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Practical Statistics For Medical Research
... (Figs 2 and 3; also see detailed information on these entheses in the protocol). Following statistical recommendations for testing precision in entheseal 3D areas [26], repeatability was evaluated using the Lin's concordance correlation coefficient (Lin's CCC), which showed values of 0.95 or above, reflecting a strong level of repeatability and reproducibility [43,44]. Additionally, a series of paired t-tests found no significant differences (P > 0.05) between repetitions within the same observer (the author) and across observers. ...
... Finally, an analysis of covariance (ANCOVA) adjusting for body mass confirmed that the observed entheseal changes were not due to body size differences among birds. For all three analyses, the necessary statistical assumptions were met, including linearity (but no multicollinearity), absence of outliers (in the variables and the residuals), approximate normality of residuals, homogeneity of slopes, homoscedasticity per group, and homogeneity of variance-covariance matrices, in line with standard statistical recommendations [26,43,45,46]. Overall, these results confirm VERA 2.0's reliability in reconstructing activity in experimental settings, without necessarily needing size adjustment. ...
... To statistically support these findings, I additionally performed a MANOVA to compare between occupational trends in each case (males and females). Significant differences between occupational groups (P < 0.05) were found in both sexes (Table 3), while all assumptions for MANOVA were met [26,43,45,46]. Spearman's correlation tests were also conducted to evaluate the relationship between the observed surface irregularities and factors such as biological age and body size (using femoral head diameters [49]), finding no significant correlations (P > 0.05) in this well-documented sample [26]. ...
In archaeological sciences, the macroscopic morphology of distinct dry bone structures, such as tubercles, ridges, epicondyles, and fossae, is routinely used to infer habitual activity patterns in past human populations, extinct hominins, and other animals. This study introduces “Validated Entheses-based Reconstruction of Activity 2.0” (VERA 2.0), a new method for precisely quantifying 3D surface irregularities on enthesis-bearing bone structures. Building on VERA 1.0, first introduced by the same author in 2016 and later named in a 2021 literature review, VERA 2.0 enhances the previous approach by incorporating a semi-automated image segmentation technique that reduces manual input while maintaining accuracy. The method involves selecting a predefined broad bone surface region, after which an algorithm automatically detects subtle surface irregularities (see example video in the step-by-step protocol at dx.doi.org/10.17504/protocols.io.5jyl82z8dl2w/v3). Validation analyses confirm VERA 2.0’s precision and reliability for activity reconstruction through intra- and inter-observer repeatability tests, experimental research comparing activity and control laboratory specimens, and analyses of historical human skeletons with extensively detailed long-term occupational data. Moreover, while this anthropological 3D measuring protocol paper cannot and does not aim to analyze the anatomical and histological nature of bone surface irregularities, preliminary anatomical dissection and virtual analysis of a cadaveric thumb enthesis suggest a possible association with attaching muscles and ligaments. Future anatomical and histological research aiming to explore soft-hard tissue interactions could clarify how these identified surface changes exactly relate to the attaching tissues. Overall, VERA 2.0 provides a robust, efficient quantitative tool for inferring activity patterns from skeletal remains, with applications across paleontological, paleoanthropological, and bioarchaeological contexts.
... Additionally, discordant outcomes between cardiologists were resolved either by acceptance of an outcome if no alternative outcome was offered, or by a third cardiologist independent review for tie-breaking. The κ statistic and associated p-value were generated for each POCUS variable, using the following ranges for interpretation [17]: ...
... Hospitalist and cardiologist agreement on POCUS findings is summarized in Table 2. Using previously described definitions [17], agreement was almost perfect for LVSF (0.84, 0.71-0.98 ...
Background: Prolonged inpatient length of stay (LOS) is associated with worse clinical outcomes and increased healthcare costs. Transthoracic echocardiography (TTE) is commonly utilized in cardiac evaluation of hospital inpatients but is associated with prolonged LOS and may not always be necessary. Point of care ultrasound (POCUS) may help reduce the need for inpatient TTEs. Objective: We aimed to demonstrate the feasibility of a POCUS-guided TTE triage protocol and estimate its impact on inpatient TTE utilization. Methods: From September to December 2023, inpatient clinicians and participating patients at a large academic institution were surveyed about their perspectives and experiences with POCUS. Cardiac POCUS exams were performed and interpreted for pre-specified clinical indications by POCUS-trained hospitalists, then reviewed independently by at least two board-certified cardiologists. Interpretations were compared using pairwise agreement analysis (kappa (κ) statistic). Finally, hospitalists and cardiologists independently offered their TTE triage recommendation, categorized as either inpatient, outpatient, or cancellation. Triage agreement between the two groups was reported as a percentage of overall cases. Results: Clinicians and patients were receptive to integrating POCUS exams into clinical care. Ninety POCUS exams were completed during the intervention period, on average 22 hours before TTE. Hospitalist and cardiologist agreement was moderate to very good (0.57-0.99) for specific cardiac findings. The hospitalist and at least one cardiologist agreed that 59 (66%) of 90 exams performed within the triage pathway could result in deferral or cancellation of inpatient TTE. Conclusions: A POCUS-guided TTE triage protocol can reduce low-value inpatient TTE use, potentially expediting necessary TTEs and reducing TTE backlog.
... The mean (M) ± standard deviation (SD) of each measurement point was calculated, and a two-tailed test was used to obtain the pvalue [21]. Statistical significance was set at a p-value < 0.05, following standard practice for experimental validation in lighting optimization studies [29]. Table 3 shows the illuminance values of each measurement point before and after optimization. ...
... The mean (M) ± standard deviation (SD) of each measurement point was calculated, and a two-tailed test was used to obtain the p-value [21]. Statistical significance was set at a p-value < 0.05, following standard practice for experimental validation in lighting optimization studies [29]. Table 3 shows the illuminance values of each measurement point before and after optimization. ...
Effective natural lighting in university library reading areas significantly influences users’ visual comfort, task performance, and energy efficiency. However, existing library lighting designs often exhibit problems such as uneven illumination, excessive glare, and underutilization of natural daylight. To address these challenges, this study proposes a multi-objective optimization framework for library lighting design based on the NSGA-II algorithm. The framework targets the following three key objectives: improving illuminance uniformity, enhancing visual comfort, and reducing lighting energy consumption. The optimization process incorporates four critical visual comfort parameters—desktop illuminance, correlated color temperature, background reflectance, and screen luminance—whose weights were determined using the analytic hierarchy process (AHP) with input from domain experts. A parametric building information model (BIM) was developed in Revit, and lighting simulations were conducted in DIALux Evo to evaluate different design alternatives. Experimental validation was carried out in an actual library setting, with illuminance data collected from five representative measurement points. The results showed that after optimization, lighting uniformity improved from less than 0.1 to 0.6–0.75, glare values (UGR) remained below 22, and daylight area coverage increased by 25%. Moreover, lighting energy consumption was reduced by approximately 20%. Statistical analysis confirmed the significance of the improvements (p < 0.001). This study provides a systematic and reproducible method for optimizing natural lighting in educational spaces and offers practical guidance for energy-efficient and user-centered library design.
... All scores in these selected matches were observed and recorded by a table tennis performance analyst with over ten years of experience with a national table tennis team. The consistency was rated as "very good" [23] with a coefficient of 1. Given the high agreement, an intra-rater reliability test was unnecessary. ...
... Both variables significantly deviated from normal distribution (Score Relevance: D = 0.100, p = 0.005; SWP: D = 0.204, p < .001). Although the ztest was employed to evaluate deviations between OWP and SWP under the standard approximation criterion, Spearman rank correlation (ρ, Equation (7), p < 0.05) was selected to evaluate the monotonic relationship between score relevance and SWP due to its non-parametric nature and robustness to non-normality [23]. This approach ensures validity across diverse data conditions. ...
The score is an indispensable element in competitive sports, playing a crucial role in determining the outcome of a match. However, the importance of scores in table tennis remains unexplored, as the hundreds of possible score scenarios in a single set make it especially challenging to assess their significance scientifically. This study is the first attempt to quantify the relevance of all possible scores in table tennis matches through probabilistic computing and empirical verification. Depending on the overall winning probability, relevance values were determined for the 121 possible scores. An extensive dataset consisting of 1,364 matches and 103,772 individual scores from top-level table tennis was examined to test the empirical winning probabilities of each score. The results highlight a significant correlation between the theoretical score relevance and players’ empirical winning probabilities. Winners perform better at more relevant scores, such as close scores or crunch time, with this trend being more pronounced among male players. Z-tests were used to identify scores with positive or negative deviations from the average scoring rate. Individual players show considerable variation in scoring performance across different score situations. These findings provide significant implications for players’ training and competition. The approach presented in this study can also be applied to other scoring games and sports.
... Quá trình thu thập dữ liệu được thực hiện bởi các bác sĩ chuyên khoa với kinh nghiệm chuyên môn trong siêu âm tuyến giáp. Dữ liệu sau đó được xử lý và phân tích bằng các phần mềm thống kê, sử dụng các chỉ số mô tả (trung bình, độ lệch chuẩn, tỉ lệ phần trăm) [6]. ...
... Corticosteroid trước sinh giúp giảm nguy cơ suy hô hấp ở trẻ, nhưng điều quan trọng là phải kéo dài thai kỳ đủ lâu để thuốc có tác dụng hoặc để chuyển thai phụ đến bệnh viện có điều kiện chăm sóc tốt hơn. Atosiban, một thuốc đối kháng oxytocin, được ứng dụng nhằm giảm cơn co tử cung và kéo dài thời gian thai kỳ [6]. ...
Đặt vấn đề: Bệnh lý tuyến giáp dạng nốt đã trở thành một trong những rối loạn nội tiết phổ biến nhất, với tỷ lệ mắc bệnh ngày càng tăng trên toàn thế giới. Siêu âm đóng vai trò then chốt trong việc phát hiện sớm và phân loại nguy cơ của các nhân giáp. Nghiên cứu này nhằm mô tả các đặc điểm siêu âm của nhân giáp và áp dụng hệ thống phân loại TIRADS để đánh giá các tổn thương dạng nốt, từ đó hướng dẫn chỉ định chọc tế bào nhỏ (FNA) xét nghiệm tế bào học ở bệnh nhân người lớn tại tỉnh An Giang. Đối tượng, phương pháp: Một nghiên cứu cắt ngang được tiến hành trên 441 bệnh nhân người lớn (tuổi trung bình 53,5 ± 12,7 năm, phạm vi từ 16 đến 94 tuổi) có nhân giáp được phát hiện qua siêu âm tuyến giáp. Nghiên cứu đánh giá các thông số siêu âm khác nhau bao gồm vị trí của nhân (theo thuỳ tuyến giáp, vị trí trong thuỳ và mối quan hệ với vỏ tuyến), kích thước (chiều cao, chiều rộng và tỉ lệ chiều cao/chiều rộng), thành phần (đặc, hỗn hợp, nang), độ hồi âm, đường bờ và các dấu hiệu vôi hoá. Dựa trên các thông số này, các nhân giáp được phân loại theo hệ thống ACR-TIRADS 2017. Kết quả: Đa số các nhân giáp cho thấy hình dạng “chiều cao ≤ chiều rộng”, gợi ý đặc điểm có tính chất lành tính. Nhóm TIRADS III là nhóm phổ biến nhất chiếm 40,8%, tiếp theo là các nhóm TIRADS I và II chiếm 27,7%, trong khi 31,5% các nhân giáp rơi vào nhóm nguy cơ cao (TIRADS IV và V), từ đó cần chỉ định FNA để đánh giá tế bào học. Kết luận: Siêu âm là một công cụ vô giá, không xâm lấn trong việc sàng lọc bệnh lý tuyến giáp dạng nốt. Việc tích hợp các đặc điểm siêu âm chi tiết và hệ thống phân loại TIRADS góp phần vào việc phân loại nguy cơ chính xác và tối ưu hoá việc lựa chọn các nhân giáp để tiến hành FNA. Những phát hiện này hỗ trợ vai trò của siêu âm trong việc cải thiện độ chính xác chẩn đoán và hướng dẫn quản lý lâm sàng, từ đó giảm nguy cơ bỏ sót các nhân giáp có khả năng ác tính và nâng cao chất lượng chăm sóc bệnh nhân.
... The data from the evaluation of comic strips were analyzed using inter-rater agreement (IRA) to evaluate the consistency among raters when assessing the quality of the comic strips. The inter-rater agreement ensures the reliability of ratings across multiple evaluators (Altman, 1991). The test data analysis results indicated that the instrument had high reliability and validity, demonstrating its suitability for assessing the students' learning. ...
... The results were then evaluated using the inter-rater agreement (Altman, 1991). It is used to determine the degree to which evaluators give the same rating to an identical observable situation using the same rating scale. ...
This study’s primary purpose is to venture into developing and evaluating the effectiveness of comic-based materials for teaching physics in junior high school. A sequential developmental and evaluation design was employed, with 15 grade 10 students from Visayas State University Integrated High School participating. Bloom's taxonomy guided the creation of open-ended pre-test and post-test questions. The comic strips were developed, evaluated, and tested. Results indicated substantial inter-rater agreement on the comic strips’ effectiveness in learning (74%) and entertainment (77.14%). Statistical analysis revealed a significant difference between the performance of grade 10 students before and after exposure to the materials, demonstrating the effectiveness of the developed comic strips in enhancing student learning. Additionally, the study found that the developed comic strips are acceptable and can serve as an impactful teaching tool in physics education. The findings contribute to the evolving landscape of innovative instructional methods and hold implications for enhancing physics education.
... There was 95.6% agreement on eligibility between raters at this stage. The inter-rater reliability calculated between raters was deemed as 'almost perfect', Cohen's κ = 0.91 (Landis & Koch., 1977;Altman, 1999). EN and HR independently screened 20% of the full texts of eligible studies (n = 130). ...
... EN and HR independently screened 20% of the full texts of eligible studies (n = 130). There was an agreement of 82.3% on inclusion between raters, where the inter-rater reliability was classified as 'substantial', Cohen's κ = 0.65 (Landis & Koch., 1977;Altman, 1999). Any disagreements were resolved through discussion. ...
Background: Anxiety is the most common childhood mental health difficulty and is likely to persist into adulthood without intervention. The aims of this thesis were twofold, firstly to examine the role that peer victimisation plays in anxiety development and its maintenance, and then to evaluate a newly developed school staff intervention that intends to support and prevent the escalation of childhood anxiety difficulties.
Methods: A meta-analysis was conducted to examine the bidirectional effects between several types of peer victimisation and anxiety symptomatology among children and adolescents. The type of anxiety was also examined as a moderator to determine its influence. The empirical study explored the feasibility and acceptability of a newly developed psychoeducation intervention on childhood anxiety for school staff. The intervention was based on cognitive behavioural approaches and aimed to provide an overview of mild to moderate anxiety difficulties, along with strategies that could be implemented by staff within the school setting.
Results: 14 studies were included in the meta-analysis, and bidirectional effects were found between all types of peer victimisation and anxiety symptoms. Relational forms of peer victimisation were shown to predict social anxiety symptoms to a greater extent than anxiety symptoms more generally. It was also found that general anxiety symptoms moderated overt types of victimisations more so than social anxiety. The empirical study recruited 76 participants in total, who rated the intervention as engaging, useful and appropriate. Participants also reported an improvement in their knowledge of childhood anxiety and increased confidence in applying anxiety strategies in their work. Preliminary efficacy findings showed that school staff responses to children’s anxious behaviours were significantly different following the intervention, as they were more likely to adopt responses and strategies supported by cognitive behavioural theory.
Conclusions: Given the findings, it has been observed that peer victimisation and childhood anxiety in schools are closely linked. Psychoeducation interventions for school staff have been shown to be a feasible and acceptable method in increasing knowledge around anxiety and aids the application of strategies that may support anxious children and prevent the escalation of anxiety difficulties at school.
... Based on the above analysis, all normally distributed variables were entered into a subsequent discriminant function analysis as dependent variables and pass/fail on road test as grouping variable. By entering five variables, the requirement for performing a discriminant analysis, i.e. that the number of cases per outcome group should be at least five times as large as the numbers of examined dependent variables (28), was fulfilled. The discriminant analysis was significant (p 00.032), i.e. based on the criterion pass or fail. ...
... For the cognitive deficits/dementia group, though, the discriminant analysis could only classify substantially fewer than two out of three with the use of NorSDSA variables, and the percentage of correctly classified was the same as that of flipping a coin. Although related, sensitivity and specificity are, however, distinct and separate constructs (28), so the term correctly classified should not be interpreted as being equivalent to the predictive ability of the test. In the Lundberg et al. study (21), the discriminant analysis could classify a total of 78% of their participants with stroke, but specificity, i.e. correctly predicted pass participants, was superior to sensitivity, i.e. correctly predicted fail participants. ...
The use of the cognitive test battery Nordic Stroke Driver Screening Assessment (NorSDSA) has increased, sometimes as a stand-alone test to evaluate fitness to drive, also for non-stroke patients such as patients suffering from cognitive deficits/dementia, approaches that may be questioned. The objective of the study was to determine whether the NorSDSA could predict an on-road test result, for large sets of stroke (n=74) and cognitive deficits/dementia participants (n=116), respectively. The percentage of correctly classified was 62% for the stroke group and 50% for the cognitive deficits/dementia group. A discriminant analysis with pass/fail on the on-road test as grouping variable could classify 62% of the stroke participants and the cognitive deficit/dementia participants. Hence, the NorSDSA could not predict the outcome of the on-road test. Therefore, NorSDSA should not be used as a stand-alone test to determine the fitness to drive of individual participants. Also, its use with participants suffering from cognitive deficits/dementia appears to be less successful than for clients with stroke.
... Figure 6 shows scatterplots of components predicted by TBNN and TenMaven plotted against each other. and a value less than 0.2 represents poor agreement [71]. Figure 6 shows that high CCC values of 0.87 to 0.97 were calculated for the components, thereby confirming strong similarity. ...
Amid growing interest in machine learning, numerous data-driven models have recently been developed for Reynolds-averaged turbulence modelling. However, their results generally show that they do not give accurate predictions for test cases that have different flow phenomena to the training cases. As these models have begun being applied to practical cases typically seen in industry such as in cooling and nuclear, improving or incorporating metrics to measure their reliability has become an important matter. To this end, a novel data-driven approach that uses mean-variance estimation networks (MVENs) is proposed in the present work. MVENs enable efficient computation as a key advantage over other uncertainty quantification (UQ) methods - during model training with maximum likelihood estimation, and UQ with a single forward propagation. Furthermore, the predicted standard deviation is also shown to be an appropriate proxy variable for the error in the mean predictions, thereby providing error quantification (EQ) capabilities. The new tensor-basis neural network with MVEN integration was compared with its popular underlying data-driven model by evaluating them on two test cases: a separated flow and a secondary flow. In both cases, the proposed approach preserved the predictive accuracy of the underlying data-driven model, while efficiently providing reliability metrics in the form of UQ and EQ. For the purposes of turbulence modelling, this work demonstrates that the UQ and EQ mechanisms in MVENs enable risk-informed predictions to be made and therefore can be insightful reliability measures in more complex cases, such as those found in industry.
... Reliability tests are statistical tests that decide whether two evaluation methods agree when evaluating the same data. Confidence intervals provide a range around the sample mean where the true population mean is likely to fall [13,14]. Narrow confidence intervals indicate less uncertainty and can be used to assess whether repeated evaluations are consistently close. ...
Background
Artificial intelligence (AI) methods have established themselves in cardiovascular magnetic resonance (CMR) as automated quantification tools for ventricular volumes, function, and myocardial tissue characterization. Quality assurance approaches focus on measuring and controlling AI-expert differences but there is a need for tools that better communicate reliability and agreement. This study introduces the Verity plot, a novel statistical visualization that communicates the reliability of quantitative parameters (QP) with clear agreement criteria and descriptive statistics.
Methods
Tolerance ranges for the acceptability of the bias and variance of AI-expert differences were derived from intra- and interreader evaluations. AI-expert agreement was defined by bias confidence and variance tolerance intervals being within bias and variance tolerance ranges. A reliability plot was designed to communicate this statistical test for agreement. Verity plots merge reliability plots with density and a scatter plot to illustrate AI-expert differences. Their utility was compared against Correlation, Box and Bland-Altman plots.
Results
Bias and variance tolerance ranges were established for volume, function, and myocardial tissue characterization QPs. Verity plots provided insights into statstistcal properties, outlier detection, and parametric test assumptions, outperforming Correlation, Box and Bland-Altman plots. Additionally, they offered a framework for determining the acceptability of AI-expert bias and variance.
Conclusion
Verity plots offer markers for bias, variance, trends and outliers, in addition to deciding AI quantification acceptability. The plots were successfully applied to various AI methods in CMR and decisively communicated AI-expert agreement.
... indicates good agreement and 0.81-1.00 signifies very good agreement for categorical variables [34]. The chosen cut-off value of kappa agreement was 0.7 for this study [31,35], as we aimed to ensure a level of agreement that falls within the upper range of "moderate" agreement and approaches "strong" agreement. ...
Background
Chronic Kidney Disease of unknown aetiology (CKDu) is an emerging global health issue, yet research on risk factors is limited. This study addresses the gap by developing, validating, and evaluating the reliability of a questionnaire to assess the risk factors of CKDu.
Methods
A draft version of the questionnaire was prepared based on thorough literature review and experts’ discussion. Six experts validated it for content validity, incorporating items with an item level content validity index ≥ 0.78. The reliability of the developed questionnaire was assessed using the test–retest method. Sample size for reliability was calculated using a tool by ArifinWN; 2018. Subjects were recruited by purposive sampling after obtaining informed consent. Data were analysed for reliability using Statistical-Package for the Social-Sciences (SPSS) version 20.0.
Results
A 10-domain questionnaire was developed to assess CKDu risk factors. Six experts, comprised of three associate professors, two nephrologists and one renal pharmacist, validated the questionnaire. All items had an item level content validity index > 0.78, and the scale level content validity index of the questionnaire was 0.98. The questionnaire was administered to 165 subjects with a mean age of 50.65 ± 12.5 years, comprising 53.9% males. Most of them were labourers (38.2%) followed by farmers (21.8%). Among the risk factors, 57% of subjects were exposed to long hours of sunlight during work, 52.7% burned garbage waste and 46.1% were exposed to insecticides and pesticides. The questionnaire was re-administered after two weeks for reliability. All items under each domain fulfilled the minimum internal consistency of > 0.7.
Conclusions
The questionnaire demonstrated its validity and reliability in assessing the risk factors of CKDu among the subjects.
Graphical abstract
... standard error [SE] 0.02), characterized as "good" agreement according to Altman. 16 Table 3 shows measures of accuracy for the race and ethnicity categories with sample sizes large enough to derive reliable measures (i.e., Black or African American, Hispanic, White). ...
Introduction: Conventional race and ethnicity categories and analysis are reductive and prone to inaccuracy. Because race and ethnicity data validity is essential to health equity efforts, we measured the accuracy of race and ethnicity data in a pediatric electronic health record (EHR) to identify areas for improvement in data collection and use.
Methods: Patients and their caregivers reported patient race and ethnicity via in-person survey in four pediatric settings (inpatient, emergency room, urgent care, and primary care). Race and ethnicity data from the EHR were compared with survey data to calculate four measures of EHR data accuracy. The U.S. Census Bureau’s novel categorization scheme was used to analyze racial and ethnic identities “alone” and “in combination” with ≥1 other identity.
Results: Caregivers for 561 patients completed the survey; 116 patients aged ≥12 years completed a patient version. For consolidated race and ethnicity fields, overall concordance between survey and EHR was 74.6%. Concordance differed by race and ethnicity category when alone (Black or African American 96.1%, Hispanic 90.6%, and White 92.5%) and in combination with another category (Black or African American 93.9%, Hispanic 88.6%, and White 84.4%). The EHR had low accuracy for patients with multiple racial or ethnic identities (overall sensitivity 35%). Such patients’ identities were often oversimplified due to EHR design. Using “alone” and “in combination” analysis for race and ethnicity categories allowed all patient identities to be visible across categories, unlike in conventional race and ethnicity analysis.
Discussion: Identifying and eliminating health disparities depend on accurate race and ethnicity data, but current EHR design provides an unreliable data foundation for needed analyses. Conventional categorization used in race and ethnicity analysis is problematic, hiding identities in a reductive set of groupings. New approaches to validation, categorization, and analysis, as explored in this study, are urgently needed to advance health equity goals.
... Each item is answered using a three-point Likert scale (English: not at all, a little, a lot; Spanish: nada, poco, bastante) with scores 0, 1 or 2 points, respectively. The FROM-16 also has an established range of score banding descriptors [18]: no effect (0-1), small effect (2)(3)(4)(5)(6)(7)(8), moderate effect (9)(10)(11)(12)(13)(14)(15)(16), very large effect (17)(18)(19)(20)(21)(22)(23)(24)(25) and extremely large effect (26)(27)(28)(29)(30)(31)(32) on the QoL of FMs. ...
Background
The Family Reported Outcome Measure (FROM-16) is a generic tool to measure the impact of health conditions on patients’ family members and partners (FMs). This study aimed to translate, validate, evaluate, and implement FROM-16 in Ecuadorian Spanish and to assess the quality of life (QoL) of FMs of patients with skin diseases.
Methods
A cross-sectional study of patients and their FMs was performed using FROM-16 and a five-point-Likert scale to evaluate patient´s skin health by the FM and physician. Construct validity, confirmatory factor analysis and item response modelling of FROM-16 were assessed.
Results
195 FMs completed Ecuadorian FROM-16. Inter-item correlation was 0.40 and factor analysis confirmed the original two-factor model: Cronbach’s alpha 0.89, with factor loadings of 0.44–0.76. Mean age of patients = 41.8 ± 31.1 years and of FMs = 47.3 ± 7; diseases were classified as inflammatory ( n = 88) or non-inflammatory ( n = 107). The mean FROM-16 score was 12.5 ± 7 meaning “a moderate effect on QoL;” however, scores of 29.2% (57 of 195) indicated a “very large” ( n = 47) or “extremely large” ( n = 10) effect. Populations with the highest burden were adult children main carers, not cohabiting with their sick parents (mean FROM-16 = 17 ± 7.7, n = 8, p = 0.05 versus those cohabiting), and FM of patients with inflammatory conditions (mean = 14 ± 6.9, n = 88, p = 0.006 versus those with non-inflammatory dermatoses).
Conclusion
The FROM-16 is a succinct, well-structured two-domain instrument. It can be used to identify the largely overlooked impact on FMs of dermatology patients. Understanding this impact may contribute to better holistic care, inform physicians’ decisions, and encourage further support for families.
... Kappa values of < 0 are classified as no agreement (disagreement), 0.0-0.20 are classified as poor agreement; 0.21 -0.40 are classified as fair agreement; 0.41-0.60 are classified as moderate agreement and values of 0.61-0.80 classified as substantial agreement and 0.81-1.0 as an almost perfect agreement [37]. ...
Background: Asymptomatic malaria infections can serve as potential reservoirs for malaria transmission. The density of parasites contained in these infections range from microscopic to submicroscopic densities, making the accurate detection of asymptomatic parasite carriage highly dependent on the sensitivity of the tools used for the diagnosis. This study sought to evaluate the sensitivities of a variety of molecular and serological diagnostic tools at determining the prevalence of asymptomatic Plasmodium falciparum parasite infections in two communities with varying malaria parasite prevalence. Methods: Whole blood was collected from 194 afebrile participants aged between 6 and 70 years old living in a high (Obom) and a low (Asutsuare) malaria transmission setting of Ghana. Thick and thin blood smears, HRP2 based malaria rapid diagnostic test (RDT) and filter paper dried blood spots (DBS) were prepared from each blood sample. Genomic DNA was extracted from the remaining blood and used in Plasmodium specific photo-induced electron transfer poly-merase chain reaction (PET-PCR) and Nested PCR, whilst the HRP2 antigen content of the DBS was estimated using a bead immunoassay. A comparison of malaria parasite prevalence as determined by each method was performed. Results: Parasite prevalence in the high transmission site of Obom was estimated at 71.4%, 61.9%, 60%, 37.8% and 19.1% by Nested PCR, the HRP2 bead assay, PET-PCR, HRP2-RDT and microscopy respectively. Parasite prevalence in the low transmission site of Asutsuare was estimated at 50.1%, 11.2%, 5.6%, 0% and 2.2% by Nested PCR, the HRP2 bead assay, PET-PCR, RDT and microscopy, respectively. The diagnostic performance of Nested PCR, PET-PCR and the HRP2 bead assay was similar in Obom but in Asutsuare, Nested PCR had a significantly higher sensitivity than PET-PCR and the HRP2 bead assay, which had similar sensitivity. Conclusions: Nested PCR exhibited the highest sensitivity by identifying the highest prevalence of asymptomatic P. falciparum in both the high and low parasite prevalence settings. However, parasite prevalence estimated by the HRP2 bead assay and PET-PCR had the highest level of inter-rater agreement relative to all the other tools tested and have the advantage of requiring fewer processing steps relative to Nested PCR and producing quantitative results.
... This suggests that males may have slightly impaired renal function or higher protein metabolism compared to females, which could contribute to elevated urea levels. Other factors, such as dietary protein intake and muscle mass, might also explain these differences [15]. Females, on the other hand, generally have lower muscle mass and hence lower baseline creatinine levels [16]. ...
This study examines the impact of metformin therapy on fasting blood sugar (FBS), renal function (urea and creatinine), and liver function (GOT, GPT, and ALP) in male and female type 2 diabetic patients. FBS levels, while numerically lower in females (106.8 ± 9.7 mg/dL) compared to males (119.7 ± 19 mg/dL), showed no statistically significant difference (p = 0.561), suggesting similar glycemic control across genders. Renal function assessment revealed significantly higher urea levels in males (37.40 ± 9.91 mg/dL) than in females (29.37 ± 5.02 mg/dL, p = 0.041), potentially indicating subtle gender-specific differences in renal function or protein metabolism. Similarly, creatinine levels were significantly higher in males (0.950 ± 0.158 mg/dL) compared to females (0.73 ± 0.1636 mg/dL, p=0.007), suggesting the need for closer renal monitoring in male patients. Liver function parameters, including GOT, GPT, and ALP, revealed no statistically significant differences between genders. Although males exhibited higher mean values of GOT (40.0 ± 74.2 U/L) and GPT (31.0 ± 18.05 U/L) compared to females (20.3 ± 8.60 U/L and 18.37 ± 8.77 U/L, respectively), the differences did not reach significance (p = 0.415 and p = 0.062). ALP levels were nearly identical between genders (p = 0.696), indicating no gender-based variations in biliary or bone metabolism. In conclusion, metformin therapy demonstrates comparable efficacy and safety in managing glycemic and hepatic parameters in both genders. However, higher renal biomarkers in males highlight the importance of gender-specific monitoring. Further studies are recommended to explore these trends with larger cohorts.
... Qualitative variables were summarized using relative and absolute frequencies. (24) Data normality was assessed using descriptive statistics, histograms, box plots, and normal probability plots. Homoscedasticity was verified using Levene's test, and when this assumption was violated, the Brown-Forsythe correction was applied. ...
... 25,26 Data collection was performed systematically, and laboratory results were documented in a structured proforma . 27 All collected data were entered into Microsoft Excel 2014 and analyzed using SPSS version 20. 28 Statistical analysis involved double-checking for outlier values and ensuring accuracy. Categorical variables were summarized as proportions and percentages, while continuous variables were analyzed using means and standard deviations. ...
Background: Type 2 Diabetes Mellitus (T2DM) is associated with metabolic dysfunctions, including Dyslipidemia and liver enzyme abnormalities. Elevated fasting lipid profiles and liver enzymes have been linked to poor glycaemic control, increasing the risk of cardiovascular disease and non-alcoholic fatty liver disease (NAFLD). This study aims to investigate the correlation between glycaemic status, lipid abnormalities, and liver enzyme alterations in T2DM patients. Methods: A cross-sectional observational study was conducted at Dr. M.K. Shah Medical College & Research Centre and Smt. S.M.S. Multispecialty Hospital, Ahmedabad. A total of 125 T2DM patients were enrolled based on ADA guidelines. Demographic data, glycaemic parameters (FBS, PPBS, HbA1c), fasting lipid profile, and liver function tests (SGOT, SGPT) were analyzed. Data were statistically assessed using SPSS version 20, with a p value <0.05 considered significant. Results: A significant association was observed between poor glycaemic control (HbA1c>10%) and elevated liver enzymes, with a fivefold increase in SGOT and SGPT levels (p<0.05). Dyslipidemia was highly prevalent, with increased triglycerides and LDL levels strongly correlating with worsening glycaemic status. HDL levels showed no significant association. Conclusions: The findings emphasize the importance of monitoring liver function and lipid profiles in T2DM patients to prevent complications such as NAFLD and cardiovascular disease. Early detection of metabolic abnormalities can aid in risk stratification and targeted therapeutic interventions for better diabetes management.
... Of these, 100 records relating to 40 studies met the inclusion criteria. There was good and very good 24 inter-rater agreement for screening (k=0.69) and eligibility assessment (k=0.88), respectively. ...
Objective
To systematically review available data on the effects of heated tobacco products (HTPs) on biomarkers of potential harm (BoPH) and adverse events, including comparison to cigarettes, e-cigarettes and smoking abstinence.
Data sources
Web of Science, Scopus, MedRxiv, ClinicalTrials.gov, ICTRP database and HTP manufacturer libraries were searched from January 2010 to December 2024.
Study selection
Included studies were interventional clinical trials of any design that measured BoPH or adverse events in adults assigned a marketed HTP and another assigned either cigarettes, e-cigarettes or smoking abstinence.
Data extraction
Two reviewers independently extracted data into a predesigned form and assessed risk of bias using Cochrane’s Risk of Bias tool version 1.
Data synthesis
BoPH data were synthesised using effect direction plots. A random-effects model was used to calculate pooled risk ratios for adverse event data. 40 studies (10 independent, 29 industry-affiliated and 1 of unclear affiliation) were included. Only nine studies lasted longer than 5 days. 19 involved using the intervention just once. Risk of bias was high for 32 studies and unclear for 8. Data on 143 BoPH indicated short-term HTP use had mixed effects compared with cigarettes, e-cigarettes and smoking abstinence. The rate of adverse event reporting was not significantly different between HTP and any comparator group.
Conclusions
Despite a growing evidence base, significant limitations hinder interpretation of the data, which do not yet provide clear indication of harm or benefit, even compared with cigarettes. Longer, better quality studies independent of tobacco industry funding are needed to determine the health impacts of HTPs.
... 'reasonable' 0.21-0.4; and 'poor' ≤ 0.2 (Altman 1991). The dataset can be found as part of the Supplementary material. ...
Pain monitoring and diagnosis are crucial in seeking to improve animal welfare. This pilot study aimed to investigate the impact of long hours observation on pain assessment and the intra-observer reliability in piglets using video recording. A total of ten piglets, five from the control group (sham castration; pain-free) and five from the pain group (surgical castration; pain-state), were video-recorded immediately post-castration. The videos were randomised and assessed by an experienced observer using the Unesp-Botucatu Pig Composite Acute Pain Scale (UPAPS). The same ten videos were watched at three different times (trial initiation, half-way point, trial termination) with a four-week interval between them. During the four-week interval periods, the observer watched an additional 360 videos from another study to simulate long observation periods. For the pain group, no differences were found in the post hoc test for the UPAPS total score, and most of the UPAPS items. In contrast, for the control group, the UPAPS total score was higher at the half-way time-point, and no differences were found between UPAPS items. The intra-class correlation coefficient (ICC) inferred ‘very good’ intra-observer reliability for UPAPS total score in all time-points of assessment for both groups. Video-recorded pain assessment is a reliable method to assess pain in piglets given that observation duration for pain assessment had only minimal impact on the UPAPS total score, and no differences were found among most of the items. From an animal welfare standpoint, video-recorded pain assessment is a non-invasive method, that can be an additional asset for pain research.
... Subgroup analysis of age (i.e., 20-39, 40-59, and ≥60 years) was also analysed. According to Altman's suggestion, the agreement is interpreted as very weak (0.0-0.19), weak (0.2-0.39), moderate (0.4-0.59), strong (0.6-0.79), and very strong (0.8-1.0) [13]. A significance level was set at p < 0.05. ...
Background
Despite a practical guideline of 30-meter walking path during 6-minute walk test (6MWT), such walking course length is not possible in every clinical setting due to unavailable sufficient space. Existing evidence has investigated using several shorter course lengths, it remains unclear whether a walking course length shorter than the standard walking course length is appropriate for 6MWD testing. This study aimed (i) to compare maximum walking distances at various shorter walking course lengths (i.e., 10, 20, and 25 meters) and 30 meters, and (ii) to assess agreements in maximum walking distances achieved at intervals below 30 meters, specifically 10, 15, 20, and 25 meters.
Methods
This study was a cross-sectional with cross-over design. Forty-eight healthy participants were randomly ordered to perform 6MWT with five different walkways (10, 15, 20, 25, 30 meters). The maximum walking distance (six-minute walk distance, 6MWD) covered was recorded.
Results
Eligible participants aged 41.0 ± 17.2 years, with equal sex (24 males) participated in this study. The 6MWD at 10, 15, and 20-meter walkways significantly shorter than the 30-meter standard walkway (489.6 ± 59.3 m, 513.1 ± 62.6 m, 524.7 ± 63.7 m vs 539.1 ± 63.1 m, respectively (P<0.01)). Very strong agreement was observed at 15, 20, and 25 meters with the standard 30 meters (0.819–0.875, P<0.001). Subgroup analysis showed strong to very strong agreement in 10-meter walkway length onwards with the standard walkway length among older adults (0.757–0.918, P<0.001).
Conclusions
Testing on 20 meters walkway and shorter yielded varied results compared to the standard 30-meter walk, with exceptional congruence observed at 15 meters onwards. In particular, a minimum walkway of 10 meters had strong agreement with a standard 30-meter walkway in elderly.
... Firstly, univariate analysis was performed first for each predictor. A lax criterion with p-value <0.25 was used to select candidate variables due to limited prior studies in this field (30). Then, three multivariate regression models were performed by selecting (Forward, likelihood) pain characteristics (Model 1), psychological aspect (Model 2), and physical functioning (Model 3). ...
Background
Previous studies have demonstrated an independent association between pain and frailty, but knowledge about this association with different pain characteristics is limited.
Objective
This study was embedded in a prospective, pragmatic, matched-control multicenter trial at 19 primary care practices in south-eastern Sweden ( ClinicalTrials.gov 170608, ID: NCT03180606), aiming to investigate the association between frailty and pain characteristics among older people (75+) at high risk of hospitalization.
Methods
High risk of hospitalization was identified using case-finding algorithm including 32 diagnostic codes of morbidities and healthcare use. Frailty was assessed by a nurse-physician team using Clinical Frailty Scale ( N = 389). Data on pain aspects, physical and ADL functioning were collected in the self-reported questionnaires.
Results
One in three ( n = 133, 34%) was classified as frail. About 36% ( n = 142) reported frequent pain (from several times per week to constantly). Slightly over 40% reported pain lasting longer than 3 months ( n = 163, 41.9%) and/or having regional or widespread pain ( n = 165, 42.4%). In comparison to non-frail peers, frail participants reported higher pain intensity, more ADL-dependency, less physical activity, and more anxiety/depression ( p < 0.01). In logistic regression analysis, pain frequency [Odds Ratio (OR) 1.8, 95% confidence interval (CI): 1.2–2.8] was associated with frailty. However, the models with ADL-staircase score (OR: 1.4, 95% CI: 1.2–1.6) had a higher explanatory power (Nagelkerke R ² : 0.39) in predicting frailty than those without this aspect ( R ² : 0.10 and 0.13).
Conclusion
In older people at high risk of hospitalization, pain frequency seemed to be related to frailty, whilst ADL dependency demonstrated a stronger association.
... Spearman rank correlation was calculated for each population in order to show the repeatability of the original colour score method that has been used in the different countries (Altman 1990;Landis and Koch 1977). The Spearman correlation was computed between the colour scores assigned to individuals for each population in their first and second breeding attempts (for those individuals recorded at least twice). ...
The maintenance of variation (i.e., different phenotypes) for heritable traits that are under selection, despite expectations of selection eroding variation and favouring only the fittest phenotype, represents an evolutionary paradox. Here, we studied variation in life‐history traits in five populations of colour polymorphic tawny owls (Strix aluco) across Europe that have been individually studied for 13 years. Tawny owls show heritable plumage colour variation ranging from less pigmented (grey) to more heavily pigmented (brown‐red). The breeding life span (BLS), lifetime egg production (LEP), lifetime reproductive success (LRS) and the number of years skipped between breeding attempts (NYS) varied between the study populations, with LEP and LRS varying across colour morphs in a population‐specific fashion. Thus, grey tawny owl females have higher lifetime fledgling and egg production than brown‐red females in some populations, but vice versa in others. Hence, our findings demonstrate disruptive selection of tawny owl plumage colourations across their European range, which may be one factor maintaining variation in heritable tawny owl colourations.
... A paired t-test on the BMI values before and after liposuction showed a p-value of 1.0210 × 10 −33 , which indicates a significant difference. A Pearson correlation analysis was also performed to determine whether the BMI values before and after liposuction share a linear relationship [28]. Pearson correlation coefficients closer to 1 indicate more positive linear relationships [29]. ...
The growing interest in weight management has elevated the popularity of liposuction. Individuals deciding whether to undergo liposuction must rely on a doctor’s subjective projections or surgical outcomes for other people to gauge how their own body shape will change. However, such predictions may not be accurate. Although deep learning technology has recently achieved breakthroughs in analyzing medical images and rendering diagnoses, predicting surgical outcomes based on medical images outside clinical settings remains challenging. Hence, this study aimed to develop a method for predicting body shape changes after liposuction using only images of the subject’s own body. To achieve this, we utilize data augmentation based on a conditional continuous Generative Adversarial Network (CcGAN), which generates realistic synthetic data conditioned on continuous variables. Additionally, we modify the loss function of Pix2Pix—a supervised image-to-image translation technique based on Generative Adversarial Networks (GANs)—to enhance prediction quality. Our approach quantitatively and qualitatively demonstrates that accurate, intuitive predictions before liposuction are possible.
... Given that results revealed non-Gaussian distribution patterns, subsequent analyses employed non-parametric statistical methodologies. Inter-rater reliability between the two SLTs' FEES scoring was evaluated through computation of weighted kappa statistics with quadratic weighting [35]. The resultant kappa coefficients were categorized according to established criteria, with values ≤ 0.20 indicating poor agreement, 0.21-0.40 ...
Late radiation-associated dysphagia (late-RAD) remains a challenge in head and neck cancer (HNC) survivorship, despite advancements in treatment methods. Although Fiberoptic Endoscopic Evaluation of Swallowing (FEES) stands as the preferred diagnostic approach for oropharyngeal dysphagia assessment in the HNC population, current studies lack a FEES-derived swallowing parameter characterization and phenotypic classification within this specific cohort. This study sought to employ FEES-based assessment to characterize swallowing safety and efficacy profiles, identify distinct phenotypes in HNC patients suffering from late-RAD, and examine potential correlations between safety and efficacy parameters. A retrospective analysis included twenty-four post-radiotherapy HNC patients evaluated using standardized FEES protocols across three bolus consistencies (liquid, semisolid, and solid). Swallowing safety was quantified using the Penetration–Aspiration Scale (PAS), while efficacy was measured via the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS). Additionally, six distinct dysphagia phenotypes were characterized within the cohort. Propulsion deficit was the predominant phenotype (92%), followed by delayed pharyngeal phase (37.5%) and protective deficit (25%), with 46% of patients exhibiting multiple phenotypes. Unsafe swallowing occurred most frequently with liquid consistency (62.5%), while residue was most prevalent with semisolid (82.6% valleculae, 52.2% pyriform sinuses) and solid consistencies (92.3% valleculae, 53.8% pyriform sinuses). Significant correlations were found between penetration–aspiration and pharyngeal residue scores across consistencies (p < 0.05). FEES examination revealed distinct phenotypes in late radiation-associated dysphagia, with a predominance of propulsion deficit and significant interdependence between safety and efficacy parameters.
... літь [3,28]. ЦП є однією з найпоширеніших причин дитячої інвалідності у світі -приблизно 17 млн осіб [2]. Моторні порушення за ЦП часто поєднуються із сенсорними, когнітивними, комунікативними порушеннями та емоційно-вольовими розладами. ...
Cerebral palsy (CP) is one of the most frequent causes of childhood disability in the world and in Ukraine. CP affects posture, balance, and the ability to move, which leads to varying degrees of impaired activity and functioning in children. Reducing the risk of secondary complications in children with CP is possible with early diagnosis and rehabilitation at an early age. The early intervention service (EI), which provides support and rehabilitation according to an individual program for children with cerebral palsy from birth to 4 years, contributes to improving the functional capabilities of the child. Aim - to carry out a comparative analysis of disorders in children aged 4 to 14 years with spastic CP, depending on whether they underwent an individual rehabilitation program within the framework of the EI service from birth to 4 years of age. Materials and methods. The study involved 105 children aged 4-14 years, divided into two groups: the Group A (43 children who received EI) and the Group B (62 children who did not). The level of violations in children was assessed using standardized international scales and laboratory-instrumental methods. Results. Children in the Group A had less pronounced orthopedic complications (scoliosis, hip dislocations, etc.). Children in the Group A had higher vitamin D levels (24.98±1.164 ng/ml versus 20.85±1.194 ng/ml). Electrocardiogram and complete blood count parameters did not reveal statistically significant differences between the groups. Conclusions. EI service from birth to 4 years with the use of an individual rehabilitation program has a positive effect on the prevention of secondary complications in children with CP, contributing to the improvement of activities, functioning and participation of children with CP. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
... The rationale for this two-step approach was to prevent inclusion bias from potentially inaccurate documentation and to ensure strict adherence to inclusion criteria. This design is consistent with methodological recommendations for stratified sampling in retrospective observational research [23,24]. A reproducible seed function in R (Version 3.4.1, ...
Objectives: Anterior crowding in the lower jaw is a common orthodontic issue often managed through premolar extraction, which can affect facial profile development. This study aimed to evaluate skeletal and dental changes in moderate to severe crowding using a novel mandibular reference line—the Ramus Anterior Vertical (RaV)—to support treatment planning. Methods: A total of 140 patients (LII > 4 mm and < 9 mm; mean age ≈ 12.5 years) were divided into two groups (G1: extraction; G2: nonextraction; total n = 140; n = 70 per group). Skeletal and dental parameters were measured before (T0) and after (T1) orthodontic treatment using 280 lateral cephalograms. RaV was defined as a vertical line through the anterior ramus point, perpendicular to the occlusal plane. Results: Sagittal measurements relative to RaV were reproducible and unaffected by mandibular mobility. Significant vertical skeletal changes were observed in G2 females, with an increased anterior facial height (N–Sp′ and Sp′–Gn) but a stable Hasund Index. In G1, the dental arch length and distances from RaV to i5 and i6 were reduced, while second molars (i7) remained stable. Sagittal incisor axis changes (L1–NB°, SAi1°) and skeletal–dental correlations (ML–NSL, Gn–tGo–Ar) were present only in G1. Conclusions: RaV proved to be a stable mandibular reference for assessing treatment effects. In this study, premolar extraction vs. nonextraction was comparably effective, though some vertical skeletal adaptations, especially in G2 females, took place.
... The prevalence (proportions) of toilets that had door handles and toilet seats testing positive for these indicator organisms was analysed. The prevalence of faecal contamination within the two groups of toilets was compared using odds ratios computed with the aid of the MedCalc online statistical calculator [23], which is based on Altman [24]. The samples were also analysed for the actual concentrations/quantities of the indicator organisms present on the contact surfaces. ...
Sharing facilities with other households offers the most realistic opportunity for access to sanitation for many households in low-income settings. However, questions remain about the safety of shared toilets, including those shared at the household level. This study sought to compare the usage and microbial safety of household-level shared and unshared toilets in a Ghanaian rural district to investigate any association between their microbial safety and sharing status. A semi-structured questionnaire was used to collect data on the user characteristics of the sampled toilets, while common contact surfaces (door handles and toilet seats) were assessed for faecal contamination following standard swab sampling and analytical protocols. The results of the study indicate that sharing toilets affords about 90% more household-level access to sanitation as compared to single-household toilets. Toilet sharing mostly occurred between two households, with a maximum user population of 14 per toilet. Generally, there was a high prevalence of faecal contamination on the door handles and seats of both shared and unshared toilets, but this had no association with the sharing status of the toilets. The median concentration of Escherichia coli (E. coli) on the door handles and seats of shared toilets was 34.3 × 10⁵ and 103.2 × 10⁵ CFU/mL, respectively, as compared to 54.7 × 10⁵ and 125.0 × 10⁵ CFU/mL, respectively, on unshared toilets. In conclusion, the sharing of toilets at the household level nearly doubles access to sanitation at home without necessarily exposing the users to a higher risk of faecal–oral disease transmission.
... The intra-observer reliability was evaluated by the same observer after a six-week interval. The level of agreement between observers was assessed using kappa statistics, yielding a mean kappa of 0.94 for intra-observer reliability and 0.91 for inter-observer reliability [30]. These results, presented in Table 3, indicate a high degree of consistency in data collection across observers, thereby enhancing confidence in the validity and generalizability of the study findings. ...
This study addresses a critical knowledge gap by providing an in-depth analysis of the characteristics of goal-scoring opportunities in the UEFA Youth League, offering valuable insights into the attacking performance of elite youth teams. The primary objective of this study was to analyze the attacking characteristics of elite youth teams competing in the UEFA Youth League. Observational analysis was conducted on 18 knock-out matches from the 2023/24 season, examining tactical and situational variables. Open play (56.7%) significantly outperformed set play (43.3%) in generating final attempts. Organized attacks proved to be more effective than counter-attacks in creating scoring opportunities. While winning teams were more likely to employ counter-attacking strategies, final attempts were more frequent when the team initiated the attack without immediate pressure and when a penetrative action was involved. Notably, an initial penetrative action also increased the likelihood of observing counter-attacks. These findings have important implications for coaching practices and youth development programs, emphasizing the need to develop players with strong technical skills, tactical awareness, and the ability to execute patient build-up play under pressure. This study contributes to a deeper understanding of attacking play in elite youth football and provides valuable insights for coaches and youth development programs.
... Inter-observer testing over 20 CT scans examined by two different operators gave an agreement rating of 0.671. Both of these readings represent good agreement (Altman 1990). ...
Background: A computed tomography (CT) scan of the medial clavicular epiphysis plays an important role in age estimation. Our study aimed to validate thin-section CT scan images of the medial clavicular epiphysis according to the Schmeling and Kellinghaus methods in a Tunisian population sample and assess its reproducibility. Results: We examined 196 thoracic CT scans of Tunisian individuals aged under 40 years (126 males, 70 females), carried out in the Radiology Department of Ibn El Jazzar University Hospital in Kairouan, Tunisia, from September 1 st , 2017, to April 30 th , 2019, with a slice thickness of 0.6 mm. The mean age was 22.2 ± 7.36 SD, with extremes ranging from 3 to 40 years. The majority of the patients were male (64.3% vs. 35.7%) with no significant age difference between the two groups (p = 0.975). Stage 1 excludes the age of the majority of male subjects. Stage 3c is a good predictor for estimating the age of the majority of both sexes. Statistically significant positive correlation was found between age and determined stage based on Spearman’s rank correlation values (total group: rho = 0.854, p < 0.001). No significant age difference was noticed between the two clavicles or between the sexes. Inter-observer and intra-observer agreements were good. Conclusions: Through our study, we have established a frame of reference, and we can conclude that the CT study of the development of the medial clavicular epiphysis represents a reliable method for age estimation in the Tunisian population.
... According to the Altman's classification [40], kappa values < 0.20, and between 0.21 and 0.40, 0.41-0.60, 0.61-0.80, ...
Background
Artificial intelligence (AI) chatbots are increasingly used in healthcare to address patient questions by providing personalized responses. Evaluating their performance is essential to ensure their reliability. This study aimed to assess the performance of three AI chatbots in responding to the frequently asked questions (FAQs) of patients regarding dental prostheses.
Methods
Thirty-one frequently asked questions (FAQs) were collected from accredited organizations’ websites and the “People Also Ask” feature of Google, focusing on removable and fixed prosthodontics. Two board-certified prosthodontists evaluated response quality using the modified Global Quality Score (GQS) on a 5-point Likert scale. Inter-examiner agreement was assessed using weighted kappa. Readability was measured using the Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) indices. Statistical analyses were performed using repeated measures ANOVA and Friedman test, with Bonferroni correction for pairwise comparisons (α = 0.05).
Results
The inter-examiner agreement was good. Among the chatbots, Google Gemini had the highest quality score (4.58 ± 0.50), significantly outperforming Microsoft Copilot (3.87 ± 0.89) (P =.004). Readability analysis showed ChatGPT (10.45 ± 1.26) produced significantly more complex responses compared to Gemini (7.82 ± 1.19) and Copilot (8.38 ± 1.59) (P <.001). FRE scores indicated that ChatGPT’s responses were categorized as fairly difficult (53.05 ± 7.16), while Gemini’s responses were in plain English (64.94 ± 7.29), with a significant difference between them (P <.001).
Conclusions
AI chatbots show great potential in answering patient inquiries about dental prostheses. However, improvements are needed to enhance their effectiveness as patient education tools.
... Specifically, the articles (title, abstract, and keywords in particular) were reviewed and coded as 'include,' 'exclude,' or 'uncertain' by the two researchers separately, after which any discrepancies and 'uncertain' articles were discussed to reach consensus. After calculating the level of agreement, the inter-rater reliability was found to reach an acceptable level (above 0.81) (Altman, 1990). In the stage of inclusion, WoS and Scopus data were merged, and duplicates were removed with the aid of CiteSpace (Chen, 2016). ...
Tourism and hospitality have been pivotal areas for linguistic research due to the abundance of linguistic data available within these fields. However, there has been a notable lack of review studies offering a comprehensive overview of the current state of the art. To fill this gap, this study employs bibliometric methods to sketch the scientific landscape of Linguistic Studies on Tourism and Hospitality (LSTH), analysing 751 journal articles published between 1994 and April 2024, sourced from the Web of Science and Scopus. This study provides insights into the general characteristics, key data sources, predominant methods, major topics, and themes within LSTH, and offers recommendations for future research. The main findings indicate that (1) social media and online travel platforms are primary data sources in LSTH; (2) (Critical) Discourse Analysis and Linguistic Landscape are the most frequently applied methods; and (3) LSTH research predominantly explores four types of tourism: dark tourism, cultural tourism, heritage tourism, and slum tourism. To further advance LSTH, this study suggests that future research should focus on underexplored social media platforms and offline interactions, make use of underutilised linguistic methods (e.g. conversation analysis and genre analysis), and investigate emerging forms of tourism, such as virtual tourism. ARTICLE HISTORY
... Parameter distributions were studied via histograms and boxplots, and generalized estimating equation models were applied for the inferential analysis [24], considering the correlation between measurements from the same newborn before and after caffeine administration. Normal or gamma distributions with a logarithmic link function were used, with the best-fitting distribution chosen based on QIC goodness-of-fit results [25]. ...
The gold standard treatment for apnea of prematurity is caffeine citrate, which is known for its effect on diaphragm muscle activity. The purpose of this study was to investigate the electrical activity of the diaphragm in preterm newborns, which was measured 30 minutes before and 60 minutes after the administration of a loading dose of caffeine citrate. In this prospective, observational, longitudinal study at a tertiary-level neonatal ICU, data were collected from 36 patients (13 females, 23 males) with a mean gestational age of 31 2/7 ± 2 1/7 weeks and a mean birth weight of 1532 ± 439 grams. The average caffeine level was 15.7 ± 5.9 mg/dL (reference range: 5–30 mg/dL). The results revealed significant increases in all the parameters used to determine the inspiratory phases of the respiratory cycle postcaffeine administration (p < 0.001). The study concluded that caffeine administration significantly enhances diaphragmatic electrical activity in preterm newborns.
... Two authors (EJ and JPSP) separately assessed the NOS of the included studies. A Cohen's kappa score was calculated to determine the level of agreement between the authors [17]. ...
Background and Objectives: Out-of-hospital cardiac arrest (OHCA) is a common manifestation of heart disease and a leading cause of death in western societies with an overall survival rate of 10%. Guidelines generally prefer the peripheral intravenous (IV) access as the first option for OHCA patients, leaving the intraosseous (IO) route for patients in which IV access is not feasible or unsuccessful. This systematic review will purely focus on the clinical differences between adrenaline administered via the IO route compared to the IV route and its effects on morbidity and mortality after OHCA. Materials and Methods: A multi-database (PubMed, Medline, Embase, and The Cochrane Library) was performed and was searched between the earliest date of each database and 16 February 2024. For data extraction, a structured checklist was used, including type of study, the number of patients, age, gender, Return of Spontaneous Circulation (ROSC), associated morbidity, mortality, neurological, and general outcome. Results: The initial literature search produced 1772 results. After screening for title and abstract, a total of nine studies were included in our systematic review. Of these studies, six were retrospective cohort studies, one prospective study, and two sub-analyses of previous randomized trials. Due to significant heterogeneity, a meta-analysis was not performed. Conclusions: In our systematic review we have found a small number of studies comparing IV and IO adrenaline administration during cardiac arrest. Due to significant heterogeneity, a meta-analysis was not performed and no firm conclusions could be drawn about which route of adrenalin administration leads to better outcomes.
... This index was defined as the percentage (%) of labeled cells out of 100 tumor cells manually counted in ten non-overlapping, random fields (×400 total magnification) with the aid of an ocular grid (Table S1). Interobserver agreement for evaluation of immunostaining was within 15% (Cohen's kappa = 0.82) [33]. Immunopositive endothelial cells were excluded from the cell counts. ...
Background: Polycystin 1 (PC1) and polycystin 2 (PC2) proteins are members of the transient receptor potential (TRP) channels family and are encoded from PKD1 and PKD2 genes, respectively. Until recently, the role of PKD1 and PKD2 has been associated with the pathogenesis of the kidney since mutations in these genes cause autosomal dominant polycystic kidney disease (ADPKD). Recent data implicates polycystins in the pathogenesis of solid tumors. In this aspect, the expression of PKD1 and PKD2 in human astrocytomas is largely unknown. The aim of the present research study was to investigate the expression of PKD1 and PKD2 in astrocytic tumors and correlate it with clinicopathological characteristics such as the grade of malignancy, age, and gender of the patients. Methods: A total of 70 cases—corresponding to 8 grade II (diffuse fibrillary astrocytomas), 12 grade III (anaplastic astrocytomas), and 50 grade IV (glioblastomas multiforme)—were examined. The mRNA expression levels of PKD1 and PKD2 were determined through molecular qRT-PCR analysis using the relative quantification ΔΔCt method and the expression of PC1 and PC2 was detected through immunohistochemistry using the semi-quantitative H-score system. Results: Increased levels of PKD1 and PKD2 in astrocytomas were found compared with that of a normal brain (p < 0.05). Glioblastomas demonstrated the greatest increase in PKD1 and PKD2 expression compared to other grades of malignancy (p < 0.05). The same pattern of expression showed PC1 and PC2 proteins. A significant correlation between PKD1 and PKD2 as well as PC1 and PC2 expressions was found (p < 0.05). Although no association was detected between PC1 or PC2 and Ki67 expression (p > 0.05), a significant correlation between PC1 and p53 immunoexpressions, in grade III and between PC2 and p53 immunoexpressions, in grade II astrocytomas (p < 0.01) has emerged. PC1 expression was correlated with age of the patients (p < 0.05). PKD1 and PKD2 expression were negatively correlated with the prognosis of glioma patients. Conclusions: The results of this study indicate the potential involvement of polycystins in the pathogenesis of astrocytomas. However, further research is required to fully understand the mechanisms that these molecules are implicated.
... good and 0.81-1.00 very good [9]. ...
Background Previous studies have shown improved image quality in pediatric cardiac imaging using photon-counting detector CT (PCDCT). However, these studies did not evaluate image quality and radiation dose when utilizing the full spectral capabilities of PCDCT scanners. Objective To compare image quality and radiation dose between high pitch cardiac CT using full spectral PCDCT and dual source energy-integrating detector CT (EIDCT). Methods This retrospective, IRB-approved study analyzed high pitch cardiac CTs from January 2021 to October 2023 in pediatric patients (< 18 years). Patients were scanned using either PCDCT with full spectral technique (“QuantumPlus”) or EIDCT. Radiation doses were measured by CT dose index (CTDI) and dose-length product (DLP). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were also calculated, and image quality was assessed using a 5-point Likert scale. Statistical analysis included unpaired T-test, Shapiro-Wilk test, Mann-Whitney test, and kappa coefficients for interrater agreement. Results 200 patients were evaluated, with 100 scanned on PCDCT and 100 on EIDCT. Most patients (148/200) were ≤ 12 months of age. CNR was similar between groups for both age groups. In patients ≤ 12 months, SNR was only significantly higher at the teres muscles for EIDCT (p < 0.0001). Radiation doses were significantly higher for PCDCT across both age groups (p < 0.0001). Conclusion High pitch cardiac CT with PCDCT using spectral processing resulted in higher radiation doses and lower SNR in infants compared to EIDCT.
... A key limitation was the lack of long-term follow-up data, making it difficult to assess the sustained effects of home modifications. Future studies should establish appropriate follow-up periods, employ objective outcome measures, and use bias assessment tools [53], such as ROBINS-I [54], to enhance reliability. Sensitivity analyses [51] will further strengthen the findings' validity. ...
Background/Objectives: The aging population has increased the demand for home modifications to support aging in place. However, existing research primarily focuses on fall prevention and physical safety, leaving gaps in understanding long-term sustainability, social engagement, and cost-effectiveness. Additionally, the interaction between home modifications and health-related changes remains under-explored. This study systematically reviews home modifications, addressing these gaps by considering functional independence, quality of life, caregiving burden, and technological advancements. Methods: A systematic review was conducted following PRISMA 2020 guidelines. One researcher and an external expert performed study selection, data extraction, and quality assessment. Thematic analysis and narrative synthesis were applied to compare study results. Results: Among 20 studies, 13 (65%) confirmed the effectiveness of home modifications in fall prevention, functional independence, and cost savings. Seven studies (35%) highlighted housing accessibility and lifestyle factors. However, few studies examined personalized interventions, smart home technologies, and long-term adaptability. Conclusions: This study emphasizes the need for personalized, technology-driven, and long-term adaptable home modifications. Future research should explore smart home innovations, interdisciplinary approaches, and policy implementation feasibility to develop sustainable aging-in-place strategies. By adopting a holistic perspective, this study provides a new framework for advancing aging-in-place strategies.
... The odds ratio (OR), together with its standard error and 95% confidence range, is computed in Table 5 for NACC hypertension, hypercholesterolaemia, thyroid disease, and diabetes patients with an AD diagnosis via the methodology described by Altman in 1990. 63 Depression was excluded from testing since it typically occurs after AD diagnosis in the MIMIC-IV analysis. In addition, the data on depression in the NACC database rely partially on self-reports, which may introduce some degree of unreliability. ...
INTRODUCTION
Comorbid conditions associated with Alzheimer's disease (AD) are poorly understood regarding timing and potential impact on disease onset and progression.
METHODS
Medical Information Mart for Intensive Care‐IV electronic health records from 2008 to 2019 were examined. The study identified 2527 AD patients (34.9% male, mean age 80.27 years) among 299,712 patients. We examined the timing of 12 cardiovascular and metabolic diseases relative to AD diagnosis. Data from the National Alzheimer's Coordinating Center validated the findings.
RESULTS
Hypertension was the most common comorbidity, diagnosed 1.09 years before AD. Depression was the only comorbidity diagnosed after AD start, 0.16 years on average. AD patients had greater rates of hypertension, hypercholesterolemia, and depression compared to the general population.
DISCUSSION
The findings emphasize early detection and therapy of AD‐related comorbidities, notably cardiovascular and metabolic diseases. The temporal link between these diseases and AD suggests opportunities for preventive strategies and improved care pathways.
Highlights
Temporal analysis of comorbidities: The study reveals hypertension and hyperlipidemia as leading precursors to AD, typically diagnosed 1 to 1.3 years prior to AD onset, while depression emerges predominantly after diagnosis.
Unique data integration: Large‐scale datasets from MIMIC‐IV (n = 299,712) and NACC (n = 51,836) were leveraged to identify chronological patterns in 12 key comorbid conditions relative to AD diagnosis.
Sex‐ and age‐specific insights: AD prevalence peaks at 80 to 86 years, with females exhibiting higher rates of LOAD compared to males.
Depression as a post‐diagnostic marker: Unlike other comorbidities, depression's post‐diagnostic mean onset (0.16 years after AD diagnosis) highlights the need for targeted mental health interventions in AD patients.
Implications for early detection: Findings suggest that managing hypertension, hyperlipidemia, and other modifiable conditions in midlife may delay or reduce the risk of AD development.
Comorbidity variability across cohorts: Hypertension and hypercholesterolemia showed significantly higher prevalence in the NACC cohort compared to MIMIC‐IV, reflecting potential dataset‐specific biases or regional healthcare differences.
Future research directions: Advocates for longitudinal, multiethnic, and global studies to refine early diagnostic criteria and explore preventive strategies tailored to comorbid conditions.
... The extent of variations among appraisers with less agreement on weight allocation was identified [31,32], and a kappa value was calculated for all guidelines. A kappa value less than 0.2 indicates poor agreement, 0.21 -0.4 fair, 0.41 -0.6 moderate, 0.61 -0.8 good, and 0.81 -1.0 very good agreement [33]. Moreover, the appraiser assigned a total guideline assessment score, made a recommendation decision and provided options of Yes, Yes with modifications, or No. ...
Background
Domestic violence is a public health concern and human rights violation affecting more than one-third of all pregnant women globally. Abused pregnant women need several interventions to reduce domestic violence and its negative consequences on mother and child. The purpose of this study was to determine the quality, scope, and consistency of clinical guidelines for managing domestic violence during pregnancy.
Methods
This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Electronic databases of Scopus, PubMed, Embase, Web of Science, Up-to-date, Cochrane Library database, Google Scholar, and Guideline repositories, including NICE, SIGN, GAC, NHMRC, NGC, New Zealand Guidelines Group, TRIP, AHRQ, G-I-N, and MD Consult, using appropriate keywords were searched. Included studies were clinical guidelines containing recommendations about domestic violence in pregnancy and postpartum. Two reviewers used the AGREE II (Appraisal of Guidelines, Research, and Evaluation version 2) instrument to evaluate the quality of guidelines, and textual syntheses were used to appraise and compare the relevant recommendations. Out of 381 relevant published guidelines, 14 clinical guidelines were ultimately reviewed systematically.
Results
Seven countries had a clinical guideline for domestic violence during pregnancy. None of the reviewed guidelines was rated > 75% across all domains of AGREE II while the highest-rated domains were scope, purpose, and clarity. Four related categories were recognized from the synthesis of recommendations within the appropriate guidelines. These consisted of an introduction, domestic violence in pregnancy, the role of health care professionals, and the resources. Recommendations for privacy and confidentiality, screening, identification, support, and documentation were the most commonly reported, which all of the guidelines advised them, suggesting the importance of identification of violence in pregnancy and support for abused pregnant women. 93% of the reviewed guidelines had recommendations on communication, support and building trust, child protection, and professional education and training.
Conclusion
The study findings suggest that there are currently gaps in clinical guidelines in various areas, including patterns of violence, the cycle of violence, identifying risk factors for violence during pregnancy, providing medical care, implementing home visitation programs, promoting self-care and empowerment, preventing violence, offering follow-up support, and conducting community education programs. Therefore, it is crucial to develop or adapt clinical guidelines for abused pregnant women, emphasizing their needs to ensure their safety and well-being.
... Based on a power calculation, 35 participants were required. This was in order to detect any relationships between variables corresponding to medium effect sizes with a power of 80% at p 00.05 (23,24). Since only 31 participants had been included at the end of the eight-month period, new consecutive patients were asked to participate, until the required number of 35 was reached. ...
The aim was to investigate how patients in a clinical setting, combining acute stroke care and rehabilitation, perceived the value and meaning attached to a commonly used instrumental occupation, namely “Brewing coffee and making an open-face cheese sandwich with sliced vegetable”. Another aim was to validate the ValMO model, proposing that value and meaning are related phenomena. Upon performing the occupation, 38 participants answered questionnaires concerning perceived meaning and occupational value. The results showed that the occupation was highly valued by the participants and that it was perceived as meaningful. No age or gender differences were found. The findings confirmed the proposed link between value and meaning. In conclusion, a commonly used and supposedly meaningful occupation was indeed found to be valued and meaningful by the patients and the findings validated the targeted aspects of the ValMO model. This study was unique in its focus on value and meaning in a clinical context. Futures studies should clarify if the link between meaningful occupation and well-being, which has been shown in many studies of everyday situations and is another of the assumptions in the ValMO model, can be proved in clinical contexts as well.
... The paper also used the interpretation given by Altman (1991) ...
Diabetes Mellitus (DM) is a chronic disorder affecting more than 300 million people world-wide and it needs urgent attention. Selecting of significant risk factors (SRFs) and their contributions to the risk of the disease is the key for early detection of the disease. The aim of this paper is to use Backward Stepwise Feature Selection Method (BSFSM) to select the SRFs and their contribution to the risk of DM and Kappa statistic value (KSV) to evaluate the model performance. Dataset consists of 400 patients with demographic, clinical, lifestyle and dietary risk factors collected from General Hospital Kaura Namoda, Zamfara State, Nigeria from 2019 to 2023 by checking the file of patients suffering from DM. The results obtained revealed that BSFSM retained twelve (12) SRFs, namely Blood Glucose level (BGL), High Body Mass Index (BMI), Family History of DM (FHDM), Preference for Sweet Food (PSWF), Age, Lack of Physical Activity (LPA), Blood Pressure (BP), Red Meat (RM), Refined Carbs (RC), Energy Drink (ED), White Rice (WR) and Processed Meat (PM), and removed two (2) Non-SRFs: Sex and Preference for Salty Food (PSF). The SRFs contributed 85.40%, 51.34%, 55.72%, 68.23%, 57.50%, 29.96%, 66.18%, 41.42%, 12.20%, 18.65%, 29.76% and 10.11% respectively to the risk of DM. Similarly, the Non-SRFs contributed 0.98% and 1.16% respectively to the risk of DM. The MLP model detected 98.6% DM patients in the training set, 96.3% in the validation set and 92.9% in test set. There were 97.8% Non-DM patients in the training set, 93.9% in the validation set and 93.8% for the test set. The KSV of the model was 0.94 and it was capable of distinguishing between DM and Non-DM patients. This paper demonstrated that BSFSM was capable of selecting the SRFs and their contributions, and KSV adequately evaluate the performance of the model.
... poor (Cicchetti, 1994). This classification (or slight variations of it; Altman, 1991;Fleiss, 1981;Landis & Koch, 1977) is the most often cited in literature. ...
Objective: This study examines YouTube comments following the overturn of Roe v. Wade, investigating how perceptions of health implications differ based on commenters’ gender and abortion stance. Methods: Using Netlytic, 25,730 comments were extracted from YouTube videos discussing the overturn of Roe v. Wade, half of which featured physicians discussing public health implications. Manual coding of 21% of the comments identified discussions on abortion stance and medical implications, while Gender API approximated the commenters’ gender. A term co-occurrence network was generated with VOSviewer to visualize key terms and their interrelations. Custom overlays explored patterns related to gender, abortion views, and medical implications, and comparisons within these overlays intersected with the medical implications overlay to illustrate contextual differences across demographics. Results: Four clusters emerged in the network: Constitutional Law, addressing the U.S. Constitution’s interpretation and legal impacts; Reproductive Rights and Responsibility, discussing alternatives to abortion and access; Human Development, exploring the intersection of abortion laws and individual beliefs; and Religious Beliefs, linking abortion laws to faith. Prochoice users focused on medical and socioeconomic impacts on women, whereas prolife users emphasized the prevention of unwanted pregnancies and moral considerations. Gender analysis revealed males centered on constitutional issues, while females highlighted medical and personal effects. Conclusion: The findings underscore that monitoring YouTube discourse offers valuable insights into public responses to shifts in health policy.
The principle of normality stands as a crucial component for statistical procedure specifically in medical research since parametric methods such as t-tests ANOVA and regression analysis depend on normally distributed data for proper inference. Real medical data databases deviate from normal distribution patterns when researchers observe skews and outliers or heavy-tailed distributions because such variations negatively impact statistical research outcomes. A performance evaluation examines classical and modified normality tests for medical data distribution assessment. Two proposed adaptations known results alongside JB a , JB σ2 , JB a,σ2 tests. The study carries out a detailed simulation analysis with 20,000 replicates among different sample sizes (10, 20, 30, 50, 100) to evaluate these tests against symmetric and asymmetric distributions. Standard testing techniques demonstrate good performance at large sample levels but show limitations when dealing with small sample-based and non-normal data which causes erroneous type I or type II detection rates. The JB* and JB** tests prove to be robust since they sustain stronger error control together with superior detection capabilities in multiple distributional environments. A correct assessment of normality remains essential for valid statistical inference in clinical trials together with biomedical studies. The presented study enhances medical statistics methodology by developing reliable statistical analyses for healthcare decisions making.
Code reviews are a critical aspect of open-source software (OSS) development, ensuring quality and fostering collaboration. This study examines perceptions, challenges, and biases in OSS code review processes, focusing on the perspectives of Contributors and Maintainers. Through surveys (n=289), interviews (n=23), and repository analysis (n=81), we identify key areas of alignment and disparity. While both groups share common objectives, differences emerge in priorities, e.g, with Maintainers emphasizing alignment with project goals while Contributors overestimated the value of novelty. Bias, particularly familiarity bias, disproportionately affects underrepresented groups, discouraging participation and limiting community growth. Misinterpretation of approach differences as bias further complicates reviews. Our findings underscore the need for improved documentation, better tools, and automated solutions to address delays and enhance inclusivity. This work provides actionable strategies to promote fairness and sustain the long-term innovation of OSS ecosystems.
All industries across the globe lacked preparedness for the truculent pandemic scenario. The objective is to identify the internal strengths and weaknesses and external opportunities and threats crucial for an industry’s survival and avoid severe impact in future unforeseen crises. The present qualitative study aims to provide possibilities and opportunities for the resurgence of the restaurant industry in an Asian market in the new normal. We conducted semi-structured interviews with 25 participants, analyzed their opinions, and listed factors in an internal factor evaluation matrix (IFEM) and an external factor evaluation matrix (EFEM). The factors were assigned weights and ranks based on priority. Next, we developed the SWOT (strengths, weaknesses, opportunities, and threats) matrix with the sum of the IFEM and EFEM scores. Finally, we created the TOWS (threats, opportunities, weaknesses, and strengths) matrix to formulate various strategies. Analysis of the favorable and unfavorable factors will help us understand how to leverage opportunities with the strengths and how weaknesses can eventually lead to threats. The study will give valuable insights to owners and policymakers for restaurant businesses in Asian markets to discover possibilities and opportunities for a resurgence. In the future, related empirical research on other industries can include the determining elements to build the survey instrument.
EDUCATIONAL STATISTICAL ANALYSIS
Objective: evaluate the ability of the ChatGPT v.3.5, DeepSeek v-3, and Gemini 2.0 flash to accurately predict major potential drug interactions (DIs) in critically ill patients. Methods: A list of 20 DIs was compiled from previously published literature. The Micromedex and Drugs.com databases were used as references. A specific prompt was designed to interact with the tools. The generated responses were stored for subsequent analysis by a pharmacist. Specificity, sensitivity, negative predictive value (NPV), positive predictive value (PPV), accuracy, and agreement were calculated for each tool based on the responses regarding DDI severity, which were categorized into five levels: contraindicated, major, moderate, minor, and no interaction. Additionally, the responses related to the mechanism of action and recommended management for each DDI were categorized as "adequate and accurate," "adequate but inaccurate", and "inadequate." Results: When the Micromedex was used as a reference, ChatGPT performed better, achieving an accuracy rate of 75%, while DeepSeek and Gemini scored 70% and 65%, respectively. Overall, there was an improvement in the performance of all tools when Drugs.com was used as the reference, with accuracy rates of 80% for DeepSeek and 75% for both ChatGPT and Gemini. However, the agreement on the severity of DDIs between the tools and references was 0.354 (weak) for Drugs.com and 0.410 (moderate) for Micromedex. In general, two "inadequate" responses and 10 "adequate but inaccurate" responses regarding the mechanism of action and recommended management were observed when compared with Micromedex (14 DDIs analyzed), while eight "inadequate" responses and 21 "adequate but inaccurate" responses were found when compared with Drugs.com (17 DDIs analyzed). Conclusion: The tools analyzed show promise to assist healthcare professionals in predicting DDI in adults hospitalized in the intensive care unit (ICU). However, their use should be approached with caution, as they may generate incorrect/inaccurate information. Additional advancements are required to ensure their reliable application in clinical practice.
Introduction
Myosteatosis, characterised by altered muscle composition detectable by muscle radiodensity attenuation on CT scans, has been associated with increased mortality in patients with cirrhosis. However, standard attenuation cut-offs, derived primarily from oncology populations, may not be appropriate for patients with cirrhosis. This study protocol aims to address this diagnostic gap by validating the Ebadi cut-offs, which are based on a retrospective cohort and have not been extensively validated in a cirrhotic population. The aim of the study is to refine these cut-offs for more accurate prediction of mortality in patients with cirrhosis using two independent patient cohorts (retrospective and prospective).
Methods and analysis
This post hoc validation study analyses muscle weakness cut-offs in patients with cirrhosis using data from two independent cohorts. A total of 1537 patients will be analysed. The study will assess interobserver variability to ensure robust results by analysing random samples of 60 patients from the two cohorts. Statistical methods will be used to determine the accuracy and relevance of current cut-offs in predicting patient mortality. The analysis will also examine the relationship between muscle wasting and clinical outcomes in cirrhosis and the relationship with muscle mass loss.
Ethics and dissemination
Ethical approval for this study has been obtained from the relevant institutional review boards. The results will be disseminated through presentations at scientific conferences and publication in peer-reviewed journals. The results of the study are expected to contribute to improved diagnostic criteria for myosteatosis in cirrhosis, providing clinicians with more tailored and accurate tools for cirrhosis prognosis.
Trial registration number
NCT06593015 .
ResearchGate has not been able to resolve any references for this publication.