Average Deviation Research Articles

Construction of a full color gamut color mixture model and a color prediction neural network model for rotor spinning melange yarn

This research is devoted to solving the bottleneck problem of spinning and color prediction of rotor spun melange yarn within the full color gamut range. Firstly, a full color gamut grid color mixture model with hue regulation range of 0–360°, saturation regulation range of 0-1 and lightness regulation range of 0-1 was constructed based on the preferred seven primary-color fibers through grid color mixing. Secondly, in the full color gamut grid color mixture model, 55 representative grid points were planned and corresponding melange yarns and fabrics were prepared based on grid point parameters, which served as the training set, testing set, and validation set for constructing neural network prediction models. Thirdly, based on the demand for color prediction of melange yarns, a color prediction model and a blending ratio prediction model with six sub-models are constructed by taking the reflectivity of the melange yarn fabric and the blending ratio of the primary-color fibers as input and output values. Finally, six prediction samples were produced to verify the predictive performance of the neural network prediction model. The results show that the average color difference between the predicted and measured colors is 1.06, and the average root mean square error value between the predicted and actual blending ratios is 0.48%. It indicates that the neural network prediction model based on the grid mixing of seven primary-color fibers can adapt to the prediction of the mixing color and blending ratio of primary-color fibers in the full color gamut. Due to the construction of six sub-models based on local hue regions, the prediction accuracy of the neural network prediction model has been greatly improved.

Native hip geometry restoration in total hip arthroplasty: a retrospective analysis of eight different short stems.

To compare different types of short stems (SS) in terms of native hip geometry reproducibility, analyzing centrum-collum-diaphyseal angle (CCD) and femoral offset (FO). These parameters allow the SS to be adapted to patient's anatomy in order to ensure better functional outcomes in total hip arthroplasty (THA). A total of 387 cases of SS met the inclusion criteria. CCD and FO were measured using MediCAD® software Version 6 in preoperative (preop-) and postoperative (postop-) X-rays at 6-12months after surgery. Considering preop-CCD, the sample was divided into three groups: ≤ 124.9° (A); 125°-129.9° (B); and ≥ 130°(C). Preop- and postop-CCD and FO and the respective average difference (Δ) were examined considering the SS individually and within groups, to verify reproducibility of these parameters. The SS considered were eight: Fitmore Zimmer, Pulchra Adler, TRIS Adler, Trifit Corin, Trilock Depuy, Actis Depuy, Profemur Microport, and SMF Smith&Nephew. Groups A, B, and C consisted, respectively, of 113, 124, and 150 cases. Considering all cases, there was a statistically significant (p < 0.05) increase in CCD and FO with surgery. Overall, Trifit and Trilock stems were the best in reproducing preop-CCD, Trifit itself followed by Pulchra and Profemur for preop-FO. In groups A and C, the reproduction of preop-CCD was better than preop-FO, in contrast in group B. With regard to preop-CCD reproduction, in group A Trifit and Pulchra, in group B Fitmore and Trifit, and in group C Fitmore and Pulchra were the best. Fitmore in group A, SMF in group B, Pulchra and Trilock in group C were the worst in reproducing preop-FO. Each hip anatomy is unique, and reproduction of preop-CCD and preop-FO can be achieved with different SS characteristics. Accurate knowledge of the stems and performing correct preop- planning are crucial to allow the best restoration of the patient's native hip geometry in THA.

Cryogenic vacuum distillation vs Cavitron methods in ecohydrology: Extraction protocol effects on plant water isotopic values

Stable isotope ratios of hydrogen and oxygen in plant water are widely used for water tracing in ecohydrology studies. In this approach, plant water is extracted for isotopic analysis of δ2H and δ18O. Among the extraction methods, cryogenic vacuum distillation (CVD) has been the most popular, but its impact on the isotopic composition of plant water is currently under debate. Newer Cavitron method have been proposed to replace CVD method for xylem water extraction. These recommendations have been largely based on comparisons between Cavitron-xylem water with low temperatures CVD-xylem water. However, the CVD protocol (extraction temperature and time) varies widely across laboratories, and no direct, systematic comparison has yet been made between extraction temperature and time protocols vs. the Cavitron approach. Here we compared the isotopic values of xylem water from the same tree obtained through CVD extraction at 60 °C (60, 120, 240, 360 min), 100 °C (30, 60, 120, 240 min), 140 °C (15, 30, 60, 120, 240 min), and 200 °C (15, 30 min). Subsequently, we compared the results of CVD-xylem water with Cavitron-xylem water. Our data show that isotopic values for CVD-xylem water became more positive with increasing extraction time under the same extraction temperature. Such extractions also became more isotopically positive with increasing extraction temperature for the same extraction time. When total extraction efficiency exceeded 98 %, there was no δ18O difference in CVD-xylem water among any of the different protocols (p > 0.05). However, lower extraction temperatures resulted in more negative δ2H when compared to higher temperature extraction (p < 0.05). Cavitron-xylem water was close to CVD-xylem water (average difference of 3 ‰ for δ2H and 0.5 ‰ for δ18O, n = 79) when total extraction efficiency for CVD was below 98 %. But for extraction efficiencies beyond 98 %, the Cavitron-xylem water was more negative in δ2H (17.3 ‰, n = 70) and δ18O (1.7 ‰, n = 70) than CVD-xylem water. Compared to Cavitron-xylem water, CVD-xylem water at 200 °C with extraction efficiency > 98 % was closer to the soil water. Further study is necessary to conduct a complete cross-comparison between Cavitron and CVD at different temperatures with different species at various water and salt stress conditions. But our results suggest that abandoning CVD for plant water maybe premature until such complete comparison work is done.

Performance evaluation of a nonstandard Parshall flume and comparison of experimental techniques for its verification in a drinking water treatment plant

ABSTRACT This article investigates a nonstandard Parshall flume (Pf) to assess the impact of engineering deficiencies on flow rate (Q) estimation and compare experimental techniques for evaluating its performance in Q quantification and velocity gradient (G) appraisal during rapid mixing. Considering construction and instrumentation issues in the studied Pf, Q estimates were 10% lower than those derived from the standard rating curve (SRC), with 9% of this discrepancy attributable to the high placement of the stilling well scale and 1% to the position of the connecting pipe to the gauging section. When contrasting Q estimates from the SRC to the current rating curve in use and a set of rating curves fitted using salt dilution gauging (SDG), acoustic Doppler velocimetry (ADV), and numerical modeling (CFD), the average differences were −10.2, −8.3, −2.2, and 0.2%, respectively, for the current rating curve in use and those fitted to ADV, SDG, and CFD data. Considering only the instrumental measuring techniques, the SDG exhibited superior fittings (R2 = 0.99), followed by ADV (R2 = 0.95). Calculations of G aligned (9.3%) with CFD estimates support these methods as reliable tools for evaluating and verifying nonstandard Pf performance.

Medicaid Reimbursement for Common Orthopedic Trauma Procedures is 16.0% Less Compared to Medicare with Substantial Variability Between States.

This study seeks to evaluate the variability of Medicaid reimbursement and compare it to Medicare reimbursement using the 20 most commonly billed orthopedic trauma CPT codes nationwide. The authors anticipate significant variability between states and hypothesize that Medicaid payment will be significantly less than Medicare payment. The top 20 most common orthopedic trauma surgery procedural codes were identified from a previous analysis performed by Haglin et al.1 The Centers for Medicare and Medicaid services physician fee schedule was used to determine reimbursement rates from Medicare, and state Medicaid fee schedules were used to determine reimbursement rates for Medicaid. State Medicaid rates were compared to their corresponding Medicare rates to determine a dollar difference. Additionally, the dollar difference for each CPT code was divided by its respective physician relative value unit (RVU). This was utilized to acknowledge the possible variability in the complexity of orthopedic procedures and the related physician effort. The Medicare Wage Index was used to adjust Medicaid rates based on the cost of living for the state as well. Coefficients of variation were calculated to represent overall variability in Medicaid and Medicare reimbursement rates. The mean reimbursement rates for Medicaid were lower for all 20 procedures compared to Medicare. On average, Medicaid reimbursed 16.0% less than Medicare, and 29.6% less when adjusting for cost-of-living. MCD reimbursed at a higher rate than MCR for all procedures in only nine states (Alaska, Arizona, Arkansas, Montana, Nebraska, New Jersey, New Mexico, and North Dakota, and South Dakota) while 38 states reimbursed at a lower rate than MCR, on average. The coefficient of variation ranged from 0.24 to 0.34 for the Medicaid unadjusted group and from 0.35 to 0.46 for the Medicare Wage-Index adjusted group. In contrast, the Medicare group was consistent at 0.06 for all 20 procedures. The average dollar difference across the 20 CPT codes for Medicaid reimbursement compared to Medicare ranged from -$76.89 to -$225.17, and the dollar difference per relative value unit ranged from -$5.96 to -$15.16. This study found a high amount of variation between state Medicaid reimbursement rates and average rates that were significantly lower than Medicare reimbursement rates for the top twenty most utilized orthopedic trauma CPT codes as identified by Haglin et al. The discrepancy in reimbursement was increased when Medicaid rates were adjusted for state cost-of-living. Level III. See Instructions for Authors for a complete description of levels of evidence.

Increasing the Potential of Pensioners at the Universitas Islam Bandung Foundation through Training on Cost of Production Calculations

This study analyzes the increase in the understanding of the pensioners of the Universitas Islam Bandung Foundation who are registered with the Universitas Islam Bandung Foundation Pension Fund after being given training and assistance on the cost of production. The number of respondents to the research are 48 people. This research used primary data collected through interviews and questionnaires. The research method used is descriptive analysis and inferential analysis called average difference test to see differences in pre-test and post-test scores. Based on the test results with SPSS, the result of independent sample test is &lt;0.05, this indicated that training and assistance on cost of production and sales had a significant effect on increasing understanding of the calculation of cost of production for pensioners of the Universitas Islam Bandung Foundation. Keywords: cost of production, community partnership program, pension

Predicting ERCP procedure time - the SWedish Estimation of ERCP Time (SWEET) tool.

The duration of an endoscopic retrograde cholangiopancreatography (ERCP) is influenced by a multitude of factors. The aim of this study was to describe the factors influencing ERCP time and to create a tool for preintervention estimation of ERCP time. Data from 74 248 ERCPs performed from 2010 to 2019 were extracted from the Swedish National Quality Registry (GallRiks) to identify variables predictive for ERCP time using linear regression analyses and root mean squared error (RMSE) as a loss function. Ten variables were combined to create an estimation tool for ERCP duration. The tool was externally validated using 9472 ERCPs from 2020 to 2021. Mean (SD) ERCP time was 36.8 (25.3) minutes. Indications with the strongest influence on ERCP time were primary sclerosing cholangitis and chronic pancreatitis. Hilar and intrahepatic biliary strictures and interventions on the pancreatic duct were the anatomic features that most strongly affected ERCP time. The procedure steps with most influence were intraductal endoscopy, lithotripsy, dilation, and papillectomy. Based on these results, we built and validated the SW: edish E: stimation of E: RCP T: ime (SWEET) tool, which is based on a 10-factor scoring system (e.g. 5 minutes for bile duct cannulation and 15 minutes for pancreatic duct cannulation) and predicted ERCP time with an average difference between actual and predicted duration of 17.5 minutes during external validation. Based on new insights into the factors affecting ERCP time, we created the SWEET tool, the first specific tool for preintervention estimation of ERCP time, which is easy-to-apply in everyday clinical practice, to guide efficient ERCP scheduling.

Does Social Trust Travel? Comparing Resident and Non‐resident Citizens from a High‐Trusting Country

In this study, we analyzed the effects of emigration on a high‐trust population's trust in other people. Our object of study was the Swedish‐speaking Finns, a homogenous national language minority of Finland with a relatively high proportion of emigrants. Using two highly comparable random sample surveys, one among Finland‐Swedes who had emigrated and one among Finland‐Swedes residing in Finland, we used emigration as a quasi‐experiment for explaining change in social trust. Theoretically, our aim was to test the symmetry of the experiential theory that, in similar studies but with low‐trust populations emigrating to higher trusting countries, has been found to explain an increase in trust. We distinguished between highly similar destinations and destinations that have lower levels of social trust. With the entropy balancing technique of weighting the covariates of the control group, we constructed two conditionally identical groups. The average difference in outcome of the weighted groups shows that the emigrants lost some of their trust when moving to countries with lower levels of trust. The effect was, however, time indifferent, which casts doubt on the assimilation hypothesis. The findings indicate that the experiential theory can explain also the loss of trust but that this comes with some restrictions.

Early monitoring of inlay wear after total knee arthroplasty on plain radiographs using model-based wear measurement

Wear of the ultra-high molecular-weight polyethylene (UHMWPE) component in total knee arthroplasty contributes to implant failure. It is often detected late, when patients experience pain or instability. Early monitoring could enable timely intervention, preventing implant failure and joint degeneration. This study investigates the accuracy and precision (repeatability) of model-based wear measurement (MBWM), a novel technique that can estimate inlay thickness and wear radiographically. Six inlays were milled from non-crosslinked UHMWPE and imaged via X-ray in anteroposterior view at flexion angles 0°, 30°, and 60° on a phantom knee model. MBWM measurements were compared with reference values from a coordinate measurement machine. Three inlays were subjected to accelerated wear generation and similarly evaluated. MBWM estimated inlay thickness with medial and lateral accuracies of 0.13 ± 0.09 and 0.14 ± 0.09 mm, respectively, and linear wear with an accuracy of 0.07 ± 0.06 mm. Thickness measurements revealed significant lateral differences at 0° and 30° (0.22 ± 0.08 mm vs. 0.06 ± 0.06 mm, respectively; t-test, p = 0.0002). Precision was high, with average medial and lateral differences of − 0.01 ± 0.04 mm between double experiments. MBWM using plain radiographs presents a practical and promising approach for the clinical detection of implant wear.

Dose rate correction for the novel 2D diode array MapCHECK 3.

To investigate the dose rate dependence of MapCHECK3 and its influence on measurement accuracy, as well as the effect of dose rate correction. The average and instantaneous dose rate dependence of MapCHECK2 and MapCHECK3 were studied. The accuracy of measurements was investigated where the dose rate differed significantly between dose calibration of the MapCHECK and the measurement. Measurements investigated include: the central axis dose for different fields at different depths, off-axis doses outside the field, and off-axis doses along the wedge direction. Measurements using an ion chamber were taken as the reference. Exponential functions were fit to account for average and instantaneous dose rate dependence for MapCHECK3 and used for dose rate correction. The effect of the dose rate correction was studied by comparing the differences between the measurements for MapCHECK (with and without the correction) and the reference. The maximum dose rate dependence of MapCHECK3 is greater than 2.5%. If the dose calibration factor derived from a 10 × 10 cm2 open field at 10cm depth was used for measurements, the average differences in central diode dose were 0.8%±1.0% and 1.0%±0.8% for the studied field sizes and measurement depths, respectively. The introduction of wedge would not only induce -1.8%±1.3% difference in central diode dose, but also overestimate the effective wedge angle. After the instantaneous dose rate correction, above differences can be changed to 1.9%±8.1%, 0.2%±0.1%, and 0.0%±0.9%. The pass rate can be improved from 98.4% to 98.8%, 98.3%-100.0%, and 96.3%-100.0%, respectively. Compared with MapCHECK2 (SunPoint1 diodes), the more pronounced dose rate dependence of MapCHECK3 (SunPoint2 diodes) should be carefully considered. To ensure highly accurate measurement, it is suggested to perform the dose calibration at the same condition where measurement will be performed. Otherwise, the dose rate correction should be applied.

Research on temperature distribution rule and influencing factors of integrated mechanized stope in potassium salt mine

Managing heat damage presents a significant challenge in deep mechanized stopes. Investigating and analyzing temperature distribution patterns and influential factors within the stope environment holds profound importance for enhancing thermal conditions. This study establishes a coupling model of convection and heat transfer, encompassing air flow, heat transfer, species transport and water evaporation. Additionally, a physical model is developed using the Integrated Mechanized Stope at the Laos Kaiyuan Mining potash salt mine as a representative case study. The accuracy of the numerical model is confirmed through comparison with measured data and numerical simulations. Results from numerical simulations indicate that heat dissipation from electromechanical equipment is the primary cause of stope temperature rise. In the stope stabilized airflow region, temperatures near the bottom plate are lower compared to those near the top plate, with an average temperature difference of 1.09 °C. Variation in key parameters reveals that stope temperature decreases with reduced initial airflow temperatures and surrounding rock temperatures, while it increases with diminished initial air volume. Variance analysis indicates the order of influence of key parameters on stope temperature, with initial airflow temperature exerting the greatest impact, followed by surrounding rock temperature and initial air volume. The optimal parameter scheme for controlling heat damage in the stope includes an initial airflow temperature of 22 °C, a surrounding rock temperature of 35 °C, and an initial air volume of 20 kg/s. It can reduce the average temperature of the stope's main working area to 26.21 °C. This study offers a theoretical foundation and practical reference for managing heat damage in underground mining Integrated Mechanized Stopes.

Pengaruh Metode Demonstrasi terhadap Minat Belajar Pendidikan Agama Kristen dan Budi Pekerti Peserta Didik Kelas VII SMP Negeri 4 Siborongborong Tahun Pembelajaran 2023/2024

The aim of this research is to determine the influence of students' interest in learning using the demonstration method. The research hypothesis is: "There is a difference in students' interest in learning in class VIII SMP N 4 Siborongborong for the 2023/2024 academic year before and after learning using the demonstration method. The population is all class VIII of SMP Negeri 4 Siborongborong, North Tapanuli Regency for the 2023/2024 academic year with 206 Protestant Christians consisting of 7 classes. The research sample was determined using the Purposive Sampling technique, namely 35 students in class VIII 3 as the experimental class using the demonstration method and class VIII 5 totaling 35 students as the control class using ordinary treatment (conventional class). This research method is the Quasy Experimental Design method using a Nonequivalent Control Group Design. The instrument used in this research was a 30-item questionnaire. Research data for the questionnaire was analyzed using the average difference test formula (N-Gain Score). It was found that the average value for the experimental class was 0.7454 in the high category. And the average value for the control class is 0.1481, which is in the low category. Then carrying out an independent test using the t test obtained a value of t = 15.168 &gt; t table (α = 0.05; df = 68) = 2,000. Thus, it can be concluded that the research hypothesis is accepted, namely that there is a difference in students' interest in learning in class VIII of SMP N 4 Siborongborong for the 2023/2024 academic year before and after learning using the demonstration method.

Efficacy of Corticosteroids for Sore Throat Management in Adults: A Systematic Review and Meta-Analysis of Randomized Trials.

Sore throat (acute pharyngitis) is among the most common complaints among adults and is a reason for seeking healthcare globally. Antibiotics are widely used among patients with infectious sore throat. Previous research has indicated that corticosteroids could offer an alternative symptomatic treatment for sore throats.To estimate the corticosteroid efficacy as an additional therapy for sore throat adult patients, the literature search included PubMed, Medline, OVID, Cochrane CENTRAL, and Scopus for articles published until July 1st, 2024. The outcomes included the onset of pain relief (average time), complete resolution of pain (average time), absolute reduction of pain at 24 and 48 hours, requirement of antibiotics, and adverse effects related to treatment. Standardized mean difference (SMD) and risk difference were used to report numerical and dichotomous results. Five studies were included. Among the five included studies, corticosteroids showed significant effectiveness in resolving pain at 24 hours (average risk difference: 0.2200, 95% CI: 0.0500 to 0.3899, p = 0.0112) but with notable heterogeneity (I² = 82.4255%). At 48 hours, the benefit was not statistically significant (average risk difference: 0.4063, 95% CI: -0.1857 to 0.9984, p = 0.1786, I² = 98.9219%). Corticosteroids also decreased the average time to onset of pain relief (average SMD: -0.6590, 95% CI: -1.2857 to -0.0323, p = 0.0393, I² = 89.7914%), although with high heterogeneity. Other findings indicated a possible reduction in antibiotic use and fewer days missed from work. Adverse effects were minimal and occurred at similar rates in both corticosteroid and placebo arms. Corticosteroids can decrease pain intensity and duration in adults with acute sore throats. However, significant heterogeneity among studies and methodological limitations render the overall evidence inconclusive. While some studies noted reduced antibiotic use and lower symptom recurrence, high-quality RCTs are needed to address these limitations and provide more definitive guidelines for corticosteroid use in treating acute pharyngitis.

Evaluation of Hyponatremia in Infants on Vasopressin Therapy.

Vasopressin has systemic vasoconstrictive yet pulmonary vasodilatory effects, making it an ideal agent for hypotension management in infants with congenital diaphragmatic hernia (CDH)-associated pulmonary hypertension. The side effects of vasopressin in this population, such as hyponatremia, are understudied. This study aims to characterize the effect of vasopressin on sodium concentrations in infants with and without CDH. This was a retrospective review of patients who received vasopressin while admitted to a level IV neonatal intensive care unit. The primary outcome was the incidence of hyponatremia (blood sodium <135 mmol/L) during vasopressin therapy. Secondary outcomes included time to hyponatremia, dose and duration of vasopressin, incidence of severe hyponatremia (blood sodium <125 mmol/L), and hypertonic saline use. Both blood serum and blood gas sample sodium concentrations were used to compare CDH vs non-CDH patients. The average difference between baseline and lowest blood sodium was significant for both CDH and non-CDH patients for all samples (p < 0.001). There was no significant difference in the primary outcome, nor in the secondary outcomes of time to hyponatremia or duration of vasopressin infusion. The average dose of vasopressin was higher in the CDH vs non-CDH group (p = 0.018). The incidences of severe hyponatremia and hypertonic saline use were greater in the CDH vs non-CDH group for patients who had blood serum sodium samples collected (p = 0.049 and p = 0.033, respectively). This study showed that severe hyponatremia occurred more frequently in CDH vs non-CDH patients. Extreme caution is necessary when managing total body sodium in patients with CDH.

Fetal Head and Pubic Symphysis Segmentation in Intrapartum Ultrasound Image Using a Dual-Path Boundary-Guided Residual Network.

Accurate segmentation of the fetal head and pubic symphysis in intrapartum ultrasound images and measurement of fetal angle of progression (AoP) are critical to both outcome prediction and complication prevention in delivery. However, due to poor quality of perinatal ultrasound imaging with blurred target boundaries and the relatively small target of the public symphysis, fully automated and accurate segmentation remains challenging. In this paper, we propse a dual-path boundary-guided residual network (DBRN), which is a novel approach to tackle these challenges. The model contains a multi-scale weighted module (MWM) to gather global context information, and enhance the feature response within the target region by weighting the feature map. The model also incorporates an enhanced boundary module (EBM) to obtain more precise boundary information. Furthermore, the model introduces a boundary-guided dual-attention residual module (BDRM) for residual learning. BDRM leverages boundary information as prior knowledge and employs spatial attention to simultaneously focus on background and foreground information, in order to capture concealed details and improve segmentation accuracy. Extensive comparative experiments have been conducted on three datasets. The proposed method achieves average Dice score of 0.908 ±0.05 and average Hausdorff distance of 3.396 ±0.66 mm. Compared with state-of-the-art competitors, the proposed DBRN achieves better results. In addition, the average difference between the automatic measurement of AoPs based on this model and the manual measurement results is 6.157 °, which has good consistency and has broad application prospects in clinical practice.

Quantifying assumptions underlying peak oxygen consumption equations across the body mass spectrum.

The goal of this study is toquantify the assumptions associated with the Wasserman-Hansen (WH) and Fitness Registry and the Importance of Exercise: A National Database (FRIEND) predictive peak oxygen consumption (pVO2) equations across body mass index (BMI). Assumptions in pVO2 for both equations were first determined using a simulation and then evaluated using exercise data from the Stanford Exercise Testing registry. We calculated percent-predicted VO2 (ppVO2) values for both equations and compared them using the Bland-Altman method. Assumptions associated with pVO2 across BMI categories were quantified by comparing the slopes of age-adjusted VO2 ratios (pVO2/pre-exercise VO2) and ppVO2 values for different BMI categories. The simulation revealed lower predicted fitness among adults with obesity using the FRIEND equation compared to the WH equations. In the clinical cohort, we evaluated 2471 patients (56.9% male, 22% with BMI >30 kg/m2, pVO2 26.8 mlO2/kg/min). The Bland-Altman plot revealed an average relative difference of -1.7% (95% CI: -2.1 to -1.2%) between WH and FRIEND ppVO2 values with greater differences among those with obesity. Analysis of the VO2 ratio to ppVO2 slopes across the BMI spectrum confirmed the assumption of lower fitness in those with obesity, and this trend was more pronounced using the FRIEND equation. Peak VO2 estimations between the WH and FRIEND equations differed significantly among individuals with obesity. The FRIEND equation resulted in a greater attributable reduction in pVO2 associated with obesity relative to the WH equations. The outlined relationships between BMI and predicted VO2 may better inform the clinical interpretation of ppVO2 values during cardiopulmonary exercise test evaluations.

Rapid Uptitration of Guideline-Directed Medical Therapies in Acute Heart Failure With and Without Atrial Fibrillation

BackgroundRapid uptitration of guideline-directed medical therapy (GDMT) before and after discharge in hospitalized heart failure (HF) patients is feasible, is safe, and improves outcomes; whether this is also true in patients with coexistent atrial fibrillation/flutter (AF/AFL) is not known. ObjectivesThis study sought to investigate whether rapid GDMT uptitration before and after discharge for HF is feasible, safe and beneficial in patients with and without AF/AFL. MethodsIn this secondary analysis of the STRONG-HF (Safety, Tolerability, and Efficacy of Rapid Optimization, Helped by NT-proBNP Testing, of Heart Failure Therapies) trial, GDMT uptitration and patient outcomes were analyzed by AF/AFL status and type (permanent, persistent, paroxysmal). ResultsAmong 1,078 patients enrolled in STRONG-HF, 496 (46%) had a history of AF, including 238 assigned to high-intensity care (HIC) and 258 to usual care (UC), and 581 did not have a history of AF/AFL, including 304 assigned to HIC and 277 to UC. By day 90, the average percent optimal dose of neurohormonal inhibitors achieved in the HIC arm was similar in patients with and without AF/AFL, reaching approximately 80% of the optimal dose (average absolute difference between AF/AFL and non-AF/AFL groups: −0.81%; 95% CI: −3.51 to 1.89). All-cause death or HF readmission by day 180 occurred less frequently in the HIC than the UC arm, both in patients with and without AF (adjusted HR: 0.75 [95% CI: 0.48-1.19] in AF vs adjusted HR: 0.50 [95% CI: 0.31-0.79] in non-AF/AFL patients; P for interaction = 0.2107). Adverse event rates were similar in patients with and without AF/AFL. AF/AFL type did not affect either uptitration or patient outcomes. ConclusionsNearly half of acute HF patients have AF/AFL history. Rapid GDMT uptitration before and early after discharge is feasible, is safe, and may improve outcomes regardless of AF presence or type. (Safety, Tolerability, and Efficacy of Rapid Optimization, Helped by NT-proBNP Testing, of Heart Failure Therapies [STRONG-HF]; NCT03412201)

Impact of iron tablet administration and nutritional counseling: Hemoglobin level improvement in anemic pregnant women

Background: According to the 2013 Riskesdas, the prevalence of anemia in Indonesia was 37.1%. Data from the Pariaman City Health Office showed that the prevalence of anemia in 2014 was 43.1%. This study aims to determine the effect of iron (Fe) tablets and nutritional counseling on hemoglobin levels in pregnant women with anemia in the Pariaman City area in 2016. Methods: This study is a quantitative study using a quasi-experimental design. The study population consisted of third-trimester pregnant women with anemia, divided into two groups: the Fe tablet group (n=20) and the Fe tablet plus nutritional counseling group (n=20). Data analysis was performed using univariate and bivariate analysis with the Dependent T-Test statistical test. Findings: The results showed that the average knowledge score in the Fe group was 0.3, while in the Fe plus nutritional counseling group it was 1.4. The average change in knowledge scores between the two groups showed a significant increase (p=0.002). The average attitude score in the Fe group was 2.15, while in the Fe plus nutritional counseling group it was 2.75. The average change in attitude scores between the two groups was not significant (p=0.205). The average action score in the Fe group was 1.050, while in the Fe plus nutritional counseling group it was 2.7. The average change in action scores between the two groups showed a significant increase (p=0.002). The average difference in hemoglobin levels in the Fe group was 0.280, while in the Fe plus nutritional counseling group it was 0.690. The average change in hemoglobin levels between the two groups showed a significant increase (p=0.008). Conclusion: It can be concluded that the provision of Fe supplementation and nutritional counseling results in a higher increase in hemoglobin levels compared to Fe tablets alone. It is hoped that nutritionists in the field will be more active in providing nutritional counseling to pregnant women with anemia to increase their knowledge about anemia. Novelty/Originality of this article: This study proposes an integrated nutritional intervention model combining Fe tablets with a community-based interactive nutritional counselling program. This model can increase the effectiveness of anaemia control programs in pregnant women by combining supplementation and education.

Performance of an Anti-Phase Technology-Powered Microwave Ablation System on Ex Vivo Liver, Lung and Kidney: Analysis of Temperature Trend, Ablation Size and Sphericity

PurposeInvestigating the performance of the new Dophi™ M150E Microwave Ablation System, in terms of temperature distribution, ablation size and shape, reproducibility.Materials and MethodsThe Dophi™ M150E Microwave Ablation System was tested on ex vivo liver, lung and kidney, at 6 different settings of time, power and number of MW antennas (single antenna: 50 and 100 W at 5 and 10 min; double antenna: 75 W at 5 and 10 min). The temperature distribution was recorded by Fiber Bragg Grating sensors, placed at different distances from the antennas. The ablation axes were measured and the sphericity index was calculated.ResultsThe standard deviation of ablation axes was < 5 mm, except at the highest energy and time setting for the lung. A maximum temperature rise of ~ 80 °C was measured. The measured ablation axes are overall comparable with the manufacture’s values, especially at lower power and with one MW antenna (average maximum difference is 7 mm). The mean sphericity index of 0.95, 0.79 and 0.9 was obtained for the liver, lung and kidney, respectively, with a single antenna. With double antenna setup, the sphericity index was closer to 1 when 75 W for 10 min were used.ConclusionsDophi™ M150E allows good reproducibility of ablation axes for all cases except in the lung at the highest energy level. With one antenna, an almost spherical ablation area for the liver and kidney was obtained. Using double antenna results in more homogeneous temperature distribution within the tissue compared to single antenna.Graphical

Effectiveness of Health Coaching through TB Cards on Prevention of Tuberculosis Transmission

Tuberculosis is the biggest infectious disease killer in the world and has long been faced by various countries, including Indonesia. Many TB prevention control programs have been implemented, but public compliance with preventing TB transmission is still low. The research aims to determine the effectiveness of health coaching through TB ​​cards in preventing TB transmission. Quasi-experimental quantitative research design pre-post-test with control group. Purposive sampling technique. The number of respondents in the control and treatment groups was 15 each. Data analysis to measure the significance of the average difference between the 2 groups used the non-parametric Wilcoxon test and the Mann Whitney test. The results of statistical tests show that knowledge p value = 0.000, attitude p value = 0.000 and action p value = 0.000 (p &lt; 0.005). Overall, the research shows that health education through TB ​​cards is effective in increasing TB prevention behavior in the community. Structured and easily accessible information via the TB Card helps the public understand TB transmission, symptoms and preventive measures. Health guidance through TB ​​cards also contributes to community empowerment.