Test Of Independence Research Articles

Increased 1H-NMR metabolomics-based health score associates with declined cognitive performance and functional independence in older adults at risk of cardiovascular disease.

The 1-HMR metabolomics-based MetaboHealth score, comprised of 14 serum metabolic markers, associates with disease-specific mortality, but it is unclear whether the score also reflects cognitive changes and functional impairment. We aimed to assess the associations between the MetaboHealth score with cognitive function and functional decline in older adults at increased cardiovascular risk. A total of 5292 older adults free of dementia at baseline with mean age 75.3years (SD = 3.4) from the Prospective Study of Pravastatin in the Elderly (PROSPER). MetaboHealth score were measured at baseline, and cognitive function and functional independence were measured at baseline and every 3months during up to 2.5years follow-up. Cognitive function was assessed using the Stroop test (selective attention), the Letter Digit Coding test (LDCT) (processing speed), and the two versions of the Picture Learning test (delayed and immediate; memory). Two tests of functional independence were used: Barthel Index (BI) and instrumental activities at daily living (IADL). A higher MetaboHealth score was associated with worse cognitive function (in all domains) and with worse functional independence. For example, after full adjustments, a 1-SD higher MetaboHealth score was associated with 9.02s (95%CI 7.29, 10.75) slower performance on the Stroop test and 2.79 (2.21, 3.26) less digits coded on the LDCT. During follow-up, 1-SD higher MetaboHealth score was associated with an additional decline of 0.53s (0.23, 0.83) on the Stroop test and - 0.08 (- 0.11, - 0.06) points on the IADL. Metabolic disturbance, as reflected by an increased metabolomics-based health score, may mark future cognitive and functional decline.

Multidrug-resistant tuberculosis treatment outcomes and associated factors at Yirgalem General Hospital, Sidama Region, South Ethiopia: a retrospective cohort study

BackgroundThe spread of multidrug-resistant tuberculosis (MDR-TB) poses a significant challenge to TB control efforts. This study evaluated the treatment outcomes and associated factors among patients receiving treatment for MDR-TB in southern Ethiopia.MethodsA retrospective follow-up study covering ten years, from 2014 to 2023, analyzed the records of confirmed cases of pulmonary TB admitted to Yirgalem General Hospital, an MDR-TB treatment initiation center in the Sidama Region. To compare the successful treatment outcomes across the years, a chi-square test of independence was conducted. Bivariate and multivariable logistic regression models were used to identify factors associated with treatment outcomes for MDR-TB.ResultsOut of 276 confirmed MDR-TB cases, 4(1.4%) were diagnosed with resistance to second-line drugs (SLDs). Overall, 138 patients achieved favourable treatment outcomes, resulting in a treatment success rate of 50.0% [95% CI 44.1–55.9%]. Among these 138 patients, 105(76.1%, 95 CI 68.7–83.5%) were cured, while 33(23.9%, 95 CI 16.5–31.3%) completed their treatment. The successful treatment outcomes varied significantly across the years, ranging from 3.6% in 2020 to 90% in 2021. The analysis indicated a statistically significant difference in treatment outcomes when considering data from 2014 to 2023 (χ2 = 44.539, p = 0.001). The proportion of patients with deaths, lost-to-follow-up (LTFU), treatment failures and not evaluated were 7.9% [95% CI 4.8–11.2%], 10.9% [95% CI 7.2–14.6%), 2.2% [95% CI 1.1–3.3%), and 28.9% [95% CI 23.7–34.2%] respectively. Individuals with a positive HIV status had significantly lower odds of a favorable treatment outcome [AOR = 0.628, 95% CI (0.479–0.824), p = 0.018]. Similarly, patients with a BMI of less than 18 are more likely to have unfavorable treatment outcomes compared to those with a BMI of 18 or higher [AOR = 2.353, 95% CI 1.404–3.942, p < 0.001].ConclusionThe study revealed a concerning 1.4% prevalence of additional resistance to SLDs. The 50% rate of unfavorable treatment among MDR-TB cases exceeds the target set by the WHO. A significant number of patients (10.9%) were LTFU, and the 28.9% categorized as ‘not evaluated’ is also concerning. Enhanced strategic interventions are needed to reduce such cases, and factors associated with poor treatment outcomes should receive greater attention. Future prospective studies can further explore the factors influencing improved treatment success.

The Impact of Innovative Transportation Services on Travel Behaviors: A Case Study of Istanbul

There has been a paradigm shift in urban mobility around the developments in information and communication technologies, zero emission targets to reduce transport-related emissions. Hence, traditional transportation services are replaced by sustainable, shared, smart, innovative mobility services. It is crucial to understand what extent these services, which are increasingly used in the cities and have potential to become a part of the main transportation system of the city rather than serving as an alternative mode of transportation, affect people's travel behaviors and daily activity preferences to be aware of the trends in urban mobility, passenger and freight mobility. By this study, new mobility services such as micromobility, car and ride sharing services used in Istanbul examined in the context of (1) their effect on travel behavior (2) the relationship between people's demographic, socioeconomic status and new transportation service use (3) the conditions where the adoption of these services are higher. In this study, survey was conducted with a sample of 404 people in Istanbul and the results were interpreted using both explanatory analysis methods and the chi-square independence test as a statistical method. As a result of the study, questions such as what is the relationship between the demographics, travel behaviors and the use of new mobility services, the effect of these services on the total trips, transportation modes replaced by them, in which situations they are preferred or not and under what conditions those who do not use this service can use them were answered

Navicular Drop Height Asymmetry as an Intrinsic Risk Factor for Lower Limb Injury in Male Recreational Athletes

Morphological and functional asymmetry of the lower limbs is a well-recognized factor contributing to musculoskeletal injuries among athletes across different levels. However, limited research exists on evaluating foot mobility asymmetry as a potential predictor of such injuries. This study aimed to (1) assess the frequency of foot mobility asymmetries among amateur athletes, (2) investigate the predictive value of foot mobility asymmetry (measured via navicular height drop) for injury risk, and (3) explore the relationship between foot type and injury occurrence. A cross-sectional sampling method was employed to select 45 physically active male amateur athletes (runners and team sports practitioners) from a university. Injury history was retrospectively recorded, and a modified navicular drop test was conducted to classify foot arch height. The predictive power of navicular height drop asymmetry was analyzed using ROC curves, and the relationship between foot type (neutral and defective combinations—pronated or supinated) and injury occurrence was examined using chi-square tests for independence. Multiple logistic regression was applied to calculate injury risk odds ratios across different foot type subgroups. The results revealed a significant frequency (51.1%) of participants with at least one defective foot, including 31.1% with one neutral and one defective foot and 20% with both feet defective. Navicular height drop asymmetry emerged as a valuable predictor of injuries, with a 36% asymmetry identified as the cut-off for increased injury risk (AUC = 0.832, 95% CI: 0.691–0.973, p &lt; 0.001). A significant relationship was found between foot type and injury occurrence. Only one out of 22 participants with neutral feet (4.55%) experienced an injury, compared to 9 out of 14 (64.29%) with one neutral and one defective foot and 5 out of 9 (55.56%) with both feet defective. These differences were statistically significant (χ2 = 16.24, p &lt; 0.001, Cramer’s V = 0.60). The odds ratio for injury risk was 37.8 (p = 0.016) for those with asymmetry (one neutral and one defective foot) and 26.3 (p = 0.102) for those with both feet defective, compared to participants with both feet neutral. In clinical practice, these findings suggest that routine screenings for physically active individuals should incorporate foot mobility asymmetry assessment. However, it is essential to integrate this factor with other risk indicators. For individuals exhibiting high asymmetry, general foot defect correction programs may be beneficial, but injury prevention strategies should adopt a more comprehensive approach, focusing on overall fitness and tailored interventions for high-risk individuals.

Quantization‐Based Latin Hypercube Sampling for Dependent Inputs With an Application to Sensitivity Analysis of Environmental Models

ABSTRACTNumerical models are essential for comprehending intricate physical phenomena in different domains. To handle their complexity, sensitivity analysis, particularly screening is crucial for identifying influential input parameters. Kernel‐based methods, such as the Hilbert‐Schmidt Independence Criterion (HSIC), are valuable for analyzing dependencies between inputs and outputs. Implementing HSIC requires data from the original model, which leads to the need of efficient sampling strategies to limit the number of costly numerical simulations. While, for independent input variables, existing sampling methods like Latin Hypercube Sampling (LHS) are effective in estimating HSIC with reduced variance, incorporating dependence is challenging. This article introduces a novel LHS variant, quantization‐based LHS (QLHS), which leverages Voronoi vector quantization to address dependent inputs. The method provides good coverage of the range of variations in the input variables. The article outlines expectation estimators based on QLHS in various dependency settings, demonstrating their unbiasedness. The method is applied to several models of growing complexities, first on simple examples to illustrate the theory, then on more complex environmental hydrological models, when the dependence is known or not, and with more and more interactive processes and factors. The last application is on the digital twin of a French vineyard catchment (Beaujolais region) to design a vegetative filter strip and reduce water, sediment, and pesticide transfers from the fields to the river. QLHS is used to compute HSIC measures and independence tests, demonstrating its usefulness, especially in the context of complex models.

Selecting CMIP6 global climate models (GCMs) for Coordinated Regional Climate Downscaling Experiment (CORDEX) dynamical downscaling over Southeast Asia using a standardised benchmarking framework

Abstract. Downscaling global climate models (GCMs) provides crucial high-resolution data needed for informed decision-making at regional scales. However, there is no uniform approach to select the most suitable GCMs. Over Southeast Asia (SEA), observations are sparse and have large uncertainties, complicating GCM selection especially for rainfall. To guide this selection, we apply a standardised benchmarking framework to select CMIP6 GCMs for dynamical downscaling over SEA, addressing current observational limitations. This framework identifies fit-for-purpose models through a two-step process: (a) selecting models that meet minimum performance requirements in simulating the fundamental characteristics of rainfall (e.g. bias, spatial pattern, annual cycle and trend) and (b) selecting models from (a) to further assess whether key precipitation drivers (monsoon) and teleconnections from modes of variability are captured, i.e. the El Niño–Southern Oscillation (ENSO) and Indian Ocean Dipole (IOD). GCMs generally exhibit wet biases, particularly over the complex terrain of the Maritime Continent. Evaluations from the first step identify 19 out of 32 GCMs that meet our minimum performance expectations in simulating rainfall. These models also consistently capture atmospheric circulations and teleconnections with modes of variability over the region but overestimate their strength. Ultimately, we identify eight GCMs meeting our performance expectations. There are obvious, high-performing GCMs from allied modelling groups, highlighting the dependency of the subset of models identified from the framework. Therefore, further tests of model independence, data availability and future climate change spread are conducted, resulting in a final subset of two independent models that align with our a priori expectations for downscaling over the Coordinated Regional Climate Downscaling Experiment –Southeast Asia (CORDEX-SEA).

Colonization of Bone Flaps by Cutibacterium acnes During Decompressive Craniectomies for Traumatic and Non-traumatic Indications: A Retrospective Observational Study.

Background Cutibacterium acnes (C. acnes) is one of the most common bacteria in the human skin microbiota. Due to it generally requiring special culturing techniques, it was generally not routinely included in culture. However, recent laboratory automation advancements have allowed C. acnes to be a routinely tested pathogen. Though this could improve outcomes by detecting a virulent pathogen early, it has raised concerns about potential false positives leading to increased costs and medical risks. This study aims to analyze the C. acnes colonization rates in traumatic craniectomies and compare it to non-traumatic craniectomies, the former including risk factors due to penetrations and the latter being conceptually similar to a craniotomy with a lack thereof. This would help establish a baseline rate to understand the pathogen's implications better. Methodology We analyzed the electronic health records of 124 patients who underwent a craniectomy followed by a cranioplasty at Inova Health System from January 1, 2018, to January 1, 2023. The following categories of data were recorded for each patient: patient descriptors, comprehensive surgical timelines and outcomes, and bone flap viability and microbial colonization assessment. The chi-squared tests of independence and Wilcoxon signed-rank tests were used to assess statistical significance between groups in the indications underlying surgery (traumatic vs. non-traumatic) with C. acnes colonization, flap status (reimplanted vs. discarded), hospital length of stay (LOS), and unexpected 30-day readmission. Results Traumatic (67%) and non-traumatic (33%) craniectomies were compared. There was no significant association between the two craniectomy etiologies in terms of C. acnes colonization (40% vs. 26.5%, p=0.19), flap discardment (40% vs. 24%, p=0.12), or readmission rates (20% vs. 9.6%, p=0.18). However, a significant association was found between C. acnes colonization and LOS during the index craniectomy procedure (24.8 vs. 25.9 days, p=0.049), indicating that colonization may influence LOS. No significant association was found between the type of cranial surgery and LOS (p=0.83), suggesting other factors may play a more crucial role in determining LOS. The findings highlight the need to consider the impact of C. acnes colonization on surgical outcomes and hospital protocols. Conclusion Our findings illustrate that there is no significant difference between C. acnes colonization in traumatic and non-traumatic craniectomies; therefore, C. acnes can be expected to be cultured at a baseline level regardless of the etiology. Furthermore, there was no association with surgical indication and flap status, LOS, and readmission rates. However, a significant association was found between C. acnes status and LOS, indicating the increased complexity of care associated with the pathogen's detection. These findings support the protocol of deferring C. acnes culturing unless specific concerns are found.

K-depth tests for testing simultaneously independence and other model assumptions in time series

We consider the recently developed K-depth tests for testing simultaneously independence and other model assumptions for univariate time series with a potentially related d-dimensional process of explanatory variables. Since these tests are based only on signs of residuals, they are easy to comprehend. They can be used in a full version and in a simplified version. While former investigations already showed that the full version is appropriate for testing model assumptions, we concentrate here on either testing the independence assumption on its own or on simultaneously testing independence and model assumptions with both types of tests. In an extensive simulation study, we compare these tests with several known independence test such as the runs test, the Durbin-Watson test, and the Von-Neumann-Rank-Ratio test. Finally, we demonstrate how the K-depth tests can be used for improved modeling of crack width time series depending on temperature measurements in a bridge monitoring.

Model-Based Causal Feature Selection for General Response Types

Discovering causal relationships from observational data is a fundamental yet challenging task. Invariant causal prediction (ICP, Peters, Bühlmann, and Meinshausen) is a method for causal feature selection which requires data from heterogeneous settings and exploits that causal models are invariant. ICP has been extended to general additive noise models and to nonparametric settings using conditional independence tests. However, the latter often suffer from low power (or poor Type I error control) and additive noise models are not suitable for applications in which the response is not measured on a continuous scale, but reflects categories or counts. Here, we develop transformation-model (tram) based ICP, allowing for continuous, categorical, count-type, and uninformatively censored responses (these model classes, generally, do not allow for identifiability when there is no exogenous heterogeneity). As an invariance test, we propose tram-GCM based on the expected conditional covariance between environments and score residuals with uniform asymptotic level guarantees. For the special case of linear shift trams, we also consider tram-Wald, which tests invariance based on the Wald statistic. We provide an open-source R package tramicp and evaluate our approach on simulated data and in a case study investigating causal features of survival in critically ill patients. Supplementary materials for this article are available online, including a standardized description of the materials available for reproducing the work.

Employee training as a tool to achieve goals depending on SME’s type

Employee training is one of the most important areas of human resources management and is key to the career development of employees. The aim is to determine how the sector and size of small and medium enterprises (SMEs) influence the corporate education of employees. Data were collected using a questionnaire distributed among 610 SMEs in the Czech Republic; valid answers were obtained from 581 enterprises. The respondents mainly include managers responsible for employee education or other representatives with relevant experience. This database was tested using statistical methods, including Pearson’s chi-squared test of independence, Kolmogorov-Smirnov normality test, and Kruskal-Wallis test. The results indicate that enterprises with 150-250 employees try to provide them with training that would correspond to the so-called work-life balance. Enterprises with 50-149 employees often have a larger budget and resources to invest in corporate training. The results show that in terms of SME size, employee training is most commonly applied by medium-sized enterprises. It is confirmed that the bigger the enterprise, the more frequently its employees are trained. On the other hand, the sector does not significantly influence employee training. Slightly above-average use of employee training is observed in the transport and logistics sectors, but the difference is not substantial. AcknowledgmentThis paper was supported by the project IVSUPS2303 “Current topics of the social pillar of CSR related to acquiring and developing human resources.”

A wrapper feature selection approach using Markov blankets

In feature selection, Markov Blanket (MB) based approaches have attracted considerable attention with most MB discovery algorithms being categorized as filter based techniques. Typically, the Conditional Independence (CI) test employed by such methods is different for different data types. In this article, we propose a novel Markov Blanket based wrapper feature selection method. The proposed approach employs Predictive Permutation Independence (PPI), a novel Conditional Independence (CI) test that allows it to work out-of-the-box for both classification and regression tasks on mixed data. PPI can work with any supervised algorithm to estimate the association of a feature with the target variable while also providing a measure of feature importance. The proposed approach also includes an optional MB aggregation step that can be used to find the optimal MB under non-faithful conditions. Our method11Implementation and experimental results are available at https://github.com/AnonymousMLSubmissions/PatternRecognitionSubmission. outperforms other MB discovery methods, in terms of F1-score, by 7% on average, over 3 large-scale BN datasets. It also outperforms state-of-the-art feature selection techniques on 13 real-world datasets.

A step toward the modern and sustainable agriculture: Evaluating the impact of information and communication technology on cereal production in China

AbstractAchieving food security has become a critical concern for many nations. China has also made significant efforts to ensure domestic food security. In order to provide an adequate food supply in the future, this research explores the effects of information and communication technology (ICT) on grain production. Pool Mean Group (PMG) method is used to estimate a panel dataset for 31 Chinese province administrative regions from 2005 to 2021. To ensure that the panel dataset is suitable for use with the PMG model, cross‐sectional independence tests, unit root tests, and co‐integration tests are performed. The empirical analysis shows that ICT boosts cereal crops yields over time. In particular, a 1% increase in fixed broadband users and cell phones boosts cereal production by 0.03% and 0.06%, respectively, in the long run. As a result, in order to increase yields, China must expand its use of ICT in agricultural production.

Meningkatkan Kemampuan Berpikir Kritis dan Kemandirian dengan Menggunakan Model PBL pada Materi Memperjuangkan Nilai-Nilai Kehidupan untuk Kelas XII IPA SMA Pax Patriae Tahun Ajaran 2024/2025

This Classroom Action Research (CAR) aims to improve the critical thinking skills and independence of 12th-grade students in Catholic Religious Education through the application of the Problem-Based Learning (PBL) model on the topic of advocating life values in society. Critical thinking skills and independence are essential for students to face the challenges of modern life and build a deeper understanding of the values from Scripture and the Catholic Church's teachings. The study was conducted in two cycles, where each cycle consisted of planning, implementation, observation, and reflection. The research was conducted on 23 12th grade students. Observation sheets, critical thinking, and independence tests were among the instruments used. The study's findings indicate that the PBL model significantly improves students' critical thinking and independence. Cycle I saw a moderate improvement, but Cycle II saw a significant increase in students' critical thinking and independence following adjustments. Students were able to connect the values of Scripture and Church teachings with real-life contexts and became more independent in completing assigned tasks. Thus, the Problem-Based Learning model is highly effective in enhancing students' critical thinking and independence in the topic of life values in society within Catholic Religious Education. The implementation of PBL can continue to be developed to improve the quality of learning and students' life skills.

Independence test via mutual information in the presence of measurement errors

Independence test via mutual information in the presence of measurement errors

Detection and Characterization of Online Substance Use Discussions Among Gamers: Qualitative Retrospective Analysis of Reddit r/StopGaming Data.

Video games have rapidly become mainstream in recent decades, with over half of the US population involved in some form of digital gaming. However, concerns regarding the potential harms of excessive, disordered gaming have also risen. Internet gaming disorder (IGD) has been proposed as a tentative psychiatric disorder that requires further study by the American Psychological Association (APA) and is recognized as a behavioral addiction by the World Health Organization. Substance use among gamers has also become a concern, with caffeinated or energy drinks and prescription stimulants commonly used for performance enhancement. This study aimed to identify substance use patterns and health-related concerns among gamers among a population of Reddit users. We used the public streaming Reddit application programming interface to collect and analyze all posts from the popular subreddit, r/StopGaming. From this corpus of posts, we filtered the dataset for keywords associated with common substances that may be used to enhance gaming performance. We then applied an inductive coding approach to characterize substance use behaviors, gaming genres, and physical and mental health concerns. Potential disordered gaming behavior was also identified using the tentative IGD guidelines proposed by the APA. A chi-square test of independence was used to assess the association between gaming disorder and substance use characteristics, and multivariable logistic regression was used to analyze whether mental health discussion or the mention of any substance with sufficient sample size was significantly associated with IGD. In total, 10,551 posts were collected from Reddit from June 2017 to December 2022. After filtering the dataset for substance-related keywords, 1057 were included for further analysis, of which 286 mentioned both gaming and the use of ≥1 substances. Among the 286 posts that discussed both gaming and substance use, the most mentioned substances were alcohol (n=132), cannabis (n=104), and nicotine (n=48), while the most mentioned genres were role-playing games (n=120), shooters (n=90), and multiplayer online battle arenas (n=43). Self-reported behavior that aligned with the tentative guidelines for IGD was identified in 66.8% (191/286) posts. More than half, 62.9% (180/286) of the posts, discussed a health issue, with the majority (n=144) cited mental health concerns. Common mental health concerns discussed were depression and anxiety. There was a significant association between IGD and substance use (P<.001; chi-square test), and there were significantly increased odds of IGD among those who self-reported substance use (odds ratio 2.29, P<.001) and those who discussed mental health (odds ratio 1.64, P<.03). As gaming increasingly becomes highly prevalent among various age groups and demographics, a better understanding of the interplay and convergence among disordered gaming, substance use, and negative health impacts can inform the development of interventions to mitigate risks and promote healthier gaming habits.

A conditional distribution function-based measure for independence and [formula omitted]-sample tests in multivariate data

We introduce a new index to measure the degree of dependence and test for independence between two random vectors. The index is obtained by generalizing the Cramér-von Mises distances between the conditional and marginal distribution functions via the projection-averaging technique. If one of the random vectors is categorical with K categories, we propose slicing estimators to estimate our index. We conduct an asymptotic analysis for the slicing estimators, considering both situations where K is fixed and where K is allowed to increase with the sample size. When both random vectors are continuous, we introduce a kernel regression estimator for the proposed index, demonstrating that its asymptotic null distribution follows a normal distribution and conducting a local power analysis for the kernel estimator-based independence test. The proposed tests are studied via simulation, with a real data application presented to illustrate our methods.

Australian radiographers’ digital era practice in selecting the image receptor angle for female body habitus for the mediolateral oblique view of the breast

IntroductionCorrect alignment of the image receptor (IR) in mammography for the mediolateral oblique (MLO) view of the breast is fundamental to enable the maximum inclusion of breast tissue. This study aims to assess Australian radiographers' knowledge and digital era practice in selecting the IR angle for female body habitus in the MLO view of the breast. MethodsAn online survey was distributed to all members of the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) through their electronic newsletter and via direct email to radiographers holding the Certificate of Mammographic Practice (CMP). Descriptive analysis was undertaken, and a Pearson's chi-squared test of independence was used to compare associations between academic qualification and IR selection data. A value of p < 0.05 was deemed statistically significant. ResultsA total of 107 valid surveys were returned; 67.3 % reported using the posterior lateral margin to select the IR angle. For linear body habitus, 44.9 % reported using 50°; for all other body habitus, participants most commonly used 45° (59.1 %); 85.1 % used a range of angles between 40 and 55°; 16.8 % recognised the link between correct IR angle selection and breast tissue inclusion. ConclusionThe range of angles used in practice has reduced in the digital era; the frequency of the use of 45° across all body habitus may reflect tube angle movement automation. Few radiographers recognised the important link between correct selection of IR angle and breast tissue inclusion on the image. Implications for practiceUnderstanding of the link between IR angle selection and image quality enhances current practice in the digital era to maximise the inclusion of breast tissue and minimise the potential of missed breast cancer.

Pattern of Nonmotor Symptoms in Patients with Idiopathic Parkinson's Disease in a Tertiary Care Hospital of Rural Eastern India.

Idiopathic Parkinson's disease (IPD) is associated with a spectrum of nonmotor symptoms (NMS) that contribute as much to the burden of the disease as the more obvious motor abnormalities. There is a paucity of literature determining the association between NMS and the severity of IPD, especially in rural eastern parts of India. This study explores the frequency of NMS in patients with IPD and determines the association between NMS and the severity of IPD. A cross-sectional observational study involving 65 serially enrolled IPD patients (diagnosed as per United Kingdom Parkinson's Disease Society Brain Bank Clinical Diagnostic Criteria) was conducted over a period of 18 months. The patients were evaluated for disease severity as per the Hoehn and Yahr scale (original) and were subsequently evaluated with a predesigned and validated Parkinson's Disease Non-Motor Symptoms Questionnaire. Pearson's Chi-squared test for independence of attributes or Fisher's exact test was used for comparison of categorical variables across the groups. Continuous variables were compared using a one-way analysis of variance (ANOVA) test. The most common presenting NMS of IPD was low mood (n = 61; 93.85%), followed by apathy (n = 59; 90.77%), impaired concentration (n = 58; 89.23%), restless leg (n = 54; 83.08%), and tenesmus (n = 54; 83.08%). A majority of the neuropsychiatric symptoms, autonomic dysfunctions, sleep abnormalities, gastrointestinal manifestations, and sensory abnormalities individually showed a statistically significant relation with the severity of IPD. Common presenting NMS include neuropsychiatric manifestations, autonomic symptoms, sleep-related symptoms, and gastrointestinal manifestations. Most of the NMS are significantly related to disease severity.

Assessment of Perceived Diversity and Inclusivity of Athletic Training Textbooks

Context Adopting diverse perspectives is increasingly important for athletic trainers (ATs) to provide care that fosters inclusion for all patients. Despite the NATA’s commitment to diversity, NATA membership remains approximately 80% White. Additionally, although ATs work with people from ethnically diverse backgrounds with unique body expression and body-size characteristics, it is unknown whether athletic training textbooks represent this diversity. Objective To investigate diversity characteristics of images including patients and clinicians within athletic training textbooks. Design Cross-sectional study. Patients or Other Participants Twenty percent (n = 15) of athletic training and health care textbooks included on the Board of Certification reference list were selected. Twenty percent of chapters from those textbooks were then randomly selected for inclusion. Main Outcome Measure(s) Descriptive statistics were calculated for person (athlete, nonathlete, clinician), setting (athletic venue, clinic, physician office, other), and demographic categories (perceived skin tone, race/ethnicity, age, gender, body size, body expression). Chi-square tests of goodness of fit were performed to determine significant differences between categories, and χ2 tests of independence were performed to determine differences across person type and category and across textbook domain and category. Results One thousand six hundred sixty-seven people were assessed from 1190 images. Images depicted statistically more persons with light skin tone (86%) assumed to be White (86%), young adults (75%) of average weight (95%), with no body expression diversity (95%). There were no major differences in subject characteristic majorities across person type or textbook domain. Conclusions Like other health care professions, a lack of image diversity was demonstrated within athletic training textbooks. To better recruit diverse students to the athletic training profession, and to prepare professional students to provide culturally competent and patient-centered care, these resources should better represent the diversity of ATs and their patients.

Who breaks their hip? A decade of traumatic hip fracture data

Aims & objectivesHip fractures lead to significant morbidity, mortality, and healthcare costs, particularly in elderly populations. Understanding the mechanisms underlying these fractures is crucial for developing targeted prevention strategies and counseling patients. MethodsThe National Electronic Injury Surveillance System (NEISS) was utilized to identify a cohort of 25,068 hip fractures from 2013 to 2022. The inclusion criteria mandated classification as a lower trunk fracture and explicit mention of hip fracture in the narrative. Patient age, race, sex, incident location, the time of year, and associated consumer products were compared using 95% confidence intervals and Chi-Squared tests of independence. ResultsA total of 25,068 hip fracture patients were included in this study. Females were more likely to fracture their hip (P < .001) representing 68.4% (95% CI 67.8%–69.0%) of all fractures. Patients were most likely to injure themselves at home (P < .001), accounting for 62.0 % (95% CI 61.4%–62.6%) of fractures. Falls to the floor represented 36.0 % (95% CI 35.4%–36.6%) of fractures, while fractures related to beds, stairs, and chairs emerged as other prevalent mechanisms at 11.2% (95% CI 10.8%–11.6%), 7.9% (95% CI 7.5%–8.2%), and 5.4% (95% CI 5.1%–5.7%), respectively. In the 50–60 age group, stairs present a prominent risk, representing 12.4% (95% CI 10.6%–14.5%) of fractures. Younger individuals suffered fractures most commonly due to high energy activities, such as falls from ladders, bicycles, and stairs (P < .001). ConclusionWhile falls remain the chief cause of hip fractures, many of these injuries stem from overlooked mechanisms. The heightened risk associated with falls from beds and chairs in the elderly, stair-related injuries in middle-aged individuals, and high-force modalities in younger people, highlights the necessity for tailored preventive measures. Providers should counsel their patients on risk reduction measures within the home, while Medicare and other insurers must work to expand coverage for these same measures.