Mann-Whitney Test Research Articles

Differences in physiological indicators between twin and singleton pregnancy.

It has been widely reported that there are physiological differences between twin and singleton pregnancies, as evidenced by physiological indicators examined during prenatal period. However, not all physiological indicators have been evaluated. Physiological indicators of twin pregnancies still refer to the standards of single pregnancies and lack precise variation intervals. Therefore, our study compared and analyzed the differences in physiological indicators between twin and singleton pregnancies. Retrospective cohort data of deliveries at Peking University Third Hospital from January 1, 2012, to February 8, 2021, were utilized. Information of pregnant women, including maternal characteristics, 49 physiological indicators examined during four periods (postpartum, first, second, and third trimester), and pregnancy complications, was extracted from medical records. Mann-Whitney test and multiple linear regressions were conducted to evaluate the differences in physiological indicators between twin and singleton pregnancies and to demonstrate their variation trend throughout gestation. A total of 40 746 cases were included (38 320 singleton pregnancy cases and 2426 twin pregnancy cases). In twin pregnancies, 16 indicators related to red blood cells, platelets, coagulation function, protein, creatinine, and blood lipids exhibited distinctions compared to singleton pregnancies throughout gestation. The results remained stable regardless of maternal complications. Twin and singleton pregnancies are in distinct physiological conditions. It is of great necessity to establish specific reference intervals for twin pregnancies. Further study is needed to investigate the impact of physiological indicators on predicting adverse outcomes in twin pregnancies.

Mid-term Results Following Surgical Hip Dislocation for Residual Pediatric Deformities.

Mid-term results following surgical hip dislocation (SHD) for healed slipped capital femoral epiphysis (SCFE) and Perthes-related deformities are limited. This study aimed to characterize patient-reported outcome measures [including rates of achieving the minimal clinically important difference (MCID) and patient-acceptable symptomatic state (PASS)], report survivorship free from conversion to arthroplasty, and identify risk factors associated with composite failure. Twenty-seven patients (n=13 SCFE, n=14 Perthes) with minimum 2-year follow-up (mean 5.7y) who underwent primary SHD from 2011 to 2021 were retrospectively reviewed. Modified Harris Hip Score (mHHS) and International Hip Outcome Tool-12 (iHOT-12) were collected preoperatively and at the latest follow-up. Composite failure was defined as not meeting any MCID/PASS threshold or conversion to arthroplasty. Continuous variables were analyzed using independent-sample t tests or the Wilcoxon Mann-Whitney test, where appropriate. Categorical variables were analyzed using χ2 or Fisher exact test, as indicated. Kaplan-Meier survivorship was determined. Mean mHHS improved from 56.2 to 77.2 (P=0.003) and from 63.0 to 86.3 (P<0.001), while iHOT-12 improved from 36.1 to 64.7 (P=0.008) and 36.8 to 77.2 (P<0.001) in SCFE and Perthes cohorts, respectively. MCID achievement for mHHS and iHOT-12 were 85.7% and 75.0% among SCFE, compared with 83.3% and 81.8% in Perthes. The proportion meeting PASS for mHHS and iHOT-12 was 30% for both in SCFE, compared with 61.5% and 83.3% in Perthes. 5- and 10-year survivorship free of conversion to arthroplasty was 100% and 80%, as well as 93% and 77% in the SCFE and Perthes cohorts, respectively. At mid-term follow-up, patients undergoing SHD for residual deformities related to chronic SCFE and Perthes demonstrated significant improvements in mHHS and iHOT-12, as well as relatively high rates of meeting MCID. SHD is an effective approach providing pain and functional benefit. Preoperative expectations, though, should be tempered in these cohorts, as some pre-existing damage limits the ability to completely normalize anatomy. Level III, retrospective comparative study.

Risk factors for gastric mucosa lesion in critically ill patients undergoing endoscopy for percutaneous gastrostomy: a case-control study

BackgroundPharmacologic prophylaxis for gastric ulcer is commonly prescribed in patients hospitalized in the intensive care unit (ICU). The aim of the study was to assess the current prevalence and risk factors for gastric mucosa lesion in ICU patients receiving standard pharmacologic prophylaxis undergoing endoscopy for percutaneous gastrostomy implantation.MethodsPatients hospitalized in the mixed medical-surgical ICU undergoing percutaneous endoscopic gastrostomy (PEG) were analyzed. We excluded patients receiving either no or high doses of intravenous proton pump inhibitor (PPI), only patients receiving standard doses of PPI were included. Data retrieved from the electronic medical records included: demographics, risk factors for gastric mucosa lesion (use of stimulants, comorbidities, medications, treatment methods in the ICU, laboratory derangements) and endoscopic findings. The study compared a group of patients with gastric mucosa lesions (cases) vs. patients without gastric mucosa lesions (controls). Inter-group comparisons between cases and controls were performed. Depending on the type of distribution continuous variables were assessed using two-sample t-test or Mann-Whitney test, whereas categorical variables with Chi-squared or Fisher exact test. Odds ratio (OR) with 95% confidence interval (95% CI) were calculated. Statistical significance was assumed at p < 0.05.ResultsPatients with no prophylaxis (n = 8) or receiving high doses (> 40 mg per day) of proton pump inhibitor (n = 2) were excluded. There were 182 patients receiving standard intravenous dose of PPI, 63 (34.6%) women and 119 (65.4%) men, with median age 61.5 (interquartile range IQR 46.0–70.0) years. Majority of patients (n = 169, 92.9%) were receiving pharmacological prophylaxis for venous thromboembolism. There were 53 (29.1%) patients with gastric mucosa lesion. The only risk factor that was significantly different between cases and controls was history of gastric ulcer (p = 0.04) with OR 3.8 (95% CI 1.1–12.5; p = 0.03).ConclusionsMajority of various risk factors for gastric ulceration may not predict gastric mucosa lesion in ICU patients receiving standard pharmacological prophylaxis undergoing endoscopy for PEG implantation. We found that history of gastric ulcer may be a risk factor for gastric ulceration in the ICU patients. Patients with history of gastric ulcer might benefit from higher than standard doses of anti-ulcer medication when hospitalized in the ICU.

The Effect of Access to Waterbodies and Parks on Walking and Cycling in Urban Areas

This pilot study investigated whether good and bad access to waterbodies and parks have different impacts on walking and cycling in neighborhoods in urban areas. Focusing on Paris, France, the neighborhoods were classified based on their access to the two natural environments through GIS analysis. Active mobility, past behavior, trip purpose, and subjective evaluation were collected through an online survey. The subjective evaluation included infrastructure satisfaction and the perception of transport mode choice, urban area aesthetic level, safety, health, and preference for active mobility over car use. Descriptive analyses, Mann–Whitney tests, and Fisher’s exact tests were conducted to compare between two access groups and between cycling and walking. Active mobility was mainly performed for utilitarian purposes. Weekly cycling frequency was found to be lower than walking. Access to natural environments mainly impacts walking. Contrary to general belief, cycling frequency is higher in neighborhoods with bad access to waterbodies than in ones with good access. Contrary to expectations, this study found little significant effect on active mobility in the accessibility to both natural environments. This study also highlights the influence of dominant active mobility purposes in urban areas with respect to access to natural environments, and provides a subjective evaluation for active mobility.

Sleeve Gastrectomy and Its Impact on Insulin Resistance and Metabolic Health: A Cohort Study.

Obesity is a prevalent metabolic disorder that significantly contributes to insulin resistance (IR), type 2 diabetes (T2DM), and metabolic syndrome. Sleeve gastrectomy has emerged as an effective surgical intervention for obesity, with potential benefits on metabolic health. This study investigates the impact of sleeve gastrectomy on serum insulin levels, IR (HOMA-IR), inflammatory markers, C-peptide, kidney function, and various biochemical parameters in diabetic and non-diabetic patients. A prospective cohort study was conducted, involving 199 patients over 18years old who were candidates for sleeve gastrectomy at Luqman Hakim Hospital from 2021 to 2022. Data were collected using standardized questionnaires and anthropometric measurements, and biochemical assessments were performed before surgery and 6months postoperatively. Statistical analyses included descriptive statistics, t-tests, Mann-Whitney tests, and repeated measures analysis of variances (ANOVA). The study included 199 patients (84.4% female) with a mean (± standard deviation (SD)) age of 39.79 ± 11.30years. Significant reductions were observed in weight, BMI, and abdominal circumference across all patient groups. Diabetic patients showed marked improvements in fasting blood sugar, 2-h postprandial blood sugar, and glycosylated hemoglobin levels. Insulin resistance decreased significantly, as did serum insulin and C-peptide levels. Improvements in lipid profiles and inflammatory markers were also noted. Insulin use post-surgery showed a significant inverse relationship with glycemic control improvement. Sleeve gastrectomy is a safe and effective procedure for obese patients, significantly improving insulin resistance and various obesity-associated diseases within 6months post-surgery.

Impact of postural variations on trunk rotation angle during the forward bending test in adolescents idiopathic scoliosis.

To evaluate the impact of different positions of adolescent idiopathic scoliosis (AIS) patients and examiners on the angle of trunk rotation (ATR) measured during the forward bending test (FBT) with Scoliometer. Adolescents who had come to the hospital for outpatient were recruited. Considering the location of the subject and the examiner, four postural combinations of ATR were measured. After measuring ATR, the subject underwent radiographic measurements for diagnosis of AIS. Mann-Whitney test was used for the inter-group reliability test in two examiners, and the Kruskal-Wallis test was used to measure intra-group differences in ATR for the four positions. The receiver operating characteristic curve and area under the curve were used to evaluate the diagnostic performance of ATR in AIS measured by different postures. Preplanned sensitivity analyses of the primary outcome were performed by subgroup. Of the 63 participants suspected of having AIS included, there was no statistically significant difference (P > 0.05) observed between ATR measurements taken in different postures. Only the measurements taken by the examiner from behind the subject demonstrated diagnostic capability for AIS (AUC = 0.73 for both feet together and apart, ). There was no statistically significant difference ( in diagnostic ability between the subjects who stood with feet together or apart. The sensitivity analysis supports the robustness of the conclusions ( . When the examiner measured from behind the subject, AIS can be effectively diagnosed, regardless of whether the subject is standing on feet apart or feet together. There is no difference in diagnostic ability in ATR between the two forward bending positions. Level III.

Alterations in the expression of genes involved in the mitochondrial apoptotic pathway upon exposure to lead oxide nanoparticles

Introduction. Lead production technologies pollute the air with aerosol nanoparticles, including those of lead oxide (PbO NPs). Lead can cause oxidative stress that leads to cell death. Experimental studies of effects of PbO NPs at the gene transcription level will expand our knowledge of the mechanisms of PbO NP toxicity and improve assessment of health risks for the population exposed to them. The purpose was to study the expression of genes involved in antioxidant protection and apoptosis following subchronic inhalation exposure of lead nanoparticles to rats. Materials and methods. Female albino rats were exposed to PbO NPs in an inhalation chamber at a concentration of 1.55 ± 0.06 mg/m3, 4 hours a day, 5 days a week for 1 month; the control group breathed clean air in a similar chamber. After exposure cessation, RNA was isolated from fragments of the olfactory bulb, cerebellum, lung, and liver. Expression of the P53, BAX, BCL-2, GSTM1, GSTP1, and SOD2 genes was determined by quantitative real-time PCR. The data was analyzed using the Mann-Whitney test. Results. In the olfactory bulb, BCL-2 gene expression was significantly lower, while that of P53 was higher in the exposed rodents compared to the controls. In the cerebellum of the exposed animals, BAX and P53 genes expression was statistically higher and lower than in the control group, respectively. BCL-2 gene expression in the liver was significantly lower in the exposed group. Limitations. The experiment involved only female rats, so it does not take into account sex differences and considers only gene expression, neglecting post-translational mechanisms and protein expression. Conclusion. Inhalation exposure to PbO NPs at the concentration of 1.55 ± 0.06 mg/m3 causes changes in the expression of genes associated with mitochondrial apoptosis in the brain and liver, but not in the lungs of laboratory rats.

Investigating the policy Effect of Medicine Subsidy Plan (Daruyar) on Patients' Out-Of-Pocket Payments :A Case Study of the General Health Insurance Administration of Isfahan Province

Background: The policy of removing the preferred drug currency (Daruyar plan) has been with the approach of increasing the coverage ratio and insurance obligations and paying attention to patients' out of pockets, especially incurable, chronic and low-income patients. Therefore, the purpose of this research is to investigate the effect of this plan on price and consumption ,and ultimately, the out of pocket payments after its implementation. Methods: The research method of this study was descriptive-analytical. Primary sampling included 5 pharmacies selected non-randomly and purposefully. After extracting the drug data of the insured persons related to these pharmacies from the database of the Health Insurance Organization, a sample of 384 people determined from the Morgan table was determined randomly and the number of 1803 items of medicine received by them was checked. Then the data was analyzed using SPSS 17 software and Mann-Whitney test. Results: The survey of 1803 items of medicine in the two periods of November 2021 and 2022 showed that the maximum amount of out-of-pocket payment in November 2021 was equal to 184,000,000 Rials and the average of this variable was 1,357,000 Rials and the median was 177,250 Rials. This number in 2022 was 92,000,000 Rials, 1,805,000 Rials respectively and 181,050 Rials. The results of the analysis of these data showed that after the implementation of Daruyar plan, due to the allocation of compensatory subsidies, there has been no significant change in the total out-of-pocket payment of the patients. Conclusion: This study investigated the effect of Daruyar plan on price changes, consumption and out-of-pocket payments of patients. The comparison of out-of-pocket payment data in the two time frames of November 2021 and 2022 showed that eliminating the preferred drug currency and implementing the drug subsidy plan has not made a significant change regarding patients' out-of-pocket payments.

Evaluating the anti-Candida effects of selenium nanoparticles impregnated in acrylic resins: An in vitro study

Background. Candida albicans in the oral cavity causes denture-induced stomatitis, but current treatments have side effects and contribute to drug resistance. Selenium nanoparticles (SeNPs) show promise as an antimicrobial agent, but their effectiveness against C. albicans is unknown and warrants further research. Methods. Acrylic resins containing different concentrations of SeNPs (0.2, 2, and 10 g/mL) were formulated and evaluated against C. albicans isolates. The minimum inhibitory concentration (MIC) of SeNPs was determined, and a fungal biofilm was developed on acrylic samples. The quantity of biofilm was assessed using scanning electron microscopy (SEM) and optical density (OD) at 570 nm after staining with crystal violet. Statistical analysis was performed using STATA software, with Kruskal-Wallis and Mann-Whitney tests to establish significance (P&lt;0.05). Results. The MIC of SeNPs was 25%. The OD in the group with 10% SeNPs was 0.477 and 0.547 in the group with 0.2%. Kruskal-Wallis test results showed that at least two groups among those studied had significant differences (P=0.0273). In pairwise comparisons, the differences between all the groups were statistically significant (P=0.049). SEM analysis confirmed the destruction of C. albicans cell walls, leading to reduced colonization, with the 10% group showing the highest efficacy. Conclusion. The study demonstrated that SeNPs are effective against C. albicans colonization when combined with acrylic resin. Specifically, SeNPs exhibited enhanced antifungal properties at a concentration of 10%. These findings confirm that SeNPs are a promising alternative to traditional antifungal agents for treating oral candidiasis and denture-induced stomatitis.

Trends and associated factors of mental health diagnoses in Catalan Primary Care (2010-2019).

The prevalence of mental health disorders has significantly increased in recent years, posing substantial challenges to healthcare systems worldwide, particularly primary care (PC) settings. This study examines trends in mental health diagnoses in PC settings in Catalonia from 2010 to 2019 and identifies associated sociodemographic, clinical characteristics, psychopharmacological treatments, and resource utilization patterns. Data from 947,698 individuals without prior severe mental illness, derived from the Data Analytics Program for Health Research and Innovation (PADRIS), were analyzed for this study. Sociodemographic data, diagnoses, and resource utilization were extracted from electronic health records. Descriptive statistics, chi-square tests, Mann-Whitney tests, and a multivariate binary logistic regression were employed to analyze the data. Over the study period, 172,112 individuals (18.2%) received at least one mental health diagnosis in PC, with unspecified anxiety disorder (40.5%), insomnia (15.7%) and unspecified depressive disorder (10.2%) being the most prevalent. The prevalence of these diagnoses increased steadily until 2015 and stabilized thereafter. Significant associations were found between mental health diagnoses, female sex, lower socioeconomic status, higher BMI, and smoking status in a multivariate binary logistic regression. This study highlights a growing burden of stress-related mental health diagnoses in PC in Catalonia, driven by demographic and socioeconomic factors. These findings may be indicative of broader trends across Europe and globally. Addressing this rising prevalence requires innovative approaches and collaborative strategies that extend beyond traditional healthcare resources. Engaging stakeholders is essential for implementing effective, sustainable solutions that promote mental health in Catalonia and potentially inform similar initiatives worldwide.

Can Broadening the Kidney Biopsy Criteria Reduce Misleading Diagnoses in Young Patients with End-Stage Renal Diseases? A Survey on the Sicilian Registry of Nephrology, Dialysis, and Transplantation

Audits allow analysis of the delivery of care and the prevalence of diseases. This study investigated kidney diseases’ impact on end-stage renal disease (ERSD) in patients younger than 30 years. Methods: This analysis is retrospectively conducted on young dialysis-dependent patients included in the Sicilian Registry of Nephrology, Dialysis and Transplantation Participants. It evaluated patients who started dialysis before the age of 30 retrieved in the mentioned registry. The sample was divided into two groups, according to the presence or absence of a specific diagnosis. Baseline features were reported as mean ± sd, median [IQR] and n (%). A Student T-test, Mann–Whitney test or Pearson Chi-Square test was performed. Logistic regression analysis detected the association between the variables and the unknown diagnosis, and variables with a p-value &lt; 0.2 were added to the multivariate model. ROC curves were drawn including this multivariate prediction. Results: In total, 145 patients started dialysis before the age of 30 years. Between patients with and without a diagnosis, the intake of renin–angiotensin–aldosteron system inhibitors (RAASIs) and blood pressure differed enough to be considered as possibly confounding. Logistic regression showed that blood pressure and RAASIs seemed to be related to the unknown diagnosis. ROC curves adjusted for RAASIs and blood pressure provided an AUC = 0.689. Conclusions: Although Kidney Disease Improving Global Outcomes (KDIGO) did not include hypertension among biopsy indications, our data suggest that performing renal biopsy in young patients with hypertension and worsening renal function could improve kidney diagnosis management.

The Neutrophil-Lymphocyte Ratio in Pediatric Preseptal and Orbital Infectious Cellulitis.

The neutrophil-lymphocyte ratio (NLR) is an important biomarker in a variety of systemic conditions, though its role in orbital disease remains unclear. We sought to investigate the utility of the NLR in distinguishing orbital cellulitis (OC) from preseptal cellulitis (PC) in a pediatric population. The earliest available NLRs of immunocompetent pediatric patients who presented to the emergency department with OC and PC were calculated from a single institution's database. Demographic and interventional data related to each encounter were also gathered. NLRs were compared via the Mann-Whitney test between OC and PC cases. Among patients with OC, the relationship between presenting NLR and requirement for surgical intervention and between presenting NLR and subperiosteal abscess was similarly examined. All statistical analyses were performed in GraphPad Prism 9 (Insight Partners, New York, NY, U.S.A.). Forty-three encounters of patients with OC and 23 encounters of patients with PC were identified. Median presenting NLR for the OC group was 4.18 (standard deviation: 5.44), whereas for the PC group, it was 1.96 (standard deviation: 2.38), representing a significant difference between the 2 groups (p < 0.001). The 26 patients with OC who required surgical intervention had significantly greater presenting NLR (median NLR: 6.53, standard deviation: 6.29) as compared to the 17 patients with OC who were managed medically (median NLR: 3.09, standard deviation: 2.37, p = 0.003). There was no statistically significant difference between 34 patients with OC who had a subperiosteal abscess (median NLR: 4.40, standard deviation: 5.91) and the 9 patients with OC who did not (median NLR: 3.84, standard deviation: 2.37, p = 0.401). An elevated NLR is a useful adjunct to the clinical examination in discerning OC from PC or in risk stratification for patients with OC who may need surgical treatment of their periocular infectious disease. In select cases, a reassuring NLR may allow the cost and radiation exposure associated with radiographic assessment to be avoided.

Evaluation of the Participation of Brazilian Women in Research in Oral Pathology and Oral Medicine.

Despite recent advancements, women still encounter significant challenges in various fields, including dentistry. However, the increasing interest in female participation in science acknowledges its fundamental role in the advancement of knowledge. This study aims to assess indicators of women's involvement in Brazilian research in the areas of Oral Pathology and Oral Medicine. This cross-sectional study evaluated 197 professionals affiliated with the Brazilian Society of Stomatology and Oral Pathology in 2023. Data were collected from publicly available Lattes curriculum and organized into three sets of information: researcher profile, scientific production and human resources formation. Both the data from the researcher's entire career and from the last 5 years (2019-2023) were assessed separately. Descriptive analyses of categorical variables were performed, while the Mann-Whitney test was employed to compare the numerical variables regarding researchers' gender. Of 197 professionals, 117 (59.4%) were female. Although there was no significant difference in scientific production between genders, men had more publications, received approximately twice as many citations, and exhibited higher H-index values compared to women. Notably, women surpassed men in undergraduate student supervision, while men predominated in supervising master's and PhD students. This study highlighted the relevance of female participation in Oral Pathology and Oral Medicine research in Brazil. However, disparities persist regarding women participation, especially in scientific article citations and postgraduate students' supervision.

Value of Platelet-to-Lymphocyte and Monocyte-to-Lymphocyte Ratios in Differentiating Idiopathic Orbital Inflammation From Orbital Infectious Disease.

Monocyte-lymphocyte ratio (MLR) and platelet-lymphocyte ratio (PLR) are emerging biomarkers; they have not been widely utilized in orbital disease. This study investigated the role of these ratios in distinguishing orbital inflammation from infection. A retrospective review of medical records was conducted to identify adult patients who presented acutely to a single emergency department at an academic medical center and were diagnosed with serologically and biopsy-proven idiopathic orbital inflammation (IOI, n = 9), orbital cellulitis (OC, n = 14), or necrotizing fasciitis (NF, n = 12). MLR and PLR were calculated from the first blood draw on presentation to the emergency department. Statistical analysis was performed via the Mann-Whitney test with a dedicated computerized software package (GraphPad Prism, La Jolla, CA) with p values <0.05 considered statistically significant. Mean PLRs were 194.90 (SD = 118.01), 304.21 (SD = 341.39), and 203.38 (SD = 196.32) for IOI, NF, and OC, respectively. Mean MLRs were 0.40 (SD = 0.24), 1.74 (SD = 2.41), and 0.75 (SD = 0.40) for IOI, NF, and OC, respectively. MLR was significantly lower in the IOI group compared to the NF group (p = 0.018) and OC group (p = 0.020). Differences in MLR between OC and NF groups were not statistically significant (p = 0.43). While MLR showed no significant difference between different infectious etiologies, it was significantly higher in infectious processes than in IOI, distinguishing inflammation from infection. MLR could be a valuable addition to the diagnostic toolkit for triaging patients in the emergency department and initiating prompt, focused therapy.

Introduction and Socialization of the SMART SOP (Standard Operating Procedure) Application to Malang Community Health Center Nurses

Technology in health services, both in hospitals and community health centers, plays an important role in increasing the effectiveness and efficiency of nurses' performance. One of the technological supports is the use of the SMART SOP application so that nurses' tasks can be effective, and efficient and reduce the risk of errors thereby improving the quality of service. The targets for this activity were Malang Community Health Center nurses. This activity aimed to increase knowledge and skills in using the SMART SOP application. The methods used include lectures, discussions, and simulations of application use. Include The results showed an increase in knowledge from an average score of 60.2 to 96.4 and the Mann-Whitney test shows p-value=0.000, which meant there was an influence of community service program on target knowledge. Meanwhile, skills in using the SMART SOP application on average increased to 85. The knowledge and skills possessed by nurses are important factors in adopting the use of SMART SOP in the workplace. With a good understanding of the working principles of SOPs and technological skills, nurses can more easily understand and implement procedures based on smart SOPs.

The Effect of Acupressure on Pain Associated with Chest Tube Removal in Patients with Chest Trauma

Background: Inserting a chest tube is a life-saving procedure for patients with chest trauma, but it is often associated with significant pain. To alleviate this discomfort, non-pharmacological methods such as acupressure can be employed. Therefore, this study aimed to determine the effect of acupressure on pain during chest tube removal in patients with thoracic trauma. Methods: This quasi-experimental study involved the selection of 204 patients with chest tubes following chest trauma in Zahedan in 2022. The through patients were selected purposefully and Non-random allocation divided into two intervention and control groups of 102 people. The intervention group received acupressure treatment, while the control group did not. Pain levels of the patients were measured using a pain intensity scale on both the day of chest tube insertion and the day of removal. The data were analyzed using statistical test such as independent-t, paired-t and chi-square statistical tests within the SPSS 26 software. Results: The normality of the main variable was assessed using the Kolmogorov-Smirnov (KS) test. The significance level for the pain variable was found to be less than 0.05 (P&lt;0.001), indicating a non-normal distribution. Therefore, the Mann-Whitney U test was utilized for data analysis. The results of the Mann-Whitney test revealed that before the intervention, the mean pain scores were 9.46±0.69 in the intervention group and 9.47±0.65 in the control group. After the intervention, the mean pain scores were 7.11±0.98 in the intervention group and 9.39±0.90 in the control group. Based on the Mann-Whitney U value obtained from the comparison of the two groups before and after the intervention, it can be concluded that the intervention had a significant effect on reducing pain (Table 2). Conclusion: The insertion and removal of chest tube after trauma can be an extremely painful experiences for individuals. Considering the crucial role of nurses, non-pharmacological methods such as acupressure can be used to alleviate their pain. Acupressure is a cost-effective, accessible, and readily available approach that can be utilized in this context.

Effect of Lime Solution Soaking on Physicochemical Characteristics of Catfish Bone Powder (Arius thalassinus)

Fish bone powder is one of the fisheries by product processing that has a high nutritional content, especially calcium and phosphorus content. In the processing of fish bone powder, the fishy odor is still detected due to organic compound such as protein and lipid which produce volatile compounds yielded unpleasant odor. The use of lime can eliminate fishy odors, improve color, shape, taste, texture, and extend shelf life. This study aimed to determine the difference of lime solution concentration on the physicochemical characteristics of catfish bone powder and to determine the best lime concentration used on the volatile compound content of catfish bone powder. The method carried out in this study was a laboratory experimental method and used a Complete Random Design (CRD) with 4 treatments (0%, 15%, 20%, 25%) and carried out in triplicate. Data analysis from physical and chemical tests were analyzed using ANOVA, while hedonic tests were performed using the Kruskal-Wallis test followed by the Mann-Whitney test. The results showed that soaking lime solution had a significant effect (P&lt;5%) on moisture content, protein content, fat content, ash content, calcium content and color. Catfish bone powder with the best treatment of soaking in lime solution of 20% contained a calcium of 25.17%.The results of the hedonic test showed that the best treatment (20%) had a confidence interval of 3.95 &lt; μ &lt; 4.19 from 5 scale. The volatile compound of 4-[4-(dimethylamine) Benzaldehyde associated with fishy odor was detected in fish bone powder without lime solution, but it could not be detected in sample soaked in 20% lime solution showing the capability of lime solution to reduce fishy odor in fishbone powder.

Exploring the Correlation Between Palliative Care Training in Brazil and Compassion Fatigue: A Cross-Sectional Study.

The literature lacks conclusive evidence regarding whether palliative care training confers a protective or predisposing influence on compassion fatigue. The present study hypothesizes that training in palliative care is associated with minor compassion fatigue levels among physicians and an improvement in their confidence in several procedures. To explore the physicians experiences with and without palliative care training who work as general practitioners in order to assess the prevalence of compassion fatigue in these groups. This is a quantitative and qualitative cross-sectional survey. For data analysis, Mann-Whitney and Pearson's chi-squared test tests were used considering P < 0.05 for significance. The majority respondents had no training in palliative care (77.8%), however, 58.3% declared that they cared for at least 1 palliative care patient every 2 shifts - an intermediate frequency in our analysis. Trauma levels among doctors were classified as medium (24 ± 6), burnout as low (19 ± 5) and compassion as medium (41 ± 5). Professionals without training in palliative care had higher rates of burnout (P = 0.002), but there was no association between training and rates of trauma or compassion. Doctors with training in palliative care in Brazil showed lower burnout rates when working as general practitioners in secondary hospitals. This could instigate the implementation of educational programs in palliative care at hospitals and the further development of the field so as to improve professionals' performance at patients' treatment. There was no difference between Trauma and Compassion scores.

RADHawk-an AI-based knowledge recommender to support precision education, improve reporting productivity, and reduce cognitive load.

Using artificial intelligence (AI) to augment knowledge is key to establishing precision education in modern radiology training. Our department has developed a novel AI-derived knowledge recommender, the first reported precision education program in radiology, RADHawk (RH), that augments the training of radiology residents and fellows by pushing personalized and relevant educational content in real-time and in context with the case being interpreted. To assess the impact on trainees of an AI-based knowledge recommender compared to traditional knowledge sourcing for radiology reporting through reporting time, quality, cognitive load, and learning experiences. A mixed methods prospective study allocated trainees to intervention and control groups, working with and without access to RH, respectively. Validated questionnaires and observed and graded simulated picture archiving and communication system (PACS)-based reporting at the start and end of a month's rotation assessed technology acceptance, case report quality, case report time and sourcing time, cognitive load, and attitudes toward modified learning strategies. Non-parametric regression analyses and Mann-Whitney tests were used to compare outcomes between groups, with significance set at P<0.05. The intervention group (n=28) demonstrated astatistically significant reduction in the case report time by -162s per case (95%CI -275.76s to -52.40s) (P-value = 0.002) and an increase of 14% (95%CI 8.1-19.8%) (P-value <0.001) in accuracy scores compared to the control group (n=29) at the end of the rotation. The intervention group also showed lower levels of mental demand (P=0.030) and experienced less effort (P=0.030) and frustration (P=0.030) while reporting. Additionally, >78% of the intervention group gave positive ratings on RH's effectiveness, increase in productivity, job usefulness, and ease of use. Eighty-nine percent of participants in the intervention group requested access to RH for their next rotation. This study demonstrates that RH, as the first reported AI-derived knowledge recommender for radiology education, significantly reduces reporting time and improves reporting accuracy while reducing overall workload and mental demand for radiology trainees. The high acceptance among trainees suggests its potential for supporting self-directed learning. Further testing of a larger external cohort will support more widespread implementation of RH for precision education.

The Effectiveness of Micro Learning Design on Storytelling Skills

Storytelling is an important skill in the world of education that can increase engagement, understanding, and conveying information in a more engaging way. This study aims to test the influence of micro-learning methods on students' storytelling skills by involving 500 respondents from Sultan Agung Islamic University (Semarang), University of Muhammadiyah Malang (Malang), STIBA-EIC (Jakarta), PGRI University of West Sumatra (Padang), Mataran State Islamic University (Lombok). Respondents were randomly selected from students in the city (30-40 students in each city), with an age range ranging from 19 to 22 years old. The domicile of the respondents came from the city and the surrounding area. The total number of respondents is 500. Of the 500 respondents, 100 respondents (20%) came from students majoring in foreign language colleges, 100 respondents (20%) came from the English language education department, and 300 respondents (60%) came from the Indonesian language and literature education department. The respondents were divided into two groups: experiments that used micro-learning and controls that used traditional methods. The learning design includes the introduction of learning objectives, understanding of storytelling elements, example video analysis, storytelling exercises, as well as recording and feedback. The results of statistical analysis using the Mann-Whitney test showed a significant difference between the two groups, with a significance value of 0.000 (p &lt; 0.05), which indicates that the micro-learning method has a positive and significant influence on improving students' storytelling skills compared to the traditional method. This indicates that we can reject the null hypothesis (H₀) which states that there is no significant difference between the two groups, and accept the alternative hypothesis (H₁) which states that there is a significant difference. These findings indicate that this approach is not only relevant for language teaching, but can also be adapted to various other forms of learning. With its flexible structure and customizable content, micro-learning can be applied in a variety of disciplines, such as science, mathematics, and art, by utilizing a variety of visual and narrative media.