Treatment Control Group Research Articles

The effects of an educational intervention on reducing stigma among medical students toward patients with psychiatric disorders

BackgroundStigma surrounding psychiatric disorders persists among medical students, who represent the future of healthcare provision. The reluctance of these students to engage with patients with psychiatric conditions poses challenges in delivering appropriate healthcare services. This study aimed to evaluate the effects of an educational package on reducing stigma and altering attitudes toward patients with mental illnesses among medical students.MethodsThis interventional and quasi-experimental study enrolled medical students who entered in a 4-week clinical post in psychiatry wards from September 2021 to February 2022. Each group of students was randomly assigned to the intervention or control group. All students in the two groups underwent practical training in psychiatry wards. An anti-stigma educational package was provided for the students in the intervention group. This package consisted of three components, including a one-hour virtual training session titled “Stigma, its importance, and coping strategies”, watching three short documentary films on the experiences of successfully treated patients with mental illness, and writing a reflection after a face-to-face interview with a hospitalized patient. The Attitudes Toward Mental Illness (ATMI) questionnaire was used to evaluate the attitudes of all students at the end of the rotation. Additionally, content analysis was performed on the reflection writings of the intervention group.ResultsThe intervention group (n = 142) and control group (n = 92) showed slight changes in ATMI. The effect sizes were small. Both the intervention and control groups demonstrated significant improvements in attitudes toward the treatment of mental illness. Content analysis of reflection writings highlighted increased awareness, empathy, and medical students’ need for more educational content on the significance of stigma and how to address it.ConclusionsThe educational intervention did not significantly impact medical students’ attitudes toward patients with psychiatric disorders; however, the standard clinical training and exposure to psychiatric patients may be sufficient to enhance students’ perspectives on the treatability of mental illness. Writing a reflection regarding face-to-face exposure with a patient with mental illness may increase awareness and empathy in medical students. Further investigation is needed to assess the long-term effects of reflection on medical students’ behavior.

A Physiological Analysis of Desiccation Stress in the Green Tide Species Ulva stenophylloides and Ulva uncialis in the South Pacific

Global green tide blooms of the Ulva genus have been increasing due to human activities, with mass accumulation in Algarrobo Bay, Chile, causing ecological and social issues. In this area, five Ulva species were previously identified, with Ulva stenophylloides dominating across seasons and intertidal zones; Ulva uncialis was the second most abundant, mainly in winter. In this study, we tested the hypothesis that U. stenophylloides is more tolerant to desiccation than U. uncialis, explaining its dominance in the upper intertidal zone. Based on in vitro cultures, we assessed the impact of desiccation stress on weight, blade length, cellular activity, and lipoperoxide levels. In U. uncialis, desiccation treatment caused a decrease in weight; conversely, in U. stenophylloides, both control and desiccation treatments caused a slight decrease in weight. No significant differences (p > 0.05) in blade length or lipoperoxide levels as a function of culture time were detected in the control and desiccation treatment groups for both species. Furthermore, desiccation had no negative effects on the cellular activity of either species. Although the observed weight changes suggest that U. uncialis is more desiccation-tolerant than U. stenophylloides under the experimental conditions, the cellular activity and lipoperoxidation indicate high desiccation tolerance in both species, which partly explains their intertidal dominance.

Process evaluation findings from Strong Hearts, Healthy Communities 2.0: a cardiovascular disease prevention intervention for rural women

BackgroundStrong Hearts, Healthy Communities 2.0 (SHHC-2.0) was a 24-week cardiovascular disease prevention program that was effective in improving physical activity and nutrition behaviors and clinical outcomes among women in 11 rural New York, USA towns. This study evaluated the delivery of SHHC-2.0 to prepare the intervention for further dissemination.MethodsThis process evaluation was guided by the Medical Research Council recommendations and engaged program leaders and participants (i.e., women over age 40) using quantitative and qualitative methods. The quantitative evaluation included examination of enrollment and retention data, a participant survey, and a fidelity checklist completed after classes. Descriptive and comparative statistics were used to assess implementation measures: program reach, participant attendance, dose delivered, program length, perceived effectiveness, fidelity, and participant satisfaction. The qualitative evaluation included focus groups (n = 13) and interviews (n = 4) using semi-structured guides; audio was recorded and transcripts were deductively coded and analyzed using directed content analysis and iterative categorization approaches. Comparisons across towns and between intervention and waitlist control groups were explored.ResultsAverage reach within towns was 7.5% of the eligible population (range 0.7-15.7%). Average attendance was 59.8% of sessions (range 42.0-77.4%). Average dose delivered by leaders was 86.4% of curriculum components (range 73.5-95.2%). Average session length was 51.8 ± 4.8 min across 48 sessions. Leaders’ perceived effectiveness rating averaged 4.1 ± 0.3 out of 5. Fidelity to curricular components was 81.8% (range 67.4-93.2%). Participants reported being “more than satisfied” with the overall program (88.8%) and the health benefits they obtained (72.9%). Qualitative analysis revealed that participants: (1) gained new knowledge and enjoyable experiences; (2) perceived improvements in their physical activity, nutrition, and/or health; (3) continued to face some barriers to physical activity and healthy eating, with those relating to social support being reduced; and (4) rated leaders and the group structure highly, with mixed opinions on the research elements.ConclusionsSHHC-2.0 had broad reach, was largely delivered as intended, and participants expressed high levels of satisfaction with the program and its health benefits. Our findings expand on best practices for implementing cardiovascular disease prevention programs in rural communities.Clinical trials Registrationwww.clinicaltrials.gov #NCT03059472.

Metabolomics Reveal Key Metabolic Pathway Responses to Anxiety State Regulated by Serotonin in Portunus trituberculatus.

Anxiety refers to the pathological persistence and intensification of emotional responses to danger, affecting health from psychological and physical aspects. Serotonin is an important neurotransmitter involved in the onset of anxiety. To explore the biological changes in the formation of anxiety in crustaceans under the regulation of serotonin, we applied the open field-like test method for assessing anxiety states of larval Portunus trituberculatus, a highly aggressive crustacean species with a more simple neural structure compared with rodents and mammals. Compared with the control group, serotonin treatment resulted in a significant decrease in the time spent by the larvae in the central zone, suggesting anxiety-like behavior. Clonazepam treatment reversed this result and provided further evidence that the behavior of larval P. trituberculatus displayed anxiety. Moreover, a non-targeted metabolomic analysis found a significant alteration in the metabolites involved in tryptophan metabolism pathways associated with anxiety, including L-kynurenine, N-acetyl serotonin, and serotonin. These metabolites are involved in the serotonin pathway, the kynurenine pathway, and other pathways that affect anxiety through tryptophan metabolism. There were no significant differences in tryptophan metabolism levels between the control and clonazepam treatment groups. Our results demonstrate the possible existence of anxiety-like behavior in the larvae of P. trituberculatus from two perspectives. Being a species with a simpler neural structure than that of mammals, the larvae of P. trituberculatus offer a convenient model for studying the mechanisms of anxiety in crustaceans.

Chidan Tuihuang granule modulates gut microbiota to influence NOD1/RIPK2 pathway in cholestatic liver injury recovery

BackgroundCholestatic liver injury (CLI), which occurs if bile acids are imbalanced and the liver becomes inflamed, is difficult to treat effectively ObjectiveWe investigated how the Chinese patent medicine Chidan Tuihuang granule (CDTH) ameliorates cholestatic liver injury with a focus on its effects on the NOD1/RIPK2 pathway and intestinal flora MethodsWe used an ANIT-induced SD rat model of CLI to evaluate the therapeutic effects of CDTH. The experimental design included control, model, UDCA (ursodeoxycholic acid) and CDTH treatment groups. UHPLC-Q-Orbitrap-HRMS was used to analyse the blood components of CDTH. The efficacy of CDTH was assessed by liver function tests, histopathological examination (HE and TUNEL staining), transmission electron microscopy, and ELISA to measure apoptosis and inflammatory markers. Mechanistic insights were obtained using transcriptomics and RT-qPCR, while alterations in the expression of key proteins were studied using western blotting, immunohistochemistry, and immunofluorescence. Furthermore, the impact of CDTH on the gut microbiota and its associated metabolite, meso-2,6-diaminopimelic acid (DAP), which is linked to NOD1 activation, was examined and confirmed through in vitro ResultsThe experimental results demonstrated a notable elevation in serum levels of AST, ALT, ALP, TBA, TBIL, and DBIL in the rats belonging to the model group, accompanied by the infiltration of inflammatory cells, hepatocyte degeneration, and necrosis in the liver tissue. CDTH administration significantly improved liver function and cholestasis indicators. Transmission electron microscopy and TUNEL staining revealed a marked reduction in liver cell apoptosis with CDTH treatment. ELISA results showed that CDTH effectively reduced inflammatory markers. Transcriptomic analysis showed that CDTH inhibited the NOD1/RIPK2 pathway, resulting in a significant decrease in the expression of NOD1, RIPK2 and associated genes in liver tissue. Gut microbiota analysis demonstrated that CDTH regulated intestinal flora structure, reducing the abundance of DAP-producing Gram-negative bacteria such as lactobacilli. In vitro experiments confirmed that CDTH enhanced cell viability by downregulating the DAP-mediated NOD1/RIPK2 signaling pathway secreted by intestinal bacteria ConclusionCDTH ameliorated liver damage in cholestatic rats by inhibiting the NOD1/RIPK2 signaling pathway through regulation of gut flora and downregulation of DAP metabolites.

Effectiveness of video-based teaching in surgery residents: A randomized control trial.

To determine the effectiveness of video-based teaching in surgery residents by comparing it to the routine operating room traditional teaching. The randomized control trial was done at four institutions from September 2022 to March 2023. Interventional group underwent video-based instruction of basic surgical skills whereas the control group was taught through traditional operating room teaching. Pre and post-test mean scores were analyzed on SPSS version 20 through paired t-test. Learning gain was calculated. Supervisors' perceptions were recorded on survey form regarding direct observations and recorded video evaluations of resident skills on post-test. Out of sixty (n=60), fifty-five newly inducted surgical residents completed the study including both females (n=13) and male residents (n=42). Video intervention Group (27.93±3.72) and control group (23.07±4.62) both showed improvements in their post-test scores as compared to pretest scores of 13.68±3.25 and 13.52±3.60 respectively. Mean score difference improvement was more in video intervention group (13.9±3.8) in comparison to control group (9.5±4.3) provided both groups exhibits improvements in all seven domains of the global rating system (reflected by the p <0.0001). However, learning gain of 65% was observed in intervention group as compared to learning gain (41%) of control group. Evaluators(n=5) observed that recorded video evaluations helped to provide integrated feedback, despite being time (40%) and resource intensive (60%). Video-based teaching has higher learning gain irrespective of the fact that both groups exhibit statistically significant results in all seven domains of the global rating system. Recorded video evaluation was found feasible and reliable tool for formative assessment.

Facilitation of diabetic wound healing by far upstream element binding protein 1 through augmentation of dermal fibroblast activity.

Diabetes mellitus (DM) often leads to wound healing complications, partly attributed to the accumulation of advanced glycosylation end products (AGEs) that impair fibroblast function. Far Upstream Element Binding Protein 1 (FUBP1) regulates cell proliferation, migration, and collagen synthesis. However, the impact of FUBP1 on diabetic wound healing remains unknown. This study is designed to explore the function and mechanisms of FUBP1 in diabetic wound healing. Eighteen Sprague-Dawley rats (weighing 220-240g) were randomly assigned to three groups (n = 6): a control group (NC) of healthy rats, a model group (DM) of untreated diabetic rats, and a treatment group (DM + FUBP1) of diabetic rats accepting FUBP1 treatment. A 10mm diameter circular full-thickness skin defect was created on the back of each rat. On days 1 and 7, rats in the treatment group received local injections of 5µg FUBP1 protein at the wound site, whereas the control group and model group were administered saline. Wound healing was documented on days 0, 3, 7, 10, and 14, with tissue samples from the wound areas collected on day 14 for histological analysis, including H&E staining, Masson's trichrome staining, and immunohistochemistry. Western blot analysis was utilized to assess the expression of GSK-3β, Wnt3a, and β-catenin. In vitro, the effects of various concentrations of AGEs on cell viability and FUBP1 expression were examined in human dermal fibroblasts (HDF). Cells were genetically modified to overexpress FUBP1 using lentiviral vectors and were cultured for 48h in media with or without AGEs. The impacts on fibroblast proliferation, migration, and Wnt/β-catenin signaling were evaluated using CCK-8, scratch assays, and Western blot analysis. Animal investigation revealed that from day 7 onwards, the wound healing rate of the treatment group was higher than that of the model group but lower than the control group. On day 14, the wound healing rates were as follows: control group (0.97 ± 0.01), model group (0.84 ± 0.03), and treatment group (0.93 ± 0.01). These differences were statistically significant. Histological analysis indicates that FUBP1 promotes granulation tissue formation, re-epithelialization, and collagen deposition in treatment group. Additionally, FUBP1 protein expression decreased in dermal fibroblasts when exposed to AGEs. Overexpression of FUBP1 significantly enhanced fibroblast proliferation and migration, activating the Wnt/β-catenin pathway and mitigating the inhibitory effects of AGEs. Our results suggest that FUBP1 can be a promising therapeutic target for diabetic wound healing, potentially counteracting the detrimental effects of AGEs on dermal fibroblasts through the Wnt/β-catenin pathway.

Effects of maize residue and biochar applications on soil δ13C and organic carbon sources in a subtropical paddy rice ecosystem

AbstractThis study investigates the utility of plant δ¹3C natural labeling in predicting the impacts of environmental shifts on carbon cycling within ecosystems, particularly focusing on paddy fields treated with maize (Zea mays L.) residues and biochar. Specifically, it examines how soil δ¹3C and the sources of soil organic carbon (SOC), respond in paddy fields (which cultivate C3 plants like rice) when amended with maize residues, maize biochar, and silica‐enriched biochar (derived from C4 plants). Conducted in the Fuzhou paddy fields, the experiment included control groups and treatment groups with maize residue (4 t ha⁻¹), maize biochar (4 t ha⁻¹), and silicon‐modified maize biochar (4 t ha⁻¹) during both the early and late rice growth periods. The results indicate that all soil treatments increased soil δ¹3C. The application of maize residues notably affected the δ¹3C of the upper soil profile (0–15 cm) differently from the deeper layers (15–30 cm), and it increased soil organic C more than biochar or silicon‐modified maize biochar. Soil available P (AP) and pH emerged as significant factors linking δ¹3C, influencing rice yield through changes in soil physicochemical properties. Unlike maize residues, which reduced rice yields, applications of biochar and silicon‐modified maize biochar increased rice yields. The latter, which was particularly effective in lowering SOC decomposition rates and addressing rice's silica needs, emerged as the preferred option. The study highlights maize biochar and silicon‐modified maize biochar as sustainable alternatives to maize residues for rice cultivation, enhancing soil fertility, carbon pool stability, and yields.

Effects of rumen-protected methionine and lysine on antioxidant status and lactationperformance in crossbred dairy cattle during transition

Dairy cows undergoing the transition phase often face nutritional challenges, impacting their antioxidant status and lactational performance. To address these challenges, the incorporation of rumen-protected methionine and lysine in the diet has emerged as a strategic intervention.Twelve crossbred cows inthe transition period were randomly divided into two groups of six animals. The control group and treatment group were fed with a standard diet (ICAR, 2013) while the treatment group was supplemented with rumen-protected methionine and lysine. Throughout the trial period, all the animals were subjected to consistent management and feeding conditions.Glutathione peroxide(GPx)levels exhibited a statistically significant difference between groups, with the treatment consistently showing higher GPx levels, indicating an improvement in antioxidant capacity, where it helps regulate systemic oxidative stress.The recorded milk yield data was utilized to compute the daily milk production for each individual for the experimental period. Milk yield remained unaffected, but the treatment group consistently exhibited higher milk yield, suggesting positive influences on postpartum lactation performance. Keywords: Rumen-protectedmethionine, rumen-protectedlysine,transition period, antioxidant status

Hepatocellular Changes on Paracetamol Induced Liver Damage in Long Evans Male Rats upon Green Tea Administration

Background: The liver is a vital organ that serves a number of purposes in our body. It may be harmed by pollutants, substances with toxic effects, and long-term, unchecked drug use. Green tea is a well-liked beverage that has gained popularity recently and may have hepatoprotective properties. Objective: To observe the effect of green tea (Camellia sinensis) on paracetamol induced liver damage in Long Evans male rats. Methods: From July 1st, 2018, to June 30th, 2019, this study was conducted in the Department of Physiology at Sir Salimullah Medical College (SSMC), Dhaka. For the purpose of the study, thirty (30) male Long Evans rats, weighing between 150 and 200 grams and 90 to 120 days old, appeared to be in good health. They were split into two groups after 14 days of acclimatization: Group A, which served as the control group, and Group B, which served as the experimental group (green tea pretreatment and paracetamol treated). Group A1 (baseline control group) and group A2 (paracetamol treated control group) comprised the subdivided control group. There were ten rats in each of these groups. For 28 days, the rats were all fed a baseline diet. The baseline control group was given normal saline (20 ml/kg/day) orally every day for 28 days in addition to their basal diet. For the final three days of the study—the 26th and 28th—the paracetamol-treated control group was given oral paracetamol at a dose of 1.5 g/kg/day. During the final three days of the study period (the 26th and 28th days), the experimental group was given oral paracetamol (1.5g/kg/day) and an ethanolic extract of green tea (500 mg/kg/day) for a total of 28 days. On day 29, every rat was sacrificed. Following the sacrifice, liver samples were taken. Hepatic contents of malondialdehyde (MDA) were measured by using standard laboratory method. Histopathology of liver was also done by using standard laboratory procedure in the department of pathology, SSMC. Version 22 of the Statistical Package of Social Science (SPSS) for Windows was used to do the statistical analysis. The data were displayed as mean±SD. To compare the results, one-way ANOVA, post hoc Bonferroni, and Chi-square tests were used, where appropriate. A p value of less than 0.05 was regarded as significant. Result: When compared to the baseline control group, the mean malondialdehyde concentration in the liver was significantly (p) greater in the green tea pretreatment, paracetamol treated, and control groups who received paracetamol treatment. Once more, the groups treated with green tea and paracetamol had mean malondialdehyde concentrations in their livers that were significantly (p) lower than those of the paracetamol group. Additionally, 0% of the rats in the baseline control group, 100% of the rats in the paracetamol-treated group, and 30% of the rats in the green tea-pretreated and paracetamol-treated group had abnormal histological findings of the liver. Conclusion: This study revealed that green tea has hepatoprotective effect against paracetamol induced liver damage in Long Evans male rats. Bangladesh Crit Care J September 2024; 12 (2): 145-152

A randomized-controlled trial of parent-administered interventions to improve short-term motor outcomes in hospitalized very low birthweight infants.

Premature infants are at increased risk for cerebral palsy (CP). Early interventions with a motor focus and administered by parents may improve motor outcomes. Secondary study evaluating the short-term motor outcomes and risk for CP in very low birthweight (VLBW) infants randomized to multimodal interventions with a motor focus provided by parents versus usual care. Randomized controlled trial (intervention vs. usual care (control group)). Infants (<32 weeks' gestational age (GA) and/or <1500 grams birthweight) born between March 2019 and October 2020. Short-term motor outcomes and risk for CP was evaluated using the Hammersmith Infant Neurological Evaluation (HINE, primary motor outcome), the General Movement Assessment (GMA) and the Test of Infant Motor Performance (TIMP) at 3 months' postmenstrual age (PMA). 70 participants were enrolled (GA 28.3±2.7 weeks, birthweight 1139.2±376.6 grams, 64.3% male). The in-person follow-up rate was 73%, lower than expected, in part due to COVID-19 restrictions, resulting in 25 infants (intervention) and 26 infants (control) with outcome data available for analysis. There was not a significant difference in the HINE, GMA or TIMP at 3 months' PMA between groups. Multimodal interventions with a motor focus and provided by parents need further investigation to determine if they can improve short-term motor outcomes in VLBW infants. These interventions are evidence-based and the evaluation of broader implementation into routine care is also needed.

Cow Placenta Extract Ameliorates Cyclophosphamide-Induced Intestinal Damage by Enhancing the Intestinal Barrier, Improving Immune Function, and Restoring Intestinal Microbiota

Immunosuppression undermines intestinal barrier integrity. Cow placenta extract (CPE) primarily consists of active peptides with immunomodulatory and antioxidant effects. This study aimed to examine the preventive effect of CPE against intestinal damage induced by cyclophosphamide (Cy) in immunosuppressed mice. Thirty-six mice were randomly allocated into three groups: control group (C), model group (M), and treatment group (CPE). The mice in the CPE group were provided with 1500 mg/kg/day of CPE via gavage. In the last 3 days, mice in the groups M and CPE received intraperitoneal injections of 80 mg/kg/day of Cy. The results showed that CPE improved intestinal barrier function by decreasing serum d-Lactate (D-LA) levels and diamine oxidase (DAO) activity, while elevating the relative expression of Occludin, zonula occludens-1 (ZO-1), and mucin-2 (MUC-2) mRNA. Additionally, CPE improved the immune organ index and elevated the levels of secretory immunoglobulin A (sIgA), superoxide dismutase (SOD), interleukin-1beta (IL-1β), interleukin-4 (IL-4), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α) in the intestine, thereby enhancing intestinal mucosal immune function. Furthermore, CPE improved the diversity of intestinal microbiota and increased the abundance of Candidatus_Saccharimonas, Psychrobacter, and Enterorhabdus, which promoted the proper functioning of the intestines. These findings suggest that CPE effectively ameliorates Cy-induced intestinal damage by enhancing the intestinal barrier, improving immune function, and restoring intestinal microbiota.

The mediating role of marital quality in parenting intervention: Effects on preschoolers' conduct problems and effortful control.

This study explores whether marital quality mediates the effects of a parenting intervention on preschoolers' conduct problems and effortful control. Using data from 209 children in a two-wave randomized controlled trial of the Hitkashrut program, participants were assigned to either a 14-session co-parent training group or a minimal intervention control group. Intent-to-treat analysis revealed that improvements in marital quality significantly mediated the intervention's impact on both conduct problems and effortful control. An alternative model, which hypothesized that changes in child behavior would lead to improvements in marital quality, was not supported, reinforcing the importance of targeting marital dynamics to achieve better child outcomes. These findings highlight the potential of marital-focused strategies within parenting interventions to foster healthier family environments and improve long-term developmental trajectories in children.

Effectiveness of community-based Baduanjin exercise intervention for older adults with varying frailty status: a randomized controlled trial

BackgroundDue to poorer exercise tolerance, it may be challenging for frail older adults to engage in moderate- or vigorous-intensity exercise. While low-intensity exercise interventions may be more feasible, its effectiveness for such population group remains unclear. We examined the effectiveness and implementation of community-based Baduanjin Qigong, a low-intensity exercise program in older adults with varying frailty status.MethodsA two-arm, multicenter assessor-blind parallel group randomized controlled trial was conducted at three local senior activity centers. Fifty-six community-dwelling older adults with low handgrip strength were randomly allocated to either the intervention (IG) or wait-list control (CG) group. The IG underwent a supervised 16-week Baduanjin exercise program at a frequency of 2–3 × 60 min sessions/week. The CG was instructed to maintain their usual activity and received a monthly health education talk. The primary outcome measures were knee extension strength, vital exhaustion, and fear of falling. Secondary outcome measures include physiological falls risk, handgrip strength, gait speed, timed up and go test, 30-second sit-to-stand, quality of life, depression, and frailty. All outcome measures were assessed at baseline and 4-month follow-up.ResultsOverall, there were no statistically significant differences in all outcome measures between CG and IG at 4-month follow-up. However, in exploratory compliance analysis, a statistically significant group x time interaction was found for vital exhaustion (B = -3.65, 95% CI [-7.13, -0.16], p = .047) among participants with at least 75% attendance. In post-hoc within-group comparisons, IG showed improved vital exhaustion by 4.31 points (95% CI [1.41, 7.20], d = 0.60). The average participant attendance rate was 81.3%. No major adverse events occurred, and all participants reported positive experiences with the exercise intervention.ConclusionsOur study demonstrated that Baduanjin is a safe, feasible, and acceptable exercise program that can be successfully implemented in community settings for older adults with varying frailty status. With good adherence, Baduanjin exercise could potentially be effective in alleviating vital exhaustion. However, the effectiveness of Baduanjin on physical performance, psychological measures and frailty in community-dwelling older adults remains equivocal.Trial registrationClinicalTrials.gov NCT04549103. Registered September 16, 2020.

Magical role of iron nanoparticles for enhancement of thermal efficiency and gene regulation of fish in response to multiple stresses

The present study addresses the challenges of uncontrolled temperature and pollution in aquatic environments, with a focus on fish ability to tolerate high temperature. The investigation aimed to determine the role of iron nanoparticles (Fe-NPs) in enhancing the thermal tolerance of Pangasianodon hypophthalmus exposed to high-temperature stress, arsenic (As), and ammonia (NH3) toxicity. Fe-NPs were synthesized using green approaches, specifically from fish gill. The dietary Fe-NPs were formulated and supplemented at 10, 15, and 20 mg kg⁻1 of feed. Notably, Fe-NPs at 15 mg kg⁻1 diet significantly reduced the critical thermal minimum (CTmin) (14.44 ± 0.21 °C) and the lethal thermal minimum (LTmin) (13.46 ± 0.15 °C), compared to the control and other treatment groups. Conversely, when Fe-NPs at 15 mg kg⁻1 were supplemented with or without exposure to stressors (As + NH3+T), the critical thermal maximum (CTmax) increased to 47.59 ± 0.16 °C, and the lethal thermal maximum (LTmax) increased to 48.60 ± 0.37 °C, both significantly higher than the control and other groups. A strong correlation was observed between LTmin and CTmin (R2 = 0.90) and between CTmax and LTmax (R2 = 0.98). Furthermore, dietary Fe-NPs at 15 mg kg⁻1 significantly upregulated the expression of stress-related genes, including HSP70, iNOS, Caspase-3a, CYP450, MT, cat, sod, gpx, TNFα, IL, TLR, and Ig. The enhanced thermal tolerance (LTmin and LTmax) can be attributed to these gene regulations, suggesting the mechanistic involvement of Fe-NPs in improving thermal resilience. Overall, the findings demonstrate that dietary supplementation with Fe-NPs, particularly at 15 mg kg⁻1, improves thermal tolerance and stress response in P. hypophthalmus by enhancing gene expression and overall thermal efficiency under stressor conditions.

Conscious Techniques Affected the Adolescent’s Ability In Early Breast Cancer Detection

Breast cancer is a malignant tumor and grows in the breast tissue resulting in death. Breast cancer prevention by means of breast self-examination. This study aimed to determine the effect of video media on conscious techniques with a combination of demonstrations on the practical ability of adolescents in early detection of breast cancer. The method used a quasi-experimental design, non-equivalent control group design with a population of 279 and a sample of 40 respondents with inclusion criteria of young women, aged 16 years as students of SMA Negeri 1 Tarik Sidoarjo. The data collection measured skills in 2 groups of respondents. The experimental intervention group used videos and demonstrations, while the intervention control group used lectures and leaflets. The intervention was done in 1 day, the posttest was conducted 7 days after the intervention. The results showed that the average value of the pretest posttest of the two groups increased. The results of the statistical test paired T-Test obtained a significant value of p-value = (0.000 &lt; 0.05) meant that there was an effect of providing video media with conscious techniques with a combination of demonstrations on the practical ability of adolescents in early detection of breast cancer. Educators should develop programs to improve skills for early detection of breast cancer, in collaboration with health workers through health promotion so that all students are aware of health.

A-243 Quantitative Bacteriology Parameters for Seal-Packaged Agar Plates Challenged with Experimental Low-resource Tropical Field Clinic Stress

Abstract Background InTray® Mueller Hinton Chocolate (MHC) and Colorex™ Screen (CS) plates are in vitro diagnostic devices combining prepared bacteriological agar-media with Biomed’s ‘InTray®’ format (a double sealed-packaging cassette system that provides extended shelf-life 12 months past the date of manufacture). The devices are intended for use with clinical specimens to culture, isolate and identify potentially pathogenic bacteria. This study evaluated MHC and CS device performance at 7 and 13 months past the date of manufacture after product was experimentally challenged with stress replicating a low-resource tropical field clinic scenario. Methods MHC and CS plates were exposed to high temperature (40.5°C ± 0.5) and high humidity (74.5 ± 2.5% relative humidity) for an extended time-period (18 days). After the 18 days of heat treatment, the stress-group plates were stored in the lab at working room temperature (20-25°C) for the remainder of the study. Quantitative differences between control-groups (stored under refrigeration: 2-8°C) and heat-stress treatment groups for both MHC and CS were examined via CFU/mL measurements comparing three different lab-strain bacteria chosen based on clinical sub-culturing prevalence from blood bottles; Escherichia coli (ATCC 25922), Streptococcus pneumoniae (ATCC 6305), and Staphylococcus aureus (ATCC 25923). Briefly, 24-hour (18-30 h) old bacterial colony suspensions (grown on MHC) were prepared in 0.85% saline solution, adjusted to a 0.5 McFarland standard (here defined as 0.08-0.96 Absorbance @ 625 nm), measured in triplicate and diluted. A 20 μL volume from the lowest dilution (2.5 x 103 CFU/mL) was then spread-plated to each plate in order to count colony-forming units (CFU) in the acceptable range of 25-250. Results Quantitative CFU/mL differences between control-groups (stored under refrigeration: 2-8°C) and heat-stress-treatment groups (&amp;gt;40°C and high humidity) for MHC and CS for three different test bacteria (listed above) were not statistically significant when tested at 13 months. The CS stress and control group comparison for S. pneumoniae with a p value &amp;lt; 0.05 at 7 months had a p value &amp;gt; 0.05 at 13 months, suggesting that the difference between the CFU counts may not be significant in biological terms. Conclusions In conclusion, control and heat-stress treatment groups for both MHC and CS met acceptable performance criteria as expected for the products, 13 months after the date of manufacture.

Effect of hamstring stretching for improving body function or activity in patients with knee osteoarthritis

Background: Osteoarthritis (OA) is a long-term disease characterized by abnormalities in the cartilage in the joints which causes the bones to rub together, causing stiffness, pain, decreased flexibility and impaired functional activities. Purpose: To determine effect of hamstring stretching for improving body function or activity in patients with knee osteoarthritis. Method: A quantitative quasi-experimental approach. Participants were selected using random sampling and the Issac &amp; Michael formula, resulting in 30 participants who were divided into two groups, namely 15 participants in the intervention group and 15 participants in the control group from Sebelas Maret University Hospital. Pre-test and post-test functional activity assessments using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) instrument in the intervention and control groups. Univariate statistical analysis was conducted, including a shapiro wilk and one way anova test. Results: Intervention group and control group have a p-value &lt;0.05, meaning that functional activity has an effect on have hamstring stretching exercise on increasing functional activity in knee osteoarthritis patients. Conclusion: Hamstring strengthening exercise on increasing the ability of functional activities in knee osteoarthritis. This can be considered as evidence that specific exercise interventions on the hamstring muscles provide positive benefits in individuals with knee osteoarthritis.

Impact of medication reconciliation and medication reviews on the incidence of preventable adverse drug reactions during hospitalization of elderly patients. A randomized controlled trial.

Background: Of all adverse drug reactions, 35-45% are due to medication errors and would therefore be preventable. Thus, it is essential to implement effective strategies to prevent medication errors. However, it remains unclear whether medication reviews provide an additional benefit compared to medication reconciliation regarding medication safety. Aim: The present study aimed to evaluate whether medication reconciliation and medication reviews affect the incidence of preventable adverse drug reactions in elderly patients. Method: Non-elective patients 65 years and above admitted to the hospital, taking at least one high-risk drug, were eligible for participation in a three-armed randomized controlled trial. One group went through the medication reconciliation process, a second group received a comprehensive medication review, including medication reconciliation, and the third group did not receive any pharmaceutical intervention (control group). The incidence of preventable adverse drug reactions during hospitalization was set as the primary endpoint. The severity of the preventable adverse drug reactions and the number and clinical relevance of drug-related problems and discrepancies were defined as secondary endpoints. Results: In 207 patients, 74 preventable adverse drug reactions were detected. Neither medication reconciliation nor medication reviews showed a significant impact on the incidence of preventable adverse drug reactions compared to the control group. However, medication reviews significantly reduced the severity of preventable adverse drug reactions (p=0.017). Conclusion: The current study results suggest that medication reviews may have an impact on a clinically relevant outcome by reducing the severity of preventable adverse drug reactions. A significant impact of medication reconciliation on clinically relevant outcomes could not be demonstrated. Based on the results of this study, when deciding on a pharmaceutical intervention comprehensive medication reviews should be preferred over sole medication reconciliation whenever possible.

Audio Visual and Its Impact on Pain During Immunization

Background: Immunization is an effort to increase the body's immunity to a disease and makes a significant contribution to reducing child mortality, when children are immunized, it will cause pain and the provision of audio visuals given to children is expected to reduce or divert pain during immunization. Purpose: To determine the effect of audio visual on pain during immunization in toddler children (12-36 months) in the intervention group and control group. Method: This research method is experimental which is a study by looking for the effect of audio visual on immunization pain between the intervention group and the group using a two-group posttest design involving 64 respondents who meet the inclusion criteria. Sampling using random sampling with research instruments using SOPs and FLACC. Results: The results obtained were that in the intervention group there were 56.3% of respondents who experienced mild pain and the control group there were 75.1% of respondents who experienced severe pain. Subsequent analysis using the Mann Whitney test obtained a p value of 0.001. Conclusion: Providing audio visuals is proven to have an effect on the pain scale during immunization in toddler.