Statistical Software Research Articles

Three-Dimensional Measurement of Humeral Retroversion on a Large Academic Cadaveric Database

BackgroundThe Humeral Retroversion Angle (HRA) has been described in the literature as the orientation of the humeral head compared with the epicondylar axis of the distal humerus. HRA is a crucial measurement for designing shoulder prostheses and surgical technique, and is often noted to range from 25-35 degrees in healthy adults. However, a wide range of individual variability has been reported in literature, with reported values ranging from -6 and 74 degrees. Various imaging modalities including, X-rays, CT scans and MRI have historically been used to measure this angle, but conventional 2D technologies may result in inaccuracy and variability in angular measurements. Therefore, recent studies have focused on using 3D modalities to measure HRA. These studies have shown promising results regarding accuracy and clinical significance, although most have only included a small number of subjects and have not procured conclusive findings. This study aims to measure the HRA in a large sample of subjects using 3D imaging to establish measurements for the general population. MethodsWe examined the right and left cadaveric humerus from 559 individuals (146 females, 413 males). All of the humeri underwent CT scan and surface models generated. 3D landmarks were automatically calculated on each 3D bone using custom written software in C++. Those landmarks were used to calculate 1) HRA as the angle between the epicondylar axis and the humeral neck axis. 2) Humeral Proximal Neck Angle (HPNA) as the angle between the humeral neck axis and the anatomical axis. Descriptive statistics of both HRA and HPNA was analyzed using JMP Pro statistical software version 15.2.0. ResultsThe HPNA was found to be 137.7⁰ ± 1.04⁰ for males and 136.34⁰ ± 1.4⁰ for females with a 95% confidence interval. HRA was found to be 39.89 ⁰ ± 12.77⁰ for males and 38.89 ⁰ ± 3.15⁰ for females with a 95% confidence interval. Results of ANOVA revealed that males had a statistically significant larger HRA than females (p<0.001). ConclusionOur study suggests using a standardized measurement for the HRA, which we believe may improve operative outcomes. However, future prospective trials are required to validate our results in a clinical setting.

Prevalence and associated factors of neurocognitive disorder among people living with HIV/AIDS in the South Gondar zone primary hospitals, North-West Ethiopia: an institution-based cross-sectional study

ObjectiveTo assess the prevalence and associated factors of neurocognitive disorder among people living with HIV/AIDS in South Gondar primary hospitals, North-West Ethiopia, 2023.DesignInstitution-based cross-sectional study design.SettingSouth Gondar primary hospitals, North-West...

Investigating Mass Segregation of the Binary Stars in the Open Cluster NGC 6819

We search for mass segregation in the intermediate-aged open cluster NGC 6819 within a carefully identified sample of probable cluster members. Using photometry from Gaia, Pan-STARRS, and the Two Micron All Sky Survey as inputs for a Bayesian statistics software suite, BASE-9, we identify a rich population of (photometric) binaries and derive posterior distributions for the cluster age, distance, metallicity, and reddening, as well as star-by-star photometric membership probabilities, masses, and mass ratios (for binaries). Within our entire sample, we identify 2632 cluster members and 777 binaries. We then select a main-sequence “primary sample” with 14.85 <G < 19.5, containing 1342 cluster members and 250 binaries with mass ratios q > 0.5, to investigate mass segregation. Within this primary sample, we find the binary radial distribution is significantly shifted toward the cluster center as compared to the single stars, resulting in a binary fraction that increases significantly toward the cluster core. Furthermore, we find that within the binary sample, more massive binaries have more centrally concentrated radial distributions than less massive binaries. The same is true for the single stars. We verify the expectation of mass segregation for this stellar sample in NGC 6819 through both relaxation time arguments and by investigating a sophisticated N-body model of the cluster. Importantly, this is the first study to investigate mass segregation of the binaries in the open cluster NGC 6819.

RELIABILITY AND VALIDITY OF FULLTRACK AI APP TO MEASURE CRICKET BALL SPEED UNDER TRAINING CONDITIONS

INTRODUCTION Radar guns are commonly used to accurately and reliably measure ball speed(1), a key cricket bowling performance indicator. App-based approaches, such as Fulltrack AI, are gaining popularity. This study investigated the reliability and validity of Fulltrack AI to measure cricket ball speed compared to a validated radar gun(1). METHODS Ball speed of 1081 deliveries (pace=783; spin=298) from a range of training sessions and conditions (batter, no batter; indoor and outdoor wickets) were recorded simultaneously using a radar gun (Stalker ATS2) and iPad running Fulltrack AI (version 1.13.1). Fulltrack AI data (ball speed (km/hr), line, length (m)) were extracted post-session for tabulation with radar gun data. Statistical analyses were conducted in R Statistical Software independently for bowling type (pace, spin) following exclusion of outliers. Reliability was assessed with standard error of measurement (SEM), coefficient of variation (CV) and intraclass correlation coefficient (ICC). Agreement was assessed using Bland Altman’s, 95% limits of agreement (LOA)(2). Validity was assessed using generalised additive models (GAM), controlling for line, length and interaction of training conditions. RESULTS Whilst reliability coefficients for pace deliveries demonstrated very good agreement (ICC=0.90; SEM=2.61) and lower variability (CV=2.56%) in contrast to spin (ICC=0.76; SEM=2.17; CV=3.08%); LOA demonstrated poor to fair levels of agreement, exceeding maximal allowable differences (&amp;gt;3%). When controlling for line, length and training conditions, GAMs ‘average model’ identified Fulltrack AI significantly (p&amp;lt;0.05) overestimated ball speed (pace: estimate 2.58km/hr, SE=1.24; spin: estimate 3.93km/hr, SE=0.81) when compared to the radar gun. CONCLUSION Fulltrack AI is a reliable method for monitoring ball speed where accuracy is not of paramount importance. Significant overestimation of ball speed in contrast with a radar gun, even after controlling for different training conditions, suggests software refinement is required before such technology is readily adopted for the measurement of speed. 1.Smith &amp; Burke (2021) 2.Bland &amp; Altman (1986)

Composition analysis of 1,495 cases of upper urinary tract calculi: the role of age and gender.

This study aimed to quantitatively analyze the calculi components of upper urinary tract calculi and to explore the relationship between calculus components, demographic characteristics, and underlying diseases. Clinical data of 1,495 patients with upper urinary tract calculi were retrospectively collected. The calculi were divided into simple calcium oxalate, calcium oxalate mixed, calcium phosphate mixed, uric acid, magnesium ammonium phosphate, and other components. Statistical software SPSS 22.0 was used to analyze the differences between the stone compositions and various factors. The influencing factors (p < 0.05) were analyzed using multiple logistic regression analysis. Among 1,495 patients with upper urinary tract calculi, simple calcium oxalate calculi were the most common component (39.7%), followed by calcium oxalate mixed calculi (30.4%), uric acid calculi (13.6%), calcium phosphate mixed calculi (10.4%), magnesium ammonium phosphate calculi (5.8%) and other component calculi (0.1%). Univariate analysis revealed statistically significant differences in stone composition according to gender, age, and hyperuricemia (p < 0.05). Multiple logistic regression analysis showed that compared to men, the odds ratio (OR) values of calcium oxalate mixed stones, calcium phosphate mixed stones, and magnesium ammonium phosphate stones in women were 1.61, 2.50, and 4.17, respectively (p < 0.001). Compared with elderly patients, the OR values of calcium phosphate mixed stones in young and middle-aged patients were 3.14 and 2.70, respectively (p < 0.05). Patients with different stone components had different demographic characteristics, and stone components were significantly different between gender and age. Calcium oxalate mixed stones were more common in females, and calcium phosphate mixed stones and magnesium ammonium phosphate stones were more common in females, young patients, and middle-aged patients.

Caesarean Section Trend in a Selected Hospital between 2014 And 2019: Observational Study

Caesarean Section Trend in a Selected Hospital between 2014 And 2019: Observational Study

Unilateral Genital Tract Obstruction with Ipsilateral Renal Anomaly Syndrome: Classification, Clinical Manifestations, and Precise Diagnose.

To recommend the classification of unilateral genital tract obstruction with ipsilateral renal anomaly (UGTOIRA) syndrome into five types based on the site of obstruction, and to analyze the clinical manifestations and precise diagnosis of the syndrome. The data, including demographic characteristics, symptoms, and precise diagnoses from 59 patients over the last decade, were retrospectively analyzed. Data analysis was conducted using the statistical software package SPSS 26.0. All 59 patients diagnosed with UGTOIRA syndrome were classified into five types based on the site of obstruction: Type I (vaginal obstruction) (45, 76.3%), Type II (cervicovaginal obstruction) (7, 11.9%), Type III (cervical obstruction) (3, 5.1%), Type IV (unilateral partial cervical aplasia) (3, 5.1%), and Type V (Unilateral isthmus atresia) (1, 1.7%). Of these cases, there were 34 cases (57.6%) with communication and 25 cases (42.4%) without communication between the left and right genital tracts. The chief complaints included dysmenorrhea alone in 28 cases (47.5%), dysmenorrhea accompanied by blood dripping after menstruation in 12 cases (20.3%), blood dripping after menstruation alone in 14 cases (23.7%), purulent vaginal secretions in one case (1.7%), vaginal pain in one case (1.7%), irregular menstruation in one case (l.7%), and infertility in two cases (3.4%). The precise diagnostic criteria include the affected side, abnormalities in the kidney and ureter, the site of obstruction, the location of blood accumulation, the size of the ipsilateral genital tract, whether there is communication and its site, the type based on the site of obstruction, and the presence and type of complications. This classification of UGTOIRA syndrome encompasses the anatomical features of all cases reported in our study. Only by fully understanding the anatomical characteristics of this syndrome and identifying its clinical manifestations can clinicians make precise diagnoses as early as possible and provide individualized management.

Tocilizumab demonstrates superiority in decreasing C-reactive protein levels in hospitalized COVID-19 patients, compared to standard care treatment alone.

Severe acute respiratory syndrome coronavirus 2 has caused a global pandemic, leading to health, economic, and political crisis. The virus triggers the activation of inflammatory reactants including interleukin-6 (IL-6), ferritin, and C-reactive protein (CRP), causing multiorgan damage, particularly affecting the lungs. Tocilizumab, an IL-6 receptor blocker, has the potential to diminish the progression of the disease and reduce organ damage and long-term complications. The aim of this observational retrospective cohort study was to evaluate the efficacy of tocilizumab in decreasing CRP levels in hospitalized coronavirus disease 2019 (COVID-19) patients compared to standard care without the drug. The study included 141 patients during their Hospital Stay (HS), with 100 in the Tocilizumab group and 41 in the non-Tocilizumab group. Clinical information was collected from the electronic clinical record, analyzed using statistical software, and homogenized the CRP levels from the severe group to the levels of the less complicated group at 48 h of hospitalization. The results showed a statistically significant greater decrease in CRP levels in the Tocilizumab group at 48 h after the use of the treatment, with no differences in mortality or length of stay between the groups. In conclusion, tocilizumab accelerates the diminishing of CRP levels compared to standard treatment alone, and its use may have potential benefits in the management of severe COVID-19 patients when used alongside with follow-up quantification of CRP levels reduction.IMPORTANCESevere acute respiratory syndrome coronavirus 2 has caused a global pandemic, leading to health, economic, and political crises. International guidelines for managing coronavirus disease 2019 (COVID-19) give recommendations according to the severity of the disease and the level of oxygen therapy needed. Tocilizumab is an option for the therapeutic management of hospitalized patients with any level of oxygen therapy; IL-6 serum level is the parameter for the follow-up on the efficacy, but it is not available at many hospitals. In this study, we demonstrate that C-reactive protein determination can predict the response to tocilizumab in severe COVID-19, the target patients for treatment with this drug. The use of this affordable and extensively available biomarker supports clinical decisions for the early escalation of the therapy and for the rational use of this drug on those prone to improve with the use of it.

An introduction to causal mediation analysis

AbstractCausal mediation analysis has gained increasing attention in recent years. This article guides empirical researchers through the concepts and challenges of causal mediation analysis. I first clarify the difference between traditional and causal mediation analysis and highlight the importance of adjusting for the treatment-by-mediator interaction and confounders of the treatment–mediator, treatment–outcome, and mediator–outcome relationships. I then introduce the definition of causal mediation effects under the potential outcomes framework and different methods for the identification and estimation of the effects. After that, I highlight the importance of conducting a sensitivity analysis to assess the sensitivity of analysis results to potential unmeasured confounding. I also list various statistical software that can conduct causal mediation analysis and sensitivity analysis and provide suggestions for writing a causal mediation analysis paper. Finally, I briefly introduce some extensions that I made with my colleagues, including power analysis, multisite causal mediation analysis, causal moderated mediation analysis, and relaxing the assumption of no post-treatment confounding.

Pharmacist intervention to improve adherence to medication among heart failure patients at North East Ethiopia hospital.

Heart failure (HF) is a major and growing medical problem and its management is still challenging due to the coexistence of complications, co-morbidity, and medication non-adherence. HF patients who are adherent to their medication have fewer HF exacerbations, improved survival, and lower healthcare expenditure. Adherence to HF medication plays a pivotal role in attaining maximal therapeutic outcomes. The aim was to assess the medication adherence of heart failure patients at Debre Berhan Comprehensive Specialized Hospital (DBCSH). A pre-post interventional study was undertaken from July 1, 2022, to December 31, 2022, at the medical referral clinic of DBCSH. The educational interventions were provided for 6 months. Medication adherence was determined using the Morisky Green Levin Medication Adherence Scale (MGLS). The data was entered into Epidata version 4.2.0 and analyzed using SPSS version 25.0 statistical software. Descriptive statistics and binary logistic regression analysis were performed. The strength of the association between predictor variables and outcome variables was determined using a 95% confidence interval and adjusted odd ratio. In the pre-intervention phase, 54.6% of patients had medium medication adherence, while in the post-intervention phase, 36.4% of patients had high medication adherence and 61.9% of patients had medium medication adherence. Following the intervention, medication cost (120, 50%), inadequate availability of drugs (75, 31%), and forgetfulness (30, 13%) were the main reasons for medication non-adherence. The presence of co-morbidity and the number of co-morbidity (p < .05) were significantly associated with the occurrence of decreased medication adherence in the pre-intervention phase. Interventions by pharmacists to educate HF patients about the nature of their disease and providing brochures to increase awareness of their medications have been shown to improve medication adherence.

Trend Analysis on Hair and Scalp Research Utilizing Text Mining

This study analyzes the research trends related to "hair" and "scalp" by examining scholarly articles. To compare the differences in research topics across various fields and analyze the correlation between keywords, the statistical software R Studio was employed. The aim was to understand the types of keywords extracted through data analysis, visually grasp the trends in research, and propose future development directions and solutions. The results showed a steady increase in the number of published papers, with an 8.90% increase in the first phase, 22.0% in the second, 31.7% in the third, and 37.3% in the fourth. Additionally, the research was distributed across various fields without bias towards a specific topic, as evidenced by the word cloud analysis. The analysis of keyword rankings by phase revealed that the first phase focused on hair design, the second on fieldwork and education, the third on the beauty industry, and the fourth on beauty education. The topic-based word distribution graph formed six groups, specifically related to beauty: 'hair growth', 'satisfaction', 'hair design', 'status survey', 'beauty education', and 'experiment/measurement'. The percentage of papers by topic showed 'hair growth' leading with 24.7%, followed by 'satisfaction' at 22.5%, 'hair design' at 19.4%, 'status survey' at 16.0%, 'beauty education' at 13.6%, and 'experiment/measurement' at 3.8%. The ratio of topics over time indicated that early on, research was actively conducted on hair design related to fieldwork, but as time progressed, studies on satisfaction surveys and beauty education became more prevalent. In conclusion, from 2001 to 2022, research related to "hair" and "scalp" has been actively conducted across various fields, indicating that the beauty industry, which previously remained at a technical level, has developed into a higher level of technology through academic advancement, laying the foundation to meet consumers' needs.

Effect of Altered Sleep, Perceived Stress on Muscle Strength between Night and Day Shift Workers: A Cross-Sectional Study in Chennai

A minimum of 20% of the global population suffers from sleep debt, which includes shift workers. The risks to one's health and well-being are caused by shift work, increased workload, and other substantial problems. Sleep disruptions will lead to stress, catabolize muscle proteins, and reduce muscular strength in night shift workers. To assess whether sleep quality and perceived stress level have an effect on muscle strength among shift workers. A cross-sectional analysis was performed on the airport workers. One hundred night duty workers and one hundred day duty workers aged 25-40 were randomly selected, and the study was conducted for four months in Sree Balaji Medical College and Hospital, Tamil Nadu. A validated questionnaire evaluated the quality of sleep and stress levels. Muscle strength was determined using Mosso’s ergograph. Version 3.6.3 of the R statistical software was used to analyze the data. Kolmogorov-Smimov ‘Z’ test was used to determine the data set's normality. Significant negative correlations are observed between Mosso'sergo graph and both PSS (r = -0.501, p &lt;0.001) and global PSQI score (r = -0.331, p &lt;0.001). P-value &lt;0.05 was considered statistically significant. This indicates that higher muscle strength is related to decreased perceived stress levels and better sleep quality. Workplace health policies have to be improved. Adequate resting time and stress management training are essential to reduce the adverse effects of rotational work on theworker’s performance in addition to their well-being.

Learner Competence Across Cognitive Levels In Undergraduate Medical Education: An Item Response Approach.

Objective: The current study endeavors to evaluate competence of learners using item response theory approach in undergraduate medical education. Methodology: The responses of the examinees from first professional year (MBBS) were evaluated for Anatomy discipline to gauge learner competence through knowledge, understanding and application in the subject using item response theory approach (IRT) which is an effective tool to measure the validity (discrimination and difficulty index) of assessment, while KR-20 is used to gauge reliability of the items with statistical software STATA 17. The quality of question and level of examinee responses provide skill level and competence of learners. Results: The current study found that the C1 and C3 level items from the Anatomy discipline are mostly acceptable and effectively gauge learner competence while flawed C2 level items need complete restructuring. The study also identified weak areas of average learner for items in each cognitive level. Conclusion: The study found significant role of IRT in effectively estimating competence of the examinees across cognitive levels for each discipline and in building of an effective test pool through assessment of learner ability and construction of quality SBAs to achieve valid and reliable assessment tool. Keywords: Difficulty index; Discrimination index; Single best answer questions; Cognitive levels; Item characteristic curve.

Prevalence of Malaria among Under-5 Children in a Secondary Care Level, Ondo State, Nigeria

Background: Malaria continues to be a leading cause of ill health among children. Globally, this infection remains the major cause of morbidity and mortality especially among the under-five. Aim: The aim of the study was to investigate and document the prevalence of malaria infection among age groups, genders, birth orders, and blood groups of children who attend a secondary health care level, south-west, Nigeria. Subjects and Methods: Blood samples of 500 children whose ages ranged between 1 day and 5 years were collected through venipuncture, and these were tested for malaria parasites through the microscopy method, positivity was confirmed by Polymerase Chain Reaction (PCR) test. It was a hospital-based cross-sectional study. The children were recruited from various points of entry into the hospital which included the emergency room, newborn unit, and outpatient department (OPD). Data analyses were done using the SPSS statistical software and p-value &lt; 0.05 was considered significant. Results: The prevalence of malaria among the neonates (age group 0 to 28 days) was 60.2%, the prevalence of malaria was 49.2% among the infants (aged 29 days to 1 year) while the prevalence was 52.9% among children aged 1 to 5 years (χ2 = 0.004, p &lt; 0.05). The gender prevalence of malaria infection was 30.4% for males and 21.8% for females (χ2 =0.000, p&lt;0.05). The prevalence of malaria infection among birth orders showed that children in the first, second, third, fourth, and fifth birth orders are 41.0%, 28.0%, 22.6%, 5.4%, and 3.1%, respectively (χ2 = 0.0210, p &lt; 0.05). Prevalence of malaria among the blood groups are; A− (1.92%), A+ (13.41%), B− (1.15%), B+ (19.54%), O− (6.51%), O+ (51.73%), AB− (0.38%) and AB+ (5.36%). Conclusion: There is a high prevalence of malaria among the children examined in this study, there is therefore the need to intensify efforts to reduce the burden of the infection in the study area, especially among the children.

Exploring the moderating effect of brand image on the relationship between customer satisfaction and repurchase intentions in the fast-food industry

PurposeThis study aimed to determine whether the brand image of fast-food restaurants moderates the relationship between satisfaction and loyalty among Chilean customers.Design/methodology/approachThe study was conducted using a structural equation modeling approach and involved a sample of 1,000 fast-food customers who were surveyed through nonprobabilistic sampling with a questionnaire consisting of 21 items. The instrument underwent validation by a panel of experts, and the results obtained were processed using the statistical software Smart PLS4. Convergent validity, discriminant validity and the structural model were tested to assess the acceptance or rejection of the proposed hypotheses.FindingsThe results of the research indicate that product quality, service quality and physical environment are crucial factors influencing customer satisfaction and shaping customer loyalty. However, it was found that brand image does not moderate the relationship between satisfaction and loyalty in fast-food consumption.Originality/valueThe present study contributes to the field of knowledge on fast-food consumption behavior and unveils findings that help fill knowledge gaps regarding the influence of restaurant brand image on the relationship between satisfaction and consumption loyalty. Thus, it demonstrates that, for certain customers, the brand becomes an irrelevant factor for their consumption loyalty as long as the restaurant offers product quality, excellent service and a pleasant physical environment.

The Effect of Blended Learning on Crisis Management During the Corona Pandemic (COVID-19 )

This research endeavors to investigate the influence of blended learning on the effective management of the educational challenges posed by the COVID-19 pandemic within nine government and private colleges in Iraq, to assess the level of interest exhibited by these institutions in the principal research variables and their dimensions. Additionally, the research seeks to formulate a set of conclusions aimed at enhancing performance standards to ensure the attainment of quality outcomes. These conclusions are founded upon the novelty and pressing significance of these variables in sustaining the educational process. The research methodology adopted for this research is primarily descriptive and analytical. The research population comprises teachers affiliated with departments specializing in administrative and economic sciences across the selected colleges, with a total sample size of 142 teachers. The principal research instrument employed is a questionnaire distributed to the aforementioned teachers. Furthermore, the research harnesses SPSS V.26 statistical software, for the analysis of the primary data. Both descriptive and inferential statistical techniques are utilized to assess and validate the research hypotheses. The statistical analysis reveals several noteworthy findings, most notably a substantial correlation and impact of blended learning across its dimensions (infrastructure suitability, teacher readiness, student readiness, and curriculum suitability) in the realm of crisis management, encompassing various dimensions ) the detection of warning signals, preparedness and prevention, damage containment, activity restoration, and learning(. Paper Type: Research paper

Prevalence of emotional and behavioral problems among adolescents in Bangladesh.

Emotional and behavioral problems among adolescents is a global concern. Previous studies conducted in Bangladesh have highlighted the importance to effectively prevent and address emotional and behavioral problems among adolescents to improve their psychological well-being. Despite these efforts, there remains limited research specifically addressing emotional and behavioral problems, conduct disorders, hyperactivity/attention disorders, and peer relationship problems among adolescents in Bangladesh in terms of age, gender, grade, and location. To address this knowledge gap, the present study aimed to comprehensively investigate the prevalence of emotional and behavioral problems among school-going adolescents in Bangladesh. The study employed a two-stage stratified cluster sampling technique to recruit a total of 1496 participants. The socio-demographic characteristics of the participants, such as age, gender, grade, location, birth order, family type, monthly family income, and parental education were collected. Emotional and behavioral problems were assessed using the Strength and Difficulties Questionnaire(SDQ), while the chi-square test and logistic regression were used to analyze the data with STATA software. The prevalence of emotional disorder was 9.09% (7.73 - 10.65%). The rate was 21.72% (19.70 - 23.88%) for conduct disorder, 6.21% (5.09 - 7.55%) for hyperactivity, and for peer-relationship problem, the rate was 15.10% (13.37 - 17.01%) among adolescents. Overall, gender, grade, location, monthly family income, and parental education were significantly associated with emotional and behavioral problems. More specifically, adolescent girls (OR = 2.90 for the emotional disorder), grade (8th: OR = 2.07, 9th: OR = 1.95, for the emotional disorder), urban residents (OR = 2.46, for conduct disorder; OR = 2.29, for hyperactivity; OR = 2.03, for peer-relationship problem), poor monthly family income (OR = 2.84, for peer-relationship problem) significantly increased the risk of psychiatric morbidity. The study highlights the need for school-based intervention programs to address adolescent emotional and behavioral problems. By targeting vulnerable individuals, these programs can effectively reduce mental health problems among adolescents.

Valoración Contingente Dicotómica de tres servicios ecosistémicos de la Reserva de Producción de Fauna Chimborazo, Ecuador

The moorland or paramo is a threatened ecosystem. The indiscriminate advance of the agricultural frontier is producing the loss of ecosystem services, especially water service. This research estimated the willingness to pay (WTP) of the water users corresponding to the Municipality of Riobamba for the conservation of 3 ecosystem services: water service, soil conservation and scenic beauty of the Chimborazo Fauna Production Reserve (RPFCH). Four hundred and six surveys were applied by means of the double limit dichotomous contingent valuation method, using a maximum likelihood model in the Stata software. Four models were developed: simple limit, simple limit with other explanatory variables, double limit, and double limit with other explanatory variables, the latter being statistically more significant. As a result, it was determined that the WTP for the ecosystem service of water production is USD 0.84, for soil conservation USD 0.88 and for scenic beauty USD 0.81 per month that they would be willing to pay for the care of these services.

Six Sigma Technique to Reduce Waiting Time: A Practical Application in Passport Affairs Directorate

This study investigates the impact of the Six Sigma methodology on improving waiting times in passport directorates. The Six Sigma methodology is crucial for enhancing efficiency and effectiveness in passport directorates, aiming to reduce waiting times and increase customer satisfaction by organizing services more effectively. The research was conducted in the Passport Affairs Department (Mansour Passports) from November 8, 2022, to April 19, 2023, with a sample size of 53 employees and citizens. The problem of this study is to shed light on the role played by the Six Sigma methodology in improving waiting time at the Passport Affairs Department. The study adopted the DMAIC methodology (Define, Measure, Analyze, Improve, and Control) and used statistical software (SPSS) to calculate Six Sigma levels for both citizens and employees. Access and service data analysis was conducted using Win QSB software, and arrival and service times were calculated for all stages (counter employees, accounts, and manager's computer). The most significant results indicate that the directorate operates at the first level of Sigma levels, while citizens are at the second level. There is a significant and inverse effect of Six Sigma principles on waiting. The total time a citizen waits from entering the passport office to receiving their passport is very long. Paper type: Research Paper

Relationship Between Triglyceride-Glucose Index and Microvascular Complications in Hospitalized Patients with Type 2 Diabetes Mellitus

Aim: The increasing prevalence of diabetes mellitus (DM) brings about a rise in nephropathy, retinopathy, and neuropathy, which are microvascular complications of diabetes. The triglyceride-glucose (TyG) index is a convenient indicator of insulin resistance. It is related to microvascular and macrovascular complications among nonhospitalized patients with diabetes. However, it is unclear if the TyG index poses risks for vascular complications of type 2 DM in hospitalized patients. This study aims to investigate possible relations between this index and the risk of microvascular complications in hospitalized patients with type 2 DM. Material and Methods: The present study included 420 type 2 DM patients who were hospitalized in our clinic between February 2019 and May 2022. The TyG index was measured as fasting triglycerides mg/dL × fasting glucose mg/dL/2. The presence of microalbuminuria (MAU), diabetic neuropathy, chronic kidney disease (CKD), and retinopathy (DR) were evaluated. The data were analzed using IBM SPSS 22.0 statistical software. The level of statistical significance was taken as p