Spearman Rank Research Articles

Diatom bloom trigger notable variations in microzooplanktonic ciliate composition, body-size spectrum and biotic-abiotic interaction in the Arctic Ocean

How microzooplanktonic ciliate adaptative strategies differ across diatom bloom and non-diatom bloom areas in the Arctic Ocean remains poorly documented. To address this gap, two different situations were categorized in the Arctic Ocean at summer 2023: diatom bloom stations (DBS) (genus Thalassiosira, chain-like) and non-diatom bloom stations (nDBS). Total abundance of ciliate at 3 m and 25 m in DBS was 2.8 and 1.8 folds higher than in nDBS, respectively. Aloricate ciliates were singled out in both DBS and nDBS, whilst their average abundance and biomass of large size-fraction (>50 μm) in former were 4.5–5.6 folds higher than in latter. Regarding tintinnids, high abundance of Ptychocylis acuta (Bering Strait species) mainly occurred at DBS, coupled with distribution of co-occurring Pacific-origin species Salpingella sp.1, collectively suggested a strong intrusion of Pacific Inflow during summer 2023. Additionally, presence of high abundance of Acanthostomella norvegica and genus Parafavella in nDBS might indicate the trajectory of the Transpolar Drift. Alternatively, tintinnids can serve as credible bioindicators for either monitoring currents or evaluating microzooplankton Borealization. Average abundance of total ciliate within 15–135 μm body-size spectrum in DBS was higher than nDBS. Moreover, spearman's rank correlation between biotic and abiotic analysis revealed that temperature and dissolved oxygen at DBS determined tintinnid species richness and ciliate total abundance, respectively. The results clearly demonstrate that remarkable divergences in large size-fraction of ciliate abundance between DBS and nDBS validate their irreplaceable role in controlling phytoplankton outbreak and associated biological processes in polar seas.

Increasing seasonal variation in the extent of rivers and lakes from 1984 to 2022

Abstract. Knowledge of the spatial and temporal distribution of surface water is important for water resource management, flood risk assessment, monitoring ecosystem health, constraining estimates of biogeochemical cycles and understanding our climate. While global-scale spatiotemporal change detection of surface water has significantly improved in recent years due to planetary-scale remote sensing and computing, it has remained challenging to distinguish the changing characteristics of rivers and lakes. Here we analyze the spatial extent of permanent and seasonal rivers and lakes globally over the past 38 years based on new data of river system extents and surface water trends. Results show that while the total permanent surface area of both rivers and lakes has remained relatively constant, the areas with intermittent seasonal coverage have increased by 12 % and 27 % for rivers and lakes, respectively. The increase is statistically significant in over 84 % of global water catchments based on Spearman's rank correlations (rho) above 0.05 and p values less than 0.05. The seasonal river extent is nearly 32 % larger than the previously observed annual mean river extent, suggesting large seasonal variations that impact not only ecosystem health but also estimations of terrestrial biogeochemical cycles of carbon. The outcomes of our analysis are shared as the Surface Area of Rivers and Lakes (SARL) database, serving as a valuable resource for monitoring and research of hydrological cycles, ecosystem accounting, and water management.

The relationship of gadget use with the mental and emotional of preschool children in KB TK Negeri Pembina 1 Malang, Indonesia

In the era of revolution 4.0 where technological advances in all fields, it is a new challenge for parents to educate their children. Gadgets that are currently popular with children, can have an impact on children's development. One of the negative effects of gadgets is that children experience emotional and mental problems. The purpose of this study was to determine the relationship between the use of gadgets and the emotional mentality of preschool children in KB TK Negeri Pembina 1 Malang City. Correlation analytic research design, with a cross-sectional approach with a population of 75 respondents, sampling using purposive sampling of 54 respondents. Statistical test using Spearman's Rank. The research instrument used a questionnaire on the use of gadgets and KMPE. In this study, there were 6 respondents with problematic categories and 2 respondents who doubted their emotional mentality with high use of gadgets. The results of the correlation test obtained a correlation coefficient of 0.387 with a significant p value = 0.004 (<0.05). The conclusion from the results of this study is that the higher the use of gadgets, the greater the mental and emotional problems in preschool children.

Hybrid Closed Wedge High Tibial Osteotomy Maintains the Leg Length After Surgery Compared With Open Wedge High Tibial Osteotomy.

This study aimed to assess the changes in leg length following open wedge high tibial osteotomy (OWHTO) and hybrid closed wedge high tibial osteotomy (h-CWHTO) and whether the change in leg length was associated with preoperative radiographic factors and the change in planned opening or closing width. We retrospectively evaluated the data of patients who underwent OWHTO (n=57) and h-CWHTO (n=31) between 2016 and 2019. Standing full-length anteroposterior radiographs were obtained preoperatively and one year postoperatively. Changes in the lower leg and tibial length were measured using radiography, and the planned opening or closing width was decided via operative planning. Flexion contracture was examined preoperatively and one year postoperatively using a goniometer, and the correlation factors and changes in leg length were analyzed using Spearman's rank correlation. In the OWHTO group, the lower leg was significantly longer by a mean of 6.0±8.7 mm compared to that preoperatively (p<0.01); however, no significant difference was observed in the h-CWHTO group (mean, -0.56±11.6 mm) (p=0.788). In the OWHTO group, flexion contracture did not improve after surgery, however, in the h-CWHTO group, flexion contracture significantly improved from -7.1±7.0 degrees to -4.7±6.2 degrees postoperatively (p<0.01). No radiographic factors or bone opening or closing width were associated with changes in leg length in both groups. OWHTO led to a significant elongation of the lower leg while leg length was maintained post-h-CWHTO. However, the changes in leg length following both OWHTO and h-CWHTO were not predictable from preoperative radiographic factors or changes in bone width.

National Survey on Support for Nurse Practitioner and Physician Assistant/Associate Postgraduate Fellowship/Residency Programs and Director Compensation.

Introduction Although there has been a significant and steady increase nationwide in the number of physician assistant/associate (PA) and nurse practitioner (NP) postgraduate residency/fellowship programs, there remains a paucity of research related to the level of operational support available in many of these programs to facilitate specialty training. Therefore, the primary aim of this study is to conduct a national survey to gather foundational data regarding advanced practice provider (APP) postgraduate fellowship/residency operational support and program director total compensation data in the United States. Methodology A descriptive cross-sectional survey consisting of 27 questions was distributed via email to 336 postgraduate NP, PA, joint NP/PA, and certified nurse-midwifery residency/fellowship programs between November 2023 and December 2023. Frequency tables and descriptive statistics were used to summarize the survey data. Additionally, Spearman's rank correlation coefficients were performed to determine the relationship between the dependent variables and the independent variable. Results There was a statistically significant positive relationship between the organization values the postgraduate program and having sufficient administrative time (rs = 0.342, p < 0.001), having adequate support staff (rs = 0.340, p < 0.001), and being fairly compensated (rs = 0.356, p < 0.001) for program roles and responsibilities. Moreover, slightly less than half of respondents reported having adequate support staff and sufficient administrative time to address program responsibilities. Only 50% of respondents believed they were fairly compensated for their position. Respondents moderately agreed that their organization values the postgraduate training program (M = 4.00, SD = 1.00). Conclusions The results of this study highlight the perceptions of postgraduate program directors regarding adequate administrative support and resources to facilitate specialty-specific training for NPs and PAs. Further research is warranted to evaluate the level of operational support needed to develop and sustain postgraduate APP residency/fellowship training programs now and in the future.

Interrater reliability of the Fugl-Meyer Motor assessment in stroke patients: a quality management project within the ESTREL study.

The Fugl-Meyer Motor Assessment (FMMA) is recommended for evaluating stroke motor recovery in clinical practice and research. However, its widespread use requires refined reliability data, particularly across different health professions. We therefore investigated the interrater reliability of the FMMA scored by a physical therapist and a physician using video recordings of stroke patients. The FMMA videos of 50 individuals 3 months post stroke (28 females, mean age 71.64 years, median National Institutes of Health Stroke Scale score 3.00) participating in the ESTREL trial (Enhancement of Stroke Rehabilitation with Levodopa: a randomized placebo-controlled trial) were independently scored by two experienced assessors (i.e., a physical therapist and a physician) with specific training to ensure consistency. As primary endpoint, the interrater reliability was calculated for the total scores of the entire FMMA and the total scores of the FMMA for the upper and lower extremities using intraclass correlation coefficients (ICC). In addition, Spearman's rank order correlation coefficients (Spearman's rho) were calculated for the total score and subscale levels. Secondary endpoints included the FMMA item scores using percentage agreement, weighted Cohen's kappa coefficients, and Gwet's AC1/AC2 coefficients. ICCs were 0.98 (95% confidence intervals (CI) 0.96-0.99) for the total scores of the entire FMMA, 0.98 (95% CI 0.96-0.99) for the total scores of the FMMA for the upper extremity, and 0.85 (95% CI 0.70-0.92) for the total scores of the FMMA for the lower extremity. Spearman's rho ranged from 0.61 to 0.94 for total and subscale scores. The interrater reliability at the item level of the FMMA showed (i) percentage agreement values with a median of 77% (range 44-100%), (ii) weighted Cohen's kappa coefficients with a median of 0.69 (range 0.00-0.98) and (iii) Gwet's AC1/AC2 coefficients with a median of 0.84 (range 0.42-0.98). The FMMA appears to be a highly reliable measuring instrument at the overall score level for assessors from different health professions. The FMMA total scores seem to be suitable for the quantitative measurement of stroke recovery in both clinical practice and research, although there is potential for improvement at the item level.

The relationship between patient characteristics and analgesic self-medication behavior in pharmacies in Kesesi District, Pekalongan Regency

Self-medication is an effort to self-medicate without a doctor's prescription. Analgesics are medications used to reduce or relieve pain. The purpose of this study was to determine the relationship between patient characteristics and analgesic self-education behavior in pharmacies in Kesesi District, Pekalongan Regency. This study used an analytical observational method with a cross-sectional approach, the research instrument used a questionnaire involving 97 respondents in 3 pharmacies in Kesesi District, Pekalongan Regency. The sampling technique uses the consecutive sampling method. The independent variable is the characteristic and the dependent variable is the analgesic self-medication behavior. Data analysis using univariate and bivariate analysis with non-parametric rank spearman statistical test. The results showed that the age of 26-45 years was 50.5%, women were 66%, secondary education was 61.9%, self-employed by 47.7% and 32% of moderate-income people were more self-medicated analgesics. Some patients had good behavior in self-medication analgesics by 71.1%. The conclusion of this study was that patient characteristics including age (p = 0.014), education (p = 0.000), occupation (p = 0.000) and income (p = 0.000) had a relationship with analgesic self-medication behavior in pharmacies Kesesi District, Pekalongan Regency, while unrelated patient characteristics were gender (p = 0.237).

Association Between Pandemic-Related Maternal Perinatal Anxiety and Early Postpartum Breastfeeding Success.

Prior studies have shown conflicting results on the impact of maternal anxiety on breastfeeding initiation and success. Furthermore, a substantial increase in maternal anxiety levels was shown in response to the COVID-19 pandemic. In this study, we aimed to investigate the relationship between maternal perinatal anxiety induced by the COVID-19 pandemic and early breastfeeding outcomes. This cross-sectional study was conducted in two regional maternity hospitals, involving 220 first-time pregnant patients with a gestational age of ≥37 weeks. All patients had no current diagnosis of COVID-19 and no cases of COVID-19 in their close environment at the time of admission. At 24-48 hours postpartum or at the time of discharge, threefollowing scoring systems were employed: the Coronavirus Anxiety Scale (CAS), the State-Trait Anxiety Inventory (STAI), and the LATCH (short for latch, audible swallowing, type of nipple, comfort, and hold) score. A LATCH score of ≥8 was chosen as the cutoff point for defining successful breastfeeding performance. Spearman's rank correlation was used to evaluate relationships between the CAS, STAI scores, maternal and infant factors, and LATCH scores. There were no differences in baseline characteristics between groups categorized as successful and unsuccessful in breastfeeding initiation. The mean total STAI score was 86.3±13.2, the CAS score was 1.07±1.91, and the LATCH score was 8.42±1.7. Although there was an increase in State-Trait Anxiety Inventory-State Anxiety (STAI-S) scores compared to State-Trait Anxiety Inventory-Trait Anxiety (STAI-T) scores, and the STAI-S score and CAS score were higher in the unsuccessful group, these differences did not reach statistical significance (p = 0.22 and 0.16, respectively). When we evaluated the correlation of the LATCH score with STAI total, STAI-S and STAI-T scores, CAS score, and maternal and infant factors, only the type of delivery showed a significant correlation with the LATCH score (p = 0.008). Early postpartum breastfeeding efficiency, as measured by the LATCH score, was only correlated with the type of delivery. No significant correlation was found between pandemic-related maternal perinatal anxiety and early postpartum breastfeeding success.

Comparing Bayesian models for the genetic evaluation of oocytes and embryo counts in Dairy Gir cattle.

Count traits are usually explored in livestock breeding programs, and they usually do not fit into normal distribution, requiring alternatives to adjust the phenotype to estimate accurate genetic parameters and breeding values. Alternatively, distribution such as Poisson can be used to evaluate count traits. This study aimed to compare and discuss the genetic evaluation for oocyte and embryo counts considering Gaussian (untransformed variable - LIN; transformed by logarithm - LOG; transformed by Anscombe - ANS) and Poisson (POI) distributions. The data comprised 11,343 total oocytes(TO), viable oocytes(VO), cleaved embryos(CE), and viable embryo(VE) records of ovum pick-up from 1740 Dairy Gir heifers and cows. The genetic parameters and breeding values were estimated by the MCMCglmm package of the R software. The posterior means of heritability varied from 0.40 (LIN) to 0.49 (POI) for TO, 0.39 (LIN) to 0.49 (POI) for VO, 0.30 (LOG) to 0.41 (POI) for cleaved embryos, and 0.19 (LIN) to 0.32 (POI) for viable embryos. The posterior means of repeatability varied from 0.56 (LIN) to 0.65 (POI) for TO, 0.53 (LOG) to 0.63 (POI) for VO, 0.44 (LOG) to 0.60 (POI) for CE, and 0.36 (LOG) to 0.56 (POI) for VE. Deviance information criterion and mean squared residuals indicated that POI model should be used for the genetic evaluation of embryo and oocyte count traits. Spearman's rank correlation between estimated breeding value (EBV) for embryo and oocyte count traits computed by POI, LOG, and ANS models was high (ranging from 0.77 to 0.99), indicating little reranking among the best animals. The POI model is the most adequate for genetic evaluation, resulting in more reliable EBV of oocyte and embryo count traits for Dairy Gir cattle.

Evaluating the Validity and Reliability of the Korean Version of the Scales for Outcomes in Parkinson's Disease-Cognition.

The Scales for Outcomes in Parkinson's Disease-Cognition (SCOPA-Cog) was developed to assess cognition in patients with Parkinson's disease (PD). In this study, we aimed to evaluate the validity and reliability of the Korean version of the SCOPACog (K-SCOPA-Cog). We enrolled 129 PD patients with movement disorders from 31 clinics in South Korea. The original version of the SCOPA-Cog was translated into Korean using the translation-retranslation method. The test-retest method with an intraclass correlation coefficient (ICC) and Cronbach's alpha coefficient were used to assess reliability. Spearman's rank correlation analysis with the Montreal Cognitive Assessment-Korean version (MOCA-K) and the Korean Mini-Mental State Examination (K-MMSE) were used to assess concurrent validity. The Cronbach's alpha coefficient was 0.797, and the ICC was 0.887. Spearman's rank correlation analysis revealed a significant correlation with the K-MMSE and MOCA-K scores (r = 0.546 and r = 0.683, respectively). Our. demonstrate that the K-SCOPA-Cog has good reliability and validity.

Helical Content Correlations and Hydration Structures of the Folding Ensemble of the B Domain of Protein A.

The B domain of protein A (BdpA), a small three-helix bundle, folds on a time scale of a few microseconds with heterogeneous native and unfolded states. It is widely used as a model for understanding protein folding mechanisms. In this work, we use structure-based models (SBMs) and atomistic simulations to comprehensively investigate how BdpA folding is associated with the formation of its secondary structure. The energy landscape visualization method (ELViM) was used to characterize the pathways that connect the folded and unfolded states of BdpA as well as the sets of structures displaying specific ellipticity patterns. We show that the native state conformational diversity is due mainly to the conformational variability of helix I. Helices I, II, and III occur in a weakly correlated manner, with Spearman's rank correlation coefficients of 0.1539 (I and II), 0.1259 (I and III), and 0.2561 (II and III). These results, therefore, suggest the highest cooperativity between helices II and III. Our results allow the clustering of partially folded structures of folding of the B domain of protein A on the basis of its secondary structure, paving the way to an understanding of environmental factors in the relative stability of the basins of the folding ensemble, which are illustrated by the structural dependency of the protein hydration structures, as computed with minimum-distance distribution functions.

PENGARUH KETERLIBATAN ORANG TUA TERHADAP AKHLAK SISWA

This research aims to determine the influence of parental involvement on student morals. This research uses a quantitative approach, and the type of research used is a survey. The results show that there is an influence between parental involvement and student morals. This is known from the results of the level correlation test (Spearman rank). Researchers produced a significance value of 0.007 which is lower than 0.05. Based on the basis of decision making, there is an influence between variables x and y if the significance value is less than 0.05, but there is no influence between variables x and y if the significance value is higher. Apart from that, it is known that the coefficient number is 0.353, which means it has a positive value, which means that when X and Y increase, there is a unidirectional relationship, and the coefficient classification is at a low level of strength/relationship.

Understanding dynamics and overlapping epidemiologies of HIV, HSV-2, chlamydia, gonorrhea, and syphilis in sexual networks of men who have sex with men.

We aimed to investigate the overlapping epidemiologies of human immunodeficiency virus (HIV), herpes simplex virus type 2 (HSV-2), chlamydia, gonorrhea, and syphilis in sexual networks of men who have sex with men (MSM), and to explore to what extent the epidemiology of one sexually transmitted infection (STI) relates to or differs from that of another STI. An individual-based Monte Carlo simulation model was employed to simulate the concurrent transmission of STIs within diverse sexual networks of MSM. The model simulated sexual partnering, birth, death, and STI transmission within each specific sexual network. The model parameters were chosen based on the current knowledge and understanding of the natural history, transmission, and epidemiology of each considered STI. Associations were measured using the Spearman's rank correlation coefficient (SRCC) and maximal information coefficient (MIC). A total of 500 sexual networks were simulated by varying the mean and variance of the number of partners for both short-term and all partnerships, degree correlation, and clustering coefficient. HSV-2 had the highest current infection prevalence across the simulations, followed by HIV, chlamydia, syphilis, and gonorrhea. Threshold and saturation effects emerged in the relationship between STIs across the simulated networks, and all STIs demonstrated moderate to strong associations. The strongest current infection prevalence association was between HIV and gonorrhea, with an SRCC of 0.84 (95% CI: 0.80-0.87) and an MIC of 0.81 (95% CI: 0.74-0.88). The weakest association was between HSV-2 and syphilis, with an SRCC of 0.54 (95% CI: 0.48-0.59) and an MIC of 0.57 (95% CI, 0.49-0.65). Gonorrhea exhibited the strongest associations with the other STIs while syphilis had the weakest associations. Across the simulated networks, proportions of the population with zero, one, two, three, four, and five concurrent STI infections were 48.6, 37.7, 11.1, 2.4, 0.3, and < 0.1%, respectively. For lifetime exposure to these infections, these proportions were 13.6, 21.0, 22.9, 24.3, 13.4, and 4.8%, respectively. STI epidemiologies demonstrate substantial overlap and associations, alongside nuanced differences that shape a unique pattern for each STI. Gonorrhea exhibits an "intermediate STI epidemiology," reflected by the highest average correlation coefficient with other STIs.

A new method of the dynamic assessment of the supraspinatus using ultrasonography

ObjectiveWe devised a new dynamic assessment of the supraspinatus (DAS) using ultrasonography. The objectives of this study are as follows: 1. to verify the moving distance of the supraspinatus using ultrasonography in the cadaveric shoulders; 2. to evaluate the reliability of DAS in patients with rotator cuff tear (RCT) and investigate the correlation between DAS and magnetic resonance imaging (MRI) assessments. MethodsIn Part 1, the supraspinatus in both shoulders of one cadaveric specimen was pulled laterally by 5 mm and 10 mm. In the ultrasonographic movie of the supraspinatus, the moving distances of a placed marker and a representative speckle which was visually identified as a high-intensity dot with the longest track were measured. In Part 2, among 62 RCT shoulders we verified the interrater agreement of DAS and correlation between DAS and MRI findings of RCT size and muscle atrophy. ResultsIn Part 1, during the supraspinatus traction, the moving distances of the marker and speckle were almost same; 1.07–2.68 mm and 1.60–2.67 mm, respectively (the pulled distance was 5 mm), 3.95–5.35 mm and 3.59–5.60 mm (the pulled distance was 10 mm). In Part 2, DAS showed a high interrater agreement of 0.74 in the kappa coefficients. DAS showed no correlations with tear size and atrophy, respectively (Spearman's rank correlation coefficient (ρ): 0.14 (p = 0.35) and 0.13 (p = 0.29)). ConclusionDAS can reliably demonstrate dynamic aspects of the supraspinatus in RCT patients, which have been lacked in static imaging assessments as MRI.

Electrical stimulation of the lower eyelid orbicularis oculi muscle improves periocular dark circles.

We developed and tested the safety and efficacy of a cosmetic device to improve dark circles using electrical muscle stimulation of the orbicularis oculi muscle. Overall, 18 participants (36 eyes) were studied. The following five items were evaluated before and after the intervention:(1) the Clinical Dark Circle Score using clinical findings and photographs, (2) transcutaneous oxygen partial pressure (TcPO2) on the lower eyelid, (3) thermography, (4) two-dimensional laser blood flowmetry, and (5) spectrophotometry. The mean score at baseline was 2.0±0.90 (mean±standard deviation), and that at the end of the study was 1.2±1.0 (Wilcoxon signed-rank sum test, p<0.0001), indicating a significant reduction. The spectrophotometer showed a significant decrease in a* and L* values before and after use (Wilcoxon signed-rank sum test, p<0.0001). There was also a weak negative correlation between the change in score and the change in blood flow and TcPO2 measured using a laser perfusion device (Spearman's rank correlation coefficient, r=-0.32 and -0.39, respectively). Stratified analysis of the baseline score showed a strong negative correlation between the change in score and the change in spectrophotometric a* in the subjects/group with mild periocular dark circles (Spearman's rank correlation coefficient, r=-0.46). Contrastingly, no correlation was observed for any of the measurements in the subjects/group with severe periocular dark circles. After 1 month, no device-related ophthalmic adverse events were observed in any of the participants. Electrical muscle stimulation could improve periocular dark circles, especially in the subjects/group with mild periocular dark circles, and was safe.

Predicting soil parameters in Maroua 1st, Cameroon, using correlations of geophysical and geotechnical data

This study aims to predict specific soil parameters based on quantitative and qualitative correlations between electrical and geotechnical data. A total of 21 geotechnical boreholes followed by sampling, 21 light dynamic penetrometer tests, and 76 vertical electrical sounding surveys were carried out in Maroua 1st. The electrical resistivity data of the soil layers were obtained through 1D and 2D inversions of the ERT surveys. The geotechnical data were obtained from field tests and laboratory experiments. The statistical analysis of the entire dataset indicates that most of the samples are clay formations, as demonstrated by the means of variables and low variance coefficients, enabling qualitative identification. The distribution analysis of the parameters confirms the complexity of the physical characteristics of soils and the measurement procedures for each parameter. The Spearman's rank correlation matrix indicates that these observations can be used to propose predictive models for free swelling, allowable stress, natural water content, and electrical resistivity. Correlations between free swelling (εg) and other variables are not significant, as the degree of significance is lower than the fixed limit, except for models εg - W (R2 = 0.94), εg - ρ (Ώ.m) (R2 = 0.803), and εg - σ adm (R2 = 0.757). Grouping variables in multiple linear regression enables the development of a mathematical model. The predicted values of εg from this model demonstrate good agreement with the measured values for a validity domain of 0–16 %. The soil's natural water content has a strong correlation (R2 = 0.80 and rs = – 0.87) with electrical resistivity, meaning that an increase in water content results in a decrease in electrical resistivity. The permissible stress σadm has a strong correlation (R2 = 0.89 and rs = 0.85) with electrical resistivity. This indicates that changes in soil electrical resistivity are associated with soil stiffness.

Buprenorphine prescribing and treatment accessibility in response to regulation changes due to the COVID-19 public health emergency

BackgroundIn 2021, over 80,000 fatal overdoses occurred in the United States. Since 2020, the federal government has enacted multiple regulatory changes around buprenorphine prescribing for opioid use disorder (OUD) to increase access to buprenorphine. This study aims to explore trends in buprenorphine treatment initiation pre- and post-public health emergency to evaluate changes in the context of X-waiver relaxations and telehealth allowances. MethodsIn a cross-sectional study, all RI residents who filled a buprenorphine prescription at a pharmacy in Rhode Island (RI), Massachusetts, and Connecticut between January 2017 and December 2023 were obtained from the RI Prescription Drug Monitoring Program (PDMP). The study excluded buprenorphine products not approved for OUD treatment from the analysis. Identified individuals had initiated buprenorphine for OUD during the study period if they did not have a prior prescription or if they had >30 days without buprenorphine exposure between their prescriptions. Spearman's rank correlation tests were used to identify significant associations between outcomes and regulation changes. ResultsThe average number of patients dispensed buprenorphine did not significantly change over the study period, however the average number of initiates significantly decreased (ρ = −0.38255, p = .0003). The average number of providers prescribing CII-CV substances in RI has increased 3.4 % over the study period. The average percentage of prescribers in the PDMP prescribing buprenorphine for OUD doubled (ρ = 0.96075, p < .0001). ConclusionThough efforts have been made to increase buprenorphine initiation, buprenorphine initiates remain well below pre-PHE levels. Efforts must continue to eliminate existing barriers to treatment and improve access to individuals seeking treatment.

Enhancing prediction and analysis of UK road traffic accident severity using AI: Integration of machine learning, econometric techniques, and time series forecasting in public health research

This research project explored into the intricacies of road traffic accidents severity in the UK, employing a potent combination of machine learning algorithms, econometric techniques, and traditional statistical methods to analyse longitudinal historical data. Our robust analysis framework includes descriptive, inferential, bivariate, multivariate methodologies, correlation analysis: Pearson's and Spearman's Rank Correlation Coefficient, multiple logistic regression models, Multicollinearity Assessment, and Model Validation. In addressing heteroscedasticity or autocorrelation in error terms, we've advanced the precision and reliability of our regression analyses using the Generalized Method of Moments (GMM). Additionally, our application of the Vector Autoregressive (VAR) model and the Autoregressive Integrated Moving Average (ARIMA) models have enabled accurate time series forecasting. With this approach, we've achieved superior predictive accuracy and marked by a Mean Absolute Scaled Error (MASE) of 0.800 and a Mean Error (ME) of -73.80 compared to a naive forecast. The project further extends its machine learning application by creating a random forest classifier model with a precision of 73%, a recall of 78%, and an F1-score of 73%. Building on this, we employed the H2O AutoML process to optimize our model selection, resulting in an XGBoost model that exhibits exceptional predictive power as evidenced by an RMSE of 0.1761205782994506 and MAE of 0.0874235576229789. Factor Analysis was leveraged to identify underlying variables or factors that explain the pattern of correlations within a set of observed variables. Scoring history, a tool to observe the model's performance throughout the training process was incorporated to ensure the highest possible performance of our machine learning models. We also incorporated Explainable AI (XAI) techniques, utilizing the SHAP (Shapley Additive Explanations) model to comprehend the contributing factors to accident severity. Features such as Driver_Home_Area_Type, Longitude, Driver_IMD_Decile, Road_Type, Casualty_Home_Area_Type, and Casualty_IMD_Decile were identified as significant influencers. Our research contributes to the nuanced understanding of traffic accident severity and demonstrates the potential of advanced statistical, econometric, machine learning techniques in informing evidence based interventions and policies for enhancing road safety.

Combination of prostate volume and apparent diffusion coefficient can stratify patients with a PI-RADS score of 3 to reduce unnecessary prostate biopsies.

Nowadays, there are many patients who undergo unnecessary prostate biopsies after receiving a prostate imaging reporting and data system (PI-RADS) score of 3. Our purpose is to identify cutoff values of the prostate volume (PV) and minimum apparent diffusion coefficient (ADCmin) to stratify those patients to reduce unnecessary prostate biopsies. Data from 224 qualified patients who received prostate biopsies from January 2019 to June 2023 were collected. The Mann-Whitney U test was used to compare non-normal distributed continuous variables, which were recorded as median (interquartile ranges). The correlation coefficients were calculated using Spearman's rank correlation analysis. Categorical variables are recorded by numbers (percentages) and compared by χ2 test. Both univariate and multivariate logistic regression analysis were used to determine the independent predictors. The receiver-operating characteristic curve and the area under the curve (AUC) were used to evaluate the diagnostic performance of clinical variables. Out of a total of 224 patients, 36 patients (16.07%) were diagnosed with clinically significant prostate cancer (csPCa), whereas 72 patients (32.14%) were diagnosed with any grade prostate cancer. The result of multivariate analysis demonstrated that the PV (p < 0.001, odds ratio [OR]: 0.952, 95% confidence interval [95% CI]: 0.927-0.978) and ADCmin (p < 0.01, OR: 0.993, 95% CI: 0.989-0.998) were the independent factors for predicting csPCa. The AUC values of the PV and ADCmin were 0.779 (95% CI: 0.718-0.831) and 0.799 (95% CI: 0.740-0.849), respectively, for diagnosing csPCa. After stratifying patients by PV and ADCmin, 24 patients (47.06%) with "PV < 55 mL and ADCmin < 685 μm2/s" were diagnosed with csPCa. However, only one patient (1.25%) with PV ≥ 55 mL and ADCmin ≥ 685 μm2/s were diagnosed with csPCa. In this study, we found the combination of PV and ADCmin can stratify patients with a PI-RADS score of 3 to reduce unnecessary prostate biopsies. These patients with "PV ≥ 55 mL and ADCmin ≥ 685 μm2/s" may safely avoid prostate biopsies.

Association of Frailty with Patient-Report Outcomes and Major Clinical Determinants in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

This study aimed to explore the correlation of frailty status with disease characteristics and patient-reported outcomes (PROs) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and determine the sensitivity and specificity of modified COPD PRO scale (mCOPD-PRO) for detecting frailty. This cross-sectional study surveyed 315 inpatients with AECOPD from a tertiary hospital in China from August 2022 to June 2023. Patient frailty and PROs were assessed using the validated FRAIL scale and mCOPD-PRO, respectively. Spearman's ρ was used to assess the relevance of lung disease indicators commonly used in clinical practice, and ordinal logistic regression analyses were used to identify the variables associated with frailty status. The validity of mCOPD-PRO in discriminating frail or non-frail individuals was determined using the receiver operating characteristic curve. The participants (N=302, mean age 72.4±9.1 years) were predominantly males (73.2%). Among them, 43 (14.3%) patients were not frail, whereas 123 (40.7%) and 136 (45.0%) patients were pre-frail and frail, respectively. The FRAIL scale was moderately correlated with the mCOPD-PRO scores (Spearman's rank correlation coefficient [Rs]=0.52, P<0.01) for all dimensions (Rs=0.43-0.49, P<0.01). Patients residing in rural areas (odds ratio [OR], 1.67; 95% confidence interval [95% CI], 1.01-2.76) and with higher mCOPD-PRO scores (OR, 4.78; 95% CI, 2.75-8.32) were more likely to be frail. Physically active patients (OR, 0.42; 95% CI, 0.21-0.84) were less likely to be frail. In addition, mCOPD-PRO had good discriminate validity for detecting frailty (area under the curve=0.78), with a sensitivity and specificity of 84.6% and 60.8%, respectively. The optimal probability threshold for mCOPD-PRO was ≥1.52 points. In patients with AECOPD, frailty is closely related to PROs and disease characteristics. Additionally, the mCOPD-PRO score can distinguish well between frail and non-frail patients. Our findings provide support for interventions targeting frail populations with AECOPD.