Basis Of Tests Research Articles

MÉTODOS DE DIAGNÓSTICOS DE HIPERADRENOCORTICISMO EM CÃES UMA REVISÃO NARRATIVA

The objective of this research was to investigate and evaluate the diagnostic methods used for hyperadrenocorticism in dogs by analyzing the available literature from the past 20 years. The methodology employed was a qualitative and exploratory literature review, conducted through databases such as PUBMED, MEDLINE, BVS, SCOPUS, PERIÓDICOS, BIBLIOTECA ABERTA USP, and SCIELO. Keywords such as "dogs," "canine," "hyperadrenocorticism," "endocrine," "endocrinopathy," and "Cushing" were used to identify relevant studies. The content analysis of the selected articles revealed that diagnostic methods vary according to the clinical suspicion and include detailed anamnesis, thorough clinical examination, and basic and imaging laboratory tests. The choice between suppression and stimulation hormone tests depends on the suspected origin of the condition, with the low-dose dexamethasone suppression test being highly sensitive for detecting hyperadrenocorticism, while the ACTH stimulation test is crucial for differentiating between origins. Diagnostic confirmation also involves abdominal ultrasonography to visualize the adrenal glands and identify possible masses, which is essential for guiding appropriate treatment and determining the patient’s prognosis.

Antimicrobial and biodegradable hydrogel based on nanocellulose/alginate incorporated with silver nanoparticles as active packaging for poultry products

In this research, active packaging which was made of all-natural component hydrogels from nanocellulose composited with silver nanoparticles at various concentrations (AgH) was studied. The concentration of silver nanoparticles ranged from 0.0078 to 0.0624 phr. AgH was characterized in terms of basic properties, functional properties, and packaging applications. Biocompatibility testing with the Caco-2 cell line showed that higher concentrations of silver (higher than 0.0312 phr) provided a lower cell viability rate (lower than 70% cell viability). Here, 0.0156 phr of silver nanoparticle concentration was the maximum loading that is safe for the target cell (82% cell viability) and was thus selected for use as active packaging. The antimicrobial activity showed that AgH at all concentrations inhibited both Gram bacteria up to 99.99%. Total volatile basic nitrogen compound testing showed that chicken meat preserved by AgH had the lowest values, indicating that AgH can prolong the shelf life in freshness level 1 (15% TVB-N) for 6.2 days compared to 3.9 and 4.1 days of blank and neat cellulose hydrogel. In addition, all AgH were gradually degraded over time and eventually disappeared within 15–30 days in organic soil.

Investigating the ability of standard tests to detect improvements in behavior after a 9-week training program in shelter dogs - A pilot study

Annually, millions of dogs enter shelters worldwide. As such, it is vital to develop effective methods for assessing adoptability and promoting successful rehoming that can be easily implemented by organizations with minimal resources. Many shelters use temperament testing and training programs to facilitate these goals, but there is limited research on the effects of training programs on shelter dog behavior, and no standardized tests for assessing the skills imparted by those programs. Therefore, the primary goal of this study was to evaluate the sensitivity of temperament and basic education tests to detect changes in dog behavior after training in a shelter context. As a secondary goal, we aimed to compare video and live scoring of dog behavior in these tests. Twelve shelter dogs were enrolled in a 9-week training program to learn basic education skills (e.g., walking on a leash without pulling, not jumping on people, responding to cues such as ‘sit’ or ‘stay’). Both before and after the program, each dog was tested using a previously evaluated and published temperament test designed for use in shelters and a test of basic education skills developed by the research team to determine the ability of the tests to measure training progress. Results showed no differences between pre- and post-training temperament test scores for the categories Human Sociability and Playfulness nor for the total temperament test score; however, a decrease was observed in the score for Dog Sociability. Regarding the basic education test, results showed improvements in scores for the categories ‘Walking on a loose leash’, ‘Sit, down and staying in place’, ‘Coming when called’ and for the total basic education test score; conversely, no differences were found for the categories ‘Accepting a friendly stranger’, ‘Waiting politely for petting’, ‘Walking through a crowd’ and ‘Supervised Separation’. Moreover, we found an overall high interrater agreement for both tests. The outcomes of the present study suggest that i) the proposed basic education test is a reliable measure for detecting improvements imparted by basic education programs, and that ii) basic education training has minimal effects on behavior assessed in the employed temperament test. We discuss how the utilized behavior tests and training programs may be beneficial in a shelter context.

Development of chipping and passing skill test instruments for U-23 futsal players in Central Java Province

Introduction. One of the sports that is currently developing is futsal. This sport has also been competed at beginner, semi-professional and even professional levels. Futsal is a sport that is similar to football in terms of technique, but have differences in terms of game rules. For this reason, several development efforts need to be made to achieve optimal results. One thing that needs to be considered is the test and measurement aspect. This research designed a basic futsal test measuring tool for players aged 18-23 years old with the aim of producing a basic futsal skills test by measuring the chipping test and passing test. Objective. The objective of this research is to produce a tool for measuring basic futsal skills that has high validity and reliability in chipping and passing tests so that it can be used in the learning and training process for U-23 futsal sports. Method. The research design used is developmental research with procedures for planning product development and developing initial product types/models for futsal players aged 18-23 years. The study involved 15 PORPROV futsal players for small groups and 90 PORPROV futsal players for large group trials, consisting of 6 districts: Banyumas, Klaten, Kebumen, Kendal, and Kudus Regencies. Next, validity, reliability and norm tests are carried out on the product skills test. Results. The validation and reliability tests for small-scale instruments consisted of basic skills. The validity test for the chipping test was 0.972, and the retest was 0.994 with a reliability of 0.978. The validity of the passing test was obtained at 0.910, the retest was 0.981 and the reliability was 0.947. Large-scale validity results for basic skills in the chipping test were 0.887, with a retest value of 0.975 and a reliability of 0.935. The validity of the passing test was 0.954, with a retest value of 0.989 and a reliability of 0.977. This indicates that the measuring instrument is reliable and will produce consistent results, even when tested at different times. There is no significant difference in the norms for the chipping and passing tests (p > 0.05), indicating that the product instrument used is objective. Conclusion. From this research, a reliable measuring tool for assessing futsal skills in players aged 18-23 years has been constructed.

The effect of positive and negative reinforcement to increase motivation of basic locomotor movements in children with mild intellectual disabilities

The provision of good treatment can increase various positive things for the growth and development of children with disabilities, one of which is Positive and Negative Reinforcement. This study aims to determine the influence of positive and negative reinforcement on enhancing motivation for basic locomotor movements in children with disabilities. This study uses a pre-experimental, one-group pretest-posttest design. The research was conducted at Kendungkandang State Special School with a sample of 20 students. The data collection technique in this study uses tests and measurements. The results of the study showed a significant influence of Positive Reinforcement on the increase in basic locomotor motivation in children with disabilities. This result was confirmed by a significance value of 0.000 < 0.05. Negative reinforcement also had a significant effect on improving basic locomotor motivation in children with disabilities, with a significance value of 0.000 < 0.05. Although both had a significant influence on improving basic locomotor motivation in children with disabilities, Positive Reinforcement was found to have a stronger effect. This result can be seen from the basic locomotor motion test, where the mean value for Positive Reinforcement was 72.50, while the mean value for Negative Reinforcement was only 63. Therefore, this research concludes that Positive Reinforcement has a greater influence on enhancing basic locomotor motivation in children with disabilities.

Impact of three weeks of integrative neuromuscular training on the athletic performance of elite female boxers.

To investigate the effects of integrative neuromuscular training (INT) on the athletic performance of elite female boxers. A before-and-after controlled experiment was conducted on 37 elite Chinese female boxers (Age: 26.00±3.11 years). All included athletes have competed at the international level. The INT intervention was administered 11 times per week for 3 weeks. This training includes strength training, explosive training, core stability, agility exercises, high intensity intervals and sprint intervals. Basic physical fitness tests, including the deep squat and bench press one-repetition maximum (1RM), vertical long jump, 30 m sprint run, 400 m run, 3,000 m run, 1-minute hexagonal jump, and 3-minute double shake; as well as specialized striking ability tests, including single-punch striking and 10-second, 30-second, and 3-minute continuous punching, were conducted before and after the intervention. Compared with pre-intervention baseline data, significant differences were found in the athletes' post-intervention baseline physical fitness, including squat and beach press (1RM), vertical jump, 30 m sprint run, 400 m run, 3,000 m run, 1-minute hexagonal jump, and 3-minute double shake (p<0.05). Additionally, 10-second, 30-second, and 3-minute continuous punching were significantly different compared with pre-intervention (p<0.05). However, no significant differences were found in single punch power (p>0.05). The 3-week INT can significantly improve the maximum strength, vertical explosive power, linear acceleration, agility, and continuous punching abilities of Chinese elite female boxers. The use of INT in physical training may enhance their athletic performance.

The Development of a Blended Instructional Model Using the Inquiry Process with Digital Games to Enhance Analytical Thinking Skills for Primary Students

Analytical thinking skills were an essential learning process for primary students. The research objectives were to 1) study the current condition, problems, and good practices regarding teaching and learning. 2) develop a blended instructional model using the inquiry process with digital games to enhance analytical thinking skills for elementary school. 3) study the results of using the instructional model. The research and development process was divided into 3 phases. Phase 1; study the current conditions, problems, and good practices regarding teaching and learning, the sample group included 377 teachers and 11 teachers. Phase 2; develop a blended instructional model, the sample consisted of 7 and 7 experts. Phase 3; study the results of using the instructional model the sample consisted of 34 grade 6 students. The data were analyzed by basic statistics and hypothesis testing statistics. The research found that 1) The current condition and overall problems were moderate level. The good practices included blended learning methods, the inquiry process, and instructional media with digital games. 2) The blended instructional model using an inquiry process along with a digital game included 4 core components: principles, objectives, management of teaching-learning processes, and measurement and evaluation. Seven experts evaluated and certified this instructional model that was appropriate in all aspects at a high level. 3) The results of using the instructional model found that (1) the analytical thinking skills of students who studied using the instructional model overall post-test were significantly higher than pre-test at the .05. (2) Measuring students&amp;rsquo; learning achievement overall score post-test was significantly higher than pre-test at the .05. (3) Students&amp;rsquo; post-test scores of the experimental were significantly higher than the control group at the .05. (4) Students&amp;rsquo; post-test scores of the experimental were significantly higher than the control group at the .05.

Machine-learning based prediction of obstructive coronary artery disease using integrated submodules of clinical information, chest x-ray, and electrocardiography

Abstract Background The early diagnosis of obstructive coronary artery disease (CAD) is critical. However, delays in diagnosis may occur due to subsequent high-cost tests, contributing to substantial medical expenses. A more insightful interpretation of fundamental diagnostic tools, such as chest x-ray (CXR) and electrocardiography (ECG), could mitigate medical costs and facilitate a timely diagnosis. Purpose This study explores the application of machine learning to interpret each modality and create a consolidated prediction model for significant CAD, aiming to construct a diagnostic model based on primary tests, including CXR, ECG, and clinical information. Methods Clinical information-ECG-CXR paired data were generated from 19,140 patients, with CAD confirmed through coronary angiography (CAG). Machine learning (ML) was employed to develop submodules for each modality, and various integration methods were explored. The area under the curve (AUC) served as the outcome metric for predicting obstructive CAD. Results The development set comprised data from 17,976 patients, with CAG-confirmed obstructive CAD observed in approximately 60% of patients. The obstructive CAD group exhibited characteristics such as advanced age, male predominance, a higher prevalence of chest pain, and more risk factors. The ML model, incorporating clinical information, CXR, and ECG with submodules, demonstrated the optimal prediction of obstructive CAD (AUC 0.722). This model significantly outperformed the model without submodules (0.722 vs. 0.638, p&amp;lt;0.0001) in obstructive CAD prediction. Conclusions Through the integration of submodules encompassing clinical information and basic tests, leveraging a high-quality database, the integrated ML algorithm offers improved prediction capabilities for CAG-confirmed obstructive CAD. This underscores the potential role of machine learning in clinical decision-making based on diverse modalities with distinct characteristics.

Prognostic prediction of cardiovascular adverse events in patients after percutaneous coronary intervention using machine learning

Abstract Introduction While prevention of major cardiovascular adverse events (MACE) is important in the management of patients after percutaneous coronary intervention (PCI), risk stratification of MACE remains a significant challenge with increasingly diverse and complex patient backgrounds. In response to that, this retrospective observational study aimed to explore whether machine learning (ML) methods can predict future MACE after PCI using a variety of features extracted from electronic medical records (EMRs). Methods In 3,016 patients with coronary artery disease who performed PCI, 3 machine learning (ML) algorithms (gentle boost, random forest, and neural network) and statistical model were retrospectively applied to predict the occurrence of MACE within two years after PCI (564 patients, 18.7%). MACE was defined as composite endpoint of cardiac death, myocardial infarction (MI), any revascularization, and congestive heart failure (CHF). Basic patient information (e.g., age, sex, coronary risk factors) and laboratory test results were used for the analysis. Feature importance was calculated to identify key factors for MACE. Hold-out method with an 8:2 split between training and test was used to calculate sensitivity, specificity, positive predictive value, negative predictive value, and F-value for each model. Results As shown in Figure 1, ML models showed excellent diagnostic accuracies in the prediction of MACE after PCI, demonstrating higher F-values compared with statistical model (logistic regression analysis). Similar results were seen in the subgroup analyses for estimating cardiac death, MI, revascularization, or CHF. Although the weighting of feature importance for MACE recurrence varied among ML models, infarct size (peak CK levels), increased inflammatory status, and traditional coronary risk factors were identified as important features for predicting MACE within two years after PCI (Figure 2). Conclusions It is suggested that ML using EMRs is promising for inferring future MACE within two years after PCI. Further studies are warranted to address whether ML-based risk stratification could lead to improved clinical decision-making after PCI.

Pulmonary hypertension in patients on chronic hemodialysis

Abstract Introduction Pulmonary hypertension (PH) is a common condition in patients with advanced chronic kidney disease and is associated with higher morbidity and mortality. High arteriovenous fistula (AVF) flow is one of known etiological factors, but the association of AVF flow within the acceptable range and PH has not been tested. Moreover, the prevalence of PH differed among various studies. Purpose The aims of this study were: 1. to describe the prevalence of PH in the Czech hemodialysis population; 2. to analyze the relation between dialysis fistula flow and PH; 3. to reveal other etiology of PH in a cross-sectional non-invasive trial. Methods We analyzed index visits of the cohort CZecking HF-CKD study (ISRCTN 18275480). Thus, this is a cross-sectional analysis based on detailed echocardiography with cardiac output (CO) calculation, evaluation of the central venous pressure (CVP) and AVF flow, bio-impedance and basic laboratory tests. All these measurements were done within an hour. The presence of PH was based on the peak systolic pulmonary arterial pressure (PASP) estimation above 35 mmHg. Results We analyzed data of 162 patients. They were 73,2 ± 12,6 years old, dialysis vintage 30 ± 69 months. Pulmonary hypertension was present in 35 % of analyzed patients. Among these patients, mild PH was present in 35 %, moderate in 53 % and severe in 12 %. There was no significant impact of AVF/AVG flow on the presence of PH or PASP value (Table 1.). However patients with PH had higher prevalence of heart failure (HF), which was present in 86 % of patients with PH and only in 46 % without PH (p&amp;lt;0.00001), see Figure 1. This and other differences presented in Table 1. document significant contribution of postcapillary PH. Patients with PH were also more overhydrated when considered by CVP, by overhydration measurement using bioelectrical impedance analysis and had higher N-terminal pro brain natriuretic peptide (NTproBNP) (Table 1.). There was a positive correlation between systemic vascular resistance (SVR) and PASP (R=0,333, p= .001). Conclusions PH is present in approximately one third of the dialysis patients. The presence of heart failure and changes of left heart chambers show for the postcapillary etiology of PH. Neither the prevalence nor the severity of PH were significantly related to arteriovenous access flow.

The effect of skill exercises based on the cooperative learning method on acquiring some basic futsal skills for female students

The research aims to prepare skill exercises using the cooperative learning method. In learning some basic skills with the feet football for female students and learning about the effect of the cooperative learning method in learning some basic skills in Futsal football. The researchers used the experimental method with the design of the experimental and control groups, including pre-test and post-test. This was suitable for the nature of the research, which targeted first-year female students (25 students). A sample of (20) students was selected and distributed equally into an experimental group and a control group, with (10) students in each group. The researchers identified the basic skills in futsal, which are (passing, receiving, and shooting), based on the curriculum for the first year in college. They then conducted pre-tests on the sample individuals in both the experimental and control groups before starting the implementation of the educational program to determine the level of basic skills tests in futsal. The researchers prepared exercises according to the cooperative learning method, relying on sources and references, with the help of experts in the field, to include (16) educational units, applying two educational units weekly with a duration of (90) minutes for each unit. Then, they conducted equivalence between the research groups (control and experimental), and after completing the educational program, they conducted post-tests for both the experimental and control groups. The results were extracted, and appropriate statistical treatments were used to reach the results. Subsequently, the results were presented, analyzed, and discussed. The researchers concluded that the first-year female students in the College of Physical Education and Sports Science at the University of Babylon showed that the cooperative learning method significantly addressed individual differences.

Vocational Education Administration, Bilateral System under the Office of the Vocational Education Commission Kalasin Province

Background and Aims: Vocational education administration Dual system of educational institutions under the Office of the Vocational Education Commission. It is a professional education arrangement that arises from an agreement between an educational institution and a business establishment. The main objective is to develop and train professional skills for students. To prepare for future work the objectives of this research are to study the following: (1) Level of administration of vocational education, dual system, of vocational education in Kalasin Province. According to the standards for managing vocational education in the dual system of the Vocational Education Commission. To assess the quality and efficiency of operations at the operational level. 2) Compare the level of vocational education administration in the dual system of vocational education in Kalasin Province. To find differences in management in various areas and the use of various approaches to develop educational quality. (3) Study guidelines for promoting or developing the administration of vocational education, a dual system, of educational institutions under the Office of the Vocational Education Commission, Kalasin Province. To suggest ways to improve and develop educational administration to be more efficient. Methodology: In this research the sample group used was a total of 196 people. The research tool was a questionnaire with a 5-level rating scale, which had a confidence value of 0.81 and an internal consistency (IOC) in the range of 0.6-1.00. This questionnaire was designed to inquire about the administration of vocational education. Dual system of educational institutions under the Kalasin Provincial Vocational Education Institute. For data analysis use basic statistics, including frequency, percentage, mean, standard deviation and statistical tests used to compare differences, including t-test and F-test. Results: The results of the research found that: (1) Vocational education administration overall, it was at a high level. (2) Results of comparative analysis of opinions regarding vocational education administration classified by position, educational level, and size of educational institution found that there was no difference. (3) Guidelines for developing vocational education administration It is necessary to be supported and encouraged to be able to develop and adapt to the changes in today's industrial world. The various areas that should be developed include: 1) Quality of graduates: They must have knowledge and abilities that are accepted by the industry. 2) Curriculum development: Curriculum should be developed together with entrepreneurs and other stakeholders. 3) Measurement and evaluation: An effective measurement and evaluation system should be developed. 4) Cooperation between Educational institutions and business establishments: There should be strong relationships and cooperation in developing students. Conclusion: Vocational education administration Dual system of educational institutions under the Office of the Vocational Education Commission Kalasin Province. It is necessary to strengthen cooperation between educational institutions and enterprises. By giving the private sector an opportunity to participate in setting criteria and guidelines in various areas to be clear and consistent with the needs of the labor market. In this regard, there should be an effective evaluation process in order for management to be systematic and produce good results.

The relationship between the Barthel Index and stroke-associated pneumonia in elderly patients and factors of SAP

BackgroundStroke-associated pneumonia (SAP) is a common complication in stroke patients, and the Barthel Index (BI) is a well-established metric for assessing activities of daily living (ADL). However, the association between BI and SAP in acute ischemic stroke (AIS) patients remains unclear. This study aims to investigate the relationship between BI at admission and SAP, and explore the factors in AIS elderly patients.MethodRetrospective data were collected from ischemic stroke patients hospitalized at the Second Affiliated Hospital of Nanchang University between January 2018 and July 2021, including their basic demographic and laboratory test results. Restricted cubic spline regression, multivariate logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were employed to investigate the relationship between BI and SAP. Additionally, the Shapley Additive exPlanations (SHAP) method was used to identify the factors influencing SAP.ResultsThe study included 7,548 eligible stroke patients with a mean age of 75.1 ± 7.6 years, among which 41.14% were female. The SAP group demonstrated significantly lower BI compared to the non-SAP group (50.86 ± 35.60 vs. 75.27 ± 26.33, P < 0.001). Additionally, a conspicuous trend of decreasing SAP risk across the Q1-4 groups was observed (P < 0.001). The RCS analysis further confirmed a gradual reduction in SAP risk with increasing BI. Based on the clinical model, both the BI (NRI = 0.014, P = 0.005; IDI = 0.04, P < 0.001) and the NIHSS score (NRI = 0.09, P = 0.03; IDI = 0.025, P < 0.001) demonstrated additional predictive value for SAP. Multivariate logistic regression and SHAP analysis identified WBC, CONUT, TG, UA, and RBC levels, as well as the type of health insurance (urban employee basic medical insurance), as important independent predictors of SAP.ConclusionBI at admission constitutes a risk factor for the onset of SAP in elderly patients with AIS, Compared to the NIHSS and mRS score, BI may be a more reliable and practical predictor of SAP.

Enabling laboratory readiness and preparedness for the evaluation of suspected viral hemorrhagic fevers: development of a laboratory toolkit.

Viral hemorrhagic fevers (VHFs), such as Ebola virus disease, Marburg virus disease, and Lassa fever, are associated with significant morbidity and mortality and the potential for person-to-person transmission. While most individuals in whom VHF is suspected will ultimately be diagnosed with a non-VHF illness, such patients may present to any United States healthcare facility (HCF) for initial evaluation; therefore, all HCFs must be prepared to evaluate and initiate care for suspect VHF patients, especially if they are acutely ill. Included within this evaluation is the ability to perform basic routine laboratory testing before VHF-specific diagnostic test results are available, as well as rapid malaria testing to assess for a common, dangerous "VHF mimic." To improve laboratory preparedness and readiness in the initial care of suspect VHF patients who may present to acute care hospitals. Plan-Do-Study-Act quality improvement model. Frontline healthcare facilities and their clinical laboratories. We describe the development of a laboratory testing toolkit for a suspect VHF patient that can assist frontline HCFs in providing basic laboratory testing required for the care of these patients. The toolkit provides guidance on infection prevention and control, waste management, occupational health, laboratory test collection, processing, and resulting, in the context of suspect VHF patient evaluation. The toolkit is designed to be readily adapted by any frontline HCF in the US. With the guidance provided, facilities will be able to support safer initial evaluation of VHF suspects and ensure high-quality patient care.

Study on the composition and properties of EME-SBS-Nano ZnO high modulus asphalt material

The objective of this research is to address the rut problems in asphalt pavements and to resist the permanent plastic deformation with the increasing heavy traffic loads. In this paper, a new type materials of high modulus asphalt was developed by incorporating styrene–butadiene–styrene (SBS) and zinc oxide nanoparticles (nano ZnO) with an (EME)-type high modulus modifier, guided by the synergistic effects and the preparation methods of High-speed shear. The basic road performance, mechanical response and thermal stability of the new high modulus asphalt materials were analysed through basic physical indicator tests, dynamic shear rheometer tests, thermogravimetric analysis (TGA), the time–temperature superposition principle, the Refutas model, and the Christensen-Andersen-Marasteanu model. The optimal results demonstrate that the optimal blend ratio of the developed asphalt is 12% EME/8% SBS/1.5% ZnO. Under this composition, the road performance indicator values of softening point, penetration and ductility of the modified asphalt met the standard requirements. The dynamic shear rheometer tests demonstrates that the inclusion of SBS and nano ZnO considerably enhanced the shear resistance and recovery deformation capacity of EME, effectively improving the high-temperature deformation resistance of asphalt. Furthermore,the Refutas and the Christensen-Andersen-Marasteanu model fitting results showed that adding SBS and nano ZnO considerably improved the temperature sensitivity of the EME types high modulus modified asphalt and exhibiting low frequency sensitivity. Compared to PR Module-type high modulus modifier(PRM),TGA reveals that the maximum thermal weight loss of EME-SBS-ZnO decreased by 3.5441%, indicating better thermal stability and the major character of SBS,EME and asphalt is physical reaction. Moreover, EME-nano ZnO-SBS high modulus asphalt at 64 °C shows Jnr-diff = 9.5% and passes the "E" extreme traffic grade. Additionally, its cost is 4.67% lower than that of the PRM high modulus modified asphalt, presenting considerable economic benefits.

7802 A Review of 21 Cases of Kallmann Syndrome

Abstract Disclosure: T. Kashima: None. M. Ishimaru: None. E. Tanimoto: None. S. Fukui: None. C. Nakamura: None. N. Ujita: None. H. Miyagi: None. M. Igarashi: None. H. Doi: None. K. Yoshii: None. Y. Naiki: None. R. Horikawa: None. Kallmann syndrome is the most common form of hypogonadotropic hypogonadism. The incidence is estimated to be 1 in 10,000 birth boys and 1 in 50,000 birth girls. The goals of treatment for childhood puberty are to induce the progression of secondary sexual characteristics close to physiological sexual maturity, to improve psychosocial problems caused by delayed puberty, and to achieve fertility. Methods.Twenty-one patients (fifteen males and six females) with a diagnosis of Kallmann syndrome who visited our Department between August 2004 and November 2023 were included in the study. The electronic medical records were reviewed retrospectively. Results.The median age at first visit was 15 years and 11 months (13 years and 3 months to 17 years and 7 months). The chief complained were secondary sexual characteristics not yet developed, olfactory disturbance, amenorrhea, decreased growth rate, and micropenis. Three adults had symptoms of Kallmann's syndrome and were seen for close examination. 6 had a history of hearing loss. Family history included 2 cases of hypogonadotropic hypogonadism and a sibling with Sjogren-Larsson syndrome. 9 cases had genetic testing, including KAL1, KAL2, FGF8, IL17D, 1 case each, and 2 gene variants of CHD2.At the time of initial examination, the median testicular volume in males was 1.0 mL (1.0-3.0 ml). Five of the six female patients had no breast enlargement.Endocrine examination revealed that the mean basic LH and LHRH test peak values were 0.25 and 3.40 mIU/mL, respectively; the mean basic FSH and peak FSH values were 0.91 and 4.47 mIU/m, respectively; the mean testosterone level in males was 0.09 ng/mL; and the mean estradiol level in females was 5.58 pg/mL.For the 20 patients, excluding children, gonadotropins (HCG+rFSH) for men and estrogen patches for women were both started at low doses and titrated up to Kaufman therapy in women. Median age at initiation of treatment was 16 years and 5 months (14 years and 1 month to 18 years and 6 months). Bone density increased after the start of treatment. One patient diagnosed with micropenis in infancy was treated with testosterone for micropenis at 2 years and 5 months. Two male patients had a baby with their partners. Discussion.The age of diagnosis (age of first examination) is considerably older than the average age of onset of secondary sexual characteristics, so it is necessary to educate the public so that patients can be examined earlier. The patient's fertility was partially confirmed, and a smooth transition to adult/reproductive medical care can be expected through earlier intervention. Presentation: 6/1/2024

Case study: problem-based learning model for soccer basic movement skills and learning activity

Background: The education curriculum is developed to prepare students to gain comprehensive experiences and life skills. Learning effectiveness, especially in physical education, depends on the teacher's ability to choose the right learning strategies, models and methods. However, problems often faced in the learning process include lack of student attention, teacher dominance in the learning process, and passive learning tendencies. The Problem-Based Learning (PBL) learning model emerged as a potential approach to address these issues and improve the quality of learning. Study Objectives: This study aims to evaluate the effectiveness of the Problem-Based Learning (PBL) learning model in improving the basic soccer movement skills and learning activities of elementary school students in the context of physical education. Materials and Methods: This study used a pseudo-experimental method with a one-group pretest-posttest design. The research subjects comprised 24 fifth-grade Krakitan State Elementary School, Klaten Regency students. The research instruments included basic soccer skills tests (dribbling and short passes) and student learning activity observation sheets. Data were analyzed using paired samples t-test to determine the effect of learning with the PBL model on primary skills of playing football and student learning activities. Results: The study revealed a substantial enhancement in both the basic soccer skills and student learning activities following the implementation of the PBL model. The average basic soccer skills score surged from 99.0833 in the pretest to 109.0417 in the posttest, marking a notable increase of 9.9584 points. Similarly, student learning activities showed a commendable rise, with the mean score climbing from 3.0833 at the start of the treatment to 4.3750 at the end, indicating a significant increase of 1.2917 points. Statistical analysis using paired samples t-test confirmed the significance of these improvements, with the calculated t values for basic soccer skills (6.89943) and learning activities (7.369) both surpassing the t table value (2.069). Conclusion: In conclusion, this study affirms the effectiveness of the Problem-Based Learning (PBL) model in enhancing students' basic soccer movement skills and learning activities in the context of physical education at the primary school level. The substantial improvements in both the technical ability to play soccer and in students' active engagement in the learning process underscore the potential of PBL as a potent learning strategy for physical education. These findings not only underscore the importance of problem-based learning approaches in enhancing physical skills but also in fostering students' cognitive and social engagement in the learning process, thereby making a significant contribution to the field of physical education. Keywords: Problem Based Learning, Physical Education, Soccer Skills, Learning Activity, Primary School

Biological Reference Ranges for Healthy Indian Blood Donors: Experience of a Tertiary Care Center Vis-à-Vis International Literature.

Complete blood count is the most common, basic test requisitioned in hematology. The normal reference ranges of hematological parameters are required owing to variable socioeconomic, environmental, and genetic factors in populations. The current study determines the reference ranges of the healthy Indian donor population of a high socioeconomic group. The study was conducted in the Department of Transfusion Medicine at a tertiary care hospital in India and included 4098 individuals, aged 18-65 years coming for voluntary blood donation from July 2021 to October 2022. Blood samples were collected in K2EDTA, analyzed on the Sysmex XN-31 hematology analyzer, and using statistical tools, the normal reference ranges were calculated. The reference ranges for hemoglobin (HB) (137-185 g/L), WBC (5.1-1.7 × 109/L), platelet count (115.6-370.0 × 109/L) were noted. No statistically significant changes were observed in different age groups. There were gender-wise differences noted in nearly all parameters. The HB and hematocrit (HCT) range was slightly higher in other Indian and other Asian populations with comparable values with the Chinese, Korean populations, and Western populations; RBC parameters were overall comparable with minor differences; the WBC count was higher than the other Indian and Asian populations particularly the upper limit of lymphocyte and monocyte; and the range of platelet counts had a comparable upper limit with all populations and had the lowest lower value in males in our study, which was comparable to only the Chinese population. It is concluded that reference ranges of common parameters were calculated with minor changes noted in all hematological parameters on comparing with other Indian, Asian population, and Western data.

Challenges in the care of cystic fibrosis in low-to-middle income countries.

Till few years ago cystic fibrosis (CF) was considered to be exclusively disease affecting Caucasian population. More recently CF has been reported from all over the world from different ethnic background. CF is an emerging illness in other parts of world (India with 1:2200 to 1:40,000 live birth). In low- and middle-income countries (LMICs) diagnosis of CF is missed due to ignorance and nonavailability of diagnostic tests. Diagnosis can be made using clinical features and basic lab tests. As of now there is no cure, but supportive care improved survival. However, medicines used in higher income countries are very expensive and not accessible to children with CF in LMICs. Cystic fibrosis transmembrane regulators modulators have emerged as significant advances in management. These are very expensive and beyond the reach of patients in LMICs. CF Fraternity in developed countries should work towards training of personnel and possibly making medications available in LMICs.

Endoplasmic reticulum stress and expression of nitric oxide synthases in heart failure with preserved and with reduced ejection fraction - pilot study.

Unfolded Protein Response (UPR), endoplasmic reticulum (ER) stress, and inducible nitric oxide synthase (iNOS) overexpression have been found to influence heart failure with preserved ejection fraction (HFpEF) pathogenesis. Their importance in heart failure with reduced ejection fraction (HFrEF) is not entirely established; there is little data involving a detailed comparison between HFpEF and HFrEF from this perspective. This pilot study aimed to compare circulating levels of Glucose-regulated protein 78kDa (GRP78) (ER - stress marker) and all NOS isoforms between both HFpEF and HFrEF and to analyze the correlation between these markers and the clinical characteristics of the patients. Forty-two patients with HFpEF and thirty-eight with HFrEF were involved in this study. Clinical characteristics and echocardiographic data were obtained. Basic laboratory tests were performed and ELISA tests for iNOS, endothelial NOS (eNOS), neuronal NOS (nNOS), and GRP78. Patients with HFpEF had lower circulating levels of GRP78 and higher iNOS concentrations when compared to HFrEF patients (P = 0.023, P < 0.0001, accordingly). The subgroup of the HFpEF population with eGFR < 60 mL/min/1.73m2 had higher nNOS and eNOS levels than HFpEF patients with normal GFR (P = 0.049, P = 0.035, respectively). In the HFrEF subgroup, patients with coexistent diabetes mellitus had elevated concentrations of nNOS compared to the subpopulation without diabetes mellitus (P = 0.041). There was a positive correlation between eNOS and nNOS concentrations (ρ = 0.86, P < 0.0001). In HFpEF, there is a more intensified iNOS overexpression, while in HFrEF, ER stress is more prominent.