The influence of duration of intra-abdominal hypertension on the prognosis of critically ill patients / 中华急诊医学杂志

Background:In the clinical setting, the effect of intra-abdominal hypertension on the human body is dependent on time, but its role is not yet clear.Objective:To investigate the effect of the duration of intra-abdominal hypertension (IAH) on the prognosis of critically ill patients.Methods:This prospective cohort study enrolled 256 IAH patients who were admitted to the Surgical ICU of 10 Grade A hospitals in Fujian Province from January 2018 to December 2020. The duration of IAH (DIAH) was obtained after monitoring IAP, and ICU length of stay, duration of mechanical ventilation, duration of continuous renal replacement therapy (CRRT) and average daily energy intake from enteral nutrition during ICU stay were observed and recorded. The correlation was analyzed by Spearman rank correlation. The patients were divided into the survival group and the death group according to their survival state at 60 days after enrollment. Thereafter, clinical characteristics between the two groups were compared. Multivariable logistic regression was used to study and validate the relationship between DIAH and 60-day mortality. The receiver operating characteristics (ROC) curve was established to evaluate the predictive abilities of DIAH on the mortality risk.Results:In critically ill patients, DIAH was positively correlated with duration of mechanical ventilation ( r=0.679, P<0.001), duration of CRRT ( r=0.541, P<0.001) and ICU length of stay ( r=0.794, P<0.001), respectively. In addition, there was a negative correlation between DIAH and average daily energy intake from enteral nutrition ( r=-0.669, P<0.001). After multivariable adjustment, DIAH was an independent risk factor for 60-day mortality in critically patients with IAH ( OR=1.05, 95% CI: 1.01-1.12; P = 0.012), and exhibited a linearity change trend relationship with mortality risk. The ROC curve analysis of DIAH showed that the area under ROC curve (AUC) was 0.825 (95% CI: 0.763~0.886, P<0.01). When the cut-off value was 16.5 days, the sensitivity was 78.4% and the specificity was 75.4%. Conclusions:DIAH is an important risk factor for prognosis in critically ill patients. Early identification and rapid intervention for the etiology of IAH should be performed to shorten DIAH.

How to use χ2 test correctly——CMH χ2 tests for the data collected from the three kinds of R×C contingency tables / 四川精神卫生

The purpose of this paper was to introduce the CMH χ2 test and SAS software implementation of the three kinds of R×C contingency table data. The first type was called “two-way unordered R×C contingency table data”. The CMH χ2 test corresponding to this type of data was essentially the Pearson’s χ2 test. The second type was called “R×C contingency table data with an ordinal outcome variable”. The CMH χ2 test corresponding to this kind of data was essentially a rank sum test. The third type was called “R×C contingency table data which was of two ordinal variables with different attributes”. The CMH χ2 test corresponding to the data was essentially Pearson’s correlation analysis or Spearman’s rank correlation analysis. When there were 1 or 2 “ordinal variables” in the R×C contingency table data， it was necessary to “assign or score” the ordinal variables before performing statistical analysis. In the FREQ procedure of SAS/STAT， there were four scoring methods. With different scoring approach， both the expression form and the calculation results of CMH χ2 test statistics could change accordingly.

Genetic and environmental factors that affect tick infestation in Nelore x Angus crossbreed cattle / Fatores genéticos e ambientais que afetam a infestação de carrapatos em bovinos cruzados Nelore x Angus

ABSTRACT: This study evaluated the effects of seasons and latitude on tick counting and determined the best model to estimate genetic parameters for tick count and hair coat. Records of animals naturally exposed to ticks on farms in several Brazilian states and in Paraguay were used. The ANOVA was used to verify the effects of seasons and latitude on the tick count trait. Spring was the season with the highest average, followed by summer and autumn, which showed no differences between them. The winter presented the lowest average values. Latitude -11° had the highest mean value followed by latitude -18°. The Bayesian approach was used to evaluate tick count and hair coat and to identify a suitable model for estimating genetic parameters for use in genetic evaluations. The data were analyzed using an animal model with four different specifications for "fixed" purposes. The inference was based on a Markov chain Monte Carlo (MCMC). The criteria for selection of the Bayesian model indicated that the M1 model, which considered the breed composition in the contemporary group, was superior to the other models, both for tick count and hair coat. Heritability estimates for tick count and hair coat obtained using the M1 model were 0.14 and 0.22, respectively. The rank correlations between the models for tick count and hair coat were estimated and reordering was verified for tick count. The estimated genetic correlation between tick count and hair coat traits was negative (-0.12). These findings suggest that different genes regulate tick count and hair coat.

RESUMO: Os objetivos foram avaliar os efeitos das estações e latitude na contagem de carrapatos e determinar o melhor modelo para estimar parâmetros genéticos para contagem de carrapatos e pelame. Foram utilizados registros de animais expostos naturalmente a carrapatos em fazendas em vários estados brasileiros e no Paraguai. A ANOVA foi utilizada para verificar os efeitos das estações e da latitude na característica de contagem de carrapatos. A primavera foi a estação com a maior média, seguida pelo verão e outono, que não mostraram diferenças entre eles. O inverno apresentou os menores valores médios. A latitude -11° teve o maior valor médio seguido pela latitude -18°. A abordagem bayesiana foi usada para avaliar a contagem de carrapatos e o pelame e identificar o modelo adequado para estimar parâmetros genéticos e para uso em avaliações genéticas. Os dados foram analisados usando um modelo animal com quatro especificações diferentes para efeitos "fixos". A inferência foi baseada em uma cadeia de Markov Monte Carlo (MCMC). Os critérios de seleção do modelo bayesiano indicaram que o modelo M1, que considerou a composição racial no grupo contemporâneo, foi superior aos demais modelos, tanto na contagem de carrapatos e para pelame. As estimativas de herdabilidade para contagem de carrapatos e pelame obtidas usando o modelo M1 foram de 0,14 e 0,22, respectivamente. As correlações de ranking entre os modelos para a contagem de carrapatos e pelame foram estimadas e a reordenação foi verificada para a contagem de carrapatos. A correlação genética estimada entre a contagem de carrapatos e pelame foi negativa (-0,12). Esses achados sugerem que genes diferentes regulam a contagem de carrapatos e pelame.

Correlation of Vitamin D Status with Glycaemic Status of Individuals- A Cross Sectional Study in a Rural Tertiary Care Hospital of North Bengal, India

Recent pandemic of vitamin D deficiency is co-existing with type II diabetes mellitus pandemic. Even in India, vitamin D insufficiency/deficiency is common among individuals with pre-diabetes. If correlation can be established between these two and risk of impaired glucose tolerance (IGT) or diabetes can be predicted based on serum vitamin D status, much early detection of pre-diabetes or diabetes will be possible and preventive measures can be taken. Not too many studies have been done in this context, especially in North Bengal region of West Bengal, India. We wanted to evaluate the correlation between vitamin D status and glycaemic status of individual and predict the risk of impaired glucose tolerance depending on vitamin D, independent of other factors.METHODSAfter ethical clearance and informed consent, 430 study subjects were interviewed, examined, blood sample collected and tested. Data was entered in Microsoft Excel 2007 and analysed using appropriate software. Correlation and multinomial regression analysis were done.RESULTSMean ± SD of serum 25(OH) D level is found to be 21.53±7.06 ng/ml among a total of 430 study participants. 41.86% of participants were found to be with insufficient vitamin D status. Pearson’s correlation between serum 25(OH) D level and post prandial blood sugar is found to be strongly negative while Spearman’s correlation between vitamin D status and post prandial glycaemic status of individuals is found to be strongly positive. If vitamin D status changes from “Sufficient” to “Insufficient” or “Deficient”, risk of IGT increases by 17 times and 16.3 times respectively.CONCLUSIONSStrong positive correlation exists between vitamin D status and glycaemic status of individuals. Estimation of 25(OH) D level may be used as a screening test for detection of risk of IGT.

Identification of key process parameters of Chinese materia medica production process based on grey relation analysis / 中草药

Objective: To identify the key process parameters of the Chinese materia medica (CMM) production process by using grey relation analysis (GRA) method. Methods: Taking Lonicerae Japonicae Flos and Artemisiae Annuae Herba extraction section of Reduning Injection as an example, GRA was adopted to calculate and compare the influence of the process parameters on the quality index. Meanwhile, analytic hierarchy process (AHP) combined with Spearman rank correlation analysis was used to validate mutually. Results: According to GRA Results:, the relative importance of process parameters was ranked as follows: average volume flow rate of extraction (X4) > pH after acid adjustment (X2) > the paste temperature of extracting concentration (X7) > alcohol precipitation concentrated extract weight (X1) > hydrochloric acid weight (X3) > extraction time (X6) > relative standard deviation of flow rate (X5). The correlation coefficient between the order by GRA and that by AHP was 0.893. According to the importance of process parameters, the average volume flow rate of extraction, the pH after acid adjustment, and the paste temperature of extracting concentration were identified as the key process parameters. Conclusion: The Results: obtained in this study show the feasibility of GRA in selecting key process parameters, which can provide theoretical reference for the establishment of prediction model as well as online feedback regulation.

Risk analysis of the economic viability of feedlot aberdeen angus steers fed with different proportions of concentrate / Análise de risco da viabilidade econômica do confinamento de novilhos aberdeen angus alimentados com diferentes proporções de concentrado

The economic viability of feedlot Aberdeen Angus steers fed with diets composed of different concentrate levels (CL) in dry matter (25, 40, 55 or 70%) was estimated using Monte Carlo simulation combined with Spearman rank correlation, considering nine random input variables, as well as stochastic dominance (DOM) and sensitivity (SENS) analyses. For the financial indicator simulation, net present value (NPV), cash flow with indicators of performance, and the probability distribution of all cost and income items (from 2003 to 2014) were used. Latin hypercube sampling and a Mersenne Twister random number generator was employed for the simulation, which included 2000 interactions. The expected mean values ± standard deviation for NPV (USD/animal) were 44.94 ± 68.01, 44.50 ± 69.25, 15.39 ± 69.22 and 54.20 ± 71.58 for the diets containing 25, 40, 55 and 70% CL, respectively. The probability of NPV 0 was 76.8, 76.0, 57.9 and 78.1%, respectively, from the smallest to largest CL. The DOM analysis showed that 25 and 40% CL have similar probability curves, the 70% level dominated the remaining and all CL dominated 55%. According to SENS analysis, the items that most influenced the NPV were, in decreasing order, finished and feeder cattle price, initial and final weights, concentrate and roughage price, concentrate intake, minimum rate of attractiveness and roughage intake. Based on the simulation results, the 70% CL showed a higher NPV and greater likelihood of economic viability. The probabilistic simulation technique is an interesting tool for decision-making in investment projects with beef cattle feedlot, therefore, further studies in this line of research is recommended.

Estimou-se o risco da viabilidade econômica do confinamento de novilhos Aberdeen Angus alimentados com dietas com diferentes níveis de concentrado (NC) na matéria seca (25, 40, 55 ou 70%), utilizando simulação de Monte Carlo associado com o uso de correlação de Spearman entre nove variáveis aleatórias de entrada, dominância estocástica (DOM) e análise de sensibilidade (SENS). Para a simulação do indicador financeiro Valor Presente Líquido (VPL), foi utilizado fluxo de caixa com indicadores de desempenho e distribuição de probabilidade de todos os itens de custos e receitas (anos de 2003 a 2014). Amostragem de Hipercubo Latino e gerador de números aleatórios Mersenne Twister foram utilizados para a simulação com 2.000 interações. Os valores médios esperados para VPL ± desvio padrão (USD/animal) foram de: 44,94 ± 68,01; 44,50 ± 69,25; 15,39 ± 69,22 e 54,20 ± 71,58, respectivamente, para 25, 40, 55 e 70% NC. As probabilidades do VPL 0 foram 76,8%; 76,0%; 57,9% e 78,1%, respectivamente, do menor para maior NC. A análise de DOM demonstrou que 25 e 40% de concentrado apresentam curvas de probabilidade similares; 70% dominou os demais e 55% foi dominado por todos os NC. De acordo com a SENS, os itens que mais influenciaram no VPL foram, em ordem decrescente, os preços do boi gordo e magro, os pesos final e inicial, preços do concentrado e do volumoso, consumo de concentrado, taxa mínima de atratividade e consumo de volumoso. Com base nos resultados de simulação, o NC de 70% apresentou maior VPL e maior probabilidade de viabilidade econômica. A técnica de simulação probabilística demonstrou ser interessante ferramenta para tomada de decisões em projetos de investimento com confinamento de bovinos de corte, sugerindo a expansão de estudos nesta linha de pesquisa.

Stochastic simulation of the economic viability of feedlot steers fed with different proportions of concentrate / Simulação estocástica da viabilidade econômica do confinamento de novilhos alimentados com diferentes proporções de concentrado

The economic viability of feedlot zebu bulls, slaughtered at 450 kg after 90 days of feeding with diets consisting of different proportions of concentrate in dry matter (40, 60 or 80%), was estimated using Monte Carlo simulations, with or without the inclusion of Spearman rank correlations among random input variables, stochastic dominance (DOM) and sensitivity analysis (SENS). The roughage used was chopped sugar cane. Cash flow with indicators of performance, and probability distributions of all items of cost and revenue (from 2003 to 2014), were used to stimulate net present value (NPV), the financial indicator. Latin hypercube sampling and a Mersenne Twister random number generator were employed for the simulation with 2000 interactions. The risk was found to be more accurately estimated when correlations between random input variables were included (probability of NPV 0 ± standard deviation was 35 ± 166.05% and 31 ± 139.75% for the simulation without and with correlation, respectively). Considering this result, DOM and SENS were only carried out including these correlations. The expected value for NPV was similar between the different levels of concentrate (average USD -62/animal and NPV 0 of 33%) according to DOM analysis of simulations including correlations. From the SENS analysis, the final weight, finished cattle price, feeder cattle price and initial weight were the items with the greatest influence on NPV, regardless of the level of concentrate used, followed by intake and the cost-related items of diet and minimum rate of attractiveness. Based on the results obtained by simulation, the direct benefit of feedlot could be classified as high risk, suggesting the increased use of Monte Carlo simulation for decision-making.

Estimou-se o risco da viabilidade econômica do confinamento de bovinos zebuínos abatidos com 450 kg após 90 dias de alimentação, com dietas com diferentes proporções de concentrado na matéria seca (40, 60 ou 80%), utilizando simulação de Monte Carlo associado ou não com o uso de correlação de Spearman entre as variáveis aleatórias de entrada, dominância estocástica (DOM) e análise de sensibilidade (SENS). O volumoso utilizado foi cana-deaçúcar picada. Para a simulação do indicador financeiro Valor Presente Líquido (VPL), foi utilizado fluxo de caixa com indicadores de desempenho e distribuição de probabilidade de todos os itens de custos e receitas (anos de 2003 a 2014). Amostragem de Hipercubo Latino e gerador de números aleatórios Mersenne Twister foram utilizados para a simulação com 2.000 interações. O risco foi estimado com maior precisão incluindo correlações entre variáveis aleatórias de entrada (probabilidades de VPL 0 ± desvio padrão foram 35 ± 166,05% and 31 ± 139,75% para a simulação com e sem correlação, respectivamente). A partir deste resultado, DOM e SENS foram realizadas apenas com correlação entre variáveis aleatórias de entrada. O valor esperado para VPL foi semelhante entre os diferentes níveis de concentrado (média de USD -62 / animal e VPL 0 de 33%), de acordo com a análise de DOM das simulações com correlação. Na SENS, independentemente do nível de concentrado usado, o peso final, os preços do boi gordo e magro e peso inicial foram os itens mais importantes a influenciar o VPL, seguido de consumo da dieta, preços da dieta e taxa mínima de atratividade. Com base nos resultados de simulação, poderia ser classificado o benefício direto de confinamento como de alto risco, sugerindo a expansão dos estudos com uso da técnica de simulação de Monte Carlo na tomada de decisões.

Evaluating Full Cup Study, Numeric Pain Rating Scale, and Visual Analogue Scale in Assessing Pain after Surgical Removal of Lower Third Molar

@#The objectives of this study is to evaluate the suitability of full cup test (FCT), numeric pain rating scale (NPRS), and visual analogue scale (VAS) to assess pain after surgical removal of lower third molar and to identify which of these three pain scales is the easiest to use. A total of 50 patients, age between 18 to 30 years who underwent minor oral surgery for removal of impacted third molar were sampled in Faculty of Dentistry, University of Malaya. The patients were provided with forms containing three pain scales and they were required to mark each pain scales – FCT, NPRS and VAS daily for three consecutive post-operative days. The forms were collected a week later when patients came back for review. The validity between NPRS with VAS, FCT with NPRS and FCT with VAS were tested using Spearman rank correlation coefficient. Results showed that the correlation coefficient values for each pair were very high and significant. The findings when comparing Day 1, Day 2 and Day 3 and the combination for those three days showed no significant differences. No evidences indicated that the findings for Day 1 were more superior in comparison with other days. In conclusion, FCT was as valid as NPRS and VAS. The pain scale which was claimed to be the easiest to use by patients was NPRS, followed by FCT and VAS. However, further studies are needed to investigate the reliability and sensitivity of FCT.

Prevalence And Factors Associated With Phobias Among Women

Objective: The present study is carried out to explore the factors associated with phobia, to compare the severity of phobias between cases (mentally ill women) and controls (never mentally ill) and to identify the factors predicting different types of phobias. Methods: A cross sectional study among female cases and controls is conducted. A sample of 150 female respondents including 30 cases and 120 controls is taken to assess the point prevalence of different types of phobias. The Social Phobia Inventory (SPIN) questionnaire was used to identify social phobia on a very severe, severe, moderate, mild and no phobia scale. Pearson chi square and spearman’s rank correlation was applied to assess the associations among different factors and various types of phobias. Results: The most common phobia among the population was Agrizoophobia (93%) followed by Agoraphobia (81%) and Taphophobia (74%). Among cases, age is was associated with Agoraphobia and Acrophobia, marital status of the respondent was associated with Agoraphobia and Acrophobia, marital status of father is associated with social phobia and Aichmophobia, traumatic event was associated with Mysophobia while family income was associated with Acrophobia and Aichmophobia. Age and Agoraphobia, and marital status and Acrophobia show significant results among controls. Multiple discriminant Analysis demonstrated that among cases, age was the best predictor in predicting Agoraphobia and Acrophobia , marital status of father was the best predictor in predicting Nosocomeophobia and traumatic event was the best predictor in predicting Mysophobia. Conclusion: Severe specific phobias are more prevalent among cases while controls suffer from mild specific phobias. Age, marital status of father and traumatic event in life are significant predictors for phobias.

Estimativas da trajetória genética do crescimento de codornas de corte utilizando modelos de regressão aleatória / Genetic trajectory estimates of meat type quail lines using random regression models

Avaliou-se a trajetória genética do crescimento de codornas de corte (pesos corporais nos dias 1, 7, 14, 21, 28, 35 e 42 de idade) de dois grupos genéticos, por modelos de regressão aleatória, sob modelo animal, obtendo-se estimativas de parâmetros genéticos visando definir a idade que resultaria em maior resposta à seleção. Foram pesadas 2.432 e 2.478 codornas, respectivamente, dos grupos genéticos EV1 e EV2, obtidas em três gerações de seleção. Os parâmetros genéticos foram estimados utilizando-se a sub-rotina Dxmrr do DFReml. As estimativas de herdabilidade dos pesos corporais variaram, respectivamente, de 0,01 a 0,50, para o grupo genético EV1, e de 0,01 a 0,10, para o EV2, sendo as maiores estimativas obtidas para peso corporal no 42º dia de idade, em ambos os grupos genéticos. As correlações genéticas entre o peso a um dia e os demais pesos corporais, em ambos os grupos, foram negativas, e as correlações de ambiente permanente, de modo geral, foram maiores para EV2. Pode-se concluir que, para ambos os grupos, a seleção é mais eficiente se realizada no 42º dia de idade, porém respostas poderiam ser obtidas se as codornas fossem selecionadas em idades mais jovens para o grupo EV1.

Growth genetic trajectories of two quail meat type lines for body weights at hatch and 7, 14, 21, 28, 35, and 42 days of age were evaluated using random regression model, under animal model analysis. Genetic parameters estimates were obtained to establish the most adequate age for efficient selection. Body weights of 2,432 and 2,478 quails from EV1 and EV2 genetic lines, respectively, from three generations of selection were recorded. Genetic parameter estimates were obtained using Dxmrr subroutine of the DFReml software. Heritability estimates ranged from .01 to .50 for EV1 and from .01 to .10 for EV2. For both genetic lines the highest heritability estimates were obtained for body weight at 42 days of age and genetic correlations between body weight at hatch and body weights recorded in other ages were all negatives and permanent environment correlations were higher for EV2 genetic line. The results suggest that selection to increase body weight for both genetic lines is more efficient when undertaken at 42 days of age, but reasonable responses to selection can also be obtained in younger ages for EV1 genetic line.

Parâmetros genéticos para idade ao primeiro parto estimados por diferentes modelos para rebanhos da raça Nelore / Genetic parameters for age at first calving estimated by different models for Nellore breed herds

Com objetivo de estimar parâmetros genéticos e estudar a utilização de diferentes efeitos em avaliações genéticas para idade ao primeiro parto (IPP) por diferentes modelos, foram utilizados registros de IPP de animais da raça Nelore, nascidos entre os anos de 1990 e 2005. Foram considerados os seguintes modelos (M): M1, incluindo o efeito fixo de GC1 (constituído pelos animais nascidos na mesma fazenda e ano), além da covariável, peso aos 365 dias de idade (efeito linear e quadrático), totalizando 24.263 registros de IPP; M2, considerando os efeitos fixos de GC1, ano e estação de parição, totalizando 59.792 registros de IPP e M3, incluindo os efeitos fixos de GC2 (agrupando os animais nascidos na mesma fazenda, ano e que conceberam no mesmo manejo reprodutivo), ano e estação de parição, totalizando 59.792 registros de IPP. As estimativas dos componentes de variância e herdabilidade e os valores genéticos (VG) foram obtidos pelo método da máxima verossimilhança restrita, com a inclusão da matriz de parentesco disponível. As diferenças esperadas na progênie (DEPs) foram obtidas dividindo os VG por dois. Após a obtenção desses resultados, foram realizadas correlações entre os VG e o ranqueamento das DEPs dos reprodutores para IPP, utilizando-se o procedimento PROC CORR (SAS, 2003). Ao se considerar o ano e a estação de parto nos modelos de análise (M2 e M3), esses produziram um maior R², indicando que tais modelos conseguiram explicar, em maior grau, as diferenças existentes entre os animais para IPP. As herdabilidades estimadas foram de baixa magnitude (0,14 e 0,15). As correlações entre os VG obtidas por diferentes modelos foram 0,73 (M1 x M2); 0,91 (M2 x M3) e 0,66 (M1 x M3).

With the objective of estimate genetic parameters and study the utilization of different effects on the genetic evolution for the age of the first calving (AFC) by different models, they were used AFC records from Nellore breed animals, born from 1990 to 2005. They were considered the following models (M): M1, including the fixed effect of the contemporary group (CG), CG1 (grouping the animals that were born at the same farm and year), besides the co variable, weight at 365 days of age (linear and quadratic effects), totalizing 24,263 records of AFC; M2, considering the effects of CG1, year and season of the calving, totalizing 59,792 records of AFC and M3, including effects CG2 (grouping the animals born at the same farm, year and submitted at the same reproductive management), year and season of calving totalizing 59,792 records of AFC. The components of variance and Genetic Value (GV) were obtained by Restricted Maximun Likelihood Method, with the inclusion for the relationship matrix. The Differences Expected on the Progeny (DEPs) were obtained by dividing the GV by two, after this they were estimated the correlations between GV and ranks of the reproductor's DEPs for AFC, utilizing the procedure CORR (SAS, 2003). While considering year and season of calving in the analysis models (M2 and M3), it was produced a bigger R², indicating that those models could explain, in a larger scale, the existing differences between the animals for AFC. The heritabilities estimated were of low magnitude (0,14 and 0,15). The correlations between the GV obtained by the different models were .73 (M1 x M2); .91 (M2 x M3) and .66 (M1 x M3).

Correlation Between Difficulty in Gaining Admission to Medical Schools and Achievements in Life Science Research / 医学教育

We studied the increase in difficulty in gaining admission to medical schools over the past 5 years (1991 through 1995). In private medical schools, the diffierence between maximal and minimal difficulty in gaining admission decreased slightly by the upgrade of lower group, although the difference did not change in state and public medical schools. The correlation coefficient and rank correlation coefficient between the above variables and reported achievements in life science research were determined. A weak positive correlation was found.