Statistical Tests Of Association Research Articles

Prevalence and Pattern of Ear Disease Among Primary School Students in Samoa: Preliminary Results from ENT Clinic Outreach to Urban, Rural and Remote Settings.

Objectives: To assess the prevalence and pattern of ear disease among students attending primary school in urban, rural, and remote regions of Samoa in order to develop an evidence-based national school ear and hearing health program. Methods: Retrospective clinical data review of all primary school students seen by the Ear, Nose & Throat Clinic of Samoa during school-based outreach visits from March 2022 to April 2024. A purposefully designed spreadsheet was created to extract the following information from the clinical records: school location (urban, rural, remote), gender (male, female), age (years), age category (0-4, 5-9, 10-14, 15+ years), right ear diagnosis, left ear diagnosis. Data were entered into the SPSS statistical software package for descriptive statistical analysis and association tests of significance. Results: A total of 1491 primary school students were seen for ear health examinations (51.1% male, 48.9% female), with a mean age of 9.1 years (SD = 2.3). Five primary schools were included, representing urban (n = 865), rural (n = 258), and remote (n = 368) settings. Overall, 682 (45.7%) students had normal ear examination results for both ears, 237 (15.9%) had an ear pathology in 1 ear only, and 568 (38.1%) had ear pathology in both ears. Bilateral ear pathology was significantly higher among students who were in the 5 to 9 age group (P < .00001), female (P = .035), and from rural settings (P = .0001). The most common pathology was impacted cerumen (36.8%), followed by otitis media with effusion (7.5%). Overall prevalence of chronic suppurative otitis media (CSOM) was 2.6% (n = 39 students). Following the school visits, no further intervention was required for 1180 students (79%), mostly due to successful cerumen and foreign body removals for 468 students (31.4%). Conclusion: Impacted cerumen is a significant issue among Samoan school-aged students, and future school-based ear health programs should include staff members trained in cerumen removal. CSOM prevalence suggests an avoidable burden of disease that must be addressed.

Correlation of Serum Uric Acid With Cardiovascular Risk in Nigerian Patients.

Studies exploring the relationship between serum uric acid (sUA) and cardiovascular risk in the Nigerian population remain sparse. The study aimed to assess the association between sUA levels and two measures of cardiovascular risk, namely the Framingham 10-year Cardiovascular Risk Score (FRS) and the Atherogenic Index of Plasma (AIP). This retrospective study used data from clinical records of new, previously unregistered patients presenting at a private cardiac hospital over one year from November 2022 to October 2023. In total, 428 patients presented newly to the hospital in that period. The records of 138 patients were included in the project after various exclusions were made including for incomplete anthropometric and laboratory data. Statistical tests of association were used to determine the significance of the relationship between sUA levels and the measures of cardiovascular risk. Two-tailed p <0.05 was deemed statistically significant. Hyperuricemia was more prevalent in individuals with central obesity, i.e., waist circumference ≥94cm in males or 80cm in females (93.4% vs 6.6%; p=0.03). Serum uric acid also positively correlated with FRS (correlation coefficient: 0.190; p<0.05) and serum triglyceride levels and AIP (correlation coefficient: 0.259 and 0.294, respectively; p<0.001 for both). After multivariate analyses, uric acid was significantly and independently associated with high FRS and AIP after adjusting for age, smoking and diabetes history, blood pressure, total and high-density lipoprotein cholesterol, serum triglyceridesand waist circumference (p<0.001). The results emphasize the emergence of sUA as a pertinent cardiovascular risk factor in clinical settings. More research is needed to deduce the relationship, if any, between cardiovascular risk reduction and pharmacological reduction of sUA levels.

Genomic Data Characterize Reproductive Ecology Patterns in Michigan Invasive Red Swamp Crayfish (Procambarus clarkii).

The establishment and spread of invasive species are directly related to intersexual interactions as dispersal and reproductive success are related to distribution, effective population size, and population growth. Accordingly, populations established by r-selected species are particularly difficult to suppress or eradicate. One such species, the red swamp crayfish (Procambarus clarkii) is established globally at considerable ecological and financial costs to natural and human communities. Here, we develop a single nucleotide polymorphism (SNP) loci panel for P. clarkii using restriction-associated DNA-sequencing data. We use the SNP panel to successfully genotype 1800 individuals at 930 SNPs in southeastern Michigan, USA. Genotypic data were used to reconstruct pedigrees, which enabled the characterization of P. clarkii's mating system and statistical tests for associations among environmental, demographic, and phenotypic predictors and adult reproductive success estimates. We identified juvenile cohorts using genotype-based pedigrees, body size, and sampling timing, which elucidated the breeding phenology of multiple introduced populations. We report a high prevalence of multiple paternity in each surveyed waterbody, indicating polyandry in this species. We highlight the use of newly developed rapid genomic assessment tools for monitoring population reproductive responses, effective population sizes, and dispersal during ongoing control efforts.

Effect of Bacillus Calmette–Guerin Exposure on Prostate Cancer Detection Using Magnetic Resonance Imaging: A Cohort Study

BackgroundGranulomatous prostatitis is a medical condition that may mimic prostate cancer. PurposeGranulomatous prostatitis resulting from BCG-exposure can confound the diagnosis of prostate cancer based on prostate imaging and data system (PI-RADS) classification observed on multiparametric prostate magnetic resonance imaging (mpMRI). Study type, Population, Assessment and Statistical TestsA cohort study was conducted, enrolling consecutive males at risk for prostate cancer who underwent an mpMRI-targeted prostate biopsy between February 2016 and August 2023. The focus of the study was on prior BCG-exposure as adjuvant treatment for non–muscle-invasive urothelial carcinoma within the 3 years prior the magnetic resonance imaging (MRI). Exclusion criteria were a prior androgen deprivation therapy, prostate surgery or radiation, and BCG-exposure occurring more than 3 years and less than 3 months before the MRI. Chi-square, logistic-regression, statistical association, and homogeneity tests were used. ResultsTotal 712 patients, 899 biopsied lesions (218 PI-RADS 3, 521 PI-RADS 4 and 160 PI-RADS 5) and 20 patients with 30 lesions within the BCG-exposed cohort. Chi-square and logistic-regression tests showed an association between PI-RADS with malignancy and significant tumor (ST), considering PI-RADS3 as the reference (OR: 4.9 [95% CI, 3.4-7.1] for PI-RADS4 and OR: 21.7 [95% CI, 12.4-37.8] for PI-RADS5 for malignancy, and OR: 5.3 [95% CI, 3.2-8.7] for PI-RADS4 and OR: 16.5 [95% CI, 9.4-28.9] for PI-RADS5 regarding ST). A statistically significant negative association was demonstrated between malignancy and ST with respect to BCG-exposure (OR: 0.15 [95% CI, 0.06-0.39] and OR: 0.39 [95% CI, 0.15-1.0], respectively). Statistically significant risk-difference for malignancy in patients nonexposed to BCG regarding those exposed was 45% (61.6% vs. 16.7%) for PI-RADS4, and 68.5% (90.7% vs. 22.2%) and 42.7% (64.9% vs. 22.2%) concerning malignancy and ST for PI-RADS5, respectively. Data ConclusionsGranulomatous prostate reaction caused by BCG-exposure acts as confounding factor for prostate MRI interpretation. The risk of malignancy and significant tumor on targeted biopsy to PI-RADS 3, 4 and 5 is notably lower in exposed patients.

Zero Waste household practices in informal settlements: an opportunity to improve the living conditions of the urban poor and address global challenges

Zero Waste household practices adopted in informal settlements have facilitated the reduction of greenhouse gas emissions and contributed to income generation, food security and the strengthening of the social fabric. In four informal settlements in Santiago de Cali (Colombia), these practices were identified through participatory methodologies, and statistical tests of association between variables were used to determine possible causes of their implementation. These practices were found to be associated with characteristics of the residents including their connection to the cultural traditions of their places of origin, their resilience and solidarity, the satisfaction of their basic needs and their search for a healthy environment. This paper discusses these practices, the elements that drive them and their main benefits, highlighting the need for public policies to recognize their contributions in addressing global challenges and for future research to quantify their contributions.

Compensatory mutations are associated with increased in vitro growth in resistant clinical samples of Mycobacterium tuberculosis.

Mutations in Mycobacterium tuberculosis associated with resistance to antibiotics often come with a fitness cost for the bacteria. Resistance to the first-line drug rifampicin leads to lower competitive fitness of M. tuberculosis populations when compared to susceptible populations. This fitness cost, introduced by resistance mutations in the RNA polymerase, can be alleviated by compensatory mutations (CMs) in other regions of the affected protein. CMs are of particular interest clinically since they could lock in resistance mutations, encouraging the spread of resistant strains worldwide. Here, we report the statistical inference of a comprehensive set of CMs in the RNA polymerase of M. tuberculosis, using over 70 000 M. tuberculosis genomes that were collated as part of the CRyPTIC project. The unprecedented size of this data set gave the statistical tests more power to investigate the association of putative CMs with resistance-conferring mutations. Overall, we propose 51 high-confidence CMs by means of statistical association testing and suggest hypotheses for how they exert their compensatory mechanism by mapping them onto the protein structure. In addition, we were able to show an association of CMs with higher in vitro growth densities, and hence presumably with higher fitness, in resistant samples in the more virulent M. tuberculosis lineage 2. Our results suggest the association of CM presence with significantly higher in vitro growth than for wild-type samples, although this association is confounded with lineage and sub-lineage affiliation. Our findings emphasize the integral role of CMs and lineage affiliation in resistance spread and increases the urgency of antibiotic stewardship, which implies accurate, cheap and widely accessible diagnostics for M. tuberculosis infections to not only improve patient outcomes but also prevent the spread of resistant strains.

Complications profile following regional anesthesia: Comparative analysis between ankle and unilateral spinal blocks for foot surgery

Objectives This study aims to compare the complications profile between ankle block and unilateral spinal block for foot Surgeries. Ankle block is expected to provide minimal intraoperative and postoperative complications compared to unilateral spinal block following foot surgeries. Material and Methods Fifty adult patients scheduled for elective foot surgeries that met the inclusion criteria were enrolled in the study. They were assigned into two groups of 25 each as they came, group A (ankle block) and group S (unilateral spinal block). Group A had surgery under the ankle block using 4 ml of 0.5% plain bupivacaine to block each nerve. In contrast, group S had surgery under a unilateral spinal block using 3 ml of 0.5% heavy bupivacaine. The complications were observed and recorded. The data obtained were analyzed using Statistical Package for Social Sciences version 25.0 and were presented using relevant proportions, tables, and figures. Statistical association tests were performed with a confidence level of 95%, and a p-value of less than 0.05 was taken as significant. Results The intraoperative complications observed between the two groups; three patients (12%) had nausea for group S while two patients (8.7%) had nausea from group A, two patients (8%) had vomiting from group S while one patient (4%) from group A had vomiting, three patients (12%) had bradycardia from group S and one patient (4%) had bradycardia from group A, three patients (12%) from group S had hypotension while no patient had hypotension from group A. The postoperative complications between the two groups; 2 (8%) patients had nausea from group S while only one patient (4%) had nausea from group A, Only 1 (4%) patient had vomiting from group S and one patient (4%) had vomiting from group A. Only two patients (8%) had urinary retention from group S, while no patients from group A had urinary retention. No patient had a postural puncture headache or shivering from group S. Conclusion Ankle block is associated with minimal complications compared to unilateral spinal block.

Prevalence and Risk Factors of Deep Vein Thrombosis Among Adult Surgical Patients in Aseer Central Hospital, Saudi Arabia.

Deep vein thrombosis (DVT) is a medical disorder that arises when a coagulation of blood forms in a deep vein, entirely or partially blocking veins, and commonly affects the lower limb. The occurrence is fairly common worldwide and it is said to increase with age, with males being at a higher risk than females. This study aims to determine the prevalence and risk factors of DVT among adult surgical patients in Aseer Central Hospital in the Aseer Region of Saudi Arabia. This is a cross-sectional study involving 602 adult surgical patients hospitalized in the Aseer Central Hospital. Self-administered questionnaires were used to collect data from the respondents, and the data collected were analyzed using IBM SPSS Statistics for Windows, Version 24.0 (Released 2016; IBM Corp., Armonk, New York, United States). Statistical tests of association were used among the categorical variables. Association between variables was considered significant when p-value was less than 0.05. Binary logistic regression was performed to eliminate the effect of confounders in determining the risk factors for developing DVT among the respondents. The questionnaire response rate was 100%, with the mean age of the respondents being 44.2 ± 19.7 years. The prevalence of DVT was 7% (n=42). Obesity with adjusted OR (aOR) 17.9 (95%CI =5.39-59.18), hypertension with aOR 0.3 (95%CI =0.08-1.03), ischemic heart disease with aOR4.5 (95%CI =1.18-16.83), and orthopedics aOR 0.1 (95%CI=0.013-.240) were found to be independent risk factors for developing DVT among the respondents (p-value <=0.05). Other variables like diabetes, contraception, and pregnancy were not statistically associated with the development of DVT (p-value> 0.05) in these respondents. The findings of this study indicated a significantly low prevalence in comparison to Saudi Arabian research. Key risk factors included obesity (18x higher risk), ischemic heart disease, and hypertension. Surgery location, orthopedic cast, and Doppler ultrasound also influenced risk, while age and sex weren't significant predictors.

Levels of physical activity and sedentary behaviors in different universities of Bogotá

Abstract The global recommendations for physical activity (PA) advised by the World Health Organization WHO (2012) are 150 minutes of moderate intensity (at least 600 MET-min/week) or 75 minutes of vigorous intensity per week (at least 3000 MET-min/week). The objective were determine the levels of PA and sedentary behaviors (SB) in people at different universities in Bogotá (students, administrative personal). The dimensions IPAQ was applied (PA in the transportation PAT, PA in Leisure Time PALT and auto evaluation of sedentary behaviors ASB). Study was descriptive, correlational, with simple random sampling. The project had ethics considerations aproved by Ethic Comitee of Libre University. The data were analyzed with Rversion 4.2.3. Results were n = 717 distributed in 442 (61.6%) women and 275 (38.4%) men. 100 men (36.4%) with 120.9 ± 185.9 MET-min/week and 161 women (36.4%) with 313.9 ± 198.8 MET-min/week did not fulfill PAT recommendations. 109 men (36.5%) with 193.6 ± 217.0 MET-min/week and 141 women (31.9%) with 186.4 ± 194.5 MET-min/week did not fulfill PALT recommendations. 75 men (27.3%) report sedentary time (ASB) greater than 2 hour/day (2311.2 min/week ± 1487.7) and 104 women (23.5%) report 2255.1 min/week (±1316.4). Instead, people fewer than 2 hours were 200 men (72.7%) with 323.6 min/week (±320.7) and 338 women (76.5%) with 312.4 min/week (±308.8). Statistical tests for association were applied for the variables PAT and PALT which did not have significant statistical differences but between PALT and ASB were found significant statistical differences (p-value &amp;lt; 2.2e–16, CI 1032.740–1608.664), so they were related. Universities must promote and maintain recommended PA levels through strengthening programs and infrastructure oriented to PA in population, especially promoting forms of transportation such as bicycles and different forms of active leisure time differentiated between genders. However, sedentary times are a threat to health, due to its great increase in this population. Key messages • The global recommendations for physical activity (PAG) recommended by the WHO (2012) is 150 minutes of moderate intensity or 75 minutes of vigorous intensity per week.

Burden of Noise-Induced Hearing Loss among Rice Mill Workers in Sokoto State, Northwest Nigeria

Context: Work heavily impacts workers' health globally, with noise-induced hearing loss (NIHL) increasingly becoming a major public health concern. Aim: This study accessed the prevalence and predictors of noise-induced hearing impairment among local rice mill workers in Sokoto State, Northwest Nigeria. Materials and Methods: This cross-sectional study was conducted among rice mill workers between June 2019 and July 2019. Participants were selected using a multistage sampling technique, and a pretested interviewer-administered questionnaire was used for data collection. Data were analyzed using IBM® Statistical Package for the Social Sciences (SPSS) version 22, and the results were presented in tables and figures. Statistical tests of associations were conducted using the Chi-square test and binary logistic regression with a significance level set at P &lt; 0.05. Results: The noise level in the rice mills ranged from 81.8 dBA to 91.7 dBA, with a mean of 86.7 ± 2.3 dBA. A hundred and eighty-five respondents (46.5%) of the 398 respondents had at least a symptom of hearing loss, with tinnitus (145 (36.4%)) being the most prevalent. About a third of 125 (32.5%) had hearing impairment in at least one of the ears on audiometry. The predictors of hearing impairment on audiometry were cigarette smoking, education, and having symptoms of hearing loss. Conclusion: The burden of noise-induced hearing impairment is high among rice mill workers in Sokoto State, Northwest Nigeria; hence, both the government and rice mill owners need to initiate smoking cessation programs, promote the use of personal protective equipment, and urgently implement hearing conservation programs to address the problem.

Comparison of multiple imputation and other methods for the analysis of imputed genotypes

BackgroundAnalysis of imputed genotypes is an important and routine component of genome-wide association studies and the increasing size of imputation reference panels has facilitated the ability to impute and test low-frequency variants for associations. In the context of genotype imputation, the true genotype is unknown and genotypes are inferred with uncertainty using statistical models. Here, we present a novel method for integrating imputation uncertainty into statistical association tests using a fully conditional multiple imputation (MI) approach which is implemented using the Substantive Model Compatible Fully Conditional Specification (SMCFCS). We compared the performance of this method to an unconditional MI and two additional approaches that have been shown to demonstrate excellent performance: regression with dosages and a mixture of regression models (MRM).ResultsOur simulations considered a range of allele frequencies and imputation qualities based on data from the UK Biobank. We found that the unconditional MI was computationally costly and overly conservative across a wide range of settings. Analyzing data with Dosage, MRM, or MI SMCFCS resulted in greater power, including for low frequency variants, compared to unconditional MI while effectively controlling type I error rates. MRM andl MI SMCFCS are both more computationally intensive then using Dosage.ConclusionsThe unconditional MI approach for association testing is overly conservative and we do not recommend its use in the context of imputed genotypes. Given its performance, speed, and ease of implementation, we recommend using Dosage for imputed genotypes with MAF ge 0.001 and Rsq ge 0.3.

On asymptotic distributions of several test statistics for familial relatedness in linear mixed models.

In this study, the asymptotic distributions of the likelihood ratio test (LRT), the restricted likelihood ratio test (RLRT), the F and the sequence kernel association test (SKAT) statistics for testing an additive effect of the expected familial relatedness (FR) in a linear mixed model are examined based on an eigenvalue approach. First, the covariance structure for modeling the FR effect in a LMM is presented. Then, the multiplicity of eigenvalues for the log-likelihood and restricted log-likelihood is established under a replicate family setting and extended to a more general replicate family setting (GRFS) as well. After that, the asymptotic null distributions of LRT, RLRT, F and SKAT statistics under GRFS are derived. The asymptotic null distribution of SKAT for testing genetic rare variants is also constructed. In addition, a simple formula for sample size calculation is provided based on the restricted maximum likelihood estimate of the effect size for the expected FR. Finally, a power comparison of these test statistics on hypothesis test of the expected FR effect is made via simulation. The four test statistics are also applied to a data set from the UK Biobank.

A study to explore patterns and factors of depression, anxiety and stress among students preparing for competitive exams in central India

Background: Depression, stress and anxiety among students is being increasingly recognized as a major mental health problem. Depression is a common but grave mood disorder. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in children. Objectives of current study were to explore the level of depression, anxiety and stress and to identify various factors associated with it. Methods: A descriptive, cross-sectional study on 400 students preparing for competitive exams, using a questionnaire having socio demographic profile and DASS 21 scale was carried out. Then data was entered in MS excel and SPSS Software was used for relevant inferential statistical tests of associations. Results: 65.8 % of participants were less than 18 years of age and 57.3 % were males.20.3 % of students were found to be having moderate depression, 8.8 % having severe depression, 17.8 % having moderate anxiety, 27.3% having severe anxiety, 14.8 % having moderate stress, 12 % having severe stress. Stress was found to be significant in females and those having more than 2 siblings. Significant anxiety was found in those having non supportive teachers. Significant depression was found in those having non supportive teachers and parents, those who sleep for less than 6 hours and those spending less than 2 hours on study. Conclusions: Study highlighted common factors leading to depression anxiety and stress among students. Parents and teacher are recommended to develop proper communication and be aware of this problem.

KIR/KIR-ligand genotypes and clinical outcomes following chemoimmunotherapy in patients with relapsed or refractory neuroblastoma: a report from the Children’s Oncology Group

BackgroundIn the Children’s Oncology Group ANBL1221 phase 2 trial for patients with first relapse/first declaration of refractory high-risk neuroblastoma, irinotecan and temozolomide (I/T) combined with either temsirolimus (TEMS) or immunotherapy...

Perinatal outcomes of twin pregnancies complicated with preeclampsia at a tertiary hospital in Ethiopia: A case‐control study

AbstractBackgroundPreeclampsia accounts for 10–15% maternal deaths globally, corresponding to 50,000 annual maternal deaths. Twin pregnancy is a known risk factor for preeclampsia; however, there is inadequate data on the clinical characteristics and perinatal outcomes of twin pregnancies complicated with preeclampsia. This paper studied the perinatal outcomes of twin pregnancies complicated with preeclampsia at a tertiary hospital in Ethiopia.MethodsA case‐control study was conducted at St. Paul's Hospital Millennium Medical College (Addis Ababa, Ethiopia) from September 1, 2016 till August 31, 2018. A total of 173 twin deliveries (63 preeclampsia cases and 110 normotensive controls) were included in the study and the primary outcome was the frequency of preterm delivery. Data were analyzed using SPSS version 23 and statistical test of association was done using chi‐square test for categorical data. Variables with p value of &lt;0.2 on bivariate analysis were entered into multivariable logistic regression analysis. p value &lt;0.05 were considered significant.ResultsThe frequency of preterm birth was 61.9% in the preeclampsia group and 33.6% in the normotensive group, p &lt; 0.001. Preeclampsia group were 2.58 times more likely to have preterm delivery compared to matched normotensive controls [adjusted OR = 2.58, 95% CI (1.24 – 5.35), p = 0.01]. There was no difference in the rate of adverse neonatal outcome (respiratory distress syndrome, early neonatal death, and Low Apgar score) between the groups.ConclusionsIn this study, twin pregnancies complicated with preeclampsia were found to have an increased rate of preterm birth compared to matched controls without hypertension.

DESSRT: A Novel Framework for Empirical Red Teaming at Scale

Background Red Teaming is widely used to discover vulnerabilities, test defensive measures, and anticipate emerging but novel threats. It has rarely been conducted both systematically and at scale, substantially limiting confidence in its results and the generalizability of its findings. Aim We introduce distributed, empirical, systematic, and scalable red teaming (DESSRT), a framework for translating tactical-level Red Teaming into a replicable research methodology. We apply DESSRT to address whether the information about and availability of computed tomography (CT) scanners influences adversary decision-making in aviation security. Method Using a convenience sample of 143 university students, participants role-played as adversaries in an eight-hour attack planning exercise. Via a custom instrument, participants were randomly assigned across three adversary profiles built on historical cases and then designed a simulated attack. Afterwards, one of three injects about CT scanners were randomly assigned, and participants were asked about potential changes in attack plans (including target changes). Differences among assigned profiles and CT scanner injects were evaluated using standard statistical tests of association. Results Although differences in explosive and weapon package selections were not statistically significant across profiles, security evasion methods were. Following injects, participants were equally as likely to change tactics across profiles, with the majority (53%) changing at least one tactical area. When asked, the majority (18) of those who changed targets (27/143) reported that the additional information on CT scanners did have some effect on their target change decision. Conclusion Overall, the DESSRT framework provides a novel mechanism for translating traditional Red Teaming exercises into a replicable and empirical research method. Although not a replacement for historical data, where available, DESSRT allows analysts and researchers to test theories about human decision-making, generate novel what-if insights to support planning efforts, and validate parameters within complex models.

Factors Associated with the Acceptance of COVID-19 Vaccines in Citizens of Northern Peru: Cross-Sectional Study.

PurposeThe presence of the COVID-19 coronavirus in Peru, and especially in northern Peru, was very fast and caused many deaths. As a result, vaccination proved to be the most immediate option to control it. However, a sector of the population was reluctant to vaccination. Therefore, this study aimed to analyze the factors associated with the acceptance of COVID-19 vaccines by citizens of northern Peru.Patients and MethodsThe study was observational, descriptive-correlational and the sample was stratified and consisted of 516 citizens from eight departments of northern Peru, who answered an online questionnaire regarding sociodemographic, cultural and health aspects. The data were analyzed using statistical tests of association and a logistic model was estimated to identify factors predicting vaccine acceptance.ResultsAmong the factors associated with vaccine acceptance, sociodemographic factors such as age and family income, cultural factors such as level of knowledge, and health factors such as having another chronic disease and a vaccine with a higher confidence (p<0.05) were found. In addition, 12% of the population do not trust them, 10% are afraid that they may cause thrombosis, 13% disagree with vaccination for children, 7% think that a chip will be implanted and 8% believe that their DNA will be changed. However, most people accept vaccination and consider it necessary. A multivariate analysis was also performed for the acceptance of vaccines, which presented a percentage of 80.2% correct in the prognosis.ConclusionThe multivariate analysis allowed a conclusion that the predictor variables for vaccine acceptance are household income of less than 1000 Peruvian soles per month, low or medium levels of knowledge, and having another chronic disease.

Time for speciation and niche conservatism explain the latitudinal diversity gradient in clupeiform fishes

AbstractAimThe latitudinal diversity gradient of increasing species richness from poles to equator is one of the most striking and pervasive spatial patterns of biodiversity. Climate appears to have been key to the formation of the latitudinal diversity gradient, but the processes through which climate shaped species richness remain unclear. We tested predictions of the time for speciation, carrying capacity and diversification rate latitudinal diversity gradient hypotheses in a trans‐marine/freshwater clade of fishes.LocationGlobal in marine and freshwater environments.TaxonClupeiformes (anchovies, herrings, sardines and relatives).MethodsWe tested predictions of latitudinal diversity gradient hypotheses using a molecular phylogeny, species distribution data and phylogenetic comparative approaches. To test the time for speciation hypothesis, we conducted ancestral state reconstructions to infer the ages of temperate, subtropical and tropical lineages and frequency of evolutionary transitions between climates. We tested the carry capacity hypothesis by characterizing changes in net diversification rates through time. To test the diversification rate hypothesis, we qualitatively compared the diversification rates of temperate, subtropical and tropical lineages and conducted statistical tests for associations between latitude and diversification rates.ResultsWe identified four transitions to temperate climates and two transitions out of temperate climates. We found no differences in diversification rates among temperate and tropical clupeiforms. Net diversification rates remained positive in crown Clupeiformes since their origin ~150 Ma in both tropical and temperate lineages. Climate niche characters exhibited strong phylogenetic signal. All temperate clupeiform lineages arose &lt;50 Ma, after the Early Eocene Climatic Optimum.Main conclusionsOur results support the time for speciation hypothesis, which proposes that climate niche conservatism and fluctuations in the extent of temperate climates limited the time for species to accumulate in temperate climates, resulting in the latitudinal diversity gradient. We found no support for the carrying capacity or diversification rate hypotheses.

Study of Oligohydramnios and Perinatal Outcome in Term Pregnancy

BACKGROUND&#x0D; Oligohydramnios is associated with an increased risk of adverse pregnancy outcomes. The perinatal mortality rate in oligohydramnios is high. Oligohydramnios is also associated with fetal heart conduction abnormalities, meconium staining of the amniotic fluid, umbilical cord compression, lower Apgar scores, poor tolerance of labour and fetal acidosis. We wanted to assess the perinatal outcome in term pregnancies complicated with oligohydramnios in this study.&#x0D; METHODS&#x0D; A prospective cohort study was conducted among 200 cases of pregnant women with singleton term pregnancy with intact membranes and AFI &lt; 5cm admitted from January 2019 to June 2020 in the Department of Obstetrics and Gynaecology, Government Medical College, Kozhikode. Antenatal patients with oligohydramnios confirmed by USG were induced within 24 hrs based on the Bishops score. History and examination findings were recorded in a predesigned proforma. Mode of delivery and APGAR scores were also noted. Neonatal complications and the need for ICU admission were studied up until their NICU admission or hospital stay.&#x0D; Statistical Analysis: Statistical tests of association using SPSS (version 20.0) were employed at the level of significance of 5 %.&#x0D; RESULTS&#x0D; The majority of patients in this study were primigravida (60.5 %) and belonged to the age group 20-29 yrs (73.5 %). There was a higher rate of induction (67.5 %) in oligohydramnios patients. Around 26 % had meconium-stained amniotic fluid. The rate of caesarean section was found to be 22.5 % and that of instrumental delivery was 3.5 %. Oligohydramnios was associated with a higher rate of NICU admission (27.5 %). The most common complications noted were jaundice (9.8 %), birth asphyxia (4.9 %), meconium aspiration syndrome (3.4 %) and respiratory distress syndrome (1 %). Only 1 case of neonatal mortality was seen in this study.&#x0D; CONCLUSIONS&#x0D; Oligohydramnios adversely affects the maternal and perinatal outcome. It is associated with higher rates of induction, caesarean section, meconium-stained amniotic fluid, low APGAR scores, fetal distress and perinatal morbidity and mortality. However, the outcome can be improved by good antepartum and intrapartum monitoring and neonatal care.

Health And Child Development Risk Conditions: An Analysis Of High Risk Children In A Specialized Care Outpatient Clinic

Objective: To describe the clinical and epidemiological characteristics of children seen at a high-risk outpatient clinic, report the reasons for referral to the service, the outcomes, and elucidate the importance of specialized care for children at risk provided by public health in Brazil. Method: A descriptive, quantitative, cross-sectional retrospective study that identified the clinical-epidemiological characteristics of children under 12 months of age who started care between January/2017 and December/2018 in a specialized outpatient clinic for high-risk children. Data were collected from electronic medical records and analyzed using Microsoft Excel 2013, while for statistical tests of association, calculation of the odds ratio and confidence interval (95%) the software RStudio (1.4.1103) was used. Results: Of the 246 children seen, 53.66% were male, 76.42% Caucasian, 33.62% premature, 54.73% had low/insufficient weight. At the first consultation 79.67% were less than six months old and 58.54% were eutrophic. The main reasons for referral were prematurity (26.89%), suspected congenital infection (15.53%) and nutritional/gastrointestinal disorders (14.77%). Syphilis stood out among congenital infections with 63.41%. As for the outcome, 62.28% were lost to follow-up, and the use of breast milk was a protective factor for this outcome (OR:0.49; CI:0.26-0.92; p=0.03). Conclusions: The reasons for referral to the high-risk outpatient clinic, evidenced in this study, point to the importance of preventing prematurity, controlling congenital infections, and actions to strengthen the practice of breastfeeding in children under 6 months of age, since it has proven to be a protective factor against loss to follow-up in specialized services.