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Does Using Sofa Score For Ventilator Triage Among Covid 19 Patients Result In Suboptimal Allocation Of Medical Ventilators For The Bipoc Population?, Alexandrea Mp Masocco, Elisabeth Michel, Ebbin Dotson Jul 2023

Does Using Sofa Score For Ventilator Triage Among Covid 19 Patients Result In Suboptimal Allocation Of Medical Ventilators For The Bipoc Population?, Alexandrea Mp Masocco, Elisabeth Michel, Ebbin Dotson

Journal of Health Disparities Research and Practice

Introduction: Since the COVID-19 pandemic in the United States, Black, and Latinx populations have been disproportionately affected by the COVID-19 pandemic. It can be inferred with high confidence that those most vulnerable are the least likely to receive essential care. Kidney transplant allocation and COVID-19 triage protocols share commonalities in that both protocols involve using multivariate scored criteria with objective and subjective inputs. As such, the similar conclusion in outcomes is concerning. It is worth questioning whether the racial inequalities demonstrated in the COVID-19 pandemic related to access to life-saving ventilators were associated with triage protocols.

Methodology: Using an exploratory …


Prevalence And Predictors Of Burnout Syndrome Among Italian Psychologists Following The First Wave Of The Covid-19 Pandemic: A Cross-Sectional Study, Pietro Crescenzo, Francesco Chirico, Giuseppe Ferrari, Lukasz Szarpak, Gabriella Nucera, Raffaella Marciano, Livio Tarchi, Diego Denicolo, Assunta Maiorino, Kavita Batra, Manoj Sharma Dec 2022

Prevalence And Predictors Of Burnout Syndrome Among Italian Psychologists Following The First Wave Of The Covid-19 Pandemic: A Cross-Sectional Study, Pietro Crescenzo, Francesco Chirico, Giuseppe Ferrari, Lukasz Szarpak, Gabriella Nucera, Raffaella Marciano, Livio Tarchi, Diego Denicolo, Assunta Maiorino, Kavita Batra, Manoj Sharma

School of Medicine Faculty Publications

Introduction: The main objective of this study was to assess the prevalence and predictors of Burnout Syndrome (BOS) among Italian psychologists following the first wave of COVID-19 pandemic. As a secondary objective, geographical differences in the prevalence of BOS symptoms were investigated across regional macro-areas in this category of workers. Methods: Using a non-probabilistic convenience sample, four-hundred sixty-eight participants responded to an online survey which included psychometric valid questions from the Maslach Burnout Inventory and The Big Five Inventory-10. Descriptive and inferential statistics were utilized to analyze the data. Results: The overall prevalence of BOS in the study sample was …


Covid-19 Vaccine Acceptance Behavior Among Hispanics/Latinxs In Nevada: A Theory-Based Analysis, Tara Marie Naoe Tacderan Wong Nerida Dec 2022

Covid-19 Vaccine Acceptance Behavior Among Hispanics/Latinxs In Nevada: A Theory-Based Analysis, Tara Marie Naoe Tacderan Wong Nerida

UNLV Theses, Dissertations, Professional Papers, and Capstones

The COVID-19 pandemic has impacted many lives around the world, leaving negative repercussions including health effects, economic downturns, and social and physical restrictions. The pandemic has also revealed many disproportionate health impacts on vulnerable populations, especially among the Hispanic and Latinx populations. The use of the three COVID-19 vaccines in the United States has presented a form of protection against additional negative impacts. However, hesitancy toward the COVID-19 vaccine has hindered its rapid uptake, preventing the country from reaching herd immunity and ultimately ending the pandemic. Current research is minimal in understanding the intentions of receiving the COVID-19 vaccine among …


Assessing The Compliance Of Dental Clinicians Towards Regulatory Infection Control Guidelines Using A Newly Developed Survey Tool: A Pilot Cross-Sectional Study In India, Pragati Kaurani, Kavita Batra, Himangini Rathore Hooja, N. Gopi Chander, Anamitra Bhowmick, Suraj Arora, Suheel Manzoor Baba, Shafait Ullah Khateeb, Anshad M. Abdulla, Vishakha Grover, Priyanka Saluja Sep 2022

Assessing The Compliance Of Dental Clinicians Towards Regulatory Infection Control Guidelines Using A Newly Developed Survey Tool: A Pilot Cross-Sectional Study In India, Pragati Kaurani, Kavita Batra, Himangini Rathore Hooja, N. Gopi Chander, Anamitra Bhowmick, Suraj Arora, Suheel Manzoor Baba, Shafait Ullah Khateeb, Anshad M. Abdulla, Vishakha Grover, Priyanka Saluja

School of Medicine Faculty Publications

Adherence to the dental practice regulatory guidelines instituted during the COVID- 19 pandemic is essential to minimize the transmission of SARS-CoV-2 strains. Given the lack of a valid and reliable survey tool to assess the adherence to dental practice guidelines, this study aims to develop, validate, and test a survey tool on a pilot sample of dental clinicians practicing in India. A survey tool was developed/validated through a sequential phasic approach: Phase Ideveloping survey using conceptual and literature framework; Phase II: ascertaining its validity and reliability; Phase III: pilot testing; and Phase IV: assessing construct validity by exploratory factor analysis …


Narrative Review Of Covid-19 Vaccine Hesitancy: Evidence In Late 2021, Ambree Papa Schoetker, Manoj Sharma Aug 2022

Narrative Review Of Covid-19 Vaccine Hesitancy: Evidence In Late 2021, Ambree Papa Schoetker, Manoj Sharma

Spectra Undergraduate Research Journal

The coronavirus disease, COVID-19, has changed daily life dramatically since early 2020. Although COVID-19 vaccines are available in the United States, many express distrust in this primary prevention measure and doubt both the seriousness of COVID-19 and its associated morbidity and mortality. Vaccine hesitancy, also described as the reluctance or refusal of vaccines despite availability, exists on a continuum and was a known public health threat prior to the coronavirus pandemic. This narrative review examines studies related to the determinants of COVID-19 vaccine hesitancy among adults in the United States. Also explored are the factors related to COVID-19 vaccine risk …


Assessing Covid-19 Booster Hesitancy And Its Correlates: An Early Evidence From India, Geetanjali C. Achrekar, Kavita Batra, Yashashri Urankar, Ravi Batra, Naved Iqbal, Sabiha A. Choudhury, Deepti Hooda, Roohi Khan, Suraj Arora, Aditi Singh, Francesco Chirico, Manoj Sharma Jun 2022

Assessing Covid-19 Booster Hesitancy And Its Correlates: An Early Evidence From India, Geetanjali C. Achrekar, Kavita Batra, Yashashri Urankar, Ravi Batra, Naved Iqbal, Sabiha A. Choudhury, Deepti Hooda, Roohi Khan, Suraj Arora, Aditi Singh, Francesco Chirico, Manoj Sharma

School of Medicine Faculty Publications

The emergence of SARS-CoV-2 mutants, waning immunity, and breakthrough infections prompted the use of booster doses of the COVID-19 vaccine to fight against the pandemic. India started booster doses in January 2022 and it is critical to determine the intention of booster dose uptake and its correlates. Therefore, the current cross-sectional study aimed to investigate booster dose acceptability and associated predictors among the Indian population. A convenience sampling technique was utilized to recruit a sample of 687 Indian residents. A 55-item psychometric validated survey tool was used to assess booster dose acceptability, vaccine literacy and vaccine confidence. Univariate, bivariate, and …


Covid-19 Booster Vaccination Hesitancy In The United States: A Multi-Theory-Model (Mtm) Based National Assessment, Kavita Batra, Manoj Sharma, Chia-Liang Dai, Jagdish Khubchandani May 2022

Covid-19 Booster Vaccination Hesitancy In The United States: A Multi-Theory-Model (Mtm) Based National Assessment, Kavita Batra, Manoj Sharma, Chia-Liang Dai, Jagdish Khubchandani

School of Medicine Faculty Publications

Background: Despite the availability of COVID-19 vaccines and the proven benefits of vaccinations outweighing the potential risks, hesitancy to accept vaccines and additional doses remains a persistent problem. Therefore, the purpose of the study was to investigate hesitancy, confidence, literacy, and the role of the multi-theory model (MTM) constructs in COVID-19 booster uptake. Methods: This cross-sectional study utilized a 52-item psychometric valid web-based survey conducted during the month of October 2021 to recruit a nationally representative sample of U.S. adults. Univariate, bivariate, and multivariate statistical tests were used to analyze the data. Results: Among the booster hesitant group (n = …


Factors Associated With Telemedicine Usage And Acceptance Pre- And Since Covid-19, Shivangi Sinha May 2022

Factors Associated With Telemedicine Usage And Acceptance Pre- And Since Covid-19, Shivangi Sinha

Calvert Undergraduate Research Awards

The COVID-19 pandemic has acted as a catalyst for telemedicine uptake among healthcare providers and patients. Prior research rarely has examined the lack of patient uptake of telemedicine. Known systemic barriers to accessing telemedicine in the U.S. before the COVID-19 pandemic may play a large role in its uptake. The purpose of this study is to assess the factors associated with the usage and acceptance of telemedicine pre- and since the COVID-19 pandemic. In this cross-sectional study, data was collected from persons residing within the U.S. who are 18 years of age or older using an online survey. Using an …


Improving Nurse Leaders’ Knowledge And Confidence In Transformational Leadership Skills In The Online Environment, Tanya Haight May 2022

Improving Nurse Leaders’ Knowledge And Confidence In Transformational Leadership Skills In The Online Environment, Tanya Haight

UNLV Theses, Dissertations, Professional Papers, and Capstones

Leadership is critical to the success of most organizations, and the achievement of an organization's goals is largely dependent on the leaders' ability to engage, motivate, and influence their teams—often referred to as Transformational Leadership. This is especially true for healthcare organizations wherein the morbidity and mortality of patients may be affected by the quality of leadership. At the start of the COVID-19 pandemic, in-person meetings transitioned to the online format without nurse leaders' formal training. Leaders cited this lack of orientation as impeding their ability to sustain an online-virtual transformational leadership presence with their teams. They reported varying degrees …


Assessing Psychological Impact Of Covid-19 Among Parents Of Children Returning To K-12 Schools: A U.S. Based Cross-Sectional Survey, Kavita Batra, Jennifer R. Pharr, Emylia Terry, Brian Labus Apr 2022

Assessing Psychological Impact Of Covid-19 Among Parents Of Children Returning To K-12 Schools: A U.S. Based Cross-Sectional Survey, Kavita Batra, Jennifer R. Pharr, Emylia Terry, Brian Labus

School of Medicine Faculty Publications

Background and Purpose: While impacts of the pandemic on family well-being have been documented in the literature, little is known about the psychological challenges faced by children and their parents as schools reopen after mandated closures. Therefore, the purpose of this study was to determine if sending children back to in-person school impacts the mental health of parents and the perceived mental health of their children. Methods: This cross-sectional descriptive study recruited a nationally representative, non-probability sample of parents or guardians (n = 2100) of children attending grades K-12 in the United States (U.S.) through a 58-item web-based survey. The …


Mental Disorder Symptoms During The Covid-19 Pandemic In Latin America – A Systematic Review And Meta-Analysis, Stephen X. Zhang, Kavita Batra, Wen Xu, Tao Liu, Rebecca Kechen Dong, Allen Yin, Andrew Yilong Delios, Bryan Z. Chen, Richard Z. Chen, Saylor Miller, Xue Wan, Wenping Ye, Jiyao Chen Apr 2022

Mental Disorder Symptoms During The Covid-19 Pandemic In Latin America – A Systematic Review And Meta-Analysis, Stephen X. Zhang, Kavita Batra, Wen Xu, Tao Liu, Rebecca Kechen Dong, Allen Yin, Andrew Yilong Delios, Bryan Z. Chen, Richard Z. Chen, Saylor Miller, Xue Wan, Wenping Ye, Jiyao Chen

School of Medicine Faculty Publications

Aims There is a lack of evidence related to the prevalence of mental health symptoms as well as their heterogeneities during the coronavirus disease 2019 (COVID-19) pandemic in Latin America, a large area spanning the equator. The current study aims to provide meta-analytical evidence on mental health symptoms during COVID-19 among frontline healthcare workers, general healthcare workers, the general population and university students in Latin America. Methods Bibliographical databases, such as PubMed, Embase, Web of Science, PsycINFO and medRxiv, were systematically searched to identify pertinent studies up to August 13, 2021. Two coders performed the screening using predefined eligibility criteria. …


Assessing Acceptability Of Covid-19 Vaccine Booster Dose Among Adult Americans: A Cross-Sectional Study, Tesfaye Yadete, Kavita Batra, Dale M. Netski, Sabrina Antonio, Michael J. Patros, Johan C. Bester Dec 2021

Assessing Acceptability Of Covid-19 Vaccine Booster Dose Among Adult Americans: A Cross-Sectional Study, Tesfaye Yadete, Kavita Batra, Dale M. Netski, Sabrina Antonio, Michael J. Patros, Johan C. Bester

School of Medicine Faculty Publications

Given the emergence of breakthrough infections, new variants, and concerns of waning immunity from the primary COVID-19 vaccines, booster shots emerged as a viable option to shore-up protection against COVID-19. Following the recent authorization of vaccine boosters among vulnerable Americans, this study aims to assess COVID-19 vaccine booster hesitancy and its associated factors in a nationally representative sample. A web-based 48-item psychometric valid survey was used to measure vaccine literacy, vaccine confidence, trust, and general attitudes towards vaccines. Data were analyzed through Chi-square (with a post hoc contingency table analysis) and independent-sample t-/Welch tests. Among 2138 participants, nearly 62% intended …


Correlates Of Covid-19 Pandemic On Anxiety Among Adults In Appalachia, Usa, Ram Lakhan, Louisa Summers, David Tataw, Peter Hackbert, Manoj Sharma Nov 2021

Correlates Of Covid-19 Pandemic On Anxiety Among Adults In Appalachia, Usa, Ram Lakhan, Louisa Summers, David Tataw, Peter Hackbert, Manoj Sharma

Social & Behavioral Health Faculty Publications

Background: Anxiety problems have increased in the COVID-19 pandemic worldwide. However, very little is known about the anxiety rates in the new normal phase of the disease when adults have been assumed to be adjusted. The study aimed to find out the difference in anxiety in a convenience sample of Appalachian adults during the new normal phase of the COVID-19 pandemic, examine its association with sociodemographic factors, and compare it with the anxiety levels before the pandemic as recalled by the participants. Study design: A cross-sectional study. Methods: The Generalized Anxiety Disorder-7 scale was used in the present study. The …


A Theory-Based Analysis Of Covid-19 Vaccine Hesitancy Among African Americans In The United States: A Recent Evidence, Manoj Sharma, Kavita Batra, Ravi Batra Sep 2021

A Theory-Based Analysis Of Covid-19 Vaccine Hesitancy Among African Americans In The United States: A Recent Evidence, Manoj Sharma, Kavita Batra, Ravi Batra

Environmental & Occupational Health Faculty Publications

African Americans have been disproportionately vaccinated at lower rates, which warrants the development of theory-based interventions to reduce vaccine hesitancy in this group. The fourth-generation theories, e.g., multi-theory model (MTM) of health behavior change, are vital in developing behavioral interventions. Therefore, the current study aims to determine recent trends in COVID-19 vaccination rates and to test the MTM model in predicting the initiation of COVID-19 vaccines among vaccine-hesitant Blacks. A sample of 428 unvaccinated African Americans were recruited through a web-based survey using a 28-item psychometric valid questionnaire. Chi-square, independent-samples-t-test or Welch’s t test, and Pearson’s correlation tests were utilized …


Testing The Multi-Theory Model (Mtm) To Predict The Use Of New Technology For Social Connectedness In The Covid-19 Pandemic, Manoj Sharma, Kavita Batra, Jason Flatt Jul 2021

Testing The Multi-Theory Model (Mtm) To Predict The Use Of New Technology For Social Connectedness In The Covid-19 Pandemic, Manoj Sharma, Kavita Batra, Jason Flatt

Environmental & Occupational Health Faculty Publications

Loneliness or social isolation, recently described as a “behavioral epidemic,” remains a long-standing public health issue, which has worsened during the COVID-19 pandemic. The use of technology has been suggested to enhance social connectedness and to decrease the negative health outcomes associated with social isolation. However, till today, no theory-based studies were performed to examine the determinants of technology use. Therefore, the current study aims to test theory-based determinants in explaining the adoption of new technology in a nationally representative sample during the COVID-19 pandemic (n = 382). A psychometrically reliable and valid instrument based on the multi-theory model (MTM) …


Conceptualization Of College Students' Covid-19 Related Mask-Wearing Behaviors Using The Multi-Theory Model Of Health Behavior Change, Robert E. Davis, Manoj Sharma, Kayla E. Simon, Amanda H. Wilkerson May 2021

Conceptualization Of College Students' Covid-19 Related Mask-Wearing Behaviors Using The Multi-Theory Model Of Health Behavior Change, Robert E. Davis, Manoj Sharma, Kayla E. Simon, Amanda H. Wilkerson

Environmental & Occupational Health Faculty Presentations

Background: Recommendations and policies, regarding the use of face coverings, have been instituted to control transmission of coronavirus disease 2019 (COVID-19). Understanding of psychosocial factors related to the use of face coverings within the context of COVID-19 is needed. This study aimed to conceptualize mask-wearing behavior among students using the Multi-theory Model (MTM) of behavior change. Methods: In October 2020, students (n = 595) enrolled in a large public southeastern US university were recruited to participate in a cross-sectional survey, using a valid and reliable instrument. Univariate, bivariate, and multivariate techniques described mask-wearing behavior and differentiated theoretical drivers of mask-wearing …


Conceptualization Of College Students' Covid-19 Related Mask-Wearing Behaviors Using The Multi-Theory Model Of Health Behavior Change, Robert E. Davis, Manoj Sharma, Kayla E. Simon, Amanda H. Wilkerson May 2021

Conceptualization Of College Students' Covid-19 Related Mask-Wearing Behaviors Using The Multi-Theory Model Of Health Behavior Change, Robert E. Davis, Manoj Sharma, Kayla E. Simon, Amanda H. Wilkerson

Environmental & Occupational Health Faculty Publications

Background: Recommendations and policies, regarding the use of face coverings, have been instituted to control transmission of coronavirus disease 2019 (COVID-19). Understanding of psychosocial factors related to the use of face coverings within the context of COVID-19 is needed. This study aimed to conceptualize mask-wearing behavior among students using the Multi-theory Model (MTM) of behavior change. Methods: In October 2020, students (n = 595) enrolled in a large public southeastern US university were recruited to participate in a cross-sectional survey, using a valid and reliable instrument. Univariate, bivariate, and multivariate techniques described mask-wearing behavior and differentiated theoretical drivers of mask-wearing …


Knowledge, Protective Behaviors And Risk Perception Of Covid-19 Among Dental Students In India: A Cross-Sectional Analysis, Kavita Batra, Yashashri Urankar, Ravi Batra, Aaron F. Gomez, Meru S., Pragati Kaurani May 2021

Knowledge, Protective Behaviors And Risk Perception Of Covid-19 Among Dental Students In India: A Cross-Sectional Analysis, Kavita Batra, Yashashri Urankar, Ravi Batra, Aaron F. Gomez, Meru S., Pragati Kaurani

School of Medicine Faculty Publications

Objective: This study’s objective was to examine the knowledge, performance in practicing protective behaviors, and risk perception of Coronavirus disease-19 (COVID-19) among dental students of India. Methods: A web-based cross-sectional survey was conducted from 10–30 August 2020, involving 381 dental students that were enrolled at the Uttaranchal Dental and Medical Research Institute in India. A web-based structured questionnaire assessed the COVID-19 related knowledge, protective behaviors, and risk perception performance. The independent-samples-t and analysis of variance tests were used to analyze the differences in knowledge, protective behaviors, and perception across the groups. Results: Of the dental students surveyed, 83% had adequate …


Economic Insecurity As A Risk Factor During The Covid-19 Pandemic, Klaus E. Cavalhieri Apr 2021

Economic Insecurity As A Risk Factor During The Covid-19 Pandemic, Klaus E. Cavalhieri

Journal of Health Disparities Research and Practice

The novel coronavirus disease 2019 (COVID-19) is currently spreading at a rapid rate worldwide. The current pandemic may have several adverse effects on overall psychological functioning and health behaviors. Economic insecurity, operationalized as financial strain and employment uncertainty, can be a significant risk factor for both psychological outcomes and compliance with shelter-in-place recommendations (i.e., health behaviors). One hundred and twenty four participants answered survey data on economic security, fear of COVID-19, health care system distrust, anxiety, well-being, and compliance with CDC recommendations to curb the spread of COVID-19 (i.e., health behaviors; CDC, 2020). Economic security was significantly associated with well-being, …


A Covid-19 Risk Score Combining Chest Ct Radiomics And Clinical Characteristics To Differentiate Covid-19 Pneumonia From Other Viral Pneumonias, Zuhua Chen, Xiadong Li, Jiawei Li, Shirong Zhang, Pengfei Zhou, Xin Yu, Yao Ren, Jiahao Wang, Lidan Zhang, Yunjiang Li, Baoliang Wu, Yanchun Hou, Ke Zhang, Rongjun Tang, Yongguang Liu, Zhongxian Ding, Bin Yang, Qinghua Deng, Qin Lin, Ke Nie, Zhaobin Cai, Shenglin Ma, Yu Kuang Mar 2021

A Covid-19 Risk Score Combining Chest Ct Radiomics And Clinical Characteristics To Differentiate Covid-19 Pneumonia From Other Viral Pneumonias, Zuhua Chen, Xiadong Li, Jiawei Li, Shirong Zhang, Pengfei Zhou, Xin Yu, Yao Ren, Jiahao Wang, Lidan Zhang, Yunjiang Li, Baoliang Wu, Yanchun Hou, Ke Zhang, Rongjun Tang, Yongguang Liu, Zhongxian Ding, Bin Yang, Qinghua Deng, Qin Lin, Ke Nie, Zhaobin Cai, Shenglin Ma, Yu Kuang

Health Physics & Diagnostic Sciences Faculty Publications

With the continued transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) throughout the world, identification of highly suspected COVID-19 patients remains an urgent priority. In this study, we developed and validated COVID-19 risk scores to identify patients with COVID-19. In this study, for patient-wise analysis, three signatures, including the risk score using radiomic features only, the risk score using clinical factors only, and the risk score combining radiomic features and clinical variables, show an excellent performance in differentiating COVID-19 from other viral-induced pneumonias in the validation set. For lesion-wise analysis, the risk score using three radiomic features only also …


Explaining Handwashing Behavior In A Sample Of College Students During Covid-19 Pandemic Using The Multi-Theory Model (Mtm) Of Health Behavior Change: A Single Institutional Cross-Sectional Survey, Manoj Sharma, Kavita Batra, Robert E. Davis, Amanda H. Wilkerson Jan 2021

Explaining Handwashing Behavior In A Sample Of College Students During Covid-19 Pandemic Using The Multi-Theory Model (Mtm) Of Health Behavior Change: A Single Institutional Cross-Sectional Survey, Manoj Sharma, Kavita Batra, Robert E. Davis, Amanda H. Wilkerson

Environmental & Occupational Health Faculty Publications

Amidst the COVID-19 pandemic, handwashing offers a simple and effective hygienic measure for disease prevention. Reportedly, a significant proportion of college students did not follow handwashing recommendations provided by the Centers for Disease Control and Prevention (CDC) in the pre-COVID era. The purpose of this cross-sectional study was to explore and explain the handwashing behavior among college students during the COVID-19 pandemic using a contemporary fourth-generation multi-theory model (MTM) of health behavior change. Data were collected from 713 college students at a large public university in the Southern U.S. in October 2020 using a validated 36-item survey. Statistical analyses included …


Investigating The Psychological Impact Of Covid-19 Among Healthcare Workers: A Meta-Analysis, Kavita Batra, Tejinder Pal Singh, Manoj Sharma, Ravi Batra, Nena Schvaneveldt Dec 2020

Investigating The Psychological Impact Of Covid-19 Among Healthcare Workers: A Meta-Analysis, Kavita Batra, Tejinder Pal Singh, Manoj Sharma, Ravi Batra, Nena Schvaneveldt

Environmental & Occupational Health Faculty Publications

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Previous meta-analyses were conducted during the initial phases of the COVID-19 pandemic, which utilized a smaller pool of data. The current meta-analysis aims to provide additional (and updated) evidence related to the psychological impact among healthcare workers. The search strategy was developed by a medical librarian and bibliographical databases, including Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for studies examining the impact of the COVID-19 pandemic on the psychological health of healthcare workers. Articles were screened by three reviewers. Heterogeneity among studies was assessed by I2 statistic. The random-effects model …