A Mathematical Modelling Approach to Analyze the Dynamics of Math Anxiety

Title from PDF of title page, viewed August 23, 2022Dissertation advisor: Majid Bani YaghoubVitaincludes bibliographical references (pages 148-161)Dissertation (Ph.D)--Department of Mathematics & Statistics, Division of Teacher Education and Curriculum Studies. University of Missouri--Kansas City, 2022The main objective of this study is to develop a mathematical modeling framework for a deeper understanding of dynamics of math anxiety as a contagious process. Borrowing from theories of the spread of infectious disease, we develop two classes of mathematical models representing the spread of math anxiety in math gateway classes. The first mathematical model does not entirely fit with our collected data of math anxiety (n=53, Calculus II & III summer of 2020). However, the second mathematical model, which is a generalization of the first model, can exhibit periodic solutions as observed in the collected data. In addition to the mathematical modeling framework, we have applied a variety of statistical methods and models to analyze the survey data. This includes descriptive analysis of the data, correlation and hypothesis testing, and a machine learning approach, which utilizes the classification and regression tree models to identify key factors associated with math anxiety. These regression tree models include factors such as gender, academic level, number of hours studied, motivation, and confidence. In conclusion, the present work lays the foundation for applying mathematical models to measure the spread of math anxiety in gateway STEM courses.Introduction to math anxiety -- inference and math anxiety data -- Modelling math anxiety using machine learning -- Mathematical modelling of math anxiety -- Advanced mathematical modelling and analysis -- Conclusion and future wor

High prevalence of spondyloarthritis and ankylosing spondylitis among familial Mediterranean fever patients and their first-degree relatives: further evidence for the connection

INTRODUCTION: Familial Mediterranean fever (FMF) is an auto-inflammatory disease characterized by recurrent attacks of fever and serositis. Limited data suggest that the prevalence of sacroiliitis is increased in patients with FMF. In our present study, we assessed the prevalence of spondyloarthritis (SpA), including ankylosing spondylitis (AS), among a cohort of FMF patients and their unaffected first-degree relatives (FDRs). METHODS: The current study cohort comprised a consecutive group of 201 unrelated patients with FMF and 319 FDRs (≥ 16 years old). These subjects were examined according to a standard protocol. RESULTS: A total of 157 FMF patients (78.1%) and 233 (73%) unaffected FDRs reported back pain. Fifteen FMF patients (7.5%) and nine unaffected FDRs fulfilled the modified New York (mNY) criteria for AS. One additional FDR with AS was identified after review of the medical records. None of the FMF patients with AS was HLA-B27 positive. The allele frequency of M694V among the FMF patients with radiographic sacroiliitis was significantly higher in comparison with those without sacroiliitis (OR 4.3). When compared with the general population, the risk ratios for SpA and AS among the FDRs of our FMF patients were 3.3 (95% CI; 2.0 to 5.5) and for AS 2.9 (95% CI; 1.3 to 6.4), respectively. CONCLUSIONS: Our study suggests that a) factors other than HLA-B27 play a role in the association of FMF and SpA/AS; b) MEFV gene variations may be one of the geographic/region-specific potential pathogenetic links between these two disorders in the Turkish population

Anxiety Levels of Children with Primary Ciliary Dyskinesia and Their Mothers at the Beginning of the COVID-19 Pandemic and Change in the First Year

We aimed to assess anxiety of children with primary ciliary dyskinesia (PCD) and their primary caregivers at the beginning of Coronavirus disease-2019 (COVID-19) pandemic and change in levels of anxiety in first year with prolongation of pandemic. This was a two-step study; first step was questionnaire-based, conducted via teleconference. In first step, 29 patients and 105 healthy children and their mothers were participated; 25 children with PCD and their mothers were in second step. Demographic characteristics, clinical informations were recorded. Children’s and mothers’ state and trait anxiety levels were assessed and compared. Anxiety levels of mothers of patients were assessed according to clinical characteristics of children. Mothers’ knowledge of COVID-19 and effect of teleconference on their anxiety was evaluated. State anxiety levels in the first year of pandemic of children with PCD and their mothers were also compared. Compared to control group, state anxiety of children in 13-18 age group and trait anxiety of their mothers were lower (p<0.05). In both groups, trait and state anxiety of 13-18 years old children and mothers positively correlated. Trait anxiety of mothers of patients negatively correlated with patients’ FEV1 and MEF25-75. Patients’ mothers reported feeling less anxiety at the end of teleconference. Anxiety of mothers of patients (especially under 9 years old) had increased as pandemic continued. At the beginning of pandemic, children with PCD were less anxious than healthy children, and their mothers had lower trait anxiety than mothers of healthy children. Being followed for chronic disease and obtaining information about COVID-19 may have reduced anxiety of children with PCD and their mothers. However, as pandemic continues, need to protect their children with PCD from infection, especially of mothers with younger children, may have raised their concerns

Adrenocortical oncocytic neoplasm presenting with Cushing's syndrome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Oncocytic neoplasms occur in several organs and are most commonly found in the thyroid, kidneys and salivary glands. Oncocytic neoplasms of the adrenal cortex are extremely rare and are usually non-functioning.</p> <p>Case presentation</p> <p>We report the case of an adrenocortical oncocytic neoplasm with uncertain malignant potential in a 31-year-old man with Cushing's syndrome. The patient had been operated on following diagnosis of a 7 cm adrenal mass. Following surgery, the Cushing's syndrome resolved. The patient is still alive with no metastases one year after the surgery.</p> <p>Conclusion</p> <p>Adrenocortical oncocytic neoplasms must be considered in the differential diagnosis of both functioning and non-functioning adrenal masses.</p

Dikkat eksikliği hiperaktivite bozukluğunda kalp ritmi ve otonom fonksiyonların 24 saatlik holter ekg ve kalp hızı değişkenliği ile değerlendirilmesi ve metilfenidatın bu fonksiyonlara etkisi

Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) okul çağındaki çocuklarda en sık görülen nörodavranışsal bozukluktur. Hem DEHB’nin, hem de bu hastalığın tedavisinde kullanılan metilfenidatın (MPH) otonom sinir sistemi (OSS) fonksiyonları ve kalp ritmi üzerindeki etkileri tartışmalıdır. Kalp hızı değişkenliği (KHD), OSS fonksiyonları ile ani ölüm ve aritmi riskinin değerlendirilmesinde kullanılabilir. Çalışmamızda, DEHB saptanan çocuklarda EKG, 24 saatlik Holter monitorizasyonu ve KHD parametreleri kullanılarak OSS fonksiyonları ve aritmi riski araştırılmıştır. Çalışmaya yaşları 6 ile 13 arasında değişen (Ort±Ss=9,46±2,0) DEHB tanılı 28 çocuk (6 kız, 22 erkek) ve aynı yaş grubunda (Ort±Ss=9,57±2,0) 20 sağlıklı çocuk (7 kız, 13 erkek) alındı. Hastaların 11’i Dikkat Eksikliği Baskın tip ve 17’si Bileşik tip olarak değerlendirildi. Tüm olgulara ayrıntılı öykü ve fizik muayeneye ek olarak 12 derivasyonlu yüzey EKG, ekokardiyografi ve 24 saatlik Holter EKG monitorizasyonu uygulandı. DEHB hastalarında aynı değerlendirmeler tedavinin 4 ila 8. haftaları arasında (Ort±Ss=53,4±15,5 gün), hastalar 0,25-1mg/kg dozunda (Ort±Ss=0,62±0,2 mg/kg) MPH kullanırken tekrarlandı. İlaç öncesi ve sonrası fizik muayene, EKG, Holter monitorizasyonu bulguları ile KHD parametrelerinden zaman alanlı SDNN, SDANN, SDNNi, rMSSD ve pNN50 ve frekans alanlı LF, HF, LF/HF oranı karşılaştırıldı. İlaç dozu ile tüm parametreler arasında ilişki olup olmadığı çalışıldı. DEHB’li hastalarda QTc ölçümü kontrol grubuna göre daha uzun bulundu (sırasıyla 421,9±22,3 ms; 410,4±21,6 ms, p=0,039). 24 saatlik Holter kayıtlarından elde edilen KHD parametrelerinden SDNN uyku dilimi (22:00-08:00) değeri DEHB grubunda düşüktü (sırasıyla 108,7±24,1 ms; 126,5±30,3 ms, p=0,039). Hasta ve kontrol gruplarında önemli aritmi saptanmadı. MPH tedavisi sırasında kalp tepe atımı (KTA) ve diyastolik kan basıncı (DKB) ölçümleri tedavi öncesine göre yüksek bulundu (KTA için MPH öncesi: 89,8±8,6 atım/dk; MPH sonrası: 96,5±12,5 atım/dk; p=0,014; DKB için MPH öncesi: 62,5±9,7 mmHg; MPH sonrası: 66,9±7,6 mmHg, p=0,03). Bileşik tip DEHB hastalarında QT dispersiyonu MPH tedavisi ile anlamlı artış gösterdi (MPH öncesi: 33,0±16,7 ms; MPH sonrası: 41,8±18,3 ms, p=0,038). SDNN uyku dilimi değeri (MPH öncesi: 108,7±24,1 ms; MPH sonrası: 124,6±39,3 ms, p=0,015) ve SDANN değeri (MPH öncesi: 123,4±26,5 ms; MPH sonrası: 140,2±40,3 msn, p=0,016) artmış olarak saptandı. pNN50 değerinin ise gün boyunca ve uyanıklık dilimindeki (08:00-22:00) kayıtlarda MPH kullanımı ile azaldığı gözlendi (MPH öncesi: %19,4±9,8; MPH sonrası: %15.8±8,5, p=0,003). Bu bulgular, özellikle Dikkat Eksikliği Baskın tipte belirgindi. Bir hastada MPH altında 4-5 atımlık ventriküler taşikardi atağı görüldü. DEHB hastalarında uykuda otonom sinir sistemi fonksiyonları sağlıklı çocuklarınkine göre farklılık gösterirken MPH tedavisinin bu farklılıkları düzeltici yönde etkileri görüldü. MPH’nin etkili olduğu uyanıklık saatlerinde parasempatik aktivitenin baskılandığı sonucuna varıldı. MPH başlamadan önce aritmi riski taşıyan hastaların ayrıntılı incelenmesi ve yakın izlemi önerilir. ANAHTAR SÖZCÜKLER: Ani Ölüm, Aritmi, Dikkat Eksikliği Hiperaktivite Bozukluğu, Kalp Hızı Değişkenliği, Metilfenidat, Otonom Sinir Sistemi. ABSTRACT Attention Deficit Hyperactivity Disorder (ADHD) is the most common neurobehavioral disorder of school-age children. The effects of ADHD and methylphenidate (MPH) – the latter is used in the treatment of ADHD – on autonomic nervous system (ANS) functions and heart rhythm are controversial. Heart rate variability (HRV) can be used to assess the ANS functions and risk of sudden death and arrhythmia. In this study electrocardiogram (ECG), 24-hour-ambulatory Holter monitoring, and HRV are used to investigate ANS functions and risk of arrhythmia in ADHD patients. The study group included 28 children (6 girls and 22 boys) with ADHD in between the ages of 6-13 (mean±SD=9.46±2.00 years) and 20 healthy children (7 girls and 13 boys) at the same age interval (mean±SD=9.57±2.00 years). 11 patients were evaluated as of pre-dominantly inattentive subtype while 17 were of the combined subtype. In addition to a detailed history and physical examination, 12-lead-surface ECG, echocardiography, and 24-hour-ambulatory Holter monitoring were performed on all subjects. Same evaluations were repeated while the patients were receiving MPH between the dosages of 0.25-1 mg/kg (mean±SD=0.62±0.20 mg/kg) in between the fourth and eighth weeks of the treatment (mean±SD=53.4±15.5 days). Pre and post-treatment physical examination, ECG, and Holter ECG findings, and HRV parameters including time domain (SDNN, SDANN, SDNN-i, r-MSSD, pNN50) and frequency domain (LF, HF, LF/HF) were all compared. The relation between MPH dosage and all the parameters was studied. In ADHD group QTc duration was measured higher than the control group (421.9±22.3 ms vs. 410.4±21.6 ms, p=0.039 resp.). In ADHD group SDNN sleep segment (10pm-8am) measured out of the 24-hour Holter recordings was lower than the control group (108.7±24.1 ms vs. 126.5±30.3 ms, p=0.039 resp.). None of the patients in each group had significant rhythm abnormalities. Average heart rate (AHR) and diastolic blood pressure (DBP) measurements were higher during MPH treatment than pre-treatment measurements (AHR Pre-MPH: 89.8±8.6 bpm; Post-MPH: 96.5±12.5 bpm, p=0.014; DBP Pre-MPH: 62.5±9.7 mmHg; Post-MPH: 66.9±7.6 mmHg, p=0.03). A significant increase in QTdispersion measurements was found in the combined subtype patients after MPH treatment (Pre-MPH: 33.0±16.7 ms; Post-MPH: 41.8±18.3 ms, p=0.038). During MPH treatment SDNN sleep segment values (Pre-MPH: 108.7±24.1 ms; Post-MPH: 124.6±39.3 ms, p=0.015) and SDANN values (Pre-MPH: 123.4±26.5 ms; Post-MPH: 140.2±40.3 ms, p=0.016) were observed significantly higher than pre-treatment values. A significant decrease was further observed in pNN50 values during all day long and awake segment (8am-10pm) recordings after MPH treatment (Pre-MPH: 19.4±9.8 %; Post-MPH: 15.8±8.5 %, p=0.003 respectively). These findings were notable in particular in the pre-dominantly inattentive subtype patients. A 4-to-5 beat long ventricular tachycardia was found in one patient under MPH treatment. Autonomic nervous system functions of the ADHD patients in sleeping hours differed from those of the healthy children while the effects of MPH treatment were in an ameliorating trend. It is concluded that parasympathetic activity is suppressed during the awake hours when MPH is most effective. Close examination and follow-up are suggested before starting an MPH treatment on the patients who may be under risk of arrhythmia. KEYWORDS: Arrhythmia, Attention Deficit Hyperactivity Disorder, Autonomic Nervous System, Heart Rate Variability, Methylphenidate, Sudden Dea

Management of health-care waste in Izmir, Turkey

The aim of this study was to evaluate health-care waste in the 18 districts of metropolitan municipality of the third biggest city in Turkey. This cross-sectional study was carried out with 825 health institutions established in the 18 districts of Izmir metropolitan municipality, in 2007. The total amount of health-care waste collected was 4841 tons and 621 kilograms per patient's bed in 2007. Most of the medical wastes were collected from Konak, Karsiyaka and Bornova districts and were 2308, 272 and 1020 tons, respectively. Regarding to overpopulation, the number of health institutions in these districts are more than the number of health institutions in the other administrative districts. There was a statistically significant, positive correlation between the amount of health-care waste collected and population of the 18 districts (r = 0.79, p < 0.001), and number of beds/patients (r = 0.83, p < 0.001). To provide a safe health-care waste management metropolitan municipality must provide hazardous waste separation in health institutions, establish sterilization units for infectious waste, and provide the last storage of medical waste in completely different, safe and special areas apart from the municipal waste storage areas

The prevalence of metabolic syndrome among young adults in Izmir, Turkey.

Objective: The aim of this study was to determine the prevalence of metabolic syndrome and its components among the young adult ages in İzmir, Turkey. Methods: A population-based cross-sectional study was held including 885 subjects aged between 20 to 39 years from 45 primary health care centres in Konak, which is the biggest urban area in İzmir. A stratified sampling method was used to select the participants of 318 males and 567 females. In the study, metabolic syndrome was classified according to NCEP ATP III criterion on the basis of metabolic risk factors evaluated between December 2001 and April 2002. Results: The crude prevalence of metabolic syndrome (having three or more of the metabolic risk factors) was 3.6% among 20 and 29 years old men and 19.6% among 30 and 39 years old men and the increase by age was significant (p<0.001). The results were similar in women and the crude prevalence of metabolic syndrome increased significantly from 7.5% in 20 and 29 years old women to 24% in 30 and 39 years old women (p<0.001). With regard to the highest prevalences of the first three metabolic risk factors, hypertriglyceridemia, low HDL-cholesterol and high blood pressure, the age-adjusted prevalence of the metabolic syndrome was significantly higher in women than in men and all subjects (15% vs 10.2% vs 13.6%, p<0.01) respectively. Conclusion: This study revealed that the prevalence of metabolic syndrome was extremely high between young adults in urban areas and the most prevalent components of the metabolic syndrome were found to be high triglycerides, low HDL cholesterol, high blood pressure, abdominal obesity and high fasting glucose, respectively