Spearman Rank Coefficient Research Articles

Coagulation standards in healthy newborns and infants

BackgroundThe range of normal values for coagulation factors in the healthy newborn was described 30 years ago but since then the reagents, automated systems, and dosing techniques have changed considerably. For 30 years, several authors have tried to update the standards and references in children using updated reagents but the newborn and infant population in these studies has been quite small, limiting the findings. The aim of this study was to establish the normal coagulation standards in healthy newborns. MethodsWe included all consecutive healthy newborns with pyloric stenosis presenting to our reference center over a period of 5 years. We calculated the reference ranges defined as mean±2 SD. Normality of distribution was checked graphically and by using the Shapiro–Wilk test. Correlations between two continuous variables were assessed using Spearman's rank coefficient correlation. Statistical testing was done at the two-tailed α-level of 0.05. Data were analyzed using the SAS software package, release 9.4 (SAS Institute, Cary, NC). ResultsWe included 112 healthy newborns and infants. The median age was 35.5 days (15.0–88.0), median weight was 4062g (2855–6040), and 90.2% were boys. Activated partial thromboplastin time (aPTT) and prothrombin time (PT) were not correlated with age (P=0.92 and P=0.21, respectively) or with weight (P=0.16 and P=0.90, respectively). The reference range was 28.6–46.2 s for aPTT, 0.91–1.49 for aPTT ratio, and 71.3–110.6 s for PT. Regarding fibrinogen (n=24), the median was 2.2g/L (1.2–3.2); the median for factor II was 67.0U/dL (51.0–130.0; n=20), and 101.5U/dL for factor V (68.0–233.0; n=20). Regarding factor VIII, the median was 75.0U/dL (45.0–152.0; n=25), 49.0U/dL for factor IX (32.0–96.0; n=25) and 53.0U/dL (29.0–112.0) for factor XI (n=23). ConclusionThis study can help to establish standards for coagulation testing in this very specific population. Indeed, our study represents the largest newborn population in a recent investigation of PT and aPTT using updated reagents.

Spatiotemporal parameters from instrumented motion analysis represent clinical measurement of upper limb function in children with cerebral palsy

BackgroundThere are various tools that measure upper limb function in children with cerebral palsy(CP) clinically, but these measurement methods are examiner-dependent and scale values are not proportional to the upper limb function which makes it difficult to quantify the function. Research questionThe purpose of this study was to investigate whether the new parameters derived from 3D motion analysis reflect the upper limb function which measured by Melbourne Assessment 2 (MA2) in children with cerebral palsy (CP) compared to the clinical measurements. MethodsForty children with CP (24 boys, 16 girls; mean [SD] age, 6 years 11 months [3 years 5 months]) were recruited. Motion capture was conducted during phases T1–T4 of Reach and Grasp Cycles. New parameters (movement time, number of movement units, index of curvature) were derived from wrist marker data. Range of motion (ROM), accuracy, dexterity, and fluency of unilateral upper limb function were assessed using MA2. Spearman rank coefficients were determined to evaluate correlations between MA2 and the new parameters. Results and significanceIndex of curvature correlated negatively with MA2 accuracy scores during T1 (rs -0.347, p < 0.05), T2 (rs -0.471, p < 0.01), and T3 (rs -0.660, p < 0.01). Number of movement units correlated negatively with MA2 ROM, accuracy, and fluency scores during T1 (ROM rs -0.334; accuracy rs -0.331; fluency rs -0.375; p < 0.05) and T3 (ROM rs -0.499; accuracy rs -0.531; fluency rs -0.515; p < 0.01). Index of curvature and number of movement units are objective, simple parameters showing fair to good correlation with MA2 accuracy and fluency of upper limb function.

Patterns of Venetoclax Sensitivity in Chronic Lymphocytic Leukemia

Patterns of Venetoclax Sensitivity in Chronic Lymphocytic Leukemia Chronic lymphocytic leukemia (CLL) is predominantly a disease of older adults. The 5-year overall survival is 70-91%, depending on Rai/Binet stage at diagnosis (80% overall), and although a subset of CLL takes a very indolent course, it can be aggressive as well. Disease course and responsiveness to therapeutic agents may be predictable, to some degree, based on specific genetic lesions or other patient population characteristics. Monotherapies targeting specific cell pathways are rapidly increasing in prevalence. Ibrutinib (Bruton tyrosine kinase inhibitor) has shown promise as a single agent as well as in combination with other agents. In particular, ibrutinib has shown efficacy in combination with venetoclax (inhibitor of cell death suppressor BCL2). This combination appears to be particularly potent in patients with a del(11q) karyotype. Cytogenetic information is used already in several other leukemias to inform prognosis and treatment. Although CLL is a disease of monoclonal proliferation, precise definition of the diseased clone will allow for more individualized treatment. Stratification of drug sensitivity based on genetic and cytogenetic features will directly affect patient outcomes in CLL. Primary patient mononuclear cells (from either peripheral blood or bone marrow) were plated ex vivo with a panel of 49 drug combinations and the 16 respective single agents (SA) in 384-well plates using 10,000 cells/well. Drugs were tested in 7-point concentration series; wells with drug combinations were added at fixed molar ratios. Cell viability was assessed after a 72 hour culture period. In this assay, primary cells maintain viability but do not proliferate. In CLL, the most frequent mutations were: del(17p); del(11q); del(13q14); trisomy 12; complex karyotype (at least three chromosomal aberrations). Selected analysis of these data from 157 unique patients were performed by isolating the most potent inhibitors (defined by lowest median AUC) either as a single agent or in combination with known treatments. These were evaluated with nonparametric tests (Kruskal-Wallace, Mann-Whitney, Spearman rank coefficient) on the statistical software Prism. By subdividing the data by available genetic and cytogenetic information, patterns that have not been previously described in the literature emerged. In the cohort of patients with any karyotypic abnormality (not complex karyotype), SA venetoclax and the combination of venetoclax-ibrutinib (VEN/IBRUT) were equivalently effective with no significant difference in efficacy observed between SA venetoclax and the combination. As previously described, del(11q) independently predicts increased efficacy of SA venetoclax and VEN/IBRUT, and this efficacy was validated by ex vivo potency here as well. However, we show that male gender is an independent predictor of potency in both SA venetoclax and VEN/IBRUT as well. Interestingly, doramapimod (an inhibitor of p38 MAP kinase) was not particularly potent as a SA, however, the combination of venetoclax-doramapimod (VEN/DORA) proved to be the most potent of all combinations tested, more potent than even VEN/IBRUT. This effect could not be replicated in any subgroup, as VEN/DORA samples for the entire cohort were relatively limited (n=31). Although this analysis has inherent limitations, including underpowered data to analyze in less frequent cytogenetic events (e.g. del(6q)), we did find significant patterns of potency. These may or may not translate to clinical efficacy in CLL and do not address any potential toxicity. However, these data suggest future directions for more targeted research on these drugs and drug combinations. Disclosures Tyner: Petra:Research Funding;Janssen:Research Funding;Seattle Genetics:Research Funding;Incyte:Research Funding;Genentech:Research Funding;Constellation:Research Funding;AstraZeneca:Research Funding;Aptose:Research Funding;Gilead:Research Funding;Takeda:Research Funding;Syros:Research Funding;Agios:Research Funding;Array:Research Funding.Druker:EnLiven:Consultancy, Research Funding;Gilead Sciences:Consultancy, Membership on an entity's Board of Directors or advisory committees;Cepheid:Consultancy, Membership on an entity's Board of Directors or advisory committees;Dana-Farber Cancer Institute:Patents &amp; Royalties;Bristol-Myers Squibb:Research Funding;Blueprint Medicines:Consultancy, Current equity holder in private company, Membership on an entity's Board of Directors or advisory committees;Aptose Therapeutics Inc. (formerly Lorus):Consultancy, Current equity holder in publicly-traded company, Membership on an entity's Board of Directors or advisory committees;ARIAD:Research Funding;Third Coast Therapeutics:Membership on an entity's Board of Directors or advisory committees;The RUNX1 Research Program:Membership on an entity's Board of Directors or advisory committees;Pfizer:Research Funding;Patient True Talks:Consultancy;Oregon Health &amp; Science University:Patents &amp; Royalties;Novartis Pharmaceuticals:Membership on an entity's Board of Directors or advisory committees, Patents &amp; Royalties, Research Funding;MolecularMD (acquired by ICON):Consultancy, Current equity holder in publicly-traded company, Membership on an entity's Board of Directors or advisory committees;Millipore (formerly Upstate Biotechnology):Patents &amp; Royalties;VB Therapeutics:Membership on an entity's Board of Directors or advisory committees;Vivid Biosciences:Membership on an entity's Board of Directors or advisory committees;ALLCRON:Consultancy, Membership on an entity's Board of Directors or advisory committees;Amgen:Current equity holder in publicly-traded company, Membership on an entity's Board of Directors or advisory committees;Aileron Therapeutics:Membership on an entity's Board of Directors or advisory committees;Merck &amp; Co:Patents &amp; Royalties;McGraw Hill:Patents &amp; Royalties;GRAIL:Consultancy, Current equity holder in private company, Membership on an entity's Board of Directors or advisory committees;Henry Stewart Talks:Patents &amp; Royalties;Iterion Therapeutics (formerly Beta Cat Pharmaceuticals):Membership on an entity's Board of Directors or advisory committees;Leukemia &amp; Lymphoma Society:Research Funding.

Surgical outcomes and complications following distal biceps tendon reconstruction: a systematic review and meta-analysis.

BackgroundPrimary repair of chronic distal biceps tendon ruptures may not be possible because of tendon retraction, and there remains no clear consensus on the type of reconstruction technique used. The purpose of this study was to report the clinical outcomes and complication rates following reconstruction of chronic distal biceps tendon ruptures.MethodsA systematic review was performed following PRISMA guidelines. The following databases were searched: Embase, MEDLINE, and Cochrane Central Register of Controlled Trials. The primary outcomes of interest included range of motion, strength, and functional outcome scores. Secondary outcomes included complication, reoperation, and revision rates. Outcomes and complication rates of each graft type and fixation technique were aggregated and compared with nonparametric Wilcoxon signed rank and rank sum tests. Spearman rank coefficients were calculated for time from injury to surgery on all outcomes.ResultsThere were no significant differences found between the graft type or fixation technique for postoperative range of motion, strength, and patient-reported outcomes. Postoperative complications were substantially higher in the autograft group (34%) as compared to the allograft group (14%). The fixation technique used also demonstrated a significantly increased complication rate in the weave group compared with the onlay group (34% and 9%, respectively).ConclusionOur results do not reveal any statistically significant differences between groups in the primary outcomes. However, substantially higher complication rates were observed in the autograft and weave cohorts; more than half of the complications related to the use of autograft were associated with donor site morbidity. No specific graft type was identified as superior, although this may be due to the small patient numbers included within this study.

Baseline impedance via manometry and ambulatory reflux testing are not equivalent when utilized in the evaluation of potential extra-esophageal gastroesophageal reflux disease.

BackgroundEsophageal baseline impedance (BI) shows promise for the diagnosis of gastroesophageal reflux disease (GERD), but means of acquisition and relevance to extra-esophageal manifestations of GERD (EE-GERD) remain unclear. In this study we aim to (I) evaluate concordance between BI as measured by 24-hour pH-impedance (pH-MII) and high-resolution impedance manometry (HRIM), and (II) assess relationship to potential EE-GERD symptoms.MethodsIn this prospective open cohort study, patients presenting for outpatient HRIM and pH-MII studies were prospectively enrolled. All patients completed the GERD-HRQL, NOSE, and respiratory symptom index questionnaire (RSI), plus questions regarding wheezing and dental procedures. HRIM and pH-MII were evaluated with calculation of BI. Correlations were assessed using either Pearson’s correlation or Spearman’s rank coefficients.Results70 HRIM patients were enrolled, 35 of whom underwent pH-MII. There was no correlation between BI measurements as assessed by HRIM and pH-MII proximally, but there was moderate-weak correlation distally (r=0.34 to 0.5). Distal acid exposure time correlated with distal BI only for measurements by pH-MII (rho= −0.5 to −0.65), and not by HRIM. There was no relationship between proximal acid exposure time and proximal BI. There were no correlations when comparing proximal or distal BI measurements, acid exposure times, and impedance events to symptoms.ConclusionsConcordance between BI as measured by HRIM and pH-MII is poor, especially proximally, suggesting that these two methods are not interchangeable. There is no correlation between BI both distally/proximally and symptoms of either GERD/EE-GERD, suggesting that many symptoms are unrelated to acid or that BI is not an adequate marker to assess EE-GERD symptoms.

ABO blood group system is associated with COVID-19 mortality: An epidemiological investigation in the Indian population.

BackgroundNovel coronavirus disease-19 (COVID-19) has spread worldwide, and to date presence of the virus has been recorded in 215 countries contributing 0.43 million of death. The role of blood groups in susceptibility/resistance to various infectious diseases has been reported. However, the association of blood groups with susceptibility to COVID-19 infections or related death are limited. In the present report, we performed an epidemiological investigation in the Indian population to decipher the importance of blood groups concerning susceptibility or mortality in COVID-19 infection.Materials and methodsData on COVID-19 infection and mortality was obtained from the website of the Government of India. Prevalence of ABO blood groups in different states and union territories of India were searched using different databases such as PubMed and Google Scholar. Relevant articles were downloaded, and data were extracted. Spearman's rank coefficient analysis was employed to study the correlation between blood group frequencies and COVID-19 infection or mortality rate.ResultsA significant inverse correlation was observed between the frequency of O blood group and the COVID-19 mortality rate (Spearman r = −0.36, P = 0.03), indicating a possible protective role of O blood group against COVID-19 related death. In contrast, the prevalence of blood group B was positively correlated with COVID-19 death/million (Spearman r = 0.67, P < 0.0001), suggesting B blood type as a deleterious factor in COVID-19 infection.ConclusionsABO blood group system is associated with poor prognosis of COVID-19 infection. Blood group O may protects, and subjects with blood type B could be susceptible to COVID-19 mortality. However, further studies on COVID-19 infected patients in different population are required to validate our findings.

Spatial accessibility to colonoscopy and its role in predicting late-stage colorectal cancer.

ObjectiveTo better determine the relationship between spatial access to colonoscopy and colorectal cancer (CRC) outcomes, our objective was to examine the agreement of the classic, enhanced, and variable two‐step floating catchment area (2SFCA) methods in evaluating spatial access to colonoscopy and to compare the predictive validity of each method related to late‐stage CRC. 2SFCA methods simultaneously consider supply/demand of services and impedance (ie, travel time).Data SourcesColonoscopy provider locations were obtained from the South Carolina Ambulatory Surgery Database. ZIP code tabulation area (ZCTA) level population estimates and area‐level poverty level were obtained from the American Community Survey. Rurality was determined by the United States Department of Agriculture's Rural‐Urban Commuting Area codes. Individual‐level CRC data were obtained from the South Carolina Central Cancer Registry.Study DesignUsing the classic, enhanced, and variable 2SFCA methods, we calculated ZCTA‐level spatial access to colonoscopy. We assessed agreement between the three methods by calculating Spearman's rank coefficients and weighted Kappas (Κ). Global and Local Moran's I were used to assess spatial clustering of accessibility scores across 2SFCA methods. We performed multilevel logistic regression analyses to examine the association between spatial accessibility to colonoscopy, area‐ and individual‐level factors, and late‐stage CRC.Principal FindingsWe found strong agreement (Weighted Κ = 0.82; 95% CI = 0.79‐0.86) and identified similar clustering patterns with the classic and enhanced 2SFCA methods. There was negligible agreement among the classic/enhanced 2SFCA and the variable 2SFCA. Across all 2SFCA methods, regression models showed that spatial access to colonoscopy, rurality, and poverty level were not associated with greater odds of late‐stage CRC, though Black race was associated with late‐stage CRC across all models.ConclusionsNone of the 2SFCA methods showed an association with late‐stage CRC. Future studies should explore which elements (spatial or nonspatial) of access to care have the greatest impact on CRC outcomes.

Diet composition and neighboring prey community of the Phuping newt (Tylototriton uyenoi) in Maesa–Kogma Biosphere Reserve, Chiang Mai Province, northern Thailand

Abstract. Dowwiangkan T, Chuaynkern Y, Dumrongrojwattana P, Duengkae P. 2020. Diet composition and neighboring prey community of the Phuping newt (Tylototriton uyenoi) in Maesa–Kogma Biosphere Reserve, Chiang Mai Province, northern Thailand. Biodiversitas 21: 4515-4523. The present work reports the comparison of fecal pellet prey composition of Tylototriton uyenoi from Maesa-Kogma Biosphere Reserve (Chiang Mai Province, northern Thailand) based on an analysis of its fecal pellets. Males of T. uyenoi consumed more diverse prey than those of females (53 groups of prey versus 14 groups). The analysis reveals a diverse diet of Arthropoda (Insecta, Arachnida, Diplopoda, Chilopoda, and Malacostraca), Mollusca (Gastropoda), Chordata, and conspecific eggs. Partial remnants of plant materials were also found in the pellets. The percentage frequency of prey occurrence was higher in Formicidae (21.34), Lymnaeidae (17.39), unknown snails (10.67), and Blattidae (9.881). The percentage of the relative number of preys was higher in Lymnaeidae (41.02) and Formicidae (17.17). The volumetric prey percentage was higher in Lymnaeidae (30.78), Paradoxosomatidae (19.14), and unknown snails (12.71). The index of relative importance was higher in Lymnaeidae (1,248.62), Formicidae (376.972), unknown snails (188.275), and Paradoxosomatidae (166.433). The percentage of IRI was higher in Lymnaeidae (57.128) and Formicidae (17.248). The Spearman rank coefficient (95% confidence interval test) showed a significant positive correlation (p&lt;0.05) between prey volume and number and SVL.

Pattern-specific hypotheses based on multiple joint gait patterns to identify the optimal candidates for selective dorsal rhizotomy

It has been postulated that hip muscle stiffness can be inferred from postural assessment, and that predictable relationships exist between passive stiffness of opposing muscles. Despite a lack of evidence to demonstrate such relationships, manual therapy textbooks continue to direct clinicians to treat hip muscles following postural analysis.Do significant correlations exist between standing posture, and hip muscle stiffness and range of motion?20 participants volunteered for this observational study. Passive hip stiffness was calculated as the derivative of the moment-angle curve measured during leg raising in a variety of lying postures. Stiffness was measured during hip flexion, extension, abduction and adduction. Stiffness data was obtained during the first degree and at ROM, and at the highest common angle achieved by participants in each posture Spinal curvature and other postural components were measured using a motion tracking device. Spearman rank coefficients were determined to assess any correlations between passive stiffness, range of motion, spinal curvature and other postural components.Consistent relationships were found between maximum range of motion and hip stiffness at the common angles (P < 0.01), but not at maximum stiffness (P > 0.05). Consistent correlations were found between abductor stiffness and Q-angle (P < 0.05). Hip extensor range of motion correlated with lumbar lordosis (r = -0.472, P = 0.036). Other correlations were reported, but typically lacked consistency between left and right sides. Spinal curvature did not correlate with hip stiffness in frontal or sagittal planes (P > 0.05).Significant correlations were few compared with where correlations lacked statistical significance. This study demonstrates that overly simplistic assumptions about spinal posture and hip stiffness cannot be supported. Hip muscle stiffness should only be targeted in treatments where testing has demonstrated a direct need, and not assumed based upon postural assessment alone.

One-step Multiplex Real-time RT-PCR for Molecular Detection and Typing of Dengue Virus Infection From Paraffin-embedded Tissues During the Brazilian 2019 Outbreak.

Formalin-fixed paraffin-embedded (FFPE) tissues are an important source for investigation of dengue virus (DENV) infection, particularly when blood or fresh frozen (FF) samples are unavailable. Histopathologic features and immunohistochemistry may have poor sensitivity and serotype determination is not always possible. Viral RNA genome detection tests are faster and considered the most sensitive technique for this kind of analysis, however, the use of molecular methods applied to FFPE tissues is still limited. The authors applied a single-step multiplex reverse transcription-quantitative polymerase chain reaction (RT-qPCR) for the investigation of DENV infection and typing to FFPE samples of 32 fatal cases received during the 2019 outbreak that occurred in São Paulo state, Brazil. The authors compared the results with those obtained using FF tissues. Of the 24 cases with both FF and FFPE samples, 22 (91.67%) of the FF and 19 (76.20%) of the FFPE specimens were positive. Two cases (8.33%) tested negative in both types of samples. All 8 cases with only FFPE samples available were positive. The accuracy (87.5%) of the RT-qPCR for DENV in FFPE samples were satisfactory. Although the cycle quantification (Cq) values were significantly higher in these materials (P<0.0001, Wilcoxon signed-rank test) when compared with FF tissues, Spearman's rank coefficient indicated a good correlation between the Cq values from both sample types (P=0.0063; rho=0.576). RT-qPCR applied to FFPE samples improved detection of DENV in fatal cases and represents a useful tool for diagnosis and epidemiologic studies.

Relationship between molecular charge distribution and wettability reversal efficiency of cationic surfactants on calcite surfaces

Wettability reversal is a critical factor in enhanced oil recovery (EOR) from predominantly oil-wet carbonate reservoirs. Cationic surfactants are able to efficiently reverse carbonate wettability due to their electrostatic interactions with the surface adsorbed carboxylate (acidic) components of the crude oil. However, details concerning the relationship between the surfactant molecular structures and their wettability alteration efficiency are lacking. In this study, we systematically probe the effect of the molecular charge distribution of quaternary ammonium type cationic surfactants on the wettability reversal efficiency. The local charges on the hydrophilic head group of the surfactants were varied by insertion of different functional groups and the charge distribution was calculated using quantum mechanical density functional theory (DFT) method. Ten modified surfactants as well as the reference octyltrimethylammonium molecule were tested using the molecular dynamics (MD) simulations. The results imply that the charge on the hydrogen atoms in the methylene group of a quaternary ammonium moiety has the most significant influence on the wettability reversal ability of the surfactants, with the Spearman rank coefficient (ρ) being as high as 0.782, while charges on the quaternary ammonium group as a whole do not pose any considerable effect, with ρ being −0.264. The calculations further suggest some feasible chemical modifications of the surfactants leading to the highest wettability alteration efficiency (i.e., insertion of a ketone group). Additionally, the effect of alkyl chain length was explored and an optimal length was identified that suggests the importance of establishing the structural compatibility between the surfactants and the oil phase. The correlations obtained in this study can facilitate the design of high-efficiency cationic surfactants for wettability reversal in carbonate reservoirs.

Toward Mapping Dietary Fibers in Northern Ecosystems Using Hyperspectral and Multispectral Data

Shrub proliferation across the Arctic from climate warming is expanding herbivore habitat but may also alter forage quality. Dietary fibers—an important component of forage quality—influence shrub palatability, and changes in dietary fiber concentrations may have broad ecological implications. While airborne hyperspectral instruments may effectively estimate dietary fibers, such data captures a limited portion of landscapes. Satellite data such as the multispectral WorldView-3 (WV-3) instrument may enable dietary fiber estimation to be extrapolated across larger areas. We assessed how variation in dietary fibers of Salix alaxensis (Andersson), a palatable northern shrub, could be estimated using hyperspectral and multispectral WV-3 spectral vegetation indices (SVIs) in a greenhouse setting, and whether including structural information (i.e., leaf area) would improve predictions. We collected canopy-level hyperspectral reflectance readings, which we convolved to the band equivalent reflectance of WV-3. We calculated every possible SVI combination using hyperspectral and convolved WV-3 bands. We identified the best performing SVIs for both sensors using the coefficient of determination (adjusted R2) and the root mean square error (RMSE) using simple linear regression. Next, we assessed the importance of plant structure by adding shade leaf area, sun leaf area, and total leaf area to models individually. We evaluated model fits using Akaike’s information criterion for small sample sizes and conducted leave-one-out cross validation. We compared cross validation slopes and predictive power (Spearman rank coefficients ρ) between models. Hyperspectral SVIs (R2 = 0.48–0.68; RMSE = 0.04–0.91%) outperformed WV-3 SVIs (R2 = 0.13–0.35; RMSE = 0.05–1.18%) for estimating dietary fibers, suggesting hyperspectral remote sensing is best suited for estimating dietary fibers in a palatable northern shrub. Three dietary fibers showed improved predictive power when leaf area metrics were included (cross validation ρ = +2–8%), suggesting plant structure and the light environment may augment our ability to estimate some dietary fibers in northern landscapes. Monitoring dietary fibers in northern ecosystems may benefit from upcoming hyperspectral satellites such as the environmental mapping and analysis program (EnMAP).

Assessing Post‐operative Pain with Self‐reports via the Jerrycan Pain Scale in Rural Kenya

Perioperative pain management is an essential component to improving patient outcomes. Measurement and description of pain are challenging and vary in different contexts. The objective of this study was to assess the utility of self-reporting via visual analogue scales using the Jerrycan visual analogue scale in the assessment of post-operative pain and to validate the use of this novel scale compared to standard pain scales. Two hundred and forty-one inpatients who underwent surgical procedures were prospectively assessed for post-operative pain over a 12-month period from February 2016 to January 2017. Participants included patients who underwent general surgery, orthopedic and obstetrics/gynecology procedures. On post-operative day one, four scales were assessed: Verbal scale, Hands scale, Faces scale and Jerrycan scale, each ranging from 0-5. Scores for each scale were recorded, and agreements between scales were calculated using kappa values and Spearman's rank coefficients. The mean age was 34.8yearsandmore female subjects were evaluated (68%). Themajority received spinal anesthesia (61%). Themean pain score was 2.5 for all scales. The Jerrycan (0.50) and Faces scales (0.43) had moderate agreements with the Verbal scale. Participants preferred the Jerrycan Pain Scale. The Jerrycan pain scale had comparable scores and reasonable agreement with 3 other pain scales among a cohort of post-operative patients. Patient preference and ease of use of the Jerrycan scale may impact assessment and management of pain in a rural African setting. This scale may be adapted for use in similar resource settings for post-operative pain management.

Breast mass segmentation in ultrasound with selective kernel U-Net convolutional neural network

In this work, we propose a deep learning method for breast mass segmentation in ultrasound (US). Variations in breast mass size and image characteristics make the automatic segmentation difficult. To address this issue, we developed a selective kernel (SK) U-Net convolutional neural network. The aim of the SKs was to adjust network's receptive fields via an attention mechanism, and fuse feature maps extracted with dilated and conventional convolutions. The proposed method was developed and evaluated using US images collected from 882 breast masses. Moreover, we used three datasets of US images collected at different medical centers for testing (893 US images). On our test set of 150 US images, the SK-U-Net achieved mean Dice score of 0.826, and outperformed regular U-Net, Dice score of 0.778. When evaluated on three separate datasets, the proposed method yielded mean Dice scores ranging from 0.646 to 0.780. Additional fine-tuning of our better-performing model with data collected at different centers improved mean Dice scores by ∼6%. SK-U-Net utilized both dilated and regular convolutions to process US images. We found strong correlation, Spearman's rank coefficient of 0.7, between the utilization of dilated convolutions and breast mass size in the case of network's expansion path. Our study shows the usefulness of deep learning methods for breast mass segmentation. SK-U-Net implementation and pre-trained weights can be found at github.com/mbyr/bus_seg.

CONTENTS OF HEAVY METALS IN SOILS AND MEDICINAL PLANTS OF LAMIUM ALBUM L. (LAMIACEAE) IN THE TERRITORY OF THE TRANSCARPATHIAN REGION

Formation of the chemical composition of plants under natural conditions occurs at the same time as a large number of environmental factors, including the geochemical conditions of the ecotope and the exogenous entry of elements into the soil. However, it cannot be excluded that the translocation of heavy metals from the arable layer of soil into plants depends not only on edaphic factors, but also on the physiological and biochemical characteristics of plants.This study presents the results of heavy metals content in soils and medicinal plant lamium Album L. (Lamiaceae), in the territory of Transcarpathian region. It is established that the gross content of heavy metals is the highest in the soils of Uzhhorod district in comparison with other studied territories. However, exceeding the maximum permissible concentration is not observed. Comparison of the concentration of ecotoxicants in the investigated soils with the background content makes it possible to judge the presence or absence of anthropogenic pollution. It is important that fixed forms of ecotoxicants do not pose a threat to living organisms. The greater danger is the content of acid-soluble forms.According to the obtained, as in the case of gross content, the concentration of mobile forms of ecopolyants is the highest for the Uzhhorod district. The lowest values were recorded in the soils of Svaliava district. This, obviously, can be caused by both the geomorphological features of the area and the increase of anthropogenic load on the territory. Regarding the migration of heavy metals in the soil-plant system, it is found that the content of eco-pollutants in the plant is directly proportional to their soil content. The results of the studies showed that the plants lamium Album L. (Lamiaceae), accumulate heavy metals, acting as a kind of filtration system, which is relevant from the standpoint of evaluating the quality of medicinal plant raw materials, as well as predicting the possibilities of phytoremediation. Calculating the Spearman's rank coefficient, it is found that the content of Zn, Pb content in lamium Album L. is significantly dependent on the concentration of this metal in the soil and its mobile forms. For Cu and Cd, no such regularity was found.

The added value of geriatric assessment in evaluating a patient's Health-Related Quality-of-Life: A study in ≥70-year-old early-stage invasive breast cancer patients.

The objective of this study was to assess the relationship between geriatric assessment (GA) and health-related Quality-of-Life (HRQOL) in older patients with breast cancer. Patients were assigned either to adjuvant chemotherapy (CTG) or to a control group (CG). Spearman rank coefficients (ρ) calculated correlations between HRQOL and GA at baseline, 3months and 1year. Multivariate regressions modelled the prognostic value of GA in evaluating of a patient's HRQOL and the accuracy of baseline GA in predicting HRQOL decline (change of ≥10 points). The analysis included 57 patients in the CTG and 52 in the CG. Strong correlations (ρ≥0.5) were reported between the EORTC QLQ-C30 Physical Functioning Scale and Activities of Daily Living (ADL), Instrumental ADL (iADL) and Leuven Oncogeriatric Frailty Score Scale (LOFS). Multivariate models demonstrated that poor iADL, ADL and LOFS (CG) and ADL and iADL (CTG) contributed to a statistically (all p<.05) worse HRQOL. The relative gain in predicting 3-month and 1-year HRQOL decline was 24.1% and 4.7% (CG) and 6.1% and 18.3% (CTG). Our results show that the functional measures in the GA are strongly correlated with patient self-reported functioning. Poor baseline GA has a modest probability of predicting HRQOL deterioration.

Public health surveillance of habitual physical activity in adolescents and adults in Namibia: a cross-sectional validation of activity questionnaires against accelerometry.

Monitoring population-level physical activity is crucial for examining adherence to global guidelines and addressing obesity. This study validated self-reported moderate-to-vigorous physical activity (MVPA) against an accurate device-based method in Namibia. Adolescent girls (n = 52, mean age 16.2 years [SD 1.6]) and adult women (n = 51, mean age 31.3 years [SD 4.7]) completed the PACE+/GPAQ self-report questionnaires and were asked to wear an Actigraph accelerometer for 7 days. Validity of self-reported MVPA was assessed using rank-order correlations between self-report and accelerometry, and classification ability of the questionnaires with Mann-Whitney tests, kappa's, sensitivity and specificity. In the adolescents, Spearman's rank coefficients between self-reported MVPA (days/week) and accelerometry measured MVPA were positive but not significant (r=0.240; P=0.104). In the adults, self-reported MVPA (minutes/day) was moderately and significantly correlated with accelerometer-measured MVPA (r=0.396; P=0.008). In both groups, there was fair agreement between accelerometry and questionnaire-defined tertiles of MVPA (adolescents κ=0.267; P=0.010; adults κ=0.284; P=0.008), and measured MVPA was significantly higher in the individuals self-reporting higher MVPA than those reporting lower MVPA. The PACE+ and GPAQ questionnaires have a degree of validity in adolescent girls and adult females in Namibia, though more suitable for population than individual level measurement.

Sensitivity and uncertainty analysis for a radioecological model / Sensitivitäts- und Unsicherheitsanalyse eines radioökologischen Modells

Abstract Uncertainty and sensitivity analysis were conducted for a radioecological model which was developed and applied for severe accident scenario for Akkuyu NPP in Turkey. Uncertainty was investigated in the doses and activity concentrations. Sensitivity analysis was conducted to find out most influencing parameters on the doses. 96 parameters, related with foodstuffs, feedstuffs and grass, inhalation rate and reduction factor for external irradiation, and transfer of 137Cs, 134Cs and 131I isotopes, were studied by probabilistic methods. Latin Hypercube Sampling method was used to generate random parameters. In sensitivity analysis Spearman rank coefficients between the parameters and doses were calculated. The uncertainty analysis proves that the lifetime doses are in the range of 4.8 - 32 mSv and short-term doses are in the range of 1.1 - 2.8 mSv when all parameters vary simultaneously. Sensitivity analysis proves that soil-plant and feed-cow milk transfer factors for cesium, beef and grain consumption, and reduction factor for external irradiation have more influence on the lifetime doses, and transfer factor for cow milk for iodine and interception factor for grass also affect the short-term doses.

Examination of the effects of non-measurable explanatory variables on the value of real estate in the process of mass valuation of land

The paper proposes a solution to the problem of how to introduce non- -measurable features (attributes) of a property that significantly affect its value to the process of its valuation. The authors adopt two measures enabling them to study the influence of order features on the value of property, the Spearman rank coefficients and standardized ßk coefficients, and proceed to check their efficiency, applying an algorithm of mass property valuation (SAMWN) to the sample of 567 plots of land in Szczecin designated for housing purposes. The results thus obtained are then compared with the valuations of these plots of land performed by property appraisers. The study demonstrates that lower valuation errors are obtained when using standardized ßk coefficients than the Spearman rank coefficients.

Geographical accessibility of community social services and incidence of self-harm

ObjectiveThe study aimed to explore the association between area-based coverage of community services and the incidence of self-harm, which will provide an evaluation framework for the support of self-harm. MethodsEnhanced two-Step floating catchment area method was used to estimate the centersto- population ratio and geographical accessibility adjusted by a distance-decay function. Spearman's rank coefficient was used to examine the association between the self-harm rate and adjusted accessibility index. ResultsThere was a significant negative correlation between the accessibility index and selfharm rate in youth (rho = −0.87, P < 0.01) and older adults (rho = −0.87, P < 0.01). The survival curves showed no relationship between self-harm repetition and service accessibility in youth or older adults. ConclusionsThe uneven spatial accessibility of community social service centers and the independence between spatial accessibility and self-harm highlights the need to explore personal barriers to community service utilization.