Friedman Test Research Articles

A Pilot Study of the Convergent and Discriminant Validity of the Dutch Version of the Parametric Go/No-Go Task.

The parametric go/no-go (PGNG) task is a computerized task that is designed to measure cognitive flexibility, response inhibition, and working memory. The PGNG task has been shown to measure core executive functions (EFs) in a psychometrically sound, brief, and ecologically valid manner. To analyze the psychometric properties of the Dutch version of the PGNG task in a convenience sample of nonclinical adults. The sample consisted of 74 highly educated adults, with an average age of 36 years. Forty-two participants completed test battery A to investigate the task's convergent validity; 36 participants completed test battery B to investigate the task's discriminant validity. The results were analyzed using a repeated-measures ANOVA, Friedman's test, paired-samples t test, and correlation analyses. Level 3 of the PGNG task places increased demands on sustained attention, response inhibition, and set-shifting. Several moderate correlations between level 3 and a complex EFs measure supported the convergent validity of this level of the PGNG task. The convergent validity of levels 1 and 2 was not supported. No significant correlations were found between PGNG levels and non-EF tests, supporting discriminant validity. Our study included a rather homogenous sample of highly educated participants, which might explain the convergent validity of level 3 of the Dutch version of the PGNG task. Hence, to overcome these potentially confounding factors, the Dutch version of the PGNG task should be investigated in a larger and more heterogeneous population in terms of age and educational level.

The Effect of Virtual Reality Practice and Music on Patients' Pain, Comfort, and Vital Signs After Laparoscopic Abdominal Surgery.

This research was conducted to identify the effect of virtual reality and music on patients' pain, comfort, and vital signs after laparoscopic abdominal surgery. This study was designed as a prospective randomized controlled single-blind clinical trial. The research population consisted of adult patients who underwent laparoscopic abdominal surgery in surgery clinics. The research sample comprised 225 patients who had laparoscopic abdominal surgery. Experimental groups watched virtual reality videos and listened to music, whereas no intervention was administered to the control group. The research data were evaluated with descriptive statistics, the χ 2 test, the Friedman test, the one-way analysis of variance, the Kruskal-Wallis test, and Tukey's and Dunn's post hoc tests. In the post-test phase after the 2 interventions, the virtual reality and music groups had lower pain and comfort levels than the control group, and this intergroup difference was statistically significant ( P <0.05). Results for vital signs in successively repeated post-test measurements after interventions were in general different, and these differences were statistically significant. Patients in the virtual reality group generally had higher pulse rate, diastolic blood pressure, respiratory rate, and body temperature values in successively repeated post-test measurements than patients in other groups ( P <0.05). Patients in the control group generally had higher systolic blood pressure and saturation values in successively repeated post-test measurements than patients in other groups ( P <0.05). It was discerned that music and the virtual reality practice reduced patients' pain and comfort levels and had positive effects on their vital signs after laparoscopic abdominal surgery.

Accuracy of Complete-Arch Scans Obtained by Intraoral Scanner and Smartphone Three-Dimensional Scanning Applications With Different Smartphone Position Setups: An In Vitro Study.

The high cost of intraoral scanners (IOS) for complete-arch scans makes them less accessible for many dental practitioners. As a viable alternative, smartphone scanner applications (SMP) provide comparable scanning capabilities at a significantly low cost. However, there is limited data on the accuracy of SMP, especially when used in various smartphone positions. This study aimed to compare the three-dimensional (3D) and linear accuracy of complete-arch scans acquired by an IOSand SMP (KIRI Engine, KIRI Innovations, Guangdong, China) at three shooting angles (0°, 45°, and 90° for SMP_3A) and two shooting angles (30° and 60° for SMP_2A). A stone dental cast was scanned with a laboratory scanner as a reference, with 11 scans performed by an IOS, SMP_2A, and SMP_3A. In 3D analysis, trueness and precision were evaluated through superimposition with the reference scanand within each group, respectively, using the best-fit algorithm of Geomagic Wrap software (3D Systems, Inc., Rock Hill, SC). Trueness in linear discrepancy was assessed by comparing the occlusal-cervical and mesiodistal dimensions of reference teeth (canine, premolar, and molar), intercanine width, and intermolar width on the digital casts to measurements of the stone cast, while precision was measured using the coefficient of variance. Differences between groups were analyzed using the Friedman test, followed by the Dunn-Bonferroni post hoc test with a significance level set at 0.05. IOS exhibited significantly lower trueness than SMP_2A (p = 0.003) with significantly greater width discrepancies on canines (p = 0.001) and molars (p < 0.001). Discrepancy patterns differed among the three scanning methods. The IOS showedgreater discrepancieson the occlusal surfaces of posterior teeth. While SMP_3A demonstrated higher variation on the palatal surfaces and interproximal areas of posterior teeth. For precision,SMP_3A (p = 0.028) and SMP_2A (p = 0.003) showed a significantly lower precision in 3D analysis, but a comparable reproducibility in linear measurement to IOS. TRIOS IOS (3Shape,Copenhagen, Denmark) exhibited lower trueness in 3D and linear accuracy analyses for complete-arch scans. The positions of the smartphonesignificantly enhanced trueness at the undercut region. SMP_2A and SMP_3A can be a potential alternative for precise linear measurement in complete-arch scans with selective use.

AI-assisted clinical summary and treatment planning for cancer care: A comparative study of human vs. AI-based approaches.

1523 Background: Understanding a patient's clinical narrative, timeline, and history is critical for accurate treatment decision-making. However, reviewing and summarizing complex records is time-consuming and error-prone. Recent advancements in artificial intelligence (AI), specifically large language models (LLM), offer paths to improve quality and efficiency. Methods: A study was conducted on 50 breast cancer cases from an academic medical institution, utilizing all medical records—clinic, pathology, and radiology reports—up until the point of the initial treatment decision. All cases were processed using three different approaches: AI-assisted; full-AI; and human-only. In the AI-assisted method, two oncology physician assistants (PAs) revised AI-generated summaries to create clinical summaries. The full-AI method had AI independently produce clinical summaries, while the human-only method had the PAs compile summaries without AI. Eight board-certified international oncology specialists blindly evaluated summaries for faithfulness, completeness, and succinctness using a 3-point scale, ranked their preferences, and tried to predict which summaries were full-AI. Rankings were assessed using a Friedman test followed by a Wilcoxon signed-rank test, and full-AI prediction was assessed using a two-sided one-sample binomial test. After summarization, a distinct AI system with access to clinical guidelines provided treatment plans. These plans were then evaluated by a board-certified oncologist with access to the original treatment decision. Results: The study found specialists favored AI-assisted, followed by full-AI, and then human-only summaries, with average ranks of 1.73, 1.93, 2.34 respectively (lower is better, p&lt;0.001). The difference between full-AI and AI-assisted was not significant (p=0.11). Evaluation scores (mean±95%CI, higher is better) showed AI-assisted, full-AI, and human-only scored 2.35±0.13, 2.14±0.14, 2.17±0.14 for faithfulness; 2.28±0.12, 2.01±0.12, 1.93±0.14 for completeness; and 2.33±0.12, 2.21±0.12, 1.99±0.13 for succinctness. The average summarization time was 19.71, 1.17, 26.03 minutes. Full-AI identification accuracy was 0.28 (not different from chance 0.33, p=0.46). With AI-assisted summaries, the treatment plans were accurate in 45 cases (90%) and partially accurate in 5 cases (10%). In the 5 partially accurate cases, the system was accurate with the provided input data, but there were inaccuracies with the input data, including incorrect formats or missing data. Conclusions: Incorporating LLMs into the creation of medical summaries has shown improvements in both quality and efficiency, achieving up to 22.2x speed up with full-AI, indicating that AI-assisted summarization tools can potentially enhance care quality. AI-assisted summaries yield accurate treatment plans when the input data is accurate.

Influence of Diclofenac Potassium versus Prednisolone on Postendodontic Pain and Pulpal Interleukin-8 Expression in Symptomatic Irreversible Pulpitis Cases: A Randomized Placebo-controlled Trial

AimThis prospective, randomized, double-blind clinical trial investigated the impact of diclofenac potassium, prednisolone, and placebo as oral premedication on postendodontic pain and pulpal interleukin (IL)-8 expression in patients with irreversible pulpitis. MethodsThirty-six patients undergoing conventional endodontic treatment were assigned into one of 3 groups (n = 12). Pulpal blood samples were taken after access cavity preparation and stored until they were analyzed using enzyme-linked immunosorbent asssay for quantification of IL-8. Postendodontic pain was scored using the visual analogue scale. Outcome data were statistically analyzed using one-way analysis of variance, Kruskal-Wallis, Friedman's, Dunn's, Chi-square, and Fisher's exact tests and Spearman's correlation coefficient. The significance level (α) was set at 0.05. ResultsApart from preoperative pain scores, all groups had similar baseline characteristics (P > .05). Immediate postendodontic pain scores had a significant difference between all groups (P < .05) where placebo group showed the highest score. There was no significant difference between all groups at 6 and 12 hours postoperatively (P > .05). Furthermore, there was no significant difference in the incidence of postendodontic pain and in mean IL-8 levels between the 3 groups (P > .05). ConclusionsThe only impact the premedications had was on the immediate postendodontic pain intensity, and they had no influence on the later time points, incidence of postendodontic pain or pulpal IL-8 levels.

Evaluation of the neuroprotective effect of antipsychotics by serum quantification of protein S100B

ObjectiveThis research delves into the intricate interplay between antipsychotic medications and neuroprotection focusing on the S100B protein—a central player in the regulation of neuroapoptotic activity. MethodBlood samples were collected to assess serum S100B protein levels using an immunoassay of immunoelectrochemiluminescence. The first two samples were collected with a 3-month interval between each, and the third sample was obtained 6 months after the previous one. Changes in S100B protein levels throughout the study were assessed using Friedman's ANOVA test. This was followed by the Wilcoxon signed-rank test with Bonferroni correction to account for multiple comparisons. ResultsThis study involved 40 patients diagnosed with severe mental disorders (34 schizophrenia, 4 schizoaffective disorder, 1 bipolar disorder, and 1 borderline personality disorder). These patients had been receiving antipsychotic treatment for an average duration of 17 years. The results revealed that the S100B protein remained within physiological levels (median values 39.0 ng/L for the first sample, median values 41.0 ng/L for the second sample, and median values 40.5 ng/L for the third sample) with no significant changes (p = 0.287), with all anti-psychotic medicaments values consistently below 50 ng/L, a lower value compared to maximum range of 105 ng/L. Importantly, there were no significant differences in S100B protein levels between patients on monotherapy and those on combination antipsychotic therapy (p = 0.873), suggesting that combination therapy did not increase neuroapoptotic activity. ConclusionsThese findings provide compelling evidence for the potential neuroprotective effects of long-term antipsychotic treatment in individuals with severe mental disorders. By maintaining physiological levels of the S100B protein, antipsychotic medications may help protect against neuronal damage and dysfunction. This research contributes valuable insights into the neuroprotective mechanisms of antipsychotic drugs, enhancing our understanding of their potential benefits in the treatment of severe mental disorders.

Mastery Learning in Preclinical Endodontics Using Customized 3D-Printed Tooth Models for Deliberate Practice: An Application of Educational Design Research

IntroductionThis study, conducted within an educational design research (EDR) framework, assessed the use of customized 3D-printed tooth models at various difficulty levels to enhance mastery learning and deliberate practice in preclinical endodontic training. MethodsThe EDR was conducted in a preclinical endodontic training involving 42 third-year students. The study focused on developing and evaluating 3D-printed tooth models customized into 3 difficulty levels to facilitate mastery learning for the access opening procedure on upper anterior teeth. To promote deliberate practice, we ensured ample availability of these models. The evaluation combined quantitative analysis, using Friedman and Wilcoxon Signed-Rank tests to assess practice volume and performance, with qualitative feedback from interviews and focus groups, analyzed via content analysis. ResultsThere was a significant reduction in practice time across the different model levels, with students using an average of 1.5–1.8 models per level. No significant differences in performance scores were observed across levels and natural tooth (P = .333). Feedback highlighted the models' educational value in enhancing dental training, indicating their effectiveness in improving learning experiences and skill development in endodontic education. ConclusionsThe innovative design of a 3D-printed tooth model system, which features 3 levels of difficulty and was developed within an EDR framework, allowed for tailored learning progressions and ample practice opportunities. This significantly enhanced the endodontic training experience and skill development by providing varied and realistic challenges.

A Comparison of Analgesic and Recovery Profiles of Ketamine, Lignocaine, and Dexmedetomidine (KeLiDex) Versus Fentanyl-Based Anesthesia in Laparoscopic Nephrectomies: A Randomized, Single-Blind, Pilot Study.

In the search for opioid-free anesthesia, notable numbers of drugs, singly or in combinations, have been tested with variable results. However, most of the drugs used are not as strong as opioids. Even if some non-opioid drugs are potent enough, they cause significant untoward effects, necessitating the use of lower effective dosages of multiple drugs as a substitute. The present pilot study evaluated low-dose combinations of ketamine, lignocaine, and dexmedetomidine (KeLiDex) against fentanyl-based anesthesia for analgesia and recovery profiles in laparoscopic nephrectomies. Twenty patients (10 in each group) randomly received KeLiDex or fentanyl infusion as an analgesic component for balanced general anesthesia. Entire patients also received paracetamol and quadratus lumborum block-2. Anesthesia depth, neuromuscular blockade, and reversal were standardized. Intraoperative hemodynamic variation, time to extubation after reversal (T-tEAR) administration, postanesthesia care unit (PACU) discharge readiness assessed using modified Aldrete score, sedations using Richmond Agitation Sedation Scale, postoperative pain, and rescue analgesia consumptions were compared using different validated scales. P-value <0.05 was considered significant. The KeLiDex group had a significantly lower heart rate (HR) between 45-90 minutes and at the time of reversal. Mean arterial pressure (MAP) (mean ± standard deviation (SD)) differed significantly at only a 60-minute interval (KeLiDex group 80.90 ± 9.50 versus fentanyl group 92.60 ± 16.13 mmHg, p-value 0.041). The Friedman test for change in HR and MAP over time within each group was also insignificant. The mean ± SD of T-tEAR was 6.37 ± 2.13 in KeLiDex, and 8.18 ± 2.92 minutes in the fentanyl group, p-value 0.27. Sedation scores, Modified Alderette scores, pain scores, and rescue analgesic requirements were also comparable. KeLiDex could effectively control hemodynamics and pain both at rest and in movements in line with fentanyl-based anesthesia for laparoscopic nephrectomies. Further, recovery from the anesthesia, sedation, and PACU discharge readiness were similar.

Is a 12-week home-based functional teletraining for individuals with type 2 diabetes an alternative for blood glucose control?

BackgroundVirtual or Tele-exercise programs have emerged due to safety concerns of COVID-19 contamination for at-risk groups. However, blood glucose (BG) comparisons concerning in-person and virtual exercise programs need to be scientifically researched. Understanding and monitoring home-based teletraining effects on glycemia is vital for safe management of people with type-2 diabetes (T2DM). Purpose: To verify a 12-week functional teletraining on the capillary BG and compare it with in-person exercise before the COVID-19 pandemic in people with T2DM. MethodsT2DM participants underwent tele-exercise during the COVID-19 pandemic. It consisted of functional training (functional resistance training (FRT) for 12 weeks, 2 times a week, ∼60 min). Capillary BG was performed before and after (pre-post) each exercise session. The pre-post ΔBG for each session was considered for statistical analysis. Friedman's test with repetitive measures over time was performed to compare the ΔBG of the teletraining and the results of these participants before the pandemic. The minimum detectable difference was performed to verify clinical ΔBG for each session over the weeks. ResultsSimilar responses were seen over time without a statistical time effect after the programs (p = 0.177). A noticeable minimum difference of 24.5 mg/dL was observed in the in-person group post-session in all sessions. The virtual group showed a minimum detectable difference of 21.1 mg/dL post-session with clinical relevance over the 12 weeks. ConclusionDespite the teletraining being twice weekly and the in-person program thrice weekly, both exhibited similar outcomes over time, with the virtual program showing significant clinical improvements in BG after each session.

The Effect of Auricular Acupressure on Uterine Contractions, Fetal Heart Rate, and Length of Labor in the Active Phase of Primigravida

The still high maternal mortality rate (MMR) in Indonesia, especially in East Java, is caused by indirect causes or other causes such as prolonged labor, so a method is needed to treat cases of prolonged labor such as auricular acupressure. Auricular acupressure (AKAR) is a non-pharmacological method proven effective for uterine contractions, but its side effects on the fetal heart rate (FHR) are unknown. The research aimed to analyze the AKAR method on uterine contractions, FHR, and labor duration in the first stage's active phase. This type of research is truly experimental, with a pretest-posttest control group design. The research subjects were 41 respondents, primigravida active phase first-stage mothers, selected by consecutive sampling and randomly divided into two groups, namely 21 AKAR groups and 20 deep breathing relaxation control groups. The research results of the Friedman test statistical test ρ-value equal 0.000 in the AKAR group and ρ-value equal 0.000 in the control group, meaning that AKAR influences uterine contractions. The Friedman Test findings show that AKAR does not affect FHR (ρ-value equal 0.618). The Independent Sample Test ρ-value equal 0.29 indicates no statistically significant difference between the two groups' labor lengths throughout the first stage's active phase. The AKAR group's average labor time in the first stage of the active phase was 365.40 minutes, with a minimum of 267 minutes and a high of 395 minutes. Conclusion: The auricular acupressure method affects uterine contractions but does not affect the fetal heart rate. There was no difference in the length of labor in the first active phase of labor between the auricular acupressure and deep breathing relaxation groups, so it is recommended that the auricular acupressure method can be used as an alternative complementary care to prevent prolonged labor.

Pattern of plant biomass and carbon stock along different elevational forests in eastern Nepal

The primary aim of this investigation was to determine the biomass and carbon stock distribution pattern among different forest stands of diverse elevations in the Morang district of East Nepal. It is noteworthy to estimate carbon stock and biomass of relatively least underexplored forests in east Nepal. The data for estimating the biomass and carbon stocks of the five different forest sites, viz. Bhaunne, Raja-Rani, Murchungi, Adheri, and Sagma located between 100-1300m above the mean sea level, were acquired through the measurement of inventory plots selected randomly. Altogether, 50 sample plots were established within five forest stands located on different elevational zone; within each forest site, 10 sample plots of 20m × 20m size, were laid out for the measurement of trees. In the case of shrubs and herbs, nested plots of 5m × 5m and 1m ×1m, respectively were established. Calculation of the biomass of trees and shrubs was facilitated through the application of an allometric equation, while the biomass of herbs was determined by the harvest method. The carbon concentration in the plant materials was estimated using ash content method. The comprehensive analysis of the stand biomass in the Bhaunne, Raja-Rani, Murchungi, Adheri, and Sagma forest sites were: 815.86 Mg ha-1, 414.19 Mg ha-1, 606.81 Mg ha-1, 519.20 Mg ha-1, and 299.96 Mg ha-1, respectively, with minimum at the Sagma site (high-altitude forest) and maximum at the Bhaunne site (low-altitude forest). As per the variation in stand biomass, the carbon stocks in the forest sites also showed the same trend, but the values ranged from 140.19 Mg C ha-1 to 333.63 Mg C ha-1, with the minimum in the Sagma site and the maximum in the Bhaunne site. The application of the Friedman Test revealed statistically significant variation in the tree biomass between the Murchungi and Sagma sites and also in the shrub biomass between the Adheri and Sagma sites. Similarly, noteworthy variations were observed in the herb biomass of the Bhaunne, Raja-Rani, Murchungi, and Adheri sites as compared to that of the Sagma site. The present study contributes to the understanding of forest ecosystems in context to carbon management.

THE EFFECT OF SUBSTITUTION OF ALMOND FLOUR WITH SOYBEAN FLOUR ON THE PHYSICAL PROPERTIES AND ACCEPTABILITY OF MARZIPAN

This study aims to analyze the effect of soybean flour substitution on marzipan making on physical properties and consumer acceptability. This research was conducted at the Pastry and Bakery Laboratory of the Culinary Education Study Program, Faculty of Engineering, State University of Jakarta. The sample in this study was soybean flour substitution marzipan with a percentage of 50%, 60%, 70%. This research was conducted with an experimental method, namely testing the density and acceptability of consumers conducted on 30 rather trained students of the Culinary Education Study Program with assessment aspects including aspects of color, sweetness, aroma, softness, stickiness, and elasticity. The results of the density value study were analyzed using calipers and digital scales that showed the substitution of soybean flour in marzipan with a percentage of 0% having a high density of 1.27 g / cm3. The consumer acceptance test analyzed by the Friedman test showed that there was no influence on the aspects of color, sweetness, aroma, softness, and stickiness which resulted in the substitution of soybean flour in marzipan with a percentage of 70% preferred, but there was an influence on the aspect of elasticity so that continued with the Tuckey's test which resulted in the substitution of soybean flour in marzipan with a percentage of 70% preferred by the panelists.

Post-operative pain in non-surgical root canal treatment after sealer-based obturation versus warm vertical compaction: A randomized clinical trial.

Post-operative pain may occur after non-surgical root canal treatment (NSRCT). The root filling technique and choice of sealer may be contributing factors. This randomized controlled clinical trial compared post-operative pain and analgesics intake after NSRCT using a sealer-based obturation technique (SBO) with single-cone gutta-percha and calcium silicate sealer (CSS) versus a warm-vertical compaction (WVC) technique with gutta-percha and a resin-based sealer (RBS). This study was designed as a parallel-two arm, double-blind, randomized superiority clinical trial registered at www. gov (NCT04753138). Patients referred for NSRCT fulfilling the inclusion criteria participated in this study. Pre-operative periapical radiographs and CBCT scans were taken and numerical rating scale (NRS) pain scores were recorded. Upon completion of canal instrumentation, participants were randomly allocated to either Group SBO: SBO with CSS or Group WVC: Warm-vertical compaction with RBS. Post-operative pain and analgesics intake were recorded at 1, 3 and 7 days after endodontic treatment completion. Non-parametric Mann-Whitney U and Friedman tests and a generalized estimating equation were used to assess differences in pain scores between the groups, within each treatment group at different time points and for correlations, respectively. The study included 195 participants (212 teeth). One participant declined to submit the NRS form. Therefore, 194 participants (211 teeth) were included in the final analysis (99.5% response rate). No statistically significant differences in post-operative pain or analgesic intake existed between the two groups at any time point (p > .05). Age, pre-operative pain, apical diagnosis and post-operative analgesic intake were significantly related to post-operative pain (p < .05). Sealer-based obturation technique with CSS was associated with similar post-operative pain levels and analgesics intake as WVC with RBS. Regarding post-operative pain, SBO with CSSs may be a suitable clinical alternative.

Potentially inappropriate medication on communitydwelling older adults: Longitudinal analysis using the International Mobility in Aging Study.

Medications are a fundamental part of the treatment of multiple pathologies. However, despite their benefits, some are considered potentially inappropriate medications for older people given their safety profile. Epidemiological data differences related to potentially inappropriate medications make it difficult to determine their effects on elderly people. To estimate the prevalence and types of potentially inappropriate medications using the 2019 Beers Criteria® in a cohort of adults older than 65 years. We performed an observational, multicenter, retrospective, longitudinal study of a four-year follow-up of potentially inappropriate medications in community-dwelling older adults. We followed 820 participants from five cities for four years (2012-2016) and evaluated them in three different moments (m1 = 2012, m2 = 2014, and m3 = 2016). The average age was 69.07 years, and 50.9% were women. The potentially inappropriate medication prevalence in the participants was 40.24%. The potentially inappropriate medications' mean among the studied subjects in the first moment was 1.65 (SD = 0.963), in the second was 1.73 (SD = 1.032), and in the third was 1.62 (SD = 0.915). There were no statistical differences between measurements (Friedman test, value = 0.204). The most frequent potentially inappropriate medications categories were gastrointestinal (39.4%), analgesics (18.8%), delirium-related drugs (15.4%), benzodiazepines (15.2%), and cardiovascular (14.2%). About half of the population of the community-dwelling older adults had prescriptions of potentially inappropriate medications in a sustained manner and without significant variability over time. Mainly potentially inappropriate medications were gastrointestinal and cardiovascular drugs, analgesics, delirium-related drugs, and benzodiazepines.

Ensemble meta-heuristics and Q-learning for staff dissatisfaction constrained surgery scheduling and rescheduling

In this study, we investigate the multi-objective surgery scheduling and rescheduling problems with considering medical staff dissatisfaction and fuzzy surgery time. Rescheduling is activated when emergency patients arrive. First, a multi-objective mathematical model is established for maximizing the average patient satisfaction, and minimizing the fuzzy maximum completion time and total medical cost, simultaneously. Second, five meta-heuristics are employed and improved to solve the concerned problems. Five heuristic rules are developed to improve the diversity and quality of initial solutions. For improving the performance of meta-heuristics, six local search operators are designed and two Q-learning-based strategies are developed to select optimal ones intelligently. Finally, 29 instances with different scales are used to verify the performance of the proposed algorithms. Compared with the basic meta-heuristics, the average performance of the algorithms with the second Q-learning-based strategy is improved by 62.5%, 62.1%, 50%, 70.7%, and 70.7%, respectively. Through the Friedman test, the asymptotic significance values of both metrics (0.034 and 0.000) are less than 0.05, indicating that there is a significant performance gap among five algorithms with the second Q-learning-based strategy. The average rank values of the teaching-learning-based optimization with the second Q-learning strategy are 3.7069 and 2.0690 for two metrics, which are better than the compared ones.

Performance Assessment of Natural Survivor Method-Based Metaheuristic Optimizers in Global Optimization and Engineering Design Problems

This study presents the comparative performance analysis of Natural Survivor Method (NSM)-based algorithms in solving the IEEE CEC 2022 test suite benchmark problems and four real-world engineering design problems. Three different variants (Case1, Case2, Case3) of the NSM-TLABC, NSM-SFS and NSM-LSHADE-SPACMA algorithms were used in the study. The data obtained from the experimental studies were statistically analyzed using Friedman and Wilcoxon signed-rank tests. Based on the Friedman test results, NSM-LSHADE-SPACMA_Case2 showed the best performance with an average Friedman score of 3.96. The Wilcoxon signed-rank test showed that NSM-LSHADE-SPACMA_Case2 outperformed its competitors in 13 out of 16 experiments, achieving a success rate of 81.25%. NSM-LSHADE-SPACMA_Case2, which was found to be the most powerful of the NSM-based algorithms, is used to solve cantilever beam design, tension/compression spring design, pressure vessel design and gear train design problems. The optimization results are also compared with eight state-of-the-art metaheuristics, including Rime Optimization Algorithm (RIME), Nonlinear Marine Predator Algorithm (NMPA), Northern Goshawk Optimization (NGO), Kepler Optimization Algorithm (KOA), Honey Badger Algorithm (HBA), Artificial Gorilla Troops Optimizer (GTO), Exponential Distribution Optimization (EDO) and Hunger Games Search (HGS). Given that all results are together, it is seen that NSM-LSHADE-SPACMA_Case2 algorithm consistently produced the best results for the global and engineering design problems studied.

Chronic coronary artery disease: aspects of recording and coding in clinical practice (results of a survey of physicians)

Aim. To study the opinion of doctors about the applicability, frequency and criteria for practical use of codes of the International Classification of Diseases, 10th revision (ICD-10) from the group of chronic coronary artery disease (CAD) — I25.0, I25.1, I25.8, I25.9.Material and methods. This cross-sectional study was conducted in the period from February 27, 2024 to March 11, 2024 on a continuous sample of medical workers who agreed to participate in an anonymous survey as respondents. The questionnaire consisted of an introductory, personal and main part, which consisted of 19 questions devoted to various aspects of chronic CAD coding at the doctor’s appointment and during preparing medical death certificate. This article presents the results of a survey of cardiologists (group 1) and internists/general practitioners/family physicians (group 2). The χ2 test was used to compare two groups. The Friedman test was used to test the hypothesis that the physicians' opinion about the use of different chronic CAD codes was random. The Kendall test was used to assess the agreement between physicians. Calculations were carried out using Microsoft Office Excel 2021 and SPSS-26.0.Results. A total of 883 doctors from 47 constituent entities of the Russian Federation took part in the survey. Half of the respondents believed that there are differences between the codes I25.0, I25.1, I25.8, I25.9 and that they are necessary for statistical recording. Although cardiologists (59,2%) were less likely than internists/general practitioners/family doctors (65,9%) to believe that one or more of the 4 codes analyzed could be used only on the basis of risk factors, differences did not reach significance (p=0,1). The need to confirm chronic CAD using paraclinical research methods varied from 57,3% for code I25.9 to 83,1% for code I25.1. In case of death of a patient from chronic CAD, almost a third of respondents do not see the differences between the 4 specified codes, but are ready to use them in different clinical setting. In addition, 14,6% responded that when filling out medical death certificates they would not use any of the 4 specified codes. There is no agreement among physicians regarding the use of codes in clinical practice (Kendall's coefficient of concordance 0,084; p&lt;0,001) and as a cause of death (0,148; p&lt;0,001).Conclusion. There is no unified stance among doctors on the rules and applicability of using at least 4 codes (I25.0, I25.1, I25.8, I25.9). To correctly assess morbidity and mortality rates from individual forms of chronic ACAD based on ICD-10 codes, guidelines that should include a description and consideration of all the most significant clinical scenarios of chronic CAD should be developed.

Experience of focused workshop intervention in presentation skills - Importance of foundational skills for ophthalmologists in training.

The study was conducted to assess the impact of a workshop intervention designed to enhance presentation skills of ophthalmology fellows in training. A 10-hour workshop on presentation skills was conducted for ophthalmology fellows in the 2022 cohort at a single institution. An email was sent to the 2022 cohort to recruit participants. A total of 29 fellows (19 females, 10 males) volunteered to participate in the study. Participants completed a self-rating questionnaire to assess improvement in their presentation skills at four different time points of the workshop. The self-rating questionnaire utilized a ten-point rating scale (1-10) and evaluated properties and content (PC) and soft skills (SS). Data were analysed using SPSS software. Friedman and post-hoc tests compared self-ratings at four time points. Statistical significance was set at p-value < 0.05. Both properties & content (PC) and soft skills (SS) showed significant difference (p < 0.001) post workshop compared to earlier stages. The higher self-rating (PC4 and SS4) highlights increased awareness towards the scope of improving the presentation after the workshop intervention. Presentation skills empower medical professionals to better communicate with diverse audiences, demonstrating their currency in medical knowledge, lobbying for correct understanding, and bringing praxis to pedagogy. The findings support the integration of similar workshops into medical curricula to foster well-rounded medical professionals.

Techniques for Memorizing the Quran: A Comparative Study of the Memory System Tendencies of Maahad Integrasi Tahfiz Selangor (MITS) Students

Memorizing the Quran typically employs memorizers’ common techniques, which also result in manners appreciation, and the development of motivation and self-inspiration in them as well. The approach is frequently utilized as a spontaneous practice when memorizing the Quran. However, the memorizing strategies used frequently change depending on the memory system’s propensity: (a) semantics; (b) episodic; and (c) visual. This study aimed to identify and compare techniques for memorizing the Quran among the students of Maahad Integrasi Tahfiz Selangor (MITS) Klang, Selangor. MITS secondary school students from form one to form four were involved as a sample (n=192). The methodology used in this study is quantitative. A questionnaire and IBM SPSS Statistics (version 27) computer software were utilized in the instrumentation. The Friedman test and descriptive statistics were used to analyze the data. Techniques for memorizing the Quran using a semantic memory system indicated the most frequent practice (63, 32.8%) compared to the visual memory system (44, 23%) and episodic memory system (18, 9.4%). Additionally, the Friedman test found that the techniques in memorizing the Quran that use the semantic memory system (mean rank: 2.17) are the most frequently used with a significant difference χ2(2)=36.892, ρ=.000 compared to the visual memory system (mean rank: 2.02) and episodic memory system (mean rank: 1.82). This study suggests that secondary school students of MITS Klang have a tendency towards the semantic memory system in memorizing the Quran compared to the visual and episodic memory systems. Further studies related to semantic methods in hafazan can be explored, perhaps through qualitative methods as well as a wider range of studies.

The Effect Of The Comparison Of Binders In The Manufacture Of Carp Rolade (Cyprinus Carpio) On The Physical Properties And Consumer Acceptability

This research aims to analyze the effect of binder ratio in the making of carp fish roulade on the physical properties and consumer acceptance. The research was conducted at the Food Processing Laboratory, Department of Culinary Education, Universitas Negeri Jakarta. The research period began in August 2023 and ended in June 2024. The method used in this research was experimental. The research sample used grass carp roulade with a binder ratio between tapioca flour and wheat flour at 1:1, 2:1, and 1:2. The samples were then tested on 30 moderately trained panelists who evaluated overall aspects. Based on the results of statistical hypothesis testing using the Friedman test, it was found that there was no influence of binder ratio on the acceptance of carp fish roulade at ratios of 1:1, 2:1, and 1:2 in terms of skin color before and after frying, filling color before and after frying, fish aroma, spice aroma, taste, and structural compactness. However, one aspect that had an influence was the level of tenderness. Based on the results of statistical hypothesis testing, physical testing using the Kruskal-Wallis test showed that the binder ratio had no significant influence on the physical quality of grass carp roulade in terms of hardness level. The conclusion of this study is that the acceptance of carp fish roulade is recommended at a binder ratio of 1:1 between tapioca flour and wheat flour.