Independent T-test Research Articles

Investigating the Relationship Between Metabolic Syndrome with Physical Activity and Eating Habits: The Result of the Tabari Cohort Study

Background: Metabolic syndrome (MetS) is a group of metabolic issues that increase the risk of type 2 diabetes and heart disease. Objectives: To reduce deaths from type 2 diabetes and heart disease, this study was conducted to determine the relationship between metabolic syndrome, physical activity, and eating habits in participants of the Tabari cohort study. Methods: In this descriptive cross-sectional study, data from the Tabari cohort in an urban and mountain area in Sari, Mazandaran, was utilized from June 2015 to November 2017. Background information of participants was documented, and their eating habits were assessed using a food habit questionnaire. Additionally, the physical activity levels of the participants were recorded. All individuals were assessed for metabolic syndrome according to the third Adult Treatment Panel (ATP III) guidelines. The gathered data was then inputted into SPSS V.23 software for analysis. Qualitative variables, such as demographic and epidemiological data, were compared between the two groups using the chi-square test, while quantitative variables were compared using an independent t-test. Results: A total of 10,255 adults between the ages of 35 and 70 participated in this study, and after applying entry and exit criteria, 9,976 people, including 4,083 with metabolic syndrome and 5,893 healthy individuals, were included in the final analysis. There was no significant difference in the average Body Mass Index (BMI) between individuals with metabolic syndrome (30.6 ± 4.5 kg/m²) and healthy individuals (26.8 ± 4.4 kg/m²). However, individuals with metabolic syndrome exhibited significantly higher values for height, weight, waist circumference, abdominal circumference, and wrist circumference compared to the control group (P = 0.001). The average Metabolic Equivalent of Task (MET) for the entire population was 43.03 ± 9.27, with a median of 40.68 (range: Twenty-four-one hundred three) hours/day. A greater percentage of individuals with metabolic syndrome (57.0%) and healthy individuals (45.2%) had MET values below the average (P = 0.001). Regarding energy intake, individuals with metabolic syndrome consumed an average of 2189.74 ± 721.90 calories, while healthy individuals consumed 2354.92 ± 4.04 calories, showing a significant difference (P = 0.006). Moreover, healthy individuals demonstrated significantly higher consumption of added salt in food, fried foods, fried potatoes, fried onions, fried vegetables, and various types of cooking oils compared to those with metabolic syndrome (P = 0.001). Conclusions: Based on the results of the Tabari cohort study, the prevalence of metabolic syndrome in Mazandaran was 41.10%, highlighting the need for prevention and screening programs. In this study, individuals with metabolic syndrome consumed fewer fried foods, trans fats, and daily calories compared to the healthy group. Considering that this study is cross-sectional and utilized data from the Tabari cohort, it is assumed that the difference is due to dietary compliance and lifestyle changes in patients with metabolic syndrome. It is recommended that prospective studies be designed to evaluate the causes of differences in metabolic syndrome components between the two groups.

Investigation of Factors Associated with Gut Microbiota in Demodex-associated Skin Conditions.

This study describes the relationships of factors related to gut microbiota and skin conditions associated with Demodex, including demodicosis, rosacea, and perioral dermatitis. A total of 113 patients from Dokuz Eylül University Hospital Dermatology Department answered a cross-sectional questionnaire. They consisted of 42 cases of Demodex-related skin diseases and 71 healthy controls. Demographic data and medical history, dietary and lifestyle habits, and gastrointestinal symptoms were recorded. Statistical analysis included descriptive statistics, chi-square tests, Fisher's Exact tests, independent samples t-tests, and logistic regression methods. Our findings identified alcohol consumption [odds ratio (OR)=11.13, 95% confidence interval (CI): 4.11-17.22, p<0.01] and smoking (OR=10.32, 95% CI: 2.47-21.57, p<0.01) as strong risk factors for Demodex-related conditions. Low water intake (0-1 liter per day) (OR=3.39, 95% CI: 2.08-5.57, p=0.03) and infrequent exercise (less than 1 hour per week) (OR=4.87, 95% CI: 2.70-12.54, p=0.02) were also significant risk factors. Additional factors associated with increased Demodex risk included reduced bowel movements (OR=2.71, 95% CI: 1.45-4.06, p=0.01) and higher pet ownership (OR=2.85, 95% CI: 2.13-4.27, p=0.03). Although vegetarian and high-fat diets showed some associations, they were not independently significant. This study demonstrates key environmental and lifestyle factors, such as low water intake, infrequent exercise, reduced bowel movements, higher pet ownership, alcohol consumption, and smoking, that are significantly associated with Demodex-related skin conditions. These factors, related to gut microbiota, may provide valuable insights for managing these skin conditions and suggest promising directions for future research.

Guideline Concordance of Aspirin Use for Primary Prevention in Adult Outpatients

Recent guidelines have recommended a reduced role for primary prevention aspirin use, which is associated with increased bleeding risk. This study seeks to characterize guideline-discordant aspirin use among adults in a community care setting. As part of a quality improvement initiative, patients at one internal medicine and one family medicine clinic affiliated with an academic hospital were sent an electronic survey. Patients were included if they were at least 40 years old, had a primary care provider at the specified sites, and were seen in the last year. Patients were excluded if they had an indication for aspirin other than primary prevention. Responses were collected from February 15 to March 16, 2022. Analyses were performed to identify predictors of primary prevention aspirin use and predictors of guideline-discordant aspirin; aspirin users and non-users were compared using Fisher’s exact test, independent samples t-tests, and multivariable logistic regression. Of 1460 patients sent a survey, 668 (45.8%) responded. Of respondents, 132 (24.1%) reported aspirin use that was confirmed to be for primary prevention. Overall, 46.2-58.3% of primary prevention aspirin users were potentially taking aspirin contrary to guideline recommendations. Predictors of discordant aspirin use included a history of diabetes mellitus and medication initiation by a primary care provider. In conclusion, primary prevention aspirin use may be overutilized and discordant with recent guideline recommendations for about half of patients, suggesting a need for aspirin de-implementation. These efforts may be best focused at the primary care level.

The differential effects of parent-targeted alcohol harm-reduction campaigns with varying executional styles.

Parental provision of alcohol to children is associated with a range of negative outcomes. Public health campaigns discouraging this practice are required as part of a comprehensive approach to reduce alcohol-related harm among minors, however, limited research has examined the relative effectiveness of different messaging approaches. This study compared the effects of two campaigns with different executional styles on parents' intentions to provide alcohol to minors-one campaign used a fear-based approach and the other adopted a first-person narrative approach. The study used a repeated cross-sectional design. An independent samples t-test was used to compare the effects of two campaigns with alternative executional styles on parents' alcohol provision intentions. Two ordinal logistic generalised linear models were used to assess whether intentions effects differed according to parents' demographic and behavioural characteristics. Both campaigns were effective at motivating parents to abstain from providing alcohol to minors. This outcome was particularly notable among female respondents and those who had never provided alcohol to their children. Older respondents and those who used less alcohol were more likely to intend to change their behaviours as a result of exposure to the fear-based campaign, while the campaign using a narrative approach was more effective with heavier drinkers. Overall strong performance of both campaigns combined with varying effectiveness by parent attributes highlights the utility of parent-focused campaigns targeting alcohol provision to minors. To best protect minors, continued investments are needed to develop suites of evidence-based campaigns that resonate with different parent subgroups.

Effect of Kshoudradi Aschyotana in Arjuna w.s.r to Sub-Conjunctival Haemorrhage: A Randomised Clinical Trial

Introduction: Subconjunctival haemorrhage (SCH) is a frequent eye condition marked by bleeding beneath the conjunctiva, which causes noticeable discoloration and generally disturbs the affected person. There is currently no specific treatment for SCH in contemporary medical practices. According to Ayurveda, it correlates with Arjuna. It is a rakta pradoshaj vikara (disease caused by vitiated blood) and primarily a pitta-predominant disease manifesting in the Shukla mandala of netra. Objectives: The objective of the study was to compare the efficacy of Kshoudradi Aschyotana with Flurbiprofen Eye Drops in Arjuna with special reference to sub-conjunctival haemorrhage. Materials and Methods: After securing ethical clearance and registering the trial with the CTRI, twenty patients satisfying the inclusion criteria and diagnosed with arjuna were randomised into two groups(10 in each group). The trial group and the control group received Kshoudradi Aschyotana and Flurbiprofen eye drops for 5 days respectively. Objective parameters were assessed using Slit-Lamp photography and the area of the lesions was recorded on the baseline, 5th, and 7th days. The statistical analysis of the area of haemorrhage was conducted using independent and paired t-test for between and within-group analysis respectively. Results: Kshaudraadi Aschyotana has exhibited better results in reducing the area of subconjunctival haemorrhage as compared with flurbiprofen eye drops within five days(P &lt;0.05). Conclusion: The study concludes that Kshaudraadi Aschyotana has beneficial effects in the management of Arjuna as compared with the flurbiprofen eyedrops.

8395 Exploring the Relationship of Dietary Advanced Glycation End-products (AGEs) with Glycemic Control among Adults with Type 1 Diabetes (T1D)

Abstract Disclosure: C.E. Nevarez: None. A.B. Murthy: None. G. Jung: None. B. Gray: None. E. Cagliero: None. V. Aroda: None. E.W. Yu: None. Introduction: Accumulation of advanced glycation end products (AGEs) are thought to play a crucial role in the pathophysiology of diabetic complications, yet the contributions of dietary AGE (dAGE) intake to systemic AGE levels and glycemic control have not been established. Utilizing a newly developed methodology for evaluating dAGEs, our objective was to test whether dAGE impact systemic AGEs and glycemic outcomes in adults with longstanding Type 1 Diabetes (T1D). Methods: We examined adults aged 50+ years participating in the T1D BEACON cohort (n=97 T1D, n=53 non-diabetic controls). We developed a novel algorithm to quantify dietary AGE intake by associating items from the 2014 Block Food Frequency Questionnaire with their AGE content (as determined by ELISA from a previously published dataset; Urribarri et al., 2010). Daily dAGE intake was normalized using the nutrient density method (Willett et al., 1997). Additional measurements included autofluorescent skin AGEs (AGE Reader, DiagnOptics Technologies), diabetic history, hemoglobin A1C and 14-day continuous glucose monitoring to assess percentage time in glucose target range (70-180 mg/dL). We compared dAGEs between T1D and controls and evaluated associations of dAGEs with outcomes using independent t-tests, Pearson’s correlations, and multivariate linear regression with adjustments for age, sex, and body mass index (BMI). Results: Mean age and sex distribution was similar in the T1D and control groups (63.54 ± 6.7 yrs, 50.7% female). BMI was higher in the T1D group (27.9 ± 5.0 vs. 26.0 ± 4.9 kg/m^2, p = 0.031). The mean ± SD duration of diabetes in the T1D cohort was 46.1 ± 9.8 yrs, with A1c of 7.1 ± 1.0%. Utilizing our novel algorithm, the mean daily normalized dAGE intake was higher in the T1D than control groups (8.8 ± 2.3 kU/kcal vs. 7.9 ± 2.5 kU/kcal, p = 0.046) although this did not remain significant after multivariate adjustment (adj p = 0.123). Skin AGEs were higher in the T1D group (3.0 vs 2.5 AU, adj p&amp;lt;0.001). Within the full cohort, dAGE intake was significantly correlated with skin AGEs (r = 0.32, adj. p = 0.003), which was driven primarily by association within the T1D group (r = 0.32, adj p = 0.002). Additionally, dAGE intake was associated with higher A1C values within the full cohort (r = 0.27, adj. p = 0.019), and there was a trend that higher dAGE correlated with decreased time in target glucose range (r = -0.22, adj p = 0.062). Conclusion: Our analyses have revealed novel associations between dAGE intake, skin AGEs, and glycemic outcomes among adults with type 1 diabetes, underscoring the contribution of dietary patterns to systemic AGEs and physiological outcomes within diabetic populations. Future investigations will be needed to validate this novel dAGE assessment in external cohorts and to evaluate the potential impact of dietary AGE intake upon diabetic complications. Presentation: 6/1/2024

6488 Factors associated with the response to SGLT2 inhibitors and GLP-1 Receptor Agonists in Veterans with Type 2 Diabetes

Abstract Disclosure: S. Hashmi: None. K. Samson: None. G. Arora: None. S. Azad: None. D. Awad: None. C.V. Desouza: None. Background: SGLT2 inhibitors and GLP1 agonists are recommended as first line pharmacological therapy (along with metformin) for type 2 DM, particularly in patients with CKD, CVD, or HF. Despite their effectiveness, there is limited evidence available to predict which patient subsets will respond favorably to SGLT2 inhibitors or GLP1 agonist. Purpose of study: To determine if baseline characteristics can predict response to therapy and to compare the differences in characteristics between SGLT2 inhibitor and GLP1 agonist groups. Methodology: Retrospective study of veterans ages 19-89 yr with T2DM initiated on treatment from Jan 1, 2015, to Dec 31, 2022, with either SGLT2 inhibitor or GLP 1 agonist for at least 6 months. The cohort comprised 866 patients, of which 544 individuals met the inclusion criteria (332 in the GLP-1 agonist group and 212 in the SGLT2 inhibitor group). Baseline characteristics assessed included age, sex, race, comorbidities, weight, BMI, HbA1c, eGFR, BP and lipids. Treatment response thresholds were defined as an HbA1c reduction of more than 0.5 percentage points and more than 3% of pretreatment weight loss, evaluated 6-12 months after initiating treatment. A complete response was defined as both treatment thresholds being met. Statistical analysis involved Chi-Square tests and independent samples t-test between variables of interest. Logistic regression was conducted with the dichotomous complete response outcome, for variables with bivariate p-values less than 0.10, in addition to variables preselected for inclusion based on the clinical relevance. Results: Three variables were statistically significant in the final logistic regression with complete response outcome. Patients on GLP1 had an increased adjusted odds of having a complete outcome (AOR: 2.45 (95% CI: 1.45, 4.15) relative to patients on SGLT2. In addition, older patients (AOR: 1.34 (95% CI: 1.02, 1.74)) and patients with a higher baseline HbA1c (AOR: 1.18 (95% CI: 1.02, 1.36)) had increased adjusted odds of having a complete response relative to patients 10 years younger and patients with an A1c 1 unit lower, respectively. 72.6% of patients on GLP1 agonists achieved the A1c response goal, in contrast to 48.6% on SGLT2 inhibitors (p &amp;lt; 0.001). Also, 47.6 % of individuals achieved weight loss goals on GLP1 agonist as compared to 41 % on SGLT2 inhibitor. A greater proportion of females (66.7%) achieved the A1c reduction goal compared to males (45.9%) on SGLT2 inhibitors (p = 0.04). Conclusion: Individuals receiving GLP-1 agonists had a twofold increased odds of achieving A1c reduction and weight loss goals after a 6-12 month treatment period compared to those prescribed SGLT2 inhibitors. Older patients and patients with higher baseline A1c levels had greater odds of reaching A1c and weight loss threshold whereas other baseline variables were not significantly associated with the outcome. Presentation: 6/3/2024

Enhancing mathematical problem-solving ability through project-based learning: A study of vocational high school student

This study aims to improve the mathematical problem-solving ability of students at Vocational High School (VHS) through implementing Project Based Learning (PjBL). The research method used was a quasi-experiment with a matching-only pretest-posttest control group design, with a sample of 64 students divided into two classes, namely experimental and control classes, each consisting of 32 students. The sampling technique used was purposive sampling, where the sample was selected based on specific criteria relevant to the research objectives. Data were collected using tests of mathematical problem-solving ability administered before (pre-test) and after (post-test) the treatment. Data were analyzed using an independent sample t-test and a two-way ANOVA test with univariate general linear model (GLM) analysis. The results showed a difference between the experimental and control groups before the treatment. However, after the treatment, the experimental group had higher mathematical problem-solving ability than the control group, including the improvement and interaction between PjBL implementation and the Early Mathematics Skills (EMS) category.

6662 Effect of Selenium Supplementation on Mild Graves’ Ophthalmopathy at a Tertiary Hospital - A Six-Month Open-Labelled, Assessor-Masked, Randomized-Controlled Trial

Abstract Disclosure: J.M. Flores: None. N.G. Sioson: None. J.D. Uy-Ho: None. A.L. Suller-Pansacola: None. Graves’ orbitopathy is associated with increased oxidative stress. Selenium, with its antioxidant and immunoregulatory actions, has been proposed as an adjuvant therapy. Objective: This study was undertaken to determine whether selenium supplementation for six months can decrease signs and prevent worsening of mild Graves ophthalmopathy among Filipinos. Methods: We conducted an open-labelled, assessor-masked, Randomized-Controlled Trial on patients with mild Graves’ ophthalmopathy wherein one arm was assigned to standard of care (eye drops) only for a period of six months while another arm was assigned to 200 ug/day oral Selenium supplementation alongside standard of care. Population: Adult patients with Graves’ hyperthyroidism, with at least one sign of mild ophthalmopathy with GO disease duration of less than 18 months Results: Independent Sample T-test, Mann-Whitney U test and Fisher’s Exact/Chi-square test were used to determine the difference of mean, rank and frequency, between patients given Selenium versus patients given standard of care. Paired Sample T-test, Wilcoxon Sign rank test and McNemar test were used to determine the difference of mean, rank and frequency on patients from initial to 3rd month or 6th month observation. Null hypotheses were rejected at 0.05α-level of significance. There was a significant difference in Clinical Activity Score (CAS) between patients given selenium supplementation and those assigned to standard of care. On initial examination for the Selenium group, 14 eyes (33.33%) had a CAS score of 0, which increased to 27 eyes (64.29%) on the third month and ended to a 26 eyes (61.9%) at the sixth month of treatment. For the non-selenium group, 11 eyes had a CAS score of zero initially, increased to 16 eyes (and 38.1%) then finally arrived to a total count of 14 eyes (33.33%). Improvement in CAS may be attributed specifically to improvement in caruncle/plical swelling showing a significant difference (p-value 0.040). Comparing the two groups, a statistical significance in CAS is noted between the treatment versus the control group with a p-value of 0.017 on the 6th month. Conclusion: Selenium supplementation provided significant benefit in terms of decreasing signs and preventing worsening of mild GO through improved CAS score. Further studies exploring the baseline and end of treatment selenium concentrations in the Philippines may be warranted. Presentation: 6/3/2024

Enhancing Reading Motivation of Kindergarten Pupils through Home-School Collaboration: A Causal-Comparative Approach

The purpose of this study is to examine how home-school collaboration affects kindergarteners' reading motivation. The researcher chose 100 kindergarten teachers in Talomo A District, Davao City, as study participants. Respondents were chosen using stratified random sampling. A causal-comparative quantitative research design was used. Data was analyzed using these statistical tools: Mean Percentage Scores, Frequency Distribution Percentage, Mean, Independent Sample T-Test, and Eta-Squared Univariate General Linear Model. One category (n=50) was assigned to home-school collaboration and the other to non- collaborative groups by simple random assignment. The results showed that kindergarteners in Talomo A District, Davao City, had extensive reading motivation. Additional results demonstrated a substantial statistical difference in kindergarten students' reading motivation between home- school collaboration and non-collaboration groups. The results also demonstrate that home-school partnership improved kindergarteners in Talomo A District, Davao City. Thus, home-school partnership made this issue easier to teach. The study was done to publish findings in a recognized academic journal.

The effect of guided group reflection on the ability and convenience of breaking bad news in pre-hospital emergency staff

BackgroundBad news refers to any information that create negative changes in a person’s understanding or expectations of in present and future. Breaking Bad News (BBN) is a stressful task that may have disturbing effects on the professional performance and general health of the medical staff. Pre-hospital emergency staff often needs to deliver bad news to the patient or his family. This study was conducted to determine the effect of guided group reflection training on the ability and comfort of BBN in pre-hospital emergency staff.MethodsThis quasi-experimental study was conducted on 95 staff of the pre-hospital emergency, in the test and the control groups. For the test group, a 4-hour training workshop on BBN was held, and then a group was formed in virtual space to discuss and exchange opinions about the scenarios of BBN and reflecting on it. Data collection tools were SPIKES Questionnaire and the Visual Analogue Mood Scale. The data were analyzed with SPSS V.18.ResultsThe mean score of the ability to BBN after the intervention was 44.01 ± 6.21 in the test group and 31.40 ± 4.51 in the control group, and a significant difference was found using the independent t-test (P = 0.0001). Besides, the mean scores of the convenience of BBN in post-test was 5.52 ± 1.64 in the test group and 3.50 ± 1.28 in the control group using the independent t-test with a significant difference (P = 0.0001).ConclusionAccording to the findings, training in guided group reflection improved the ability to BBN and its convenience in pre-hospital emergency staff. Therefore, it is suggested the use of this method in training for health care providers. Relating to BBN.

Evaluation and Comparison of the Effect of Three Dental Luting Cements on Mineralized Bone Derived from Dental Pulp Stem Cells: An In Vitro Study

Background and Objectives: This study aimed to investigate the effect of zinc phosphate (ZnP) cement, glass ionomer cement (GIC), and nano-integrated bio-ceramic (NIB) cement on mineralization when placed in contact with bone tissue-forming cells. Materials and Methods: ZnP cement, GIC, and NIB cement were divided into direct and indirect groups. A total of 72 cement pellets (24 pellets of each test sample) of 3 × 1 mm (width × height) were prepared using polytetrafluoroethylene molds. A total of 3 sample groups were demarcated using 96- cell well culture plates. In the control group, 24 wells were filled with mineralized osteoblasts and 1 µL of gingival crevicular fluid (GCF). In test group 1, to show a direct effect, 36 samples were plated with mineralized osteoblasts and 1 µL GCF for 24 h; the cells were directly exposed to cement pellets. A total of 36 samples were immersed in GCF for 24 h; later the supernatant was transferred to the mineralized osteoblasts to demonstrate an indirect effect in test group 2. To assess the mineralization, osteoblasts were stained with alizarin red and later observed under an inverted phase-contrast microscope. Data were analyzed using the statistical package for social sciences. An independent t-test compared the direct and indirect effects of the ZnP cement, GIC, NIB cement, and control groups on the mineralization of osteoblasts derived from hDPCs. Results: A statistically significant difference was observed between the ZnP cement, GIC, and NIB cement groups (p &lt; 0.05). ZnP cement exhibited a moderate, NIB cement the least harmful effect, and GIC showed the most harmful effect on the mineralization of osteoblast cells. Conclusions: The biocompatibility of dental luting cements is an important aspect that clinicians should consider during their selection. Nano-integrated bio-ceramic cement showed the least negative effect on the mineralization of osteoblast cells which is beneficial for the cementation of cement-retained implant prostheses. However, further studies are needed to evaluate osteoblast and osteoclast activity in vivo.

Palatal relaxing incisions versus nasopharyngeal relaxing incisions in Palatoplasty.

Bone denudation after conventional relaxing incisions could be a critical factor in inhibiting maxillofacial growth. To address this, alternative relaxing incisions were designed. Thus, this study aimed to compare the effectiveness of palatal relaxing incisions versus nasopharyngeal relaxing incisions in enhancing postoperative outcomes. A retrospective cohort study was conducted, involving a total of 120 patients divided into three groups: 40 patients have received modified Furlow palatoplasty with nasopharyngeal relaxing incisions (M.F + N.P.I palatoplasty), and 40 patients who received modified Furlow palatoplasty with palatal relaxing incisions (M.F + P.R.I palatoplasty). The other 40 patients received original Furlow palatoplasty without relaxing incisions (F palatoplasty). Data collected included gender, cleft type, cleft width, age at repair, velopharyngeal function, presence of palatal fistula, and follow-up. The chi-square test compared frequencies of sex, cleft type, postoperative fistula, and velopharyngeal outcomes across groups. The Mann-Whitney and independent t-tests compared mean values, with statistical significance set at p < 0.05. The mean age at repair was similar across groups, with follow-up periods ranging from 5 to 11 years. No significant differences were found among the M.F + N.P.I and M.F + P.L.I groups regarding gender, cleft type, cleft width, and age at repair. However, the F group had a significantly narrowest cleft width compared to the other groups. Postoperative outcomes showed no significant differences in velopharyngeal function among the three groups, but the F group had a significantly higher rate of palatal fistula (32.5%) compared to the M.F + P.L.I (10%) and M.F + N.P.I (7.5%) groups. A comparison of the two modified Furlow techniques revealed no significant differences in velopharyngeal closure rates or the incidence of velopharyngeal insufficiency and persistent palatal fistula across different Veau classifications. While both incisions showed similar impacts on palatoplasty outcomes, palatal relaxing incisions may expose more bone and pose a higher risk of secondary healing issues. Therefore, nasopharyngeal relaxing incisions are recommended as an effective and potentially preferable technique in palatoplasty whenever feasible. The current study suggests that, whenever feasible, nasopharyngeal relaxing incisions are advised as an effective and potentially superior technique in palatoplasty.

Mandibular morphology in schizophrenia patients compared with non-psychiatric controls using digital panoramic radiography: a retrospective cross-sectional study from Istanbul, Türkiye

BackgroundSchizophrenia is a chronic severe mental disorder characterized by impairment in cognition, emotion, perception, and other aspects of behavior. In light of the association of craniofacial dysmorphology with schizophrenia, mandibular morphology may provide clues about the role of neurodevelopment in the pathophysiology of schizophrenia. This retrospective cross-sectional study aimed to compare the mandibular morphology of patients with schizophrenia with controls using digital panoramic radiography (DPR).Methods302 recorded diagnostic panoramic images obtained from 143 schizophrenia patients (98 males, 45 females), and 159 controls (73 males, 86 females), aged 18–45 years, were evaluated. Seven mandibular measurements consisting of ramus height, condylar height, gonial angle, antegonial angle, antegonial notch depth, ramal notch depth and bigonial width were measured from the DPRs in a double-blinded manner. Bivariate comparisons were carried out using the Independent t-test and Mann–Whitney U test. Logistic regression analysis was used for multivariate comparisons.ResultsLinear measurements were higher while angular measurements were lower in schizophrenia patients. Regression analyses indicated that female patients had greater ramus height (OR = 1.243; P = 0.001), condylar height (OR = 1.463; P = 0.048) and bigonial width (OR = 1.082; P < 0.001); male patients had greater ramus heights (OR = 1.216; P = 0.001) and bigonial width (OR = 1.076; P < 0.001) as well as lower antegonial angle (OR = 0.908; P = 0.012) compared to their respective controls.ConclusionQuantitative differences in mandibular morphology in schizophrenia patients versus controls deserve attention and corroborate with the concept of abnormal neurodevelopment in schizophrenia.

Truth and dare: patients dare to tell the truth when using PROMs in clinical practice.

As patient-reported outcome measures (PROMs) are increasingly used in clinical practice for screening, monitoring, and management, the potential for response bias has been raised (e.g., over-reporting problems for attention, under-reporting to avoid treatment changes/discontinuation). We investigated whether patients systematically bias their responses when they know clinicians will review their PROM results. We conducted secondary analyses of three experimental studies evaluating PROMs in adult and pediatric care. Prior to PROM completion, intervention group patients were informed that the results would be shown to their clinicians ("feedback" arm), whereas control group patients were told that their clinicians would not see their responses ("no feedback" arm). Independent sample t-tests compared the "feedback" and "no feedback" arms' PROM scores at baseline. Effect sizes and 95% confidence intervals were estimated using Cohen's d statistics with Hedges' g correction, and effect sizes > 0.50 were considered clinically relevant. Across the 29 domains assessed in the three studies, no between-arm differences reached an effect size of ± 0.50. Only 3/29 effect sizes exceeded ± 0.30. The confidence intervals for 14 domains included ± 0.50, with 4 favoring the "no feedback" arm and 10 favoring the "feedback" arm. Two domains reached statistical significance, one favoring the "no feedback" arm and one favoring the "feedback" arm. This study does not support the hypothesis that patients systematically bias their PROM responses if they know that clinicians will see their results. These findings support using PROMs in clinical practice as a valid mechanism to promote patient-centered care.

Maternal Gatekeeping Scale for infancy period (0–24 months) adaptation into Turkish: Mother and Father Form

This research aimed to adapt the Maternal Gatekeeping Scale into Turkish for use with infants and to evaluate its validity and reliability with parents. The study employed a descriptive survey model, a quantitative research approach. Participants were selected using criterion sampling, a purposeful sampling technique. The study sample included 305 mothers and 209 fathers with infants aged 0–24 months, who are married, living together, and agreed to participate. The data in the study were collected with the “Demographic Information Form” and “Maternal Gatekeeping Scale” created by the researcher. Confirmatory factor analysis was performed for the construct validity of the Maternal Gatekeeping Scale- Mother Form and Maternal Gatekeeping Scale- Father Form. The internal consistency reliability coefficient of the Maternal Gatekeeping Scale-Mother Form was 0.76; the control sub-dimension was 0.75, the encouragement sub-dimension was 0.81, and the obstacle sub-dimension was 0.76. The internal consistency reliability coefficient of the Maternal Gatekeeping Scale-Father Form was 0.87; the control sub-dimension was 0.83, the encouragement sub-dimension was 0.87, and the obstacle sub-dimension was 0.87. In order to calculate item discriminations, 27% lower-upper groups were formed and independent sample t-test was applied to these groups. Item-total correlation values were calculated to determine the relationship between each item in the scale and other items. The findings of this study demonstrate that both the Mother and Father Forms of the Maternal Gatekeeping Scale are valid and reliable tools for assessing maternal gatekeeping among parents with infants in Türkiye. The adaptation of this scale represents a significant advancement in the field of maternal gatekeeping during infancy. It is anticipated that this adapted scale will serve as a foundational resource for future research, facilitating the exploration of determinants and consequences associated with maternal gatekeeping in infancy.

Relationship between perceived value, attitudes, and academic motivation in distance learning among nursing students in rural areas

BackgroundNursing students manifest a distinct level of intellect and comprehension, impacting their attitudes and perceived significance of distance learning in education. This study examined the attitudes, perceived value, and academic motivation surrounding distance learning among Jordanian nursing students, offering insights crucial to optimizing their educational journey.MethodsA descriptive cross-sectional design was used. A convenience sample of 298 undergraduate Jordanian nursing students was recruited from two public universities in rural cities in south Jordan. Data were collected via self-reported instruments (June 2022 to August 2022). A Pearson correlation and independent t-test were used to examine the relationship between variables.ResultsThe mean age of students was 20.9 years (SD = 1.16), and most students have a low perceived value of distance learning (n = 181, 60.7%). Most students (n = 179, 60.1%) have negative attitudes toward distance learning, and only 39.9% reflected positive attitudes. More than half of the participants (n = 166, 55.7%) reflected less academic motivation toward distance learning. Positive significant relationships were found between students’ perceived value of distance learning and their attitudes and academic motivation toward distance learning; low perceived value of distance learning was related significantly with low attitudes (r = 0.844, p < 0.01) and less academic motivation toward it (r = 0.721, p < 0.01).ConclusionNursing students’ perceived value, attitudes, and academic motivation toward DL in rural regions is inadequate. Educators must provide valuable visions to expand the quality of health education in rural universities and improve health care.

Assessment of hearing and balance functions in patients with acromegaly by the use of an audiovestibular test battery: a cross-sectional study.

Patients with acromegaly may have abnormalities in their hearing and balance as a result of modifications in body composition and involvement of the temporal bone. The objective of this study is to examine if there are any changes in the auditory and vestibular systems in individuals with acromegaly by using audiogram and vestibular function tests. This prospective study included 33 healthy controls and 33 acromegaly patients who were matched for age and gender distribution. A pure-tone audiometry test was conducted, including frequencies ranging from 250Hz to 8000Hz. Videonystagmography (VNG) was employed to assess nystagmus, an essential parameter used for assessing vestibular functions. The Video Head Impulse Test (v-HIT) was used to assess the vestibulo-ocular reflex (VOR). The Dizziness Handicap Inventory (DHI) was applied to evaluate the subjective complaints of the participants. The acromegaly patients had significantly elevated hearing thresholds at all frequencies (250, 500, 1000, 2000, 4000, and 6000Hz) compared to the control group (p < 0.005). The VNG tests, including gaze horizontal, gaze vertical, saccade, spontaneous nystagmus, optokinetic, smooth pursuit, and positioning tests, did not show any statistically significant difference between the two groups (p values > 0.05). The patient group demonstrated reduced VOR gains compared to the control group in the anterior and posterior channels (p < 0.005). There was no statistically significant difference between the two groups for the occurrence of aberrant eye movements (p values > 0.05). The patient group had a total DHI score of 6.6 ± 3.2, while the control group had a score of 3.2 ± 2.6 (independent samples t-test; p < 0.001). Therefore, The patient group exhibited significantly greater subjective vestibular symptoms. Patients with acromegaly experience impaired auditory function. The central vestibular system remains unaffected, while the gains of the vestibulo-ocular reflex (VOR) in the posterior and anterior semicircular canals are decreased. Additionally, these patients report experiencing subjective dizziness. Screening for hearing and balance in patients with acromegaly may improve the quality of life of patients and prevent problems related to balance disorders at an early stage.

Attitudes of lecturers towards e-learning: BA ISAGO university

In Botswana e-learning is still in its infancy with most universities currently implementing different strategies to integrate e-learning into the teaching and learning process. A cross-sectional study was conducted to investigate whether the variables age, gender, training to use e-learning tools, e-learning experience, internet access, and computer skills were associated with the lecturer’s attitudes towards e-learning. The study consisted of thirty-eight randomly selected lecturers at BA ISAGO University, Gaborone campus. The data was collected using a closed-ended questionnaire with items that seek to ascertain their attitudes towards e-learning. To test out the study hypothesis descriptive statistics, Pearson correlations and independent samples t-test were computed. The results indicated that half of the participants had positive attitudes towards e-learning. Proving that e-learning was an acceptable teaching method to be utilised at this tertiary education institution. The study further showed that age and gender were not significantly associated with the lecturers’ attitudes towards e-learning. Also, the results indicated that there was no significant relationship between attitudes towards e-learning and training to use e-learning tools, e-learning experience, internet access as well as computer skills. It was therefore concluded that these variables had no impact on attitudes of lecturers towards e-learning as lecturers had become competent and confident in using computers as part of teaching methodology at BA ISAGO University. It is crucial for this university to strengthen the digital culture through training and support, and motivational strategies to build positive attitude towards e-learning.

Efficacy of Preoperative Autologous Blood Donation for Surgical Treatment of Thoracic Spinal Stenosis: A Propensity-Matched Cohort Study.

Thoracic spinal stenosis (TSS) surgeries necessitate a substantial amount of allogeneic blood resources. However, the efficacy of preoperative autologous blood donation (PABD) in TSS surgery has not been clearly evaluated. Therefore, we aimed to evaluate the efficacy of PABD for TSS surgery. This study is a retrospective study. Totally 397 patients who underwent TSS surgeries at our institution from January 2019 to June 2023 were included. Propensity score matching (PSM) was used to make the PABD and Non-PABD groups comparable at baseline. Regarding outcome measures, the incidence and amount of allogeneic blood transfusion, changes in postoperative hemoglobin and hematocrit levels, occurrence of postoperative complications, medical costs, drainage time, length of hospital stay, and postoperative neurological function were analyzed. The outcomes were compared between the matched PABD (n = 79) and Non-PABD (n = 79) groups. Univariate analysis methods were used for statistical analysis, including independent samples t-test, Wilcoxon rank-sum test, and chi-square test. The incidence of allogeneic blood transfusion (8.9% vs. 25.3%, p = 0.006) and volume of intraoperative red blood cell (RBC) transfusion (10.12 ± 54.52 vs. 122.78 ± 275.00 mL, p < 0.001) in the PABD group were significantly lower than those in the Non-PABD group. The PABD group had significantly higher average postoperative hemoglobin and hematocrit levels than the Non-PABD group at 1, 3, and 5 days after surgery (p < 0.05). Similarly, the PABD group exhibited a smaller reduction in hemoglobin and hematocrit levels compared with the Non-PABD group on 1, 3, and 5 days postoperatively. There were no significant intergroup differences in terms of transfusion-related complications, medical expenses, neurological function, length of hospital stay, or drainage time. Notably, PABD was an independent protective factor of allogeneic transfusion in the multivariate regression analysis (OR = 0.334, 95%CI = 0.051-0.966). PABD can effectively reduce the incidence of allogeneic blood transfusion and amount of allogeneic blood in TSS surgeries with safety. It also significantly improved the postoperative hemoglobin and hematocrit levels. Under the premise of clear indications, PABD is worth promoting for the surgical treatment of TSS.