Heart Rate Variability and Pulse Rate Variability: Do Anatomical Location and Sampling Rate Matter?

Wearable technology and neuroimaging equipment using photoplethysmography (PPG) have become increasingly popularized in recent years. Several investigations deriving pulse rate variability (PRV) from PPG have demonstrated that a slight bias exists compared to concurrent heart rate variability (HRV) estimates. PPG devices commonly sample at ~20-100 Hz, where the minimum sampling frequency to derive valid PRV metrics is unknown. Further, due to different autonomic innervation, it is unknown if PRV metrics are harmonious between the cerebral and peripheral vasculature. Cardiac activity via electrocardiography (ECG) and PPG were obtained concurrently in 54 participants (29 females) in an upright orthostatic position. PPG data were collected at three anatomical locations: left third phalanx, middle cerebral artery, and posterior cerebral artery using a Finapres NOVA device and transcranial Doppler ultrasound. Data were sampled for five minutes at 1000 Hz and downsampled to frequencies ranging from 20 to 500 Hz. HRV (via ECG) and PRV (via PPG) were quantified and compared at 1000 Hz using Bland-Altman plots and coefficient of variation (CoV). A sampling frequency of ~100-200 Hz was required to produce PRV metrics with a bias of less than 2%, while a sampling rate of ~40-50 Hz elicited a bias smaller than 20%. At 1000 Hz, time- and frequency-domain PRV measures were slightly elevated compared to those derived from HRV (mean bias: ~1-8%). In conjunction with previous reports, PRV and HRV were not surrogate biomarkers due to the different nature of the collected waveforms. Nevertheless, PRV estimates displayed greater validity at a lower sampling rate compared to HRV estimates.

[Effects of nasal valve on subjective nasal patency and nasal resistance: a correlation study on numerical simulation of nasal airflow].

Objective: To investigate the correlations between subjective nasal patency, nasal valve area size and aerodynamic parameters in normal nasal cavity by means of numerical simulation, and to explore the effect of nasal valve on nasal subjective sensation and nasal airflow regulation. Methods: A total of 52 healthy participants (31 males and 21 females) with the average age of 37.8 years, were recruited from the outpatient Department of Otorhinolaryngology Head and Neck Surgery, the Ninth People's Hospital Affiliated to the Medical College of Shanghai Jiao Tong University between January and August 2023. Visual Analog Scale (VAS) scores for unilateral nasal subjective sensation were obtained from all participants. Additionally, the aerodynamic characteristics of inspiratory airflow were simulated. A correlation matrix analysis was conducted to identify the correlation strength between these subjective and objective parameters. Results: VAS scores showed negative correlations with unilateral nasal valve cross-sectional area (r=-0.85, P<0.01) and unilateral intranasal airflow (r=-0.57, P<0.01), and was a positive correlation with unilateral nasal resistance (NR) at the front-end of inferior turbinate (r=0.61, P<0.01). The average cross-sectional area of unilateral nasal valve was (0.85±0.35) cm2. The cross-sectional area of unilateral nasal valve was negatively correlated with unilateral NR (r=-0.50, P<0.01), and positively correlated with unilateral nasal airflow (r=0.61, P<0.01). The NR at the nasal valve area accounted for (40.41±23.54)% of the total unilateral NR. Nearly half of the unilateral NR [(46.74±21.38)%] and air warming [(49.96±10.02)%] occurring before the front end of inferior turbinate were achieved. Conclusions: The nasal valve area plays a crucial role in influencing nasal NR, unilateral nasal airflow, and changes in nasal airflow temperature. Moreover, it is associated with subjective perception of nasal patency.

Correlación entre el polimorfismo de los genes LHCGR y NR5A1y el riesgo de infertilidad masculina / Correlation between LHCGR and NR5A1 genes polymorphism and male infertility risk

Introducción La infertilidad constituye un problema de salud que afecta gravemente la reproducción humana. En el caso de la infertilidad masculina, la mayoría de los casos se deben a factores genéticos. En este estudio nos propusimos realizar un análisis de correlación entre la infertilidad masculina idiopática y el polimorfismo de un solo nucleótido (SNP, por Single Nucleotide Polymorphism) de los genes LHCGR (rs2293275) y NR5A1 (rs1057517779) en la población azerí de Irán. Métodos En este estudio de casos y controles participaron 100 varones infértiles y 100 varones sanos procedentes de la población azerí iraní. La genotipificación se realizó mediante el aislamiento del ADN genómico a partir de muestras de sangre total con el sistema de amplificación por reacción en cadena de la polimerasa refractario a mutaciones Tetra-primer (Tetra-ARMS-PCR). El análisis de los datos se llevó a cabo mediante la prueba de Chi-cuadrado (χ2) y la prueba exacta de Fisher. Resultados Según el análisis de genotipificación del polimorfismo LHCGR (rs2293275), la frecuencia del alelo C en el grupo de casos era significativamente mayor que en el grupo de control (p<0,05). El análisis del polimorfismo NR5A1 (rs1057517779) indicó que la frecuencia del alelo A y del genotipo heterocigoto GA en el grupo de casos era significativamente superior a la del grupo de control (p<0,05). Conclusión Nuestro estudio demostró que los SNP de los genes LHCGR (rs2293275) y NR5A1 (rs1057517779) pueden desempeñar un papel crucial en la infertilidad masculina de la población azerí en Irán. Sin embargo, se requieren más estudios realizados en otros orígenes étnicos con muestras de mayor tamaño para obtener resultados más precisos. Además, podrían ser necesarios experimentos funcionales para comprender el papel de estos polimorfismos en las vías moleculares implicadas en la fertilidad masculina. (AU)

Introduction Infertility is one of the important phenomena in human reproduction. Genetic factors are the most important cause of male infertility. Here, we aimed to investigate the correlation between idiopathic male infertility and SNPs of the LHCGR (rs2293275) and NR5A1 (rs1057517779) genes in the Iranian-Azeri population. Methods This case-control study consisted of 100 males with infertility and 100 healthy males from the Iranian Azeri population. Genomic DNA isolation from whole blood samples and Tetra-primer amplification refractory mutation system-polymerase chain reaction (Tetra-ARMS-PCR) method was used for genotyping. The data analysis was performed by Chi-square (χ2) and Fisher's exact tests. Results Genotyping analysis for LHCGR (rs2293275) polymorphism indicated that the frequency of C in the case group was significantly higher than in the control group (P<.05). Moreover, genotyping analysis for NR5A1 (rs1057517779) polymorphism indicated that the frequencies of the A allele and heterozygote GA genotype in the case group were significantly higher than those in the control group (P<.05). Conclusion Our study demonstrated that the SNPs of LHCGR (rs2293275) and NR5A1 (rs1057517779) genes may play a critical role in male infertility in the Iranian Azeri population. However, further studies on other ethnic origins with larger sample sizes are essential for accessing more accurate results. Moreover, functional experiments might be needed to understand the role of these polymorphisms in the molecular pathways involved in male fertility. (AU)

A simplified, 2-question grading system for evaluating abstracts in orthopedic scientific meetings: a serial randomization study.

BACKGROUND AND PURPOSE: Efficient abstract scoring for congress presentation is important. Given the emergence of new study methodologies, a scoring system that accommodates all study designs is warranted. We aimed to assess the equivalence of a simplified, 2-question abstract grading system with a more complex currently used system in assessing abstracts submitted for orthopedic scientific meetings in a serial randomized study. METHODS: Dutch Orthopedic Association Scientific Committee (DOASC) members were randomized to grade abstracts using either the current grading system, which includes up to 7 scoring categories, or the new grading system, which consists of only 2 questions. Pearson correlation coefficient and mean abstract score with 95% confidence intervals (CI) were calculated. RESULTS: Analysis included the scoring of 195 abstracts by 12-14 DOASC members. The average score for an abstract using the current system was 60 points (CI 58-62), compared with 63 points (CI 62-64) using the new system. By using the new system, abstracts were scored higher by 3.3 points (CI 1.7-5.0). Pearson correlation was poor with coefficient 0.38 (P < 0.001). CONCLUSION: The simplified abstract grading system exhibited a poor correlation with the current scoring system, while the new system offers a more inclusive evaluation of varying study designs and is preferred by almost all DOASC members.

[Correlation study of NCF2 in chronic rhinosinusitis with nasal polyps].

Objective:After selecting NCF2 based on bioinformatics, clinical experiments were conducted to verify the expression of NCF2 in chronic rhinosinusitis with nasal polyps to study its correlation. Methods:The differentially expressed genes（DEGs） between CRSwNP and non-CRS patients were explored using the CRS-related dataset from the gene expression omnibus GEO database. The weighted gene co-expression network（WGCNA） was used for cluster analysis. The expression and cell distribution of NCF2 in the tissues were determined by single gene enrichment analysis（GSEA）, immune inflammatory infiltration analysis, and principal component（PCA） analysis. The expression degree of NCF2 in the tissues of the subjects was determined by immunohistochemistry, and the percentage of EOS in the peripheral blood of the subjects was detected and the correlation was analyzed. EOS in the tissues of the subjects were counted under a microscope and compared. Results:①The Venn diagram was obtained by crossing the module with the highest correlation between DEGs and WGCNA to determine the core gene NCF2. ②GSEA analysis showed that NCF2 was significantly related to the immunological processes such as allogeneic rejection and asthma. ③The area under the ROC curve was 1, indicating that NCF2 had diagnostic value for CRSwNP. ④NCF2 was highly expressed in nasal polyps, mainly distributed in monocytes and eosinophils. ⑤HE staining showed that the number of EOS in ECRSwNP tissues and the percentage of eosinophils in peripheral blood were higher than those in nonECRSwNP and control groups. ⑥The immunohistochemistry results showed that NCF2 was significantly expressed in the nasal polyps of ECRSwNP patients, which was higher than that in the nasal mucosa of nonECRSwNP group and control group. ⑦The expression of NCF2 in tissues was positively correlated with EOS count in ECRSwNP group and EOS expression in peripheral blood. Conclusion:The expression of NCF2 is increased in eosinophilic chronic rhinosinusitis with nasal polyps, and it is significantly correlated with the expression of eosinophils in peripheral blood and tissues, suggesting that NCF2 may be used as a basis for the intrinsic classification of ECRSwNP and a reference index for clinical diagnosis and treatment.

The multi-strategy hybrid forecasting base on SSA-VMD-WST for complex system.

In view of the strong randomness and non-stationarity of complex system, this study suggests a hybrid multi-strategy prediction technique based on optimized hybrid denoising and deep learning. Firstly, the Sparrow search algorithm (SSA) is used to optimize Variational mode decomposition (VMD) which can decompose the original signal into several Intrinsic mode functions (IMF). Secondly, calculating the Pearson correlation coefficient (PCC) between each IMF component and the original signal, the subsequences with low correlation are eliminated, and the remaining subsequence are denoised by Wavelet soft threshold (WST) method to obtain effective signals. Thirdly, on the basis of the above data noise reduction and reconstruction, our proposal combines Convolutional neural network (CNN) and Bidirectional short-term memory (BiLSTM) model, which is used to analyze the evolution trend of real time sequence data. Finally, we applied the CNN-BiLSTM-SSA-VMD-WST to predict the real time sequence data together with the other methods in order to prove it's effectiveness. The results show that SNR and CC of the SSA-VMD-WST are the largest (the values are 20.2383 and 0.9342). The performance of the CNN-BiLSTM-SSA-VMD-WST are the best, MAE and RMSE are the smallest (which are 0.150 and 0.188), the goodness of fit R2 is the highest(its value is 0.9364). In contrast with other methods, CNN-BiLSTM-SSA-VMD-WST method is more suitable for denoising and prediction of real time series data than the traditional and singular deep learning methods. The proposed method may provide a reliable way for related prediction in various industries.

Association between self-reported METs and other perioperative cardiorespiratory fitness assessment tools in abdominal surgery-a prospective cross-sectional correlation study.

Cardiovascular complications represent a significant proportion of adverse events during the perioperative period, necessitating accurate preoperative risk assessment. This study aimed to investigate the association between well-established risk assessment tools and self-reported preoperative physical performance, quantified by metabolic equivalent (MET) equivalents, in high-risk patients scheduled for elective abdominal surgery. A prospective cross-sectional correlation study was conducted, involving 184 patients admitted to a Gastrointestinal Surgery Department. Various risk assessment tools, including the Revised Cardiac Risk Index (RCRI), Surgical Mortality Probability Model (S-MPM), American University of Beirut (AUB)-HAS2 Cardiovascular Risk Index, and Surgical Risk Calculator (NSQIP-MICA), were utilized to evaluate perioperative risk. Patients self-reported their physical performance using the MET-REPAIR questionnaire. The findings demonstrated weak or negligible correlations between the risk assessment tools and self-reported MET equivalents (Spearman's ρ = - 0.1 to - 0.3). However, a statistically significant relationship was observed between the ability to ascend two flights of stairs and the risk assessment scores. Good correlations were identified among ASA-PS, S-MPM, NSQIP-MICA, and AUB-HAS2 scores (Spearman's ρ = 0.3-0.8). Although risk assessment tools exhibited limited correlation with self-reported MET equivalents, simple questions regarding physical fitness, such as the ability to climb stairs, showed better associations. A comprehensive preoperative risk assessment should incorporate both objective and subjective measures to enhance accuracy. Further research with larger cohorts is needed to validate these findings and develop a comprehensive screening tool for high-risk patients undergoing elective abdominal surgery.

Ensemble Extreme Learning Machine Method for Hemoglobin Estimation Based on PhotoPlethysmoGraphic Signals.

Non-invasive detection of hemoglobin (Hb) concentration is of great clinical value for health screening and intraoperative blood transfusion. However, the accuracy and stability of non-invasive detection still need to be improved to meet clinical requirement. This paper proposes a non-invasive Hb detection method using ensemble extreme learning machine (EELM) regression based on eight-wavelength PhotoPlethysmoGraphic (PPG) signals. Firstly, a mathematical model for non-invasive Hb detection based on the Beer-Lambert law is established. Secondly, the captured eight-channel PPG signals are denoised and fifty-six feature values are extracted according to the derived mathematical model. Thirdly, a recursive feature elimination (RFE) algorithm is used to select the features that contribute most to the Hb prediction. Finally, a regression model is built by integrating several independent ELM models to improve prediction stability and accuracy. Experiments conducted on 249 clinical data points (199 cases as the training dataset and 50 cases as the test dataset) evaluate the proposed method, achieving a root mean square error (RMSE) of 1.72 g/dL and a Pearson correlation coefficient (PCC) of 0.76 (p < 0.01) between predicted and reference values. The results demonstrate that the proposed non-invasive Hb detection method exhibits a strong correlation with traditional invasive methods, suggesting its potential for non-invasive detection of Hb concentration.

Translation and validation of the Chinese version of the menstrual distress questionnaire.

BACKGROUND: The Menstrual Distress Questionnaire (MDQ) is a commonly used questionnaire that assesses various symptoms and distress associated with the menstrual cycle in women. However, the questionnaire has not been completely translated into Chinese with rigorous reliability and validity testing. METHODS: This study translated the Menstrual Distress Questionnaire Form Cycle (MDQC) from English into Chinese: MDQCC in two stages. First, it was translated forward and backward using Jones' model; second, to test the validity and reliability, 210 Chinese-speaking women were recruited through online announcements and posters posted between June 2019 and May 2020. Expert validity, construct validity, convergent validity, and factorial validity were determined using content validity index (CVI), intraclass correlation coefficient (ICC), composite reliability (CR), and exploratory factor analysis, respectively. For concurrent criterion validity, MDQCC score was compared with three existing pain scales. Reliability was evaluated using internal consistency across items and two-week test-retest reliability over time. RESULTS: The CVI for content validity was .92. Item-CVI for expert validities among the 46 items ranged from .50 - 1; scale-CVI for the eight subscales, from .87 - 1; ICC, from .650 - .897; and CRs, from .303 - .881. Pearson correlation coefficients between MDQCC and short-form McGill pain questionnaire, present pain intensity, and visual analog scale scores were .640, .519, and .575, respectively. Cronbach's α for internal consistency was satisfactory (.932). ICC for test-retest reliability was .852 for the entire MDQCC. CONCLUSION: MDQCC was valid and reliable for Mandarin Chinese-speaking women. It can be used to evaluate female psychiatric symptoms related to the menstrual cycle in future work.

The Menstrual Distress Questionnaire has been used to evaluate menstrual distress, including dysmenorrhoea and premenstrual syndrome. This questionnaire has been translated into Persian, Korean, Japanese, and Cantonese, rendering it to be used more and more widely all over the world. The study translated all 46 items of the Menstrual Distress Questionnaire from English to Mandarin Chinese using a two-stage strategy. The Chinese version of this questionnaire developed by the present study was found to be a valid and reliable tool in Chinese Mandarin-speaking female populations. It could be used to evaluate women's physical and psychiatric symptoms related to the menstrual cycle in future works.

Calidad de vida de las personas con enfermedad de Parkinson durante el confinamiento por la pandemia por covid-19 / Quality of life of people with Parkinson's disease during confinement due to the covid-19 pandemic

Introducción: El estudio tuvo como objetivo explorar la calidad de vida de las personas con enfermedad de Parkinson durante el confinamiento por la pandemia de coronavirus de 2019 (covid-19). Material y métodos: El estudio fue de carácter cuantitativo, descriptivo y correlacional. La muestra fue de 51 personas con enfermedad de Parkinson de la región de Magallanes y Antártica Chilena, y cuya información fue recogida desde la base de datos de la Corporación de Rehabilitación Club de Leones Cruz del Sur, a la cual pertenecen. Resultados: Los principales resultados muestran que el 51,6% de las personas manifiestan una calidad de vida «buena y muy buena» y que los principales dominios del Parkinson's Disease Questionnaire (PDQ-39) afectados son: malestar corporal, movilidad y bienestar emocional. Según el análisis de los rangos cualitativos del PDQ-39, las dimensiones que se mostraron más comprometidas durante el confinamiento por la pandemia por covid-19 fueron: comunicación, estigma y bienestar emocional. Además, las mujeres presentaron peor calidad de vida que los hombres. Por último, se demostró que la progresión de síntomas afecta la calidad de vida de las personas con enfermedad de Parkinson. Conclusiones: Durante el confinamiento por la pandemia por covid-19 las personas con enfermedad de Parkinson aumentaron los síntomas y presentaron una menor calidad de vida, sobre todo las de sexo femenino.(AU)

Introduction: The study was aimed to explore the quality of life of people with Parkinson's disease during confinement due to the coronavirus infectious disease 2019 (covid-19) pandemic. Material and methods: The study was quantitative, descriptive and correlational. The sample was 51 people with Parkinson's disease, from the region of Magallanes and Chilean Antarctica, and whose information was collected from the database of the Rehabilitation Corporation Club de Leones Cruz del Sur, to which they belong. Results: The main results show that 51.6% of people with Parkinson's disease report a «good and very good» quality of life and that the main domains of the Parkinson's Disease Questionnaire (PDQ-39) affected are: body discomfort, mobility and emotional well-being. According to the analysis of the qualitative ranges of the PDQ-39, the dimensions that were most compromised during the confinement by the covid-19 pandemic were: communication, stigma and emotional well-being. In addition, women had a poorer quality of life than men. Finally, it was shown that the progression of symptoms affects the quality of life of people with Parkinson's disease. Conclusions: In conclusion, during the confinement due to the covid-19 pandemic people with Parkinson's disease increased symptoms and presented a lower quality of life, especially women.(AU)

Patient Characteristics and Telemedicine Use in the US, 2022.

Importance: Telemedicine use was common during the COVID-19 pandemic, expanding many patients' approaches to accessing health care. Of concern is whether telemedicine access was poorer among higher-needs and disadvantaged populations. Objective: To assess patient characteristics associated with telemedicine use and telemedicine mode and describe telemedicine visit experiences by telemedicine mode. Design, Setting, and Participants: This cross-sectional study included data from the 2022 Health Information National Trends Survey and included US adults with a health care visit. Data were analyzed from May to September 2023. Exposure: Patient characteristics. Main Outcomes and Measures: Any telemedicine visits vs in-person visits only; telemedicine mode (video vs audio-only). Multivariable logistic models assessed patient characteristics associated with telemedicine visits and mode. Bivariate analyses compared telemedicine experiences by mode. Results: The study included 5437 adult patients (mean [SE] age, 49.4 [0.23] years; 3136 females [53.4%]; 1928 males [46.6%]). In 2022, 2384 patients (43%) had a telemedicine visit; 1565 (70%) had a video visit while 819 (30%) had an audio-only visit. In multivariable models, older age (≥75 years: adjusted odds ratio [aOR], 0.63; 95% CI, 0.42-0.94), no internet use (aOR, 0.62; 95% CI, 0.48-0.81), and living in the Midwest (aOR, 0.50; 95% CI, 0.35-0.70) were negatively associated with having telemedicine visits. Female sex (aOR, 1.43; 95% CI, 1.12-1.83), having chronic conditions (aOR, 2.13; 95% CI, 1.66-2.73), and multiple health care visits (2-4 visits: aOR, 1.77; 95% CI, 1.23-2.54; ≥5 visits: aOR, 3.29; 95% CI, 2.20-4.92) were positively associated. Among individuals who used telemedicine, older age (65-74 years: aOR, 2.13; 95% CI, 1.09-4.14; ≥75 years: aOR, 3.58; 95% CI, 1.60-8.00), no health insurance (aOR, 2.84; 95% CI, 1.42-5.67), and no internet use (aOR, 2.11; 95% CI, 1.18-3.78) were positively associated with having audio-only visits. We observed no significant differences in telemedicine use or mode by education, race and ethnicity, or income. Patients' experiences using telemedicine were generally similar for video and audio-only except more individuals who used audio-only had privacy concerns (20% vs 12%, P = .02). Conclusions and Relevance: In this cross-sectional study of adults with health care visits, many patients, including those with the greatest care needs, chose telemedicine even after in-person visits were available. These findings support continuing this care delivery approach as an option valued by patients. Differences were not observed by most common measures of socioeconomic status. Continued monitoring of telemedicine use is needed to ensure equitable access to health care innovations.

Unraveling the Intraday Variations in the Tear Fluid Proteome.

Purpose: Tear fluid is a complex and dynamic biological fluid that plays essential roles in maintaining ocular homeostasis and protecting against the external environment. Owing to the small sample volume, studying the tear proteome is challenging. However, advances in high-resolution mass spectrometry have expanded tear proteome profiling, revealing >500 unique proteins. Tears are emerging as a noninvasive source of biomarkers for both ocular and systemic diseases; nevertheless, intraday variability of proteins in tear fluid remains questionable. This study investigates intraday variations in the tear fluid proteome to identify stable proteins that could act as candidate biomarkers. Methods: Tear samples from 15 individuals at four time points (10 am, 12 pm, 2 pm, and 4 pm) were analyzed using mass spectrometry to evaluate protein variation during these intervals. Technical variation was assessed by analyzing pooled samples and was subtracted from the total variation to isolate biological variability. Results: Owing to high technical variation, low-abundant proteins were filtered, and only 115 proteins met the criteria for further analysis. These criteria include being detected at all four time points in at least eight subjects, having a mean peptide-spectrum match count greater than 5, and having a technical variation less than 0.10. Lactotransferrin, lipocalin-1, and several immunoglobulins were among the 51 stable proteins (mean biological coefficient of variation < 0.10). Additionally, 43 proteins displayed significant slopes across the 4 time points, with 17 increasing and 26 decreasing over time. Conclusions: These findings contribute to the understanding of tear fluid dynamics and further expand our knowledge of the tear proteome.

Feasibility of images acquired using smartphone camera for marginal and internal fit of fixed dental prosthesis: comparison and correlation study.

This study aimed to measure marginal and internal fit using images captured with both an optical microscope and a smartphone camera, comparing the fit measurement performance of these devices and analyzing their correlation. Working casts (with 10 posterior and 10 anterior teeth) created to fabricate fixed dental prostheses were used. These working casts were scanned using a desktop scanner (E1) to design an interim crown, and the designed interim crown was fabricated using a three-dimensional (3D) printer. Utilizing the silicone replica technique, the fabricated interim crown replicated the fit, which was then captured using both an optical microscope and a smartphone camera. The captured images were used to measure the marginal and internal fit according to the imaging device. Intraclass correlation coefficients (ICC) were used for reliability analysis according to the imaging device. Furthermore, the Wilcoxon signed-rank test was adopted for the comparative evaluation of the marginal and internal fit between the imaging devices (α = 0.05). The measurement results of the marginal and internal fit according to the optical microscope and smartphone camera did exhibit a significant difference (P < 0.05). The ICC between the two devices showed an "excellent" agreement of over 0.9 at all measurement points (P < 0.001). A smartphone camera could be used to obtain images for evaluating the marginal and internal fit.

Assessment of occupational stress among certified registered anesthetists in the Greater Accra region.

Background: Work-related stress is a prevailing concern within the community of Certified Registered Anesthetists (CRAs), significantly impacting both the health and professional performance of these individuals. This study aimed to assess work-related stress and its influencing factors among CRAs practicing in the Greater Accra region was examined. Methods: Using convenience sampling techniques, data were gathered from 140 participants via a Google form questionnaire distributed through WhatsApp. Descriptive statistics were employed to analyze the collected data, focusing on frequencies and proportions for categorical variables. For continuous variables, bivariate analysis (Chi-square) and ordinal logistic regression were conducted using STATA 16. A p-value <0.05 was considered significant. Results: Among the 140 CRAs, 20 individuals (14.3%) reported experiencing mild stress levels according to the Weiman Occupational Stress Scale. Approximately 3 out of 4 CRAs (73.6%) reported having moderate stress levels, and 12.1% reported severe stress levels. This indicated that the majority of CRAs experienced moderate levels of stress, which was notably affected by the type of health facility and the use of inadequate or sub-standard equipment in the hospitals. Conclusion: Based on these findings, the study recommends educational programs and counseling for CRAs to heighten awareness of the demanding nature of their job. Additionally, it suggests the provision of proper resources and standard equipment for CRAs. Facility-level motivation for CRAs is also advised to alleviate their stress. Finally, the study proposes further investigations into the factors contributing to work-related stress among CRAs.

Screening of sustainable supply chain performance evaluation indicators based on the ill-conditioned index cycle method.

The establishment of an evaluation indicator system that can accurately assess the sustainability of a supply chain while further enhancing its performance is vital and relevant. Based on the connotation of sustainable supply chains and triple bottom line theory, indicators are initially proposed from economic, environmental, and social dimensions. To increase the explanatory power of the indicator system and decrease information redundancy, the coefficient of variation is applied to identify the indicators with weak interpretation intensity, the ill-conditioned index cycle method is utilized to filter out indicators with redundant information, and data on 100 Chinese listed companies from 2019 to 2021 are used as samples. A performance evaluation indicator system of sustainable supply chains with 16 indicators is ultimately established. The information interpretation strength index and cumulative information contribution rate verify the rationality of the final indicator system. The outcome demonstrates that this screening method can strengthen the representativeness of the indicator system and rapidly reduce redundancy, leading to the better discrimination of the evaluation results. The findings of this study provide an indicator system and a methodological reference for both companies and policymakers and can aid in the transformation of supply chains toward sustainability.

Measuring e-Professional Behavior of Doctors of Medicine and Dental Medicine on Social Networking Sites: Indexes Construction With Formative Indicators.

BACKGROUND: Previous studies have predominantly measured e-professionalism through perceptions or attitudes, yet there exists no validated measure specifically targeting the actual behaviors of health care professionals (HCPs) in this realm. This study addresses this gap by constructing a normative framework, drawing from 3 primary sources to define e-professional behavior across 6 domains. Four domains pertain to the dangers of social networking sites (SNSs), encompassing confidentiality, privacy, patient interaction, and equitable resource allocation. Meanwhile, 2 domains focus on the opportunities of SNSs, namely, the proactive dissemination of public health information and maintaining scientific integrity. OBJECTIVE: This study aims to develop and validate 2 new measures assessing the e-professional behavior of doctors of medicine (MDs) and doctors of dental medicine (DMDs), focusing on both the dangers and opportunities associated with SNSs. METHODS: The study used a purposive sample of MDs and DMDs in Croatia who were users of at least one SNS. Data collection took place in 2021 through an online survey. Validation of both indexes used a formative approach, which involved a 5-step methodology: content specification, indicators definition with instructions for item coding and index construction, indicators collinearity check using the variance inflation factor (VIF), external validity test using multiple indicators multiple causes (MIMIC) model, and external validity test by checking the relationships of the indexes with the scale of attitude toward SNSs using Pearson correlation coefficients. RESULTS: A total of 753 responses were included in the analysis. The first e-professionalism index, assessing the dangers associated with SNSs, comprises 14 items. During the indicators collinearity check, all indicators displayed acceptable VIF values below 2.5. The MIMIC model showed good fit (χ213=9.4, P=.742; χ2/df=0.723; root-mean-square error of approximation<.001; goodness-of-fit index=0.998; comparative fit index=1.000). The external validity of the index is supported by a statistically significant negative correlation with the scale measuring attitudes toward SNSs (r=-0.225, P<.001). Following the removal of 1 item, the second e-professionalism index, focusing on the opportunities associated with SNSs, comprises 5 items. During the indicators collinearity check, all indicators exhibited acceptable VIF values below 2.5. Additionally, the MIMIC model demonstrated a good fit (χ24=2.5, P=.718; χ2/df=0.637; root-mean-square error of approximation<0.001; goodness-of-fit index=0.999; comparative fit index=1.000). The external validity of the index is supported by a statistically significant positive correlation with the scale of attitude toward SNSs (r=0.338; P<.001). CONCLUSIONS: Following the validation process, the instrument designed for gauging the e-professional behavior of MDs and DMDs consists of 19 items, which contribute to the formation of 2 distinct indexes: the e-professionalism index, focusing on the dangers associated with SNSs, comprising 14 items, and the e-professionalism index, highlighting the opportunities offered by SNSs, consisting of 5 items. These indexes serve as valid measures of the e-professional behavior of MDs and DMDs, with the potential for further refinement to encompass emerging forms of unprofessional behavior that may arise over time.

Correlación entre especies del género Demodex en chalaziones primarios y recurrentes / Correlation between Demodex species in primary and recurrent chalazia

Objetivo: Determinar la correlación entre la infestación por especies de Demodex y la ocurrencia de chalaziones primarios y recurrentes. Métodos: Estudio prospectivo y observacional. Se incluyeron pacientes con chalaziones primarios o recurrentes. Se tomó muestra de pestañas para determinar la presencia microscópica de Demodex spp. Se determinó la correlación entre la recurrencia del chalazión y la infestación por ácaros Demodex spp. mediante la prueba del coeficiente de correlación de rangos de Spearman. Resultados: Se incluyeron 68 pacientes adultos con diagnóstico de chalazión. En 63,2% del total de los casos se documentó la presencia de uno o más parásitos del género Demodex spp. En el estudio parasitológico cuantitativo se encontró que el 25% de todos los casos presentó infestación por Demodex spp. definida por un índice superior o igual a 0,5 parásitos por pestaña. La especie más frecuentemente encontrada fue Demodex folliculorum. De los 14 pacientes con chalazión recurrente el 50% presentó infestación por Demodex spp. y en el 91,7% de los casos la infestación fue por Demodex folliculorum. Existe una correlación positiva y directamente proporcional de (rø=+0,665; p<0,05) entre estos factores. De los pacientes con chalazión primario, solo 18,5% presentaron infestación por Demodex spp., y en el 81,6% de ellos fue causada por Demodex folliculorum. No existe una correlación significativa entre estos factores. Conclusión: Existe una correlación directa, alta y estadísticamente significativa entre la recurrencia del chalazión y la infestación por Demodex spp., no existe una correlación estadísticamente significativa entre los chalaziones primarios y la presencia de Demodex spp.(AU)

Objective: To determine the correlation between the infestation by species of Demodex spp. and the occurrence of primary and recurrent chalazia. Methods: Prospective and observational study. Patients with primary or recurrent chalazia were included. Eyelash samples were taken to determine the microscopic presence of Demodex spp. The correlation between the recurrence of the chalazia and the infestation by Demodex spp. mites was determined using Spearman's rank correlation coefficient test. Results: Sixty-eight adult patients diagnosed with chalazia were included. In 63.2% of the total cases, the presence of one or more parasites of the genus Demodex spp. was documented. In the quantitative parasitological study, it was found that 25% of all cases presented infestation by Demodex spp. defined by an index greater than or equal to 0.5 parasites per eyelash. The most frequently found species was Demodex folliculorum. Of the 14 patients with recurrent chalazia, 50% presented infestation by Demodex spp. and in 91.7% of the cases the infestation was by D. folliculorum. There is a positive, directly proportional correlation between these factors (rθ=+0.665, P<.05). In the group of patients with primary chalazion, only 18.5% presented infestation by Demodex spp., and in 81.6% of these cases it was caused by D. folliculorum. There is a non-statistically significant correlation between these two factors. Conclusion: There is a direct, high and statistically significant correlation between the recurrence of the chalazion and the infestation by Demodex spp., there is no statistically significant correlation between the primary chalazia and the presence of Demodex spp.(AU)

An Exploratory Study in the Portuguese Population on Writing a Suicide Note: Correlates in the Suicide Spectrum and Qualitative Analysis

Suicide notes are an important warning sign for suicidal behaviors. The aim of this exploratory research is (a) to contribute to understanding the place of suicide notes in the spectrum of suicidal behaviors in Portugal, and (b) to analyze the content remembered by individuals regarding a suicide note. Two complementary studies were carried out. In the first, a quantitative investigation, the statistical relationship of writing a suicide note: To the occurrence of lifetime suicide attempts, to lifetime self-harming behaviors, and to suicidal ideation in the two weeks prior to the assessment was evaluated. In the second study, a qualitative investigation, the content recalled by individuals regarding a suicide note was analyzed. In the quantitative study, 841 adults aged between 18 and 65 years, and 1,012 young adults participated. In the qualitative study, 18 young adults participated. Findings of the quantitative study reveal that writing a suicide note significantly related to the lifetime presence of a suicide attempt and to self-harming behaviors and to suicidal ideation in the two weeks prior to the assessment. Findings of the qualitative study suggest that individuals who have written suicide notes exhibit a significant self-oriented focus, yet they also demonstrate a strong sense of concern for the survivors. (AU)

Starting an undergraduate degree amid the COVID-19 pandemic: A mixed-method egocentric network study on student loneliness.

Students who began their undergraduate university studies in the midst of the COVID-19 pandemic (the 'COVID cohort'), may have been particularly at risk for experiencing increased loneliness. This study employed an exploratory egocentric network and mixed-methods approach to investigate the links between social networks and loneliness in the COVID cohort. Of sixty-one respondents meeting inclusion criteria for the study, fifty-eight first-year undergraduate students from the September 2020 intake at a large Scottish University provided egocentric network data via an online survey, as well as responses to three open-ended questions which were aimed at generating qualitative data about participants' experiences of starting university in the context of the COVID-19 pandemic. Bivariate analyses suggest that having a larger social network, and higher satisfaction with that network, was associated with reduced loneliness. We additionally explored these associations in subsamples of students living on-campus and living off-campus. Our qualitative data adds valuable insight into the impact that pandemic-related social-distancing restrictions had on limiting students' opportunities for meeting their peers and forging meaningful social connections at university. Limitations of this study include a small sample size and an exploratory approach requiring further investigation and replication. However, in the context of universities continuing to use hybrid teaching models, this study provides useful initial insights, highlighting potential avenues for institutions to support students in developing social connections in the transition to higher education.

Progress in Predicting Ames Test Outcomes from Chemical Structures: An In-Depth Re-Evaluation of Models from the 1st and 2nd Ames/QSAR International Challenge Projects.

The Ames/quantitative structure-activity relationship (QSAR) International Challenge Projects, held during 2014-2017 and 2020-2022, evaluated the performance of various predictive models. Despite the significant insights gained, the rules allowing participants to select prediction targets introduced ambiguity in model performance evaluation. This reanalysis identified the highest-performing prediction model, assuming a 100% coverage rate (COV) for all prediction target compounds and an estimated performance variation due to changes in COV. All models from both projects were evaluated using balance accuracy (BA), the Matthews correlation coefficient (MCC), the F1 score (F1), and the first principal component (PC1). After normalizing the COV, a correlation analysis with these indicators was conducted, and the evaluation index for all prediction models in terms of the COV was estimated. In total, using 109 models, the model with the highest estimated BA (76.9) at 100% COV was MMI-VOTE1, as reported by Meiji Pharmaceutical University (MPU). The best models for MCC, F1, and PC1 were all MMI-STK1, also reported by MPU. All the models reported by MPU ranked in the top four. MMI-STK1 was estimated to have F1 scores of 59.2, 61.5, and 63.1 at COV levels of 90%, 60%, and 30%, respectively. These findings highlight the current state and potential of the Ames prediction technology.