Exploring Stratification Strategies for Population- Versus Randomization-Based Inference.

Stratification on important variables is a common practice in clinical trials, since ensuring cosmetic balance on known baseline covariates is often deemed to be a crucial requirement for the credibility of the experimental results. However, the actual benefits of stratification are still debated in the literature. Other authors have shown that it does not improve efficiency in large samples and improves it only negligibly in smaller samples. This paper investigates different subgroup analysis strategies, with a particular focus on the potential benefits in terms of inferential precision of prestratification versus both poststratification and post hoc regression adjustment. For each of these approaches, the pros and cons of population-based versus randomization-based inference are discussed. The effects of the presence of a treatment-by-covariate interaction and the variability in the patient responses are also taken into account. Our results show that, in general, prestratifying does not provide substantial benefit. On the contrary, it may be deleterious, in particular for randomization-based procedures in the presence of a chronological bias. Even when there is treatment-by-covariate interaction, prestratification may backfire by considerably reducing the inferential precision.

Left-behind cumulative risk and academic adjustment in Chinese middle school students: The moderating effect of growth mindset.

Left-behind children, as a large-scale disadvantaged group, encounter an array of risk factors that impede their academic development because of parental migration. The current study aimed at investigating the roles of left-behind cumulative risk and growth mindset on academic adjustment and exploring whether growth mindset moderated the association between left-behind cumulative risk and academic adjustment in left-behind middle school students. A total of 1184 left-behind middle school students (615 males; 12-16 years) participated in the study. Results indicated that left-behind cumulative risk is negatively associated with academic adjustment in middle school students (ß = -.199, t(1183) = -7.229, p < .001). Besides, growth mindset has a protective effect on left-behind middle school students' academic adjustment (ß = .386, t(1183) = 14.070, p < .001) and a moderating effect on the relationship between left-behind cumulative risk and academic adjustment (ß = .394, t(1182) = 4.057, p < .001, ΔR2 = .012). These findings suggest that family risk factors related to left-behind status affect the academic adjustment of left-behind middle school students in a superposition way, while the positive individual factor of growth mindset could protect the negative impact caused by parental migration.

Nutritional management and physiological responses of Atriplex nummularia Lindl. on the improvement of phytoextraction in salt-affected soil.

Soil salinity is a significant abiotic stress and poses risks to environmental sustainability. Thus, the improvement of the time for recovering the salt-affect soil is crucial for the phytoextraction process using halophytes plants, especially regarding on nutritional management. We evaluated the responses of Atriplex nummularia Lindl. to nitrogen (N) and phosphorus (P) under different salinity levels. The treatments comprised doses of N (N1 = 80 kg ha-1) and P (P1 = 60 kg ha-1): (1) without N and P (N0P0) (control); (2) with N and without P (N1P0); (3) without N and with P (N0P1); and (4) with N and P (N1P1) and five levels of electrical conductivity from irrigation water: 0.08, 1.7, 4.8, 8.6, and 12.5 dS m-1. The. We evaluated dry biomass of leaves, stems, and roots 93 days after transplantation. We also assessed the leaf and osmotic water potential, the osmotic adjustment, and the nutrient contents (N, P, Na, and K). N application increased 22.3, 17.8, and 32.8% the leaf biomass, stem biomass, and osmotic adjustment, respectively; and consequently, boosts Na extraction in 27.8%. Thus, the time of the phytoextraction process can be improved with N fertilizer at a rate of 80 kg ha-1.

Very few studies have investigated the nutrient dynamics responses in Atriplex species in salt-affected soils; thus, this study represents a novelty. We tested the management of nitrogen (N) and phosphate (P) fertilizers to increase crop yield and optimize the phytoextraction process in salt-affected soils. We believe our results contribute to the improvement of the knowledge of this relevant topic, mainly in terms of the recovery of areas degraded by salinity. There is a paucity of studies associating salinity and nutritional management of soils worldwide.

Deciphering dynamic interactions among multidimensional psychological motivations, academic performance, and sociocultural adjustment: The critical influence of excessive WeChat use.

As the preeminent mobile social media platform in Mainland China, WeChat's meteoric expansion has revolutionized the dynamics of interpersonal communication and the modalities of mutual interaction among individuals. Despite the escalating significance of mobile social media in the cross-cultural adaptation of international students, existing scholarly works have largely neglected the underlying relationship between psychological motivations, excessive WeChat use, academic performance, and sociocultural adaptation of these students. Anchored in uses and gratifications theory and cross-cultural adaptation paradigm, the primary objectives of this study are to devise a theoretical model and to scrutinize differential psychological motivations propelling international students' WeChat usage, its association with excessive WeChat use, and impacts on academic performance and sociocultural adjustment. The proposed model undergoes meticulous evaluation through data amassed online from 598 Chinese international students studying in Germany. Sequential analytical techniques, especially Confirmatory Factor Analysis and Structural Equation Modeling, were employed to elucidate the dynamic interplay among key variables. The final results validate the path effect suggesting that both hedonic and social motivations are positive predictors of excessive WeChat use. Moreover, excessive WeChat use is negatively correlated with academic performance and sociocultural adjustment. However, utilitarian motivation is not significantly related to excessive WeChat use. By demystifying the driving factors and consequences of excessive WeChat use, these findings not only accentuate the pivotal role of mobile social media in the cross-cultural adaptation of international students but also enrich the theoretical landscape and enhance the strategic approaches for educators and academic institutions.

Bayes-xG: player and position correction on expected goals (xG) using Bayesian hierarchical approach.

This study employs Bayesian methodologies to explore the influence of player or positional factors in predicting the probability of a shot resulting in a goal, measured by the expected goals (xG) metric. Utilising publicly available data from StatsBomb, Bayesian hierarchical logistic regressions are constructed, analysing approximately 10,000 shots from the English Premier League (for the years of 2003 and 2015) to ascertain whether positional or player-level effects impact xG. The findings reveal positional effects in a basic model that includes only distance to goal and shot angle as predictors, highlighting that strikers and attacking midfielders exhibit a higher likelihood of scoring. However, these effects diminish when more informative predictors are introduced. Nevertheless, even with additional predictors, player-level effects persist, indicating that certain players possess notable positive or negative xG adjustments, influencing their likelihood of scoring a given chance. The study extends its analysis to data from Spain's La Liga ( ≈ 20 K shots from 1973 and 2004 to 2020) and Germany's Bundesliga ( ≈ 7.5 K shots from 2015), yielding comparable results. Additionally, the paper assesses the impact of prior distribution choices on outcomes, concluding that the priors employed in the models provide sound results but could be refined to enhance sampling efficiency for constructing more complex and extensive models feasibly.

Associations between driving status, frequency of transport use after driving cessation, and social frailty among middle-aged and older people aged 60 years and older.

Background: The use of transport other than cars is a modifiable factor in the association between driving cessation and social frailty. Clarifying this relationship may serve as a new preventive measure against social frailty among current non-drivers. This study examined the potential association of driving status and transport use with social frailty, as well as between the frequency of transport use and social frailty, among current non-drivers. Methods: This study included 977 middle-aged and older adults (average age 65.3 ± 4.8 years). The participants were classified as transport users (more than a few times a week) and transport non-users (less than a few times a month). Based on driving status and transport use, the groups were further classified into current driver, current non-driver/transport user, and current non-driver/transport non-user groups. We performed statistical analyses to examine the relationships between driving status, transport use, and social frailty. Results: The current non-driver/transport non-user group showed a significant association with a higher social frailty. The current non-driver/transport user group showed no association with social frailty compared with the current driver group. The current non-driver/transport non-user group showed a significant association with a higher social frailty rate (OR 2.14, 95%CI 1.25-3.73). Conclusions: Participants who did not drive or take transport showed significant associations with increased social frailty. Compared with current driver/transport use, current non-driver/transport non-use was associated with social frailty.

Cardiac disease-induced trauma and stress-related disorders.

OBJECTIVE: This review aims to present an updated overview of cardiac disease-induced trauma and stress-related disorders such as acute stress disorder (ASD), adjustment disorder (AjD), and posttraumatic stress disorder (PTSD). First, the prevalence of these disorders, their diagnostic criteria, and their differences from other trauma-related disorders are described. Special challenges in diagnosis and treatment are identified, with various screening tools being evaluated for symptom assessment. Additionally, the risk factors studied so far for the development of symptoms of cardiac-induced posttraumatic stress disorder and the bidirectional relationship between posttraumatic stress disorder and cardiovascular diseases are summarized. Various therapeutic interventions, including pharmacological approaches, are also discussed. Finally, various areas for future research are outlined. BACKGROUND: Experiencing a cardiovascular disease, particularly a life-threatening cardiac event, can potentially lead to stress-related disorders such as ASD, AjD, and cardiac disease-induced PTSD (CDI-PTSD). If left untreated, these disorders are associated with a worsening cardiac prognosis and higher mortality rates. Approaching treatment through a trauma-focused lens may be beneficial for managing CDI-PTSD and stress-related disorders. CONCLUSION: Future research should explore treatment options for both the patients and the caregivers as well as investigate the long-term effects of trauma-focused interventions on physical and mental health outcomes.

Will structural adjustment and financial support affect low-carbon agricultural production in the Yellow River Basin?

Based on the panel data of 75 cities in the Yellow River Basin from 2000 to 2020, this manuscript measures the agricultural low-carbon production efficiency scientifically through the Super-SBM model. In addition, the deviation degree of agricultural industry is used as the index of structural adjustment. Finally, the spatial Durbin model is used to analyze the effect direction and degree of structural adjustment, financial support, and their synergistic effect on agricultural low-carbon production efficiency. The results show that ① the agricultural low-carbon production efficiency in the Yellow River Basin shows a trend of fluctuating downward and a spatial distribution pattern of "high in the east and low in the west". ② Structural adjustment in local region and adjacent areas has a significantly negative impact on agricultural low-carbon production, and the inhibitory effect in adjacent areas is more obvious, and the negative spatial spillover effect is strong. Financial support has a significantly positive impact on agricultural low-carbon production, but the spatial spillover effect of adjacent areas is not obvious. ③ By region, structural adjustment has a significantly negative impact on low-carbon agricultural production in the midstream and downstream regions, while financial support has a significantly positive impact on low-carbon agricultural production in the upstream region. The impact of control variables on agricultural low-carbon production varies from region to region. ④ The synergistic effect of structural adjustment and financial support in the whole and midstream region shows a significantly positive impact on agricultural low-carbon production, indicating that financial support has a certain correction effect on structural adjustment. The coefficient between the upstream and downstream regions is positive but not significant. The conclusions have important reference significance for promoting the ecological protection and high-quality development and agricultural low-carbon development in the Yellow River Basin.

The increasingly dominant role of climate change on length of day variations.

The melting of ice sheets and global glaciers results in sea-level rise, a pole-to-equator mass transport increasing Earth's oblateness and resulting in an increase in the length of day (LOD). Here, we use observations and reconstructions of mass variations at the Earth's surface since 1900 to show that the climate-induced LOD trend hovered between 0.3 and 1.0 ms/cy in the 20th century, but has accelerated to 1.33 [Formula: see text] 0.03 ms/cy since 2000. We further show that surface mass transport fully explains the accelerating trend in the Earth oblateness observed in the past three decades. We derive an independent measure of the decreasing LOD trend induced by Glacial Isostatic Adjustment (GIA) of [Formula: see text]0.80 [Formula: see text] 0.10 ms/cy, which provides a constraint for the mantle viscosity. The sum of this GIA rate and lunar tidal friction fully explains the secular LOD trend that is inferred from the eclipse record in the past three millennia prior to the onset of contemporary climate change. Projections of future climate warming under high emission scenarios suggest that the climate-induced LOD rate may reach 2.62 [Formula: see text] 0.79 ms/cy by 2100, overtaking lunar tidal friction as the single most important contributor to the long-term LOD variations.

Using bone mineral apparent density for BMD adjustment in chronic diseases: Thalassemia an example.

Background: Low BMD is a common problem in major thalassaemia patient, but the use of DXA in chronic disease children with smaller bones, has some problems. Utilizing bone mineral apparent density (BMAD) helps in preventing this obstacle. Testing the usefulness of this method in resolving the effects of bone size on BMD by comparing the BMD and BMAD of our thalassemics with results of our healthy ones, is our goal. Methods: Sample size was 110 cases with mean age of 9.6 ± 4.3 y/o and contained 73 males. Gauge of BMDs done by dual x-ray absorptiometry. Then BMAD was calculated. We did comparison of BMDs and BMADs results of thalassemic children with results of healthy Iranian pediatrics. Results: Mean of femoral BMD and BMAD, spinal BMD and BMAD was 0.579±0.134 g/cm2, 0.162±0.096 g/cm3, 0.563±0.118 g/cm2 and 0.107±0.015, respectively. When results of 9-18 patients compared with BMDs and BMADs of normal children, BMD of femur and BMD and BMAD of spine of patients found significantly lower (P-values, 0.003, <0.001, <0.001, respectively). BMAD of femur of patients was not significantly different from normals. Conclusion: When bone mineral density of femur modifies by bone mineral apparent density formula, the remarkable difference between BMD of patients and normals; vanishes. Utilizing bone mineral apparent density helps in interpretation of femoral dual X-ray absorptiometry at least in thalassemic patients. As the results of vertebrae, after modification by calculating BMAD, remains significantly different, we cannot bring forward BMAD for mentioned aim in the spine of thalassemics.

Reduction in motor error by presenting subthreshold somatosensory information during visuomotor tracking tasks.

Weak sensory noise acts on the nervous system and promotes sensory and motor functions. This phenomenon is called stochastic resonance and is expected to be applied for improving biological functions. This study investigated the effect of electrical stimulation on grip force adjustment ability. The coefficient of variation and absolute motor error in grip force was measured during a visuomotor tracking task under different intensities of somatosensory noise. Depending on the style of force exertion, the grip movement used in the visuomotor tracking task consisted of force generation (FG), force relaxation (FR), and constant contraction (Constant) phases. The subthreshold condition resulted in significantly lower coefficient of variation in the Constant phase and motor errors in the FG and Constant phases than the no-noise condition. However, the differences among the other conditions were insignificant. Additionally, we examined the correlation between the motor error in the condition without electrical stimulation and the change in motor error induced by subthreshold electrical stimulation. Significant negative correlations were observed in all FG, FR, and Constant phases. These results indicated that somatosensory noise had a strong effect on subjects with large motor errors and enhanced the grip force adjustment ability. By contrast, subjects with small motor errors had weak improvement in motor control. Although the effect of subthreshold noise varies depending on the individual differences, stochastic resonance is effective in improving motor control ability.

Influence of Education on Dental Anxiety and Fear in Mental Disorders after Viewing a Molar Extraction in Three Types of Mental Disorder Compared to Persons with No Mental Disorder.

Objective: The goal of this study is to validate the psychometric properties of the Modified Dental Anxiety Scale (MDAS) and the Dental Fear Scale (DFS) at three different times: seven days before, immediately after, and seven days after watching a video of surgical extraction of a lower third molar in a sample with four strata: anxiety disorder, adjustment disorder, mixed anxiety-depressive disorder, and no mental disorder ages 18-70 in a psychiatric clinic in Malaga. Methods: The Research Ethics Committee of the Virgen Macarena-Virgen del Rocío Hospitals approved the study. After being interviewed by a psychiatrist and subsequently completing the Hamilton Rating Scales for Anxiety and Depression, the participants were divided into 4 strata (60 persons in each). The influence of education level was then analyzed. Results: The scales demonstrated good psychometric properties, with higher MDAS and DFS scores for lower levels of education and mixed anxiety-depressive disorder. Conclusions: Patients who show higher levels of dental anxiety and dental fear will be those with lower education levels, as well as those who suffer from mixed anxiety-depressive disorder.

In Search of Variables Affecting Mental Adjustment and Acceptance of Cancer among Urological Patients.

Background/Objectives: Genitourinary cancers are now considered a major problem in modern medicine. In urological oncology, the most frequently occurring diseases are prostate, bladder and renal cancer. Any cancer has a profound effect on the life of a patient. Therefore, disease acceptance and mental adjustment to the condition are the key elements in coping with cancer. Aim: The main aim of the study was the determination of the level of acceptance of illness and mental adjustment to cancer in urological patients undergoing surgical treatment and the assessment of the effect of mental adjustment on disease acceptance. Material and Methods: The study group comprised 150 patients treated at the Department of Urology and Urological Oncology at the Independent Public Clinical Hospital No 2 in Szczecin. The study made use of the diagnostic survey method with the original questionnaire and standardized research tools: Acceptance of Illness Scale (AIS) and Mental Adjustment to Cancer Scale (Mini-MAC). Results: The analysis of mental adjustment to cancer according to Mini-MAC revealed that the respondents most frequently adopted the fighting spirit strategy (M; 22.22). Slightly less frequently adopted strategies were positive re-evaluation (M; 21.28) and anxious preoccupation (M; 17.07). The least frequently adopted strategy was the helplessness-hopelessness strategy (M; 13.14). The analysis of data showed a statistically significant negative correlation (r = -0.245; p = 0.003) between disease acceptance according to AIS and age. The data analysis revealed a statistically significant positive correlation with helplessness-hopelessness and destructive style (p < 0.05). Conclusions: Mental adjustment to cancer was found to affect the acceptance of illness. When providing comprehensive care to cancer patients, it is equally crucial to consider the physical as well as mental health aspect, taking into account the aforementioned factors which affect both acceptance as well as adjustment to disease.

Developing the Additive Systems of Stand Basal Area Model for Broad-Leaved Mixed Forests.

Stand basal area (SBA) is an important variable in the prediction of forest growth and harvest yield. However, achieving the additivity of SBA models for multiple tree species in the complex structure of broad-leaved mixed forests is an urgent scientific issue in the study of accurately predicting the SBA of mixed forests. This study used data from 58 sample plots (30 m × 30 m) for Populus davidiana × Betula platyphylla broad-leaved mixed forests to construct the SBA basic model based on nonlinear least squares regression (NLS). Adjustment in proportion (AP) and nonlinear seemingly unrelated regression (NSUR) were used to construct a multi-species additive basal area prediction model. The results identified the Richards model (M6) and Korf model (M1) as optimal for predicting the SBA of P. davidiana and B. platyphylla, respectively. The SBA models incorporate site quality, stand density index, and age at 1.3 m above ground level, which improves the prediction accuracy of basal area. Compared to AP, NSUR is an effective method for addressing the additivity of basal area in multi-species mixed forests. The results of this study can provide a scientific basis for optimizing stand structure and accurately predicting SBA in multi-species mixed forests.

Foliar Application of Chitosan (CTS), γ-Aminobutyric Acid (GABA), or Sodium Chloride (NaCl) Mitigates Summer Bentgrass Decline in the Subtropical Zone.

Creeping bentgrass (Agrostis stolonifera) is an excellent cool-season turfgrass that is widely used in urban gardening, landscaping, and golf turf. Triennial field experiments from 2017 to 2019 were conducted to investigate effects of the foliar application of chitosan (CTS), γ-aminobutyric acid (GABA), or sodium chloride (NaCl) on mitigating summer bentgrass decline (SBD) and exploring the CTS, GABA, or NaCl regulatory mechanism of tolerance to summer heat stress associated with changes in chlorophyll (Chl) loss and photosynthetic capacity, osmotic adjustment (OA), oxidative damage, and cell membrane stability. The findings demonstrated that persistent ambient high temperatures above 30 °C during the summer months of 2017, 2018, and 2019 significantly reduced the turf quality (TQ), Chl content, photochemical efficiency of PSII (Fv/Fm and PIABS), leaf relative water content, and osmotic potential (OP) but significantly increased electrolyte leakage (EL) and the accumulations of free proline, water-soluble carbohydrate (WSC), hydrogen peroxide (H2O2), and malondialdehyde (MDA). The foliar application of CTS, GABA, or NaCl could significantly alleviate SBD, as reflected by improved TQ and delayed Chl loss during hot summer months. Heat-induced declines in Fv/Fm, PIABS, the net photosynthetic rate (Pn), the transpiration rate (Tr), and water use efficiency (WUE) could be significantly mitigated by the exogenous application of CTS, GABA, or NaCl. In addition, the foliar application of CTS, GABA, or NaCl also significantly improved the accumulations of free proline and WSC but reduced the EL, OP, and H2O2 content and the MDA content in leaves of creeping bentgrass in favor of water and redox homeostasis in summer. Based on the comprehensive evaluation of the subordinate function value analysis (SFVA), the CTS had the best effect on the mitigation of SBD, followed by GABA and NaCl in 2017, 2018, and 2019. The current study indicates that the foliar application of an appropriate dose of GABA, CTS, or NaCl provides a cost-effective strategy for mitigating SBD.

Development and validation of the HMS-Sepsis mortality model.

BACKGROUND: When comparing outcomes after sepsis, it is essential to account for patient case mix to make fair comparisons. We developed a model to assess risk-adjusted 30-day mortality in the Michigan Hospital Medicine Safety's sepsis initiative (HMS-Sepsis). QUESTION: Can HMS-Sepsis registry data adequately predict risk of 30-day mortality? Do performance assessments using adjusted vs unadjusted data differ? STUDY DESIGN AND METHODS: Retrospective cohort of community-onset sepsis hospitalizations in HMS-Sepsis registry (4/2022-9/2023), with split derivation (70%) and validation (30%) cohorts. We fit a risk-adjustment model (HMS-Sepsis mortality model) incorporating acute physiology, demographic, and baseline health data and assessed model performance using c-statistics, Brier's scores, and comparisons of predicted vs observed mortality by deciles of risk. We compared hospital performance (1st quintile, middle quintiles, 5th quintile) using observed versus adjusted mortality to understand the extent to which risk-adjustment impacted hospital performance assessment. RESULTS: Among 17,514 hospitalizations from 66 hospitals during the study period, 12,260 (70%) were used for model derivation and 5,254 (30%) for model validation. 30-day mortality for the total cohort was 19.4%. The final model included 13 physiologic variables, two physiologic interactions, and 16 demographic and chronic health variables. The most significant variables were age, metastatic solid tumor, temperature, altered mental status, and platelet count. The model c-statistic was 0.82 for the derivation cohort, 0.81 for the validation cohort, and ≥0.78 for all subgroups assessed. Overall calibration error was 0.0% and mean calibration error across deciles of risk was 1.5%. Standardized mortality ratios yielded different assessments than observed mortality for 33.9% of hospitals. CONCLUSIONS: The HMS-Sepsis mortality model had strong discrimination, adequate calibration, and reclassified one-third of hospitals to a different performance category from unadjusted mortality. Based on its strong performance, the HMS-Sepsis mortality model can aid in fair hospital benchmarking, assessment of temporal changes, and observational causal inference analysis.

Real-time analgesic efficacy and factors determining drug requirements of combined spinal-epidural analgesia for labor: a prospective cohort study.

PURPOSE: Combined spinal-epidural analgesia (CSEA) is effective but not sufficient for labor pain. This study was conducted to assess the real-time analgesic efficacy, side effects of anesthetic drug dosage, and maternal satisfaction in labor to provide reference for the optimization of labor analgesia. METHODS: This was a prospective, cohort, single-center study that included 3020 women who received CSEA for labor analgesia. The visual analogue scale (VAS) for labor pain, real-time anesthetic drug dosage, side effects, adverse labor outcomes, factors influencing average drug dosage, and maternal satisfaction with CSEA were assessed. RESULTS: Overall, the VAS labor pain score was lowest at the first hour after the anesthesia was given. After 4 h for primiparas and 3 h for multiparas, the VAS score was greater than 3 but the anesthetic drug dosage did not reach the maximum allowed dosage at the same time. The average anesthetic drug dosage was positively correlated with fever, urinary retention, uterine atony, prolonged active phase, prolonged second stage, assisted vaginal delivery, and postpartum hemorrhage. The average anesthetic drug dosage was the highest in women ≤ 20 years old, those with a body mass index (BMI) ≥ 24.9 kg/m2, and those with a primary or secondary education level. CONCLUSION: Appropriate age guidance and emphasis on education of labor analgesia, weight management during pregnancy, and real-time anesthetic dosage adjustment during labor based on VAS pain score may have positive effects on the satisfaction of labor analgesia. CLINICAL TRIAL NUMBER AND REGISTRY: Clinicaltrials.gov (ChiCTR2100051809).

Race-specific FRAX models are evidence-based and support equitable care: a response to the ASBMR Task Force report on Clinical Algorithms for Fracture Risk.

Task Force on 'Clinical Algorithms for Fracture Risk' commissioned by the American Society for Bone and Mineral Research (ASBMR) Professional Practice Committee has recommended that FRAX® models in the US do not include adjustment for race and ethnicity. This position paper finds that an agnostic model would unfairly discriminate against the Black, Asian and Hispanic communities and recommends the retention of ethnic and race-specific FRAX models for the US, preferably with updated data on fracture and death hazards. In contrast, the use of intervention thresholds based on a fixed bone mineral density unfairly discriminates against the Black, Asian and Hispanic communities in the US. This position of the Working Group on Epidemiology and Quality of Life of the International Osteoporosis Foundation (IOF) is endorsed both by the IOF and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO).

A novel dose-adjustment protocol for interrupted subcutaneous immunotherapy in children with allergic rhinitis.

Aim: To assess the effectiveness and safety of a new protocol for adjusting doses during interrupted subcutaneous immunotherapy maintenance, exceeding an 8-week interval, with mite allergen injections in children with allergic rhinitis. Patients & methods: 194 children with allergic rhinitis who underwent subcutaneous immunotherapy and experienced interruptions lasting more than 8 weeks during maintenance were enrolled. Following the adoption of a novel dose-adjustment protocol, a real-world study was conducted. Results: After 3 years of subcutaneous immunotherapy, the novel group exhibited a significant reduction in allergy symptoms compared with baseline. Systemic reactions related to the novel protocol did not significantly increase. Conclusion: The novel protocol was deemed safe and effective, offering advantages of time savings and reduced burdens.

There is a main treatment for allergic rhinitis. it is with regular shots of a special medicine made from dust mite allergen. Patients need to take these shots in their arm for 3 years. The shot is given once a week for 14 weeks at first; then the frequency can be reduced to every 5 weeks. However, if a patient misses their scheduled shot, they may have to start getting weekly shots again. This can lead to a lot of medical waste and can be expensive for patients. Therefore, we developed a new way to give these shots. In our study, patients who needed to start weekly shots again were administered this new treatment plan. The new plan significantly reduced the number of doctor's visits and shots. This new treatment method is safe, cost-effective and patient-friendly.