (rs = 0.556) and presurgical CRP level (rs = 0.579). There was a significant moderate correlation between postoperative length of stay and presurgical procalcitonin level (rs = 0.451), and a weak correlation between postoperative length of stay and presurgical white blood cell count (rs = 0.282). Linear regression verified CRP as an independent predictor of length of hospital stay, showing a significant linear relationship between them (p < 0.0001). A significant regression equation was found (F(1,65) = 27.089; p = 0.0001), with an R2 of 0.294. ConclusionIn this study, CRP was the key biological predictor of length of hospital stay. Statement of clinical relevanceThe ability to predict length of hospital stay and identify patients requiring intensive care management, using simple and inexpensive biological parameters (such as CRP), will enable more cost-effective care and efficient hospital bed management.

The Influence of Flipped Classroom Towards Students' Motivation and Learning Outcome in Mathematics: A Case of Students in SD Hj Isriati Baiturrahman 1 Semarang

The research problem of this study is whether the implementation of flipped classroom affects the students' motivation and achievements, whether there is the influence of motivation on students' achievement in Mathematics of the fourth grades students of SD Hj. Isriati Baiturrahman 1 Semarang? This research is a quantitative experimental research. The research design is quasi experimental research using non-quivalent control group design. The samples were used as the experimental class and control class with total of 68 students. The T test results show t count &gt; t table (3.608&gt; 1.665). In conclusion flipped classroom influence on students' motivation. The T test results show t count &gt; t table (1.854&gt; 1.665). In conclusion learning flipped classroom effect on student learning outcomes. Significance test analysis results obtained F count&gt; F table (3113.84&gt; 4, 14), it means a significant regression equation. Analysis results obtained coefficient of determination R2 = 0.7534 = 75 %. In conclusion there is an influence of learning motivation on Math learning outcomes.

Discharge Coefficients for Radial-Gated Ogee Spillways by Laboratory Data and by Design of Small Dams

Using the measured data on 15 laboratory models in USA, six models and one prototype in Turkey, the discharge coefficients (C’s) of radial-gated ogee spillways for various gate openings and lake water surface elevations are computed. Comparison of these C’s for 22 spillways with the ones given by Figure 9-31 of Design of Small Dams does not show close agreements. It is determined that C depends on both the angle Ɵ and the ratio d/H1, rather than Ɵ only where d and H1 are the gate opening and the upstream head, and statistically significant regression equations are computed individually for each one of 22 cases.

Analysis of the ex-vivo transformation of semen, saliva and urine as they dry out\xa0using ATR-FTIR spectroscopy and chemometric approach

The ex-vivo biochemical changes of different body fluids also referred as aging of fluids are potential marker for the estimation of Time since deposition. Infrared spectroscopy has great potential to reveal the biochemical changes in these fluids as previously reported by several researchers. The present study is focused to analyze the spectral changes in the ATR-FTIR spectra of three body fluids, commonly encountered in violent crimes i.e., semen, saliva, and urine as they dry out. The whole analytical timeline is divided into relatively slow phase I due to the major contribution of water and faster Phase II due to significant evaporation of water. Two spectral regions i.e., 3200–3400 cm−1 and 1600–1000 cm−1 are the major contributors to the spectra of these fluids. Several peaks in the spectral region between 1600 and 1000 cm−1 showed highly significant regression equation with a higher coefficient of determination values in Phase II in contrary to the slow passing Phase I. Principal component and Partial Least Square Regression analysis are the two chemometric tool used to estimate the time since deposition of the aforesaid fluids as they dry out. Additionally, this study potentially estimates the time since deposition of an offense from the aging of the body fluids at the early stages after its occurrence as well as works as the precursor for further studies on an extended timeframe.

Differentiated white blood cell count measures as a predictor of weight in anorexia nervosa

AimsTo explore the relationship between weight, BMI and differentiated white cell count in patients with anorexia nervosa that have commenced refeeding protocols.Hypotheses: 1. Weight and BMI will be positively correlated with differentiated white blood cell measures.2. Regression analyses will indicate that differentiated white blood cell measures can predict weight and BMI.BackgroundAnorexia nervosa is a serious mental illness with the highest psychiatric mortality rate. It is characterised by an extreme overvaluation of body image and a preoccupation with weight loss that is achieved through calorie restriction, purging or laxative abuse. The eventual malnutrition that is as a result of self-starvation causes significant negative physical sequelae. One such consequence is the detrimental effect that starvation has on the immune system, leading to bone marrow suppression and cytopenias. In obesity, weight loss has been shown to cause reductions in differentiated white blood cell counts, which are often reduced in anorexia. No studies to date have explored whether weight is related to white blood cell count in anorexia, despite being a common finding in patients.MethodAll subjects were inpatients or ex-inpatients on an eating disorder unit in the Wirral, NW England. Subjects were assessed according to an inclusion criterion. 12 consecutive weekly weights, BMIs and differentiated white blood cell measures were collected for analysis in SPSS. Correlational and regression analyses were then performed to examine the relationship between variables.Result302 data points from 26 individuals were used in the final analysis. Weight and BMI both moderately positively correlated with white cell count, r = 0.364 p &lt; 0.001 N = 302 and r = 0.521 p &lt; 0.001 N = 302, respectively. Weight and BMI also moderately positively correlated with all differentiated measures of white blood cell count. Linear regression revealed a significant regression equation between weight, BMI and white blood cell count: (F (1,301) = 22.482, p &lt; 0.001) R2 = 0.69 and (F (1,301) = 112.244 p &lt; 0.001) R2 = 0.272, respectively.ConclusionWe have demonstrated that there is a moderately positive relationship between weight, BMI and differentiated white blood cell measures. Furthermore, in line with our hypotheses, differentiated white blood cell measures have some power to predict weight and BMI. This further implicates the effect that starvation and anorexia nervosa have on the immune system. It also highlights the possibility that it might be possible to use immunological markers in order to deduce whether weights have been falsified by those with anorexia nervosa.

Can bilinguals rate their proficiency accurately in a language background questionnaire?

Research with bilinguals apply different measures to assess proficiency, one of them being language background questionnaires, which include questions about individuals’ experience and self-rated proficiency. Studies suggest that bilinguals can report their proficiency consistently with objective measures (MARIAN et al., 2007; LUK et al., 2013; GERTKEN et al., 2014; BRANTMEIR et al., 2012). Within this context, the goal of the present study was to investigate the relationship between two distinct measures of proficiency. In order to do so, we correlated participants’ self-rated proficiency (N = 112) in the Language Experience and Proficiency Questionnaire (QuExPLi - Questionário de Experiência e Proficiência Linguística) with their scores on the TOEFL ITP. We also carried out a simple linear regression between the mean scores of the two measures. Results show a significant weak correlation between participants’ self-rated proficiency and their scores on the TOEFL ITP, as well as a significant regression equation. Also, when the scores on individual skills were correlated with participants’ self-rated proficiency on those skills (N = 16), significant moderate to strong correlations were found. These results add to research that have found that bilinguals are able to report their proficiency accurately; however, more studies in different contexts are needed.

Awareness and Stigma of Autism Spectrum Disorders in Undergraduate Students.

Social stigma is a barrier for students with autism on college campuses. The purpose of this study is to examine the relationship between autism knowledge and autism stigma endorsement. 144 college undergraduate students were asked to complete the Autism Stigma and Knowledge Questionnaire as well as a brief demographic questionnaire. The relationship between stigma endorsement and ASD knowledge in the areas of diagnosis and symptoms, etiology, and treatment were evaluated using a multiple linear regression. Two independent-sample t-tests were conducted to investigate group differences between participants who know someone with autism and those who do not as well as between male and female participants. A significant regression equation was found (F(3,140) = 51.35, p = .000), with an R2 of .52. While Treatment and Etiology subscale scores significantly predicted Stigma subscale scores, Diagnosis/Symptom subscale score was not. In terms of knowing someone with an autism diagnosis, there was a significant difference in ASD diagnosis and symptom knowledge (t(142) = 4.16, p = .000), etiology knowledge (t(142) = 3.51, p = .001), treatment knowledge (t(62.99) = 3.54, p = .001), and stigma endorsement (t(142) = 3.03, p = .003). No significant differences were found between male and female participants. Contrary to past studies, gender was not associated with ASD knowledge or stigma endorsement. This study suggests that an intervention designed to increase ASD knowledge, particularly in the areas of etiology and treatment, and to increase contact with students diagnosed with autism would be effective in reducing ASD stigma.

Physical Activity, Boredom and Fear of COVID-19 Among Adolescents in Germany.

BackgroundThe effectiveness of physical activity (PA) as an intervention against anxiety disorders and depression is undeniable in clinical psychology. Therefore, the question arose whether these effects also occur when a fear stimulus, like the COVID-19 pandemic, affects otherwise healthy adolescents. Boredom is closely linked to symptoms of fear and anxiety, but the connection between PA, boredom and fear is partly unclear.MethodsA cross-sectional online study was conducted that involved 122 students. Participants were 13–19 years old (Mage = 15.83, SD = 1.73). The survey was available online from April 27th to May 3rd, 2020. At this time, schools in Germany had already been closed for 6 weeks. A self-report questionnaire was used to measure physical activity, boredom, and fear of COVID-19. A multiple linear regression model was conducted.ResultsThe reported fear of COVID-19 significantly correlates with total PA, quantity of strenuous PA, and boredom. Furthermore, a significant regression equation was found. The variables boredom, PA, and age contribute significantly to predicting the fear of COVID-19 [R2 = 0.127, F(3,118) = 6.876, p < 0.000], among adolescents.ConclusionOur results indicate that there is an association between PA, boredom and the quarantine experience of adolescents. Students who were physically more active, especially with strenuous intensity, did not feel bored and showed less fear of COVID-19.

Association between heavy metals and colon cancer: an ecological study based on geographical information systems in North-Eastern Iran

BackgroundColorectal cancer has increased in Middle Eastern countries and exposure to environmental pollutants such as heavy metals has been implicated. However, data linking them to this disease are generally lacking. This study aimed to explore the spatial pattern of age-standardized incidence rate (ASR) of colon cancer and its potential association with the exposure level of the amount of heavy metals existing in rice produced in north-eastern Iran.MethodsCancer data were drawn from the Iranian population-based cancer registry of Golestan Province, north-eastern Iran. Samples of 69 rice milling factories were analysed for the concentration levels of cadmium, nickel, cobalt, copper, selenium, lead and zinc. The inverse distance weighting (IDW) algorithm was used to interpolate the concentration of this kind of heavy metals on the surface of the study area. Exploratory regression analysis was conducted to build ordinary least squares (OLS) models including every possible combination of the candidate explanatory variables and chose the most useful ones to show the association between heavy metals and the ASR of colon cancer.ResultsThe highest concentrations of heavy metals were found in the central part of the province and particularly counties with higher amount of cobalt were shown to be associated with higher ASR of men with colon cancer. In contrast, selenium concentrations were higher in areas with lower ASR of colon cancer in men. A significant regression equation for men with colon cancer was found (F(4,137) = 38.304, P < .000) with an adjusted R2 of 0.77. The predicted ASR of men colon cancer was − 58.36 with the coefficients for cobalt = 120.33; cadmium = 80.60; selenium = − 6.07; nickel = − 3.09; and zinc = − 0.41. The association of copper and lead with colon cancer in men was not significant. We did not find a significant outcome for colon cancer in women.ConclusionIncreased amounts of heavy metals in consumed rice may impact colon cancer incidence, both positively and negatively. While there were indications of an association between high cobalt concentrations and an increased risk for colon cancer, we found that high selenium concentrations might instead decrease the risk. Further investigations are needed to clarify if there are ecological or other reasons for these discrepancies. Regular monitoring of the amount of heavy metals in consumed rice is recommended.

Antral follicle count and anti-Müllerian hormone to classify low-prognosis women under the POSEIDON criteria: a classification agreement study of over 9000 patients.

What is the agreement between antral follicle count (AFC) and anti-Müllerian hormone (AMH) levels when used to patient classification according to the Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number (POSEIDON) criteria? Our study indicates a strong agreement between the AFC and the AMH levels in classifying POSEIDON patients; thus, either can be used for this purpose, although one in four women will have discordant values when both biomarkers are used. According to the POSEIDON criteria, both AFC and AMH may be used to classify low-prognosis patients. Proposed AFC and AMH thresholds of 5 and 1.2 ng/ml, respectively, have their basis in published literature; however, no study has yet determined the reproducibility of patient classification in comparing one biomarker with the other, nor have their thresholds ever been validated within this patient population. A population-based cohort study involving 9484 consecutive patients treated in three fertility clinics in Brazil, Turkey and Vietnam between 2015 and 2017. Participants were infertile women between 22 and 46 years old in their first in vitro fertilization/intracytoplasmic sperm injection cycle of standard ovarian stimulation with exogenous gonadotropins whose baseline ovarian reserves had been assessed by both AFC and AMH. Details of pre- and post-treatment findings were input into a coded research file. Two indicators of interest were created to classify patients according to the POSEIDON criteria based upon AFC and AMH values. Patients who did not fit any of the four POSEIDON groups were classified as non-POSEIDON. AFC was determined in the early follicular phase using two-dimensional (2D) transvaginal ultrasonography, whereas AMH values were based on the modified Beckman Coulter generation II enzyme-linked immunosorbent assay. Agreement rates were computed between AFC and AMH to classify patients using Cohen's kappa statistics. Logistic regression analyzes were carried out to examine the association between ovarian markers and low (<4) and suboptimal (4-9) oocyte yield. The degree of agreement in classifying patients according to POSEIDON groups was strong overall (kappa = 0.802; 95% CI: 0.792-0.811). A total of 73.8% of individuals were classified under the same group using both biomarkers. The disagreement rates were ∼26% and did not diverge when AFC or AMH was used as the primary biomarker criterion. Significant regression equations were found between ovarian markers and oocyte yield (P < 0.0001). For low oocyte yield, the optimal AFC and AMH cutoff values were 5 and 1.27 ng/ml with sensitivities of 0.61 and 0.66, specificities of 0.81 and 0.72, and AUC receiver operating characteristics of 0.791 and 0.751, respectively. For suboptimal oocyte yield respective AFC and AMH cutoffs were 12 and 2.97 ng/ml with sensitivities of 0.74 and 0.69, specificities of 0.76 and 0.66 and AUCs of 0.81 and 0.80. Our study relied on 2D transvaginal sonography to quantify the AFC and manual Gen II assay for AMH determination and classification of patients. AMH data must be interpreted in an assay-specific manner. Treatment protocols varied across centers potentially affecting patient classification. Three of four patients will be classified the same using either AFC or AMH values. Both biomarkers provide acceptable and equivalent accuracy in predicting oocyte yield further supporting their use and proposed thresholds in daily clinical practice for patient classification according to the POSEIDON criteria. However, the sensitivity of POSEIDON thresholds in predicting low oocyte yield is low. Clinicians should adopt the biomarker that may best reflect their clinical setting. Unrestricted investigator-sponsored study grant (MS200059_0013) from Merck KGaA, Darmstadt, Germany. The funder had no role in study design, data collection, analysis, decision to publish or manuscript preparation. S.C.E. declares receipt of unrestricted research grants from Merck and lecture fees from Merck and Med.E.A. H.Y. declares receipt of payment for lectures from Merck and Ferring. L.N.V. receives speaker fees and conferences from Merck, Merck Sharp and Dohme (MSD) and Ferring and research grants from MSD and Ferring. T.M.H. received speaker fees and conferences from Merck, MSD and Ferring. The remaining authors have nothing to disclose. not applicable.

Is distal peripheral neuropathy common after shoulder arthroplasty?

BackgroundNeurologic injury after shoulder arthroplasty has been reported in previous outcome studies. However, the incidence and development of distal peripheral neuropathy (DPN) after shoulder arthroplasty requiring surgical intervention has not been previously described. HypothesisThe authors report on the incidence of DPN requiring surgical intervention following shoulder arthroplasty. MethodsA retrospective review was conducted of a prospectively collected shoulder arthroplasty registry at a single institution from a single surgeon from April 2006 to April 2017. Patients were included in the series if they had primary surgical intervention for ipsilateral or contralateral peripheral neuropathy following primary shoulder arthroplasty. Patients were excluded if they had known peripheral neuropathy or cervical radiculopathy prior to surgery. DPN was defined for the study as symptoms or diagnostic testing consistent with cubital tunnel or carpal tunnel syndrome. Demographics, patient reported outcome measures, and preoperative and postoperative shoulder range of motion were collected and analyzed with paired t-tests and multivariate regression models. ResultsOne thousand three hundred eighty-seven total shoulder arthroplasties were performed in this period. During the study period, 16 patients (1.2%) underwent surgery for ipsilateral DPN while 6 patients (0.4%) underwent surgery for contralateral DPN. ASES scores, SANE scores, and shoulder flexion improved significantly from pre- to postoperatively for both groups. There was no significant difference in postoperative scores between groups. Finally, the multivariate linear analysis did not yield any statistically significant regression equations for ASES, SANE VAS, AFE, and AER. ConclusionShoulder arthroplasty resulted in increased ipsilateral distal peripheral neuropathy. Emergence of DPN symptoms following arthroplasty is multifactorial and may be related to a form of the double crush syndrome. Level of evidenceLevel IV; Case series

Predictors of emotional wellbeing in osteopathic medical students in a COVID-19 world.

In March 2020, the World Health Organization declared the novel coronavirus disease 2019 (COVID-19) outbreak a pandemic. Due to the rapid spread, strong contagion, high incidence of lethality in severe cases, and the lack of a pharmaceutical prevention or cure, COVID-19 has posed a serious threat to human life and health. It has also had a tremendous impact on mental health, including fear and worry, difficulty sleeping or concentrating, and increased use of poor coping mechanisms. Osteopathic medical students have had additional concerns regarding the interruption of their studies, closing of clinical rotations, and postponed licensing exams. To date, few reports have focused on osteopathic medical students and their reactions to the outbreak. To assess resilience, coping, health behaviors, and emotional wellbeing of osteopathic medical students during the onset of the COVID-19 pandemic. In this cross-sectional study, we distributed an anonymous online survey to all medical students enrolled at Nova Southeastern University in May 2020 (n=1,310) via an e-mail invitation using the institution's student listservs. Our major study variables were based on published reports and anecdotal evidence; we subsequently developed the Emotional Wellbeing in Healthcare Professions Students Questionnaire (EWB-Q). This EWB-Q contained validated scales to assess the contribution of levels of coping strategies used, personal resilience, and health behaviors on the emotional wellbeing of osteopathic medical students. Multiple linear regression and other statistical analyses were conducted using SPSS v0.26. Of the 1,310 students invited to participate, 335 (25.5%) surveys were returned. Of those, 133 had more than 33% of the necessary data missing and were removed, resulting in 202 (15.4%) completed questionnaires. The mean age of the participants was 26.7 years. About half (n=92; 45.5%) were in the clinical phase (years 3 and 4) of their medical school training (in rotations). A significant regression equation was found (F[4,171]=17.481, p<0.000, R2 =0.290, R2adjusted=0.274), indicating that levels of coping, personal resilience, and health behaviors (i.e.,not sleeping more than usual, not exercising less than usual) accounted for a significant amount of the variance in emotional wellbeing scores in osteopathic medical students. Higher levels of resilience, greater use of coping strategies, not sleeping more than usual, and not exercising less than usual were predictors of emotional wellbeing. Cultivating positive mental health should be a high priority for medical educators as they develop and implement curriculum-based initiatives to help medical students bolster their personal resilience and to encourage healthy coping behaviors during times of crisis and beyond. A proactive position that assists with building personal resilience and developing stress management habits is paramount in assisting students who are grappling not only with the challenges of rigorous medical training, but also with the uncertainty and stress that exists during any major global health or socioeconomic crisis.

Enhanced coagulation coupled with heavy metal capturing for heavy metals removal from coal gasification brine and a novel mathematical model

The wastewater reuse and industrial salt recovery from coal gasification brine (CGB) is the last step for the zero liquid discharge (ZLD) of coal chemical wastewater, and the heavy metals removal is the key limiting factor for the ZLD process. In this research, heavy metals were removed by using the enhanced coagulation coupled with heavy metal capturing technology. Step by step, the optimal type and dosage of chelating agent and flocculant, as well as the optimal coagulant dosage was determined via the single-factor method. Additionally, the impacts of critical water quality parameters (temperature, pH, salinity and organics, etc.) on the removal of heavy metals were also investigated. Finally, the model targeted the removal of total arsenic (As) was constructed by four-factor quadratic regression orthogonal rotation combination design. The initial heavy metal concentration, the amount of heavy metal chelating agents (HMCAs), the amount of flocculant and the amount of coagulant were taken as independent variables, while the total As concentration of effluent was taken as the dependent variable, obtaining the significant regression equation: Y =0.1165 + 0.04187x1-0.01829x3+0.00941x22+0.0116x32-0.00719x2x3 (F2 = 264.22380, p＜0.01). The results demonstrated that appropriate amount of HMCAs and flocculant determined removal efficiency of heavy metals.

Factors affecting serum phenobarbital concentration changes in pediatric patients receiving elixir and powder formulations

BackgroundPhenobarbital (PB) is commonly used as elixir and powder formulations in pediatric care. Its dose adjustment is performed based on individual drug concentration monitoring. Few studies have comprehensively analyzed the variation factors for serum PB concentration. In this study, we retrospectively investigated the factors that influence serum PB concentration and assessed the impacts of dosage formulation and administration route.MethodsThis retrospective cohort study covered clinical data from January 2007 to September 2019 at Mie University Hospital. The present study included 60 pediatric patients administered the elixir and powder of PB through oral route and enteral tube. Simple and multiple linear regression analyses were performed to identify the risk factors that affect the weight-corrected PB serum concentration/dose (C/D) ratio in pediatric patients. Six subgroups were also established according to the concomitant use of drugs that potentially inhibit PB metabolism, dosage formulation, and administration route to investigate the difference in the PB C/D ratio among the subgroups.ResultsA significant regression equation to predict the PB C/D ratio was found through simple and multiple linear regression analyses, with an adjusted coefficient of determination of 0.53 (p < 0.001). Further, the concomitant uses of valproic acid (VPA) or amiodarone, which were the only two drugs seen in this study as potential inhibitors of PB, was found to have the greatest effect on the PB C/D ratio (standardized partial regression coefficient (β) = 0.543, p < 0.001). Furthermore, a significant difference in the PB C/D ratio was found between the subgroups classified by the concomitant use of VPA or amiodarone (p = 0.002). However, there were no significant correlations between the PB C/D ratio, dosage formulation, and administration route.ConclusionsThe most influential factor on the PB C/D ratio was the concomitant use of VPA or amiodarone with PB. This result could provide an important perspective in pediatric drug therapy where elixir and powder formulations are administered via the oral route and enteral tube.