Standard Tools Research Articles

Double Probability Integral Transform Residuals for Regression Models with Discrete Outcomes

The assessment of regression models with discrete outcomes is challenging and has many fundamental issues. With discrete outcomes, standard regression model assessment tools such as Pearson and deviance residuals do not follow the conventional reference distribution (normal) under the true model, calling into question the legitimacy of model assessment based on these tools. To fill this gap, we construct a new type of residuals for regression models with general discrete outcomes, including ordinal and count outcomes. The proposed residuals are based on two layers of probability integral transformation. When at least one continuous covariate is available, the proposed residuals closely follow a uniform distribution (or a normal distribution after transformation) under the correctly specified model. One can construct visualizations such as QQ plots to check the overall fit of a model straightforwardly, and the shape of QQ plots can further help identify possible causes of misspecification such as overdispersion. We provide theoretical justification for the proposed residuals by establishing their asymptotic properties. Moreover, in order to assess the mean structure and identify potential covariates, we develop an ordered curve as a supplementary tool, which is based on the comparison between the partial sum of outcomes and of fitted means. Through simulation, we demonstrate empirically that the proposed tools outperform commonly used residuals for various model assessment tasks. We also illustrate the workflow of model assessment using the proposed tools in data analysis. Supplementary materials for this article are available online.

Ultrasound-Guided Interventions in the Biliary System.

Ultrasound guidance in biliary interventions has become the standard tool to facilitate percutaneous biliary drainage as well as percutaneous gall bladder drainage. Monitoring of the needle tip whilst penetrating the tissue in real time using ultrasound allows precise manoeuvres and exact targeting without radiation exposure. Without the need for fluoroscopy, ultrasound-guided drainage procedures can be performed bedside as a sometimes life-saving procedure in patients with severe cholangitis/cholecystitis when they are critically ill in intensive care units and cannot be transported to a fluoroscopy suite. This article describes the current data background and guidelines and focuses on specific sonographic aspects of both the procedures of percutaneous biliary drainage and gallbladder drainage.

Characterizing Measurement-Based Care in the Texas Youth Depression and Suicide Research Network (TX-YDSRN)

AbstractIntegration of measurement-based care (MBC) into clinical practice has shown promise in improving treatment outcomes for depression. Yet, without a gold standard measure of MBC, assessing fidelity to the MBC model across various clinical settings is difficult. A central goal of the Texas Youth Depression and Suicide Research Network (TX-YDSRN) was to characterize MBC across the state of Texas through the development of a standardized tool to assess the use of MBC strategies when assessing depression, anxiety, side effects, and treatment adherence. A chart review of clinical visits indicated standardized depression measures (71.2%) and anxiety measures (64%) were being utilized across sites. The use of standardized measures to assess medication adherence and side effects was limited to less than six percent for both, with the majority utilizing clinical interviews to assess adherence and side effects; yet medication was changed in nearly half. Rates of utilization of standardized measures for participants with multiple MBC forms were similar to those who only provided one form.

Predictors of Persecutory Ideation: Impact of Hell Anxiety and Demonic Struggle among 100 level Accounting Students of Nasarawa State University Keffi

Religion has been linked to mental health over the years, but its connection to persecutory ideation remains unclear. In this study, Nassarawa State University students' persecutory ideation is examined in relation to religious characteristics as predictors. A cross-sectional survey design was used in the study. In the study, a sample of 162 individuals was chosen at random from the student body. Both the independent and dependent variables were measured with three standardized tools. The use of multiple regression analysis was used to formulate and test two hypotheses. However, the researchers discovered that students' thoughts of being persecuted were jointly and significantly predicted by both hell anxiety and demonic conflict (F = 4.598, p=0.013, R2 = 0.105, r=0.325). Individually, that demonic struggle had significant contributions to the prediction of persecutory ideation. (R2= 0.342, t=2.844; P < 0.05). Hell anxiety did not significantly predict persecutory ideation. (R2= -0.043, t=-0.360; P > 0.05).These findings recommended that religious authorities consider minimizing satanic and hell themes in their sermon and focus on angels, heaven, forgiveness, and other positive concepts that promote a favorable perspective of God thereby improving the mental health of its congregation. Additionally, psycho-spiritual therapy on the guidance of one's life by good supernatural beings like angels may assist lessen religiously-indured persecutory thinking.

DivERGe implements various Exact Renormalization Group examples

We present divERGe, an open source, high-performance C/C++/Python library for functional renormalization group (FRG) calculations on lattice fermions. The versatile model interface is tailored to real materials applications and seamlessly integrates with existing, standard tools from the ab-initio community. The code fully supports multi-site, multi-orbital, and non-SU(2) models in all of the three included FRG variants: TU^22FRG, N-patch FRG, and grid FRG. With this, the divERGe library paves the way for widespread application of FRG as a tool in the study of competing orders in quantum materials.

Codebase release 0.5 for divERGe

We present divERGe, an open source, high-performance C/C++/Python library for functional renormalization group (FRG) calculations on lattice fermions. The versatile model interface is tailored to real materials applications and seamlessly integrates with existing, standard tools from the ab-initio community. The code fully supports multi-site, multi-orbital, and non-SU(2) models in all of the three included FRG variants: TU^22FRG, N-patch FRG, and grid FRG. With this, the divERGe library paves the way for widespread application of FRG as a tool in the study of competing orders in quantum materials.

A Study on Generative Design Reasoning and Students' Divergent and Convergent Thinking

Abstract Computer-aided design (CAD) is a standard design tool used in engineering practice and by students. CAD has become increasingly analytic and inventive in incorporating artificial intelligence (AI) approaches to design, e.g., generative design (GD), to help expand designers' divergent thinking. However, generative design technologies are relatively new, we know little about generative design thinking in students. This research aims to advance our understanding of the relationship between aspects of generative design thinking and traditional design thinking. This study was set in an introductory graphics and design course where student designers used Fusion 360 to optimize a bicycle wheel frame. We collected the following data from the sample: divergent and convergent psychological tests and an open-ended response to a generative design prompt (called the generative design reasoning elicitation problem). A Spearman's rank correlation showed no statistically significant relationship between generative design reasoning and divergent thinking. However, an analysis of variance found a significant difference in generative design reasoning and convergent thinking between groups with moderate GD reasoning and low GD reasoning. This study shows that new computational tools might present the same challenges to beginning designers as conventional tools. Instructors should be aware of informed design practices and encourage students to grow into informed designers by introducing them to new technology, such as generative design.

A comparative study for the assessment of marker-less mixed reality applications for the operator training

ABSTRACT With the rising concept of Industry 5.0, the worker’s needs and well-being are placed at the center of the production process. The use of extended reality can be exploited to provide the operator with interactive training, allowing independent, step-by-step learning in the real environment, with instructional digital contents, superimposed over the machinery in the workplace. This kind of training promotes the operator’s skills, and consequently empowers the industrial competitiveness. The aim of this paper is to assess and compare the effectiveness of two different marker-less mixed reality (MR) applications to train the operator in the wire harness activities over a tractor’s drivetrain. An application based on Azure Spatial Anchors by Microsoft and another one based on the CAD model of the tractor’s drivetrain have been developed and tested through the comparison with the traditional paper-based instructions. On-field trials have been accomplished with 10 end-users. User experience, usability, perceived workload, and training effectiveness have been assessed through specific questionnaires and by analyzing user performances. Even if the Anchors-based app showed better outcomes in terms of effectiveness and acceptability, both MR applications resulted in good usability. Operators’ willingness of using this technology as a standard tool for training and support emerged.

Visualisations for Bayesian Additive Regression Trees

Tree-based regression and classification has become a standard tool in modern data science. Bayesian Additive Regression Trees (BART) has in particular gained wide popularity due its flexibility in dealing with interactions and non-linear effects. BART is a Bayesian tree-based machine learning method that can be applied to both regression and classification problems and yields competitive or superior results when compared to other predictive models. As a Bayesian model, BART allows the practitioner to explore the uncertainty around predictions through the posterior distribution. In this paper, we present new Visualisation techniques for exploring BART models. We construct conventional plots to analyse a model’s performance and stability as well as create new tree-based plots to analyse variable importance, interaction, and tree structure. We employ Value Suppressing Uncertainty Palettes (VSUP) to construct heatmaps that display variable importance and interactions jointly using colour scale to represent posterior uncertainty. Our new Visualisations are designed to work with the most popular BART R packages available, namely BART, dbarts, and bartMachine. Our approach is implemented in the R package bartMan (BART Model ANalysis).

Introduction of Internal Circulation-Based Cooling Methods and Green Coolants in Milling via Cutting Tool and Tooling Design

This paper describes the process of the design and verification of a milling tool and tooling that may contribute to the renouncement of the flood cooling method when mineral oils and oil-in-water emulsions are used as coolants. The proposed solutions are based on the idea of coolant supply in internal channels created inside of a cutting tool. As an alternative to the aforementioned mineral oil-based coolants, liquids with higher cooling efficiency and environmental friendliness (green coolants) were considered. Given coolants’ possible lack of lubricating properties and negative (corrosive, etc.) influence on a machine tool’s units, tooling delivers these coolants to the cutting tool and bypasses the standard machine tool’s supply system. The geometry of the milling tool (a cutting insert with an internal channel) was tested in the framework of a stress simulation. To perform it, cutting force components Fz, Fy, and Fx were determined empirically and then applied to the simulated area of contact between the tool and the workpiece. Based on the obtained principal stress values P1, P2, and P3, the factor of safety was calculated with the Mohr–Coulomb, P1 max, and P3 min failure criteria. The proposed milling tool, equipped with a novel type of labyrinth seal with no friction between its components, was experimentally tested to confirm its ability to maintain leak-tightness at different values of spindle speed (200~2000 rpm) and coolant supply volume (1.0~10.0 L/min). Based on the results of the stress simulation and the leak-tightness experiment, conclusions were drawn about further modernization and utilization prospects of the proposed milling tool and tooling design.

Sjögren's disease activity associates with cardiovascular disease and monoclonal gammopathy: a university cohort study of disease activity and comorbidities.

We used the University of Wisconsin cohort to determine the extent to which the EULAR Sjögren's syndrome disease activity index (ESSDAI) was associated with comorbidities that contribute to mortality. Our University of Wisconsin, Madison cohort had 111 patients with Sjögren's Disease (SjD) by 2016 ACR/EULAR criteria and 194 control patients with sicca. Our study was performed from March 1st, 2020 through April 1st, 2023. We collected data using a standardized collection tool, including components of the Charlson Comorbidity Index (CCI). Stratifying our SjD patients by ESSDAI < 5 and ESSDAI ≥ 5, we assessed differences in comorbidities associated with mortality. At time of SjD diagnosis, the ESSDAI ≥ 5 group had increased odds of peripheral vascular disease compared to controls (OR 10.17; 95% CI 1.18-87.87). Patients with a current ESSDAI ≥ 5 were more likely to have a myocardial infarction compared to controls (OR 9.87; 95% CI 1.17-83.49). SjD patients had increased prevalence of monoclonal gammopathy compared to controls (9.3% vs 0.5%, p < 0.001). SjD patients with high ESSDAI at diagnosis had greater prevalence of monoclonal gammopathy compared to the SjD patients with a low ESSDAI (16% vs 5%, p = .04). As reported elsewhere, the ESSDAI ≥ 5 group had increased odds of chronic pulmonary disease (OR 4.37; 95% CI 1.59-11.97). We found high ESSDAI scores were associated with worse cardiovascular outcomes, specifically peripheral vascular disease and myocardial infarction. Furthermore, monoclonal gammopathy was more frequent in SjD patients compared to sicca controls, supporting screening for monoclonal gammopathy in the appropriate clinical scenario. Key Points • High ESSDAI scores are associated with worse cardiovascular outcomes, specifically peripheral vascular disease and myocardial infarction. • Monoclonal gammopathy is more frequent in SjD patients than sicca controls, supporting screening for monoclonal gammopathy in the appropriate clinical scenario.

A Comparative Study of the Diagnostic Value of Once and Twice Nasopharyngeal, Oropharyngeal, and Anal Swabs, and Saliva Specimens in COVID-19 Infection

Background: Since the emergence of COVID-19 and the pandemic declaration, this disease has become the top priority for global healthcare systems. The standard diagnostic tool for COVID-19 involves conducting imaging studies alongside real-time polymerase chain reaction (RT-PCR) tests on nasopharyngeal or oropharyngeal samples. Objectives: Given the potential extrapulmonary involvement of COVID-19, our objective was to evaluate the diagnostic effectiveness of double pharyngeal sampling, as well as the use of saliva and anal swabs. Methods: This cross-sectional study involved 102 pediatric patients suspected of having COVID-19. After the routine nasopharyngeal sampling, additional samples were collected from the nasopharynx, saliva, and anal canal. These samples were subjected to RT-PCR testing using Taq Man's probe-based technology. The statistical analysis included sensitivity, specificity, positive and negative predictive values, and Kappa agreement measurement. Results: In this study, with a COVID-19 prevalence of 92.2%, we compared the diagnostic efficacy of different methods. When having at least one positive sample was considered the gold standard, double nasopharyngeal sampling exhibited the highest sensitivity, followed by RT-PCR of saliva and anal swabs (94.9%, 92.9%, and 91.9%, respectively). When double sampling was considered the gold standard for diagnosis, saliva RT-PCR showed the highest sensitivity and negative predictive value (93.6% and 40.0%, respectively). However, there was no significant difference in the specificity and positive predictive value between anal swabs and saliva RT-PCR. However, when anal swabs and saliva were compared with only one nasopharyngeal sample, anal swabs performed slightly better than saliva. Conclusions: While the combination of double sampling from the nasopharynx and oropharynx, along with anal swabs and saliva, proved effective for diagnosing COVID-19, routine use of these methods may not be cost-effective. However, during periods of epidemic control, when comprehensive case identification is crucial, these methods may warrant consideration for more extensive investigations.

Increased latissimus dorsi and teres major muscle volume after anterior transfer for irreparable anterior superior rotator cuff tear: correlation with improved internal rotation strength.

While the well-established correlation between increased muscle volume and enhanced muscle strength is widely recognized, there have been no studies assessing volumetric muscle changes in transfer surgery in the shoulder. This study aimed to evaluate changes in transferred muscle volume and their clinical implications in anterior latissimus dorsi and teres major (aLDTM) tendon transfer in patients with anterior superior irreparable rotator cuff tears (ASIRCTs). The study retrospectively examined 40 patients who underwent aLDTM tendon transfers for ASIRCTs between August 2018 and January 2022. Using ImageJ software, the LDTM muscle was segmented in T2-weighted oblique axial images, and total muscle volume (tLDTMV) of both immediate and postoperative 1-year were calculated. Pearson correlation analysis was used to determine the correlation between ΔtLDTMV and ΔASES scores, Δactive-ROM, and Δstrength. The current study revealed an 11.4% increase in tLDTMV at 1-year postoperative. Patients were grouped based on postoperative ASES score: Group 1 (Optimal, n = 17) and Group 2 (Suboptimal, n = 23). Although tLDTMVimmediate postoperative values were similar between groups (P = 0.954), tLDTMV1-year postoperative value was significantly higher in Group 1 compared to Group 2 (P = 0.021). In correlation analysis, ΔtLDTMV showed significant correlations with ΔASES score (r = 0.525, P < 0.001), ΔaROM of forward elevation (FE) (r = 0.476, P = 0.002), ΔaROM of internal rotation (IR) at back (r = 0.398, P = 0.011), Δstrength of FE (r = 0.328, P = 0.039), Δ strength of IR at 90° abduction (r = 0.331, P = 0.037), and IR at side (r = 0.346, P = 0.029). Significant increase in tLDTMV was observed at 1-year postoperative for ASIRCT patients. Notably, greater ΔtLDTMV exhibited a correlation with better ASES scores, increased aROM and strength in both FE and IR. Nevertheless, further research is required by employing more robust standardized measurement tools and a larger sample size.

Smartic: A smart tool for Big Data analytics and IoT

The Internet of Things (IoT) is leading the physical and digital world of technology to converge. Real-time and massive scale connections produce a large amount of versatile data, where Big Data comes into the picture. Big Data refers to large, diverse sets of information with dimensions that go beyond the capabilities of widely used database management systems, or standard data processing software tools to manage within a given limit. Almost every big dataset is dirty and may contain missing data, mistyping, inaccuracies, and many more issues that impact Big Data analytics performances. One of the biggest challenges in Big Data analytics is to discover and repair dirty data; failure to do this can lead to inaccurate analytics results and unpredictable conclusions. Different imputation methods were employed in the experimentation with various missing value imputation techniques, and the performances of machine learning (ML) models were compared. A hybrid model that integrates ML and sample-based statistical techniques for missing value imputation is being proposed. Furthermore, the continuation involved the dataset with the best missing value imputation, chosen based on ML model performance for subsequent feature engineering and hyperparameter tuning. K-means clustering and principal component analysis were applied in our study. Accuracy, the evaluated outcome, improved dramatically and proved that the XGBoost model gives very high accuracy at around 0.125 root mean squared logarithmic error (RMSLE). To overcome overfitting, K-fold cross-validation was implemented.

(215) Penuma® Penile Implant Adverse Events in the Manufacturer and User Facility Device Experience (MAUDE) Database

Abstract Introduction Penuma® is an FDA-approved penile implant intended to increase flaccid penile length and girth for improved cosmesis. It is the only FDA-approved product of its kind, with reportedly thousands of implants since 2004. There is a paucity of data on the adverse events related to this procedure. Objective To describe and characterize adverse events related to Penuma® using a national database. Methods The Manufacturer and User Facility Device Experience (MAUDE) database, a voluntary-reported database of medical device complications with data since 1991, was queried. The MAUDE adverse event classification system, a validated classification system, was used as a standardized tool to classify adverse events based on severity. All adverse events related to Penuma® were identified and quantified. Results 42 reports of adverse events related to Penuma® were identified (Figure 1). Of these, 35 patients were reported to undergo device removal most commonly due to infection (n=8) or protrusion (n=8). (Table 1). The most commonly reported adverse event was deformity/disfigurement (n=27), of which 18 cases reported loss of penile length. Other adverse events included: pain (n=16), infection (n=12), decreased sensitivity (n=10), scar tissue (n=9), erectile dysfunction (n=8), seroma (n=7), and erosion (n=6). Conclusions To our knowledge, this is the first study to systematically characterize publicly reported adverse events occurring with Penuma® implantation, using the MAUDE database. Further research is warranted to delineate the incidence of adverse events related to Penuma®. Disclosure No.

Ayurvedic Insights into Re-Emerging Human Brucellosis

Brucellosis is a bacterial infection caused by Brucella melintensis. It is one of the most widespread endemic zoonotic diseases present globally, more prevalent in developing countries. It is transmitted to humans either through direct contact with infected animal tissues or fluids or indirectly by ingesting contaminated meat and unpasteurized dairy products. The route of transmission includes mainly mucocutaneous. Farmers, butchers, hunters, and veterinarians are mainly at higher risk of contracting this condition. Mostly the affected individuals exhibit flu-like symptoms, remittent fever, malaise, arthralgia, and weight loss which lasts from a few days to several years. The condition is often misdiagnosed due to nonspecific clinical symptoms, leading to inadequate treatment and prolonged illness leading to severe complications like endocarditis. Currently, there is no vaccine for human brucellosis. The modern management includes administration of antibiotics. The gold standard diagnostic tool is direct bacteriological testing. Ayurvedic understanding of endemic diseases highlights the unique concept of Janapathhodhwamsa proposed by Acharyas. They considered Vayu, Jala, Kala, and Desa as common factors in manifestation of disease. Any alteration in these factors can be understood as imbalance and disease outbreak emerged due to urbanization, lack of hygienic measures in animal husbandry, etc. remaining a public health hazard. Brucellosis is known by its undulant nature which closely resembles the Vishama Jwara in classics which is a Sannipatika type of Jwara. Amapachana, Shodhana, and Samana line of management followed by Rasayana, Satvritta Palana as a preventive line can be adopted to manage Brucellosis.

ISBAR: A Handover Nursing Strategy in Emergency Departments, Scoping Review

The present work aims to map the available scientific evidence on the benefits of using the ISBAR tool in the nursing care of acutely ill adult patients’ handover in an emergency department context. To this end, a scoping review was conducted, according to the guidelines proposed by the Joanna Briggs Institute (JBI), to answer the following research question: “What are the benefits of using the ISBAR tool in the nursing care of acutely ill adult patients’ handover in an emergency department context?” The bibliographic search was carried out during August and September 2023 in the following electronic databases: CINAHL Complete; MEDLINE Complete; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; and Cochrane Methodology Register. Only works published between 2013 and 2023 were deemed fit for inclusion. All the included studies (9) show that ISBAR methodology, as a standardized tool for transferring nursing care in the emergency service, allows for a safe, clear, and concise transition of nursing care. The benefits relate to patient and professional safety, continuity, and quality of care, as well as patient and professional comfort, with health gains.

A computational study of H-bonded networks in cyclic water clusters, (H2O)n (n = 3-12).

We have performed a detailed MM and DFT investigation of neutral water clusters (H2O)n (n = 3-12). Our results show the trend of interaction energies in these clusters as a function of the size of the cluster. They show that the H-bond strength increases with cluster size and that the model of water is better described if two different partial charges are used on the hydrogen, depending on whether hydrogen is H-bonded or not. The average binding enthalpy change due to the formation of H-bonds between water molecules is found to be - 25.9kJmol-1 at B3LYP/aug-cc-pVDZ level of theory. We observe the formation of cyclic H-bonded networks through the analysis of frontier orbitals and IR vibrational frequencies spectra. For the water cluster with n = 11, we observe an unusual reduction of the bandgap indicative of a cyclic H-bonded network. Calculations were performed with the MMFF94 force field and the B3LYP method using various large basis sets. Molecular orbital diagrams and population analysis were done using standard tools in Gaussian.

Giggle incontinence: a scoping review.

Giggle incontinence (GI) is poorly described, defined, and understood. It is considered a bladder storage disorder in which laughter causes an uncontrollable episode of urinary incontinence that cannot be stopped until the bladder is completely emptied. It has been confused with stress urinary incontinence and overactive bladder. A thorough analysis of 26 articles on the subject of "giggle incontinence" and associated terms was performed, including all articles since the phrase first appeared. To date, 351 GI cases have been reported. It occurs mainly in women (69.5%) at 5 years of age, with a prevalence ranging from 8.4 to 16.2 years (average age of 12.4 years), and some cases have a family history of the disease (13-16.7%). This review discusses the historical background, current understanding, and challenges related to GI. It primarily affects females after the age of 5 years, causing complete bladder emptying during uncontrollable laughter. The exact cause is unknown, but hypotheses suggest involvement of the central nervous system. Diagnosis relies on clinical history, physical tests, and urine frequency evaluation. Management involves urotherapy techniques, biofeedback, and methylphenidate. Understanding GI will aid in developing more effective management techniques. IMPACT: Highlights limited awareness among healthcare professionals about giggle incontinence as a distinct condition, emphasizing the need for standardized diagnostic criteria and assessment tools. Addresses insufficient understanding of the underlying mechanisms and contributing factors, providing valuable insights for better diagnosis and treatment. Emphasizes the importance of patient education and support, calling for improved resources and counseling. Urges further research and evidence-based guidelines to enhance treatment strategies.

Development and validation of a tool for measuring the work-related quality of life of physical therapists

ABSTRACT Physical therapists (PTs) face several challenges in their workplace that impact their well-being, but there is no standard tool to measure their quality of life. This study brings out a new PTQoWL scale to address this issue. Study Design: Scale development and psychometric assessment of the PTQoWL scale. PTs employed in healthcare organizations in Saudi Arabia (N=373) were randomly selected. They administered a PTQoWL tool consisting of 20 items with five subscales measuring their perceptions about the work environment, psychosocial factors, training and development opportunities, compensation and rewards, and job satisfaction and safety at work. Reliability was examined using Cronbach's alpha reliability, and construct and convergent validity were determined using confirmatory factor analysis (CFA). The PTQoWL tool has a Cronbach alpha coefficient of 0.902 with consistently positive and significant inter-factor correlations. Each item had a significant positive relationship with its respective PTQoWL factor, as the structural equation modeling (SEM) analysis revealed. The observed model fit indices indicate that the proposed five-factor PTQoWL tool is wellsuited for assessing the QoWL of PTs. This new PTQoWL tool would help HCOs uncover PTs' hidden perceptions about their QoWL and develop appropriate strategies to improve their health and well-being in the workplace