Literature presents limited information on histological subtypes and their association with other factors influencing the survival of melanoma patients. To explore the risk of death due to melanoma ...associated with histological subtypes, this retrospective study used the Surveillance, Epidemiology, and End Results program (SEER) data from 1998 to 2019.
A total of 27,532 patients consisting of 15,527 males and 12,005 females. The Hypertabastic Accelerated Failure Time model was used to analyze the impact of histology on the survival of patients with cutaneous or mucosal melanoma.
The median survival time (MST) for cutaneous patients was 149 months, whereas those diagnosed with mucosal melanoma was 34 months. Nodular melanoma had a hazard ratio of 3.40 95% CI: (2.94, 3.94) compared to lentigo maligna melanoma. Across all histological subtypes, females had a longer MST, when compared to males. The hazard ratio (HR) of distant to localized melanoma was 9.56 95% CI: (7.58, 12.07).
Knowledge of patients' histological subtypes and their hazard assessment would enable clinicians and healthcare providers to perform personalized treatment, resulting in a lower risk of complication and higher survivability of melanoma patients. Significant factors were stage of the disease, age, histology, sex, and income. Focus should be placed on high-risk populations with severe and aggressive histological subtypes. Programs that emphasize preventive measures such as awareness, education, and early screening could reduce risk.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Lesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals experience higher rates of health disparities. These disparities may be driven, in part, by biases of medical providers ...encountered in health care settings. Little is known about how medical, nursing, or dental students are trained to identify and reduce the effects of their own biases toward LGBTQ individuals. Therefore, a systematic review was conducted to determine the effectiveness of programs to reduce health care student or provider bias towards these LGBTQ patients.
The authors performed searches of online databases (MEDLINE/PubMed, PsycINFO, Web of Science, Scopus, Ingenta, Science Direct, and Google Scholar) for original articles, published in English, between March 2005 and February 2017, describing intervention studies focused on reducing health care student or provider bias towards LGBTQ individuals. Data extracted included sample characteristics (i.e., medical, nursing, or dental students or providers), study design (i.e., pre-post intervention tests, qualitative), program format, program target (i.e., knowledge, comfort level, attitudes, implicit bias), and relevant outcomes. Study quality was assessed using a five-point scale.
The search identified 639 abstracts addressing bias among medical, nursing, and dental students or providers; from these abstracts, 60 articles were identified as medical education programs to reduce bias; of these articles, 13 described programs to reduce bias towards LGBTQ patients. Bias-focused educational interventions were effective at increasing knowledge of LGBTQ health care issues. Experiential learning interventions were effective at increasing comfort levels working with LGBTQ patients. Intergroup contact was effective at promoting more tolerant attitudes toward LGBTQ patients. Despite promising support for bias education in increasing knowledge and comfort levels among medical, nursing, and dental students or providers towards LGBTQ persons, this systematic review did not identify any interventions that assessed changes in implicit bias among students or providers.
Strategies for assessing and mitigating implicit bias towards LGBTQ patients are discussed and recommendations for medical, nursing, and dental school curricula are presented.
Although survival analyses have long been used in biomedical research, their application to engineering in general, and bridge engineering in particular, is a more recent phenomenon. In this ...research, survival (reliability) of bridge superstructures in Wisconsin was investigated using the Hypertabastic accelerated failure time model. The 2012 National Bridge Inventory (NBI) data for the State of Wisconsin were used for the analyses. A recorded NBI superstructure condition rating of 5 was chosen as the end of service life. The type of bridge superstructure, bridge age, maximum span length (MSL) and average daily traffic (ADT) were considered as possible risk factors in the survival of bridge superstructures. Results show that ADT and MSL can substantially affect the survival of bridge superstructures at various ages. The reliability of Wisconsin superstructures at the ages of 50 and 75 years is on the order of 63% and 18%, respectively, when the ADT and MSL values are at Wisconsin’s mean values.
The most common measure of association between two continuous variables is the Pearson correlation (Maronna et al. in Safari an OMC. Robust statistics, 2019. ...https://login.proxy.bib.uottawa.ca/login?url=https://learning.oreilly.com/library/view/-/9781119214687/?ar&orpq&email=^u). When outliers are present, Pearson does not accurately measure association and robust measures are needed. This article introduces three new robust measures of correlation: Taba (T), TabWil (TW), and TabWil rank (TWR). The correlation estimators T and TW measure a linear association between two continuous or ordinal variables; whereas TWR measures a monotonic association. The robustness of these proposed measures in comparison with Pearson (P), Spearman (S), Quadrant (Q), Median (M), and Minimum Covariance Determinant (MCD) are examined through simulation. Taba distance is used to analyze genes, and statistical tests were used to identify those genes most significantly associated with Williams Syndrome (WS).
Based on the root mean square error (RMSE) and bias, the three proposed correlation measures are highly competitive when compared to classical measures such as P and S as well as robust measures such as Q, M, and MCD. Our findings indicate TBL2 was the most significant gene among patients diagnosed with WS and had the most significant reduction in gene expression level when compared with control (P value = 6.37E-05).
Overall, when the distribution is bivariate Log-Normal or bivariate Weibull, TWR performs best in terms of bias and T performs best with respect to RMSE. Under the Normal distribution, MCD performs well with respect to bias and RMSE; but TW, TWR, T, S, and P correlations were in close proximity. The identification of TBL2 may serve as a diagnostic tool for WS patients. A Taba R package has been developed and is available for use to perform all necessary computations for the proposed methods.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Natural habitats are created and developed through pool-riffle sequences in rivers, while vegetation cover could play a critical role in the sediment transfer and its quantity and quality. In this ...study, the effect of vegetation cover on the flow structure in a pool-riffle sequence is investigated in a laboratory flume under bed formation to compare with non-vegetated cover. In this context, instantaneous point velocities were measured by ADV to determine averaged velocity, shear velocity, root mean square velocity, friction factor, Reynolds shear stress and turbulence intensities. Results showed that the vegetation cover increases the thickness of the wall law. Meanwhile, the length of the flow separation zone in the vegetated bedform is more than in the non-vegetated bedform. Variation in roughness coefficients may cause a new boundary layer in which local flow velocities decrease. In both cases (vegetated and non-vegetated bedforms), the momentum is mostly transferred by ejection and sweep phenomena between flow and bedform.
•Impact of sediment and vegetation on flow structure.•Vegetation cover increases the thickness of the wall law and roughness coefficient.•Vegetation cover decreases Reynolds shear stress value rather than the gravel bedform.
Rivers have non-uniform beds, which are called bedforms. Depending on the hydraulic conditions, these shapes have different types that cause resistance to the flow. Despite a great number of research ...works and experiments on bedforms, no accurate and comprehensive equation has been proposed to estimate separation zone dimensions formed on the lee side of the dunes. The present study is mainly focused on simulating the flow motion numerically on dunes in open channels to evaluate the effect of dune geometry on the flow separation zone. Twenty-nine simulations were conducted to study the effect of the geometry of five types of dunes with different angles and heights under different hydraulic conditions and bed roughnesses. RANS and DES turbulence models were used to simulate small and large-scale dunes, respectively. The results of the numerical model were compared with the experimental results of previous researchers to validate the work, indicating the appropriate accuracy of the numerical model. Bursting events analysis were carried out to understand dominant events phenomena, it was observed that all the events have high fluctuations near the bed and none of them is dominant. However, this could decrease and diverge by getting closer to the water surface, so that all the events would tend to converge in the vicinity of the water surface. Empirical equations were derived to estimate flow separation dimensions in terms of bed characteristics and flow conditions. The equations showed that flow separations zone dimensions are highly related to lee side angle of the dunes.
•Simulating numerically the flow motion on dunes to evaluate the effect of dune geometry on flow separation zone.•RANS and DES turbulence models were used to simulate small and large-scale dunes, respectively.•The results of the numerical model were compared with the experimental results of previous researchers to validate the work.•Flow separations zone dimensions are highly related to lee side angle of the dunes.•Selecting the most optimal mesh size by comparing simulations with different mesh size.
Certain population groups in the United States carry a disproportionate burden of cancer. This work models and analyzes the dynamics of lung and bronchus cancer age-adjusted incidence rates by race ...(White and Black), gender (male and female), and prevalence of daily smoking in 38 U.S. states, the District of Columbia, and across eight U.S. geographic regions from 1999 to 2012.
Data, obtained from the U.S. Cancer Statistics Section of the Centers for Disease Control and Prevention, reflect approximately 77% of the U.S. population and constitute a representative sample for making inferences about incidence rates in lung and bronchus cancer (henceforth lung cancer). A longitudinal linear mixed-effects model was used to study lung cancer incidence rates and to estimate incidence rate as a function of time, race, gender, and prevalence of daily smoking.
Between 1999 and 2012, age-adjusted incidence rates in lung cancer have decreased in all states and regions. However, racial and gender disparities remain. Whites continue to have lower age-adjusted incidence rates for this cancer than Blacks in all states and in five of the eight U.S. geographic regions. Disparities in incidence rates between Black and White men are significantly larger than those between Black and White women, with Black men having the highest incidence rate of all subgroups. Assuming that lung cancer incidence rates remain within reasonable range, the model predicts that the gender gap in the incidence rate for Whites would disappear by mid-2018, and for Blacks by 2026. However, the racial gap in lung cancer incidence rates among Black and White males will remain. Among all geographic regions, the Mid-South has the highest overall lung cancer incidence rate and the highest incidence rate for Whites, while the Midwest has the highest incidence rate for Blacks. Between 1999 and 2012, there was a downward trend in the prevalence of daily smokers in both genders. However, males have significantly higher rates of cigarette smoking than females at all time points. The highest and lowest prevalence of daily smoking are found in the Mid-South and New England, respectively. There was a significant correlation between lung cancer incidence rates and smoking prevalence in all geographic regions, indicating a strong influence of cigarette smoking on regional lung cancer incidence rates.
Although age-adjusted incidence rates in lung cancer have decreased throughout the U.S., racial and gender disparities remain. This longitudinal model can help health professionals and policy makers make predictions of age-adjusted incidence rates for lung cancer in the U.S. in the next five to ten years.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Bed sills are a kind of grade control structure built at the same level as the river bed to protect it against erosion and to reduce the longitudinal slope of the channel. The aim of the present ...research was to determine the optimal dimensions of the structure by devising a new methodology to minimize cost and maximize stability, based on the optimization model of the multi-objective non-dominated sorting genetic algorithm (NSGA-II). This is achieved by calculating the width, height and distance between bed sills with these stability and cost objectives in mind. The NSGA-II algorithm is applied to solve the problem, and a set of Pareto points is obtained. The results are verified by considering the bed sills of the River Madarsoo in Iran and the River Plima in Italy, and comparing the results with those obtained using the Branch-and-Bound (B-and-B) algorithm. The results indicate that the cost and stability could respectively be improved by up to 18 and 20% in the River Madarsoo, and up to 18 and 26% in the River Plima, if the NSGA-II algorithm is used.
Background:
The objective of the study was to measure the risk of death due to COVID-19 in relation to individuals’ characteristics, and severity of their disease during the dominant periods of ...Alpha, Delta, and Omicron variants have influenced mortality rates.
Methods:
This study was conducted using COVID-19 Centers for Disease Control and Prevention (CDC) Case Surveillance Public Data Taskforce for 57 states, and United States territories between January 1, 2020 and March 20, 2022. Multivariable binary Hyperbolastic regression of type I was used to analyzes the data.
Results:
Seniors and ICU-admitted patients had the highest risk of death. For each additional percent increase in fully vaccinated individuals, the odds of death deceased by 1%. The odds of death prior to vaccine availability, compared to post vaccine availability, was 1.27. When comparing the time periods each variant was dominant, the odds of death was 3.45-fold higher during Delta compared to Alpha. All predictor variables had P-values ≤.001.
Conclusion:
There was a noticeable difference in the odds of death among subcategories of age, race/ethnicity, sex, PMCs, hospitalization, ICU, vaccine availability, variant, and percent of fully vaccinated individuals.
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