Maximum Score Research Articles

Safety and Technical Feasibility of Percutaneous Renal Cryoablation of Central Tumors without Pyeloperfusion

PurposeTo assess the safety and technical success of percutaneous cryoablation (PCA) without pyeloperfusion in 94 patients with central renal tumors. Materials and MethodsA retrospective review of all central renal tumors treated by PCA without pyeloperfusion was performed. Central tumors were defined as those involving the renal sinus fat on preprocedural cross-sectional imaging. Patient demographics and baseline tumor characteristics were recorded. The details of the PCA procedure, primary and secondary technical success, rates of local recurrence, adverse events (AEs), cancer-specific survival (CSS), and overall survival (OS) were compiled. ResultsNinety-four patients (48 females [51%]; mean age, 68.2 years [range, 38–87 years]) with 94 central renal tumors were included. The mean maximal tumor diameter and mean RENAL nephrometry score were 37 mm (range, 15–67 mm) and 8 (range, 4–11), respectively. Primary technical success was achieved in 94% (n = 88) of procedures. Of the patients who did not achieve primary technical success, 3 underwent successful repeat PCA (secondary technical success, 97%; n = 91/94). The other 3 patients were surveilled for residual disease. Twenty-four patients (26%) required hydrodissection during PCA. Six patients (6%) experienced major AEs after PCA including hemorrhage requiring embolization (n = 3), hemorrhage requiring transfusions with admission (n = 2), and perinephric abscess necessitating drain placement (n = 1). Twenty-two patients (23%) experienced minor AEs. Nine patients (10%) experienced local recurrence during the follow-up period. OS was 94% (n = 88/94), whereas CSS was 98% (n = 92/94) during the study follow-up period (mean, 16 months [range, 1–102 months]). ConclusionsPCA of central renal tumors appears to be safe with high rates of technical success, even without the use of pyeloperfusion.

Perception of Students Towards the Climate of Professionalism in the Dental Colleges of the Twin Cities in Pakistan

Background: The purpose of this research was to assess dental students' opinions on professionalism teaching and behaviors in their clinical experience during their student years in order to improve the establishment of a curriculum in professionalism for dental students in the Twin Cities of Rawalpindi and Islamabad, Pakistan.
 Materials and Methodology: The cross-sectional cohort questionnaire-based study assessed 3rd and 4th year BDS students' professionalism using a "Climate of Professionalism" survey over a 6-month period. In the first section, students evaluated the frequency of 11 clinical behaviors as "rarely," "occasionally," or "mostly." The second section gathered feedback on 10 professional behaviors taught by instructors, scored as 1, 2, or 3. Demographic data like mean age, year percentages, and gender ratio were collected. Descriptive analysis was conducted. Total scores for all participants were added and the responses were compared between 3rd and 4th-year students, and significance was set at p < 0.05.
 Results: For each academic year, the mean total scores of participants' assessments of the professional conduct of dental students, residents, and professors were close to 70% of the total maximum score. The mean overall scores of participants who evaluated the professionalism of faculty members' teaching and modeling behaviors were almost 80% of the maximum score of 30. Comparing results with studies worldwide, the ratings fared similar to peer researches.
 Conclusion: The study highlights the current state of professionalism in the dental teaching institutes of Rawalpindi and Islamabad. Positive ratings, at 70% and 80%, reveal opportunities for further analysis and potential nationwide research. These findings suggest alignment with global professionalism trends thus facilitating the establishment of a standardized professional culture, improving patient responses, and strengthening trust between practitioners and patients.

Implementing a Patient-Reported Outcome Dashboard in Oncology Telemedicine Encounters: Clinician and Patient Adoption and Acceptability.

Telemedicine provides numerous benefits to patients, yet effective communication and symptom assessment remain a concern. The recent uptake of telemedicine provided an opportunity to use a newly developed dashboard with patient-reported outcome (PRO) information to enhance communication and shared decision making (SDM) during telemedicine appointments. The objective of this study was to identify barriers to using the dashboard during telemedicine, develop implementation strategies to address barriers, and pilot test use of this dashboard during telemedicine appointments in two practice settings to evaluate acceptability, adoption, fidelity, and effectiveness. Patients and clinicians were interviewed to identify determinants to dashboard use in telemedicine. Implementation strategies were designed and refined through iterative feedback from stakeholders. A pilot study of dashboard use was conducted from March to September 2022. Acceptability, adoption, and fidelity were evaluated using mixed methods. SDM was evaluated using the collaboRATE measure. One hundred two patient encounters were evaluated. Most patients (62; 60%) had completed some PRO data at the time of their telemedicine encounter. Most (82; 80%) encounters had clinician confirmation that PRO data had been reviewed; however, collaborative review of the dashboard was documented in only 27%. Degree of SDM was high (mean collaboRATE score 3.40; SD, 0.11 [95% CI, 3.17 to 3.63] out of a maximum score of 4). Implementation strategies focused on patient engagement, education, and remote PRO completion. Clinician-facing strategies included education, practice facilitation, and small tests of change. This study demonstrated that implementation of a PRO-based dashboard into telemedicine appointments was feasible and had acceptable adoption and acceptability by patients and clinicians when several strategies were used to engage end users. Strategies targeting both patients and clinicians are needed to support routine and effective PRO integration in telemedicine.

Evaluating patient experience to improve care in a specialist antenatal clinic for pregnancy after loss

In the United Kingdom, roughly 1 in 250 babies are stillborn each year. Most women who experience stillbirth become pregnant again – 80% within a year of loss. Presently, obstetric-led care is recommended; though there is a growing body of evidence to support provision of specialist services. The Rainbow Clinic is a specialist antenatal service providing care for pregnancies after loss incorporating clinical and psychological care. This study aimed to assess patient experience at the Rainbow Clinic and identify areas for clinical improvement. A 13-item questionnaire was distributed to pregnant women who attended the Rainbow Clinics at the Oxford Road and Wythenshawe sites of Saint Mary’s Hospital, Manchester, UK between July 2016 and June 2021. Descriptive statistics and unpaired t-test were used for quantitative data and summative content analysis for qualitative data. Four-hundred and fifty-six women completed the questionnaire. The mean patient experience score per quarter was stable with an average of 21.1 (± 3.0) for the five years, with a maximum attainable score of 25. The COVID-19 pandemic had no effect on patient experience at the Rainbow Clinic (pre-pandemic vs. during-pandemic: mean 21.2 v 21.3; p = 0.75). Free-text responses demonstrated women felt positively about the antenatal care received. Identified areas for improvement included “more awareness of the [Rainbow] sticker” to ensure women with previous loss are identified; increased publicity of the Rainbow Clinic services; developing more clinics at different locations to improve accessibility; and continuing specialist input into intrapartum care. Specialist antenatal care provided by the Rainbow Clinic was rated as of a high standard. Potential future improvements include sticker alterations (or other mechanisms to identify women who have experienced a previous loss) and develop increased awareness of the clinic in other institutions.

Knowledge of cervical cancer prevention and screening among women at Thai Binh hospital of Obstetrics and Gynecology in 2023

Objectives: To describe knowledge of cervical cancer prevention and screening and to identify associated factors among women at Thai Binh Hospital of Obstetrics and Gynecology in 2023. Participants and methods: A descriptive cross-sectional study design was conducted among 400 women aged 21-65 years at Thai Binh Hospital of Obstetrics and Gynecology to collect data on knowledge of cervical cancer prevention and screening by using a self – reported questionnaire. The maximum score for the general knowledge was 46 points. Results: The percentage of participants with good knowledge of cervical cancer prevention and screening was 38.8%. Knowledge of cervical cancer prevention and screening was related to age, occupation, and education level. Conclusion: The knowledge of cervical cancer prevention and screening among the women in the research was quite low. Therefore, it is necessary to strengthen communication and health education for women at the hospital by providing more information sheets (posters, leaflets...) about cervical cancer, vaccination and screening, therefore,they may improve their knowledge while getting the healthcare service at the hospital.

The 2020 immunization programme landscape: Piloting an assessment metric to evaluate the maturity of national immunization programmes across the life course

BackgroundThe World Health Organization (WHO) encourages countries to provide appropriate vaccinations for children, adolescents, and relevant adult populations. Childhood programme have been the focus of global investments, but recent pandemics have increasingly demonstrated the value of life course vaccination. Our objective is to compare national life course immunization programmatic maturity prior to mass COVID-19 vaccine introduction, the largest adult vaccination programme, globally. As coverage estimates (typically used to assess childhood programmes) are not available for adult vaccinations, this analysis pilots a standardized quantitative metric of programmatic maturity. MethodsThrough consultation with vaccination experts, we developed a standardized approach to assess national immunization programme maturity across the life course. In accordance with expert input, five vaccines were selected to represent delivery across the life course: diphtheria tetanus toxoid and pertussis (DTP); measles (MCV) second dose; human papillomavirus (HPV) final dose; pneumococcal conjugate (PCV) final dose; and seasonal influenza annual dose. Experts recommended inclusion of the following indicators for each vaccine: a legal mandate (national policy), experience delivering the vaccine (programme duration), and vaccine use (uptake for relevant populations). We developed a metric accordingly that provides up to 5 points per vaccine (“vaccine specific maturity score”) which when summed forms the “life course maturity score”, with a maximum score of 25. We analysed the prevalence of national policies, experience, and use by region and World Bank income group. ResultsMore than 55% of the 194 WHO Member States had childhood vaccine policies for all three of the vaccines considered (DTP, MCV, and PCV) compared to 60% for HPV (proxy for adolescent vaccination programme) and 52% for seasonal influenza (proxy for adult vaccination programme). Childhood vaccination programmes (e.g., MCV and DTP) had the highest vaccine specific maturity scores, while seasonal influenza and HPV vaccination programmes had much lower scores. The national life course maturity scores ranged from 1 to 23, with a global median of 12 (IQR: 8; 16). DiscussionThe piloted metric provides an overview of the maturity of life course immunization programmes. The metric is structured to be a flexible, rapid resource that can be used to assess other combinations of vaccines across the life course. The findings from this paper provide a baseline of immunization programme maturity for childhood, adolescent, and adult vaccination programmes immediately prior to the COVID-19 vaccine introduction. This maturity score, or adaptations of this approach, could be used to monitor the trajectory of national immunization programme maturity across the life course in the years ahead.

Satisfacción de los pacientes con los cuidados enfermeros en una Unidad de Cuidados Intensivos medida a través de la escala Nursing Intensive-Care Satisfaction-Scale (NICSS)

BackgroundPatient satisfaction in relation with nursing care has become a key determinant of the quality of hospital care. ObjectivesTo evaluate patient satisfaction in relation with nursing care in a critical care context; to determine the correlation between critical patient satisfaction and sociodemographic and clinical variables and to describe patient perceptions with nursing care. MethodsA descriptive, prospective, correlational study which includes the analysis of some open questions in the intensive care unit (ICU) of a tertiary level university hospital. The degree of satisfaction of all patients discharged from de ICU was evaluated. It was used the validated Spanish version of Nursing Intensive-Care Satisfaction-Scale (NICSS). There were also collected sociodemographic and clinical data and 3 open questions were asked. It was used the inferential and descriptive statistics considering statistically significant P<.05. Open questions were examined using a language context analysis. The approval of the hospital ethical committee was obtained. Results111 patients agreed to participate, with a mean age of 64,18 years (CI 95% 61,36-66,88) and with a medium level of satisfaction of 5,83 (CI 95% 5,78-5,88) being 6 the maximum score. Women, older patients and those who reflect a higher degree of recovery, are those who reported greater satisfaction. Three main themes emerged from the analysis of the open-ended questions of the surveys: nurse patient relationship, professional practice environment and ICU nature. ConclusionPatient satisfaction in relation with nursing care was elevated. Age, sex and degree of recovery significantly influenced their perception. Nurse patient relationship and the professional practice environment were aspects highlighted by patients. The professional model incorporated by the institution may encouraged these results.

Artificial Intelligence Assisted Recognition of Anatomical Landmarks and Laparoscopic Instruments in Transabdominal Preperitoneal Inguinal Hernia Repair.

Laparoscopic TAPP (Trans-Abdominal PrePeritoneal) is a minimally invasive surgical procedure used to repair inguinal hernias. Arguably, one important aspect to TAPP hernia repair is the identification of anatomical landmarks and the correct use of various laparoscopic instruments. There are very few studies regarding the use of artificial intelligence in laparoscopic inguinal hernia repair and more specifically in TAPP. The aim of this study is to evaluate the feasibility and usefulness of AI in the recognition of anatomical landmarks and tools in laparoscopic TAPP videos. Imaging data have been exported from 20 Laparoscopic TAPP videos that have been performed by the authors and another 5 high quality TAPP videos from the internet (free access) performed by other surgeons. In total 1095 selected images have been exported for annotation. To accomplish the AI result of computer vision, the YOLOv8 model of deep learning was used. In total 2716 segmented areas of interest have been exported. The AI model was able to detect the various classes with a maximum F1 score of .82 when the confidence threshold was set to .406. The mAP50 was .873 for all classes. The Precision was above 50% when the confidence was over 10%. The Recall rate was above 50% when confidence was less than 70%. These results suggest that the model is effective at balancing precision and recall, capturing both true positives and minimizing false negatives. Artificial Intelligence recognition of anatomical landmarks and laparoscopic instruments in TAPP is feasible with acceptable success rates.

Perceptions of Leprosy in the Maldives: A cross-sectional study

The aim of the study is to assess the knowledge, attitude and practices regarding leprosy. A cross sectional survey of a nationally representative sample was implemented among the resident adult population (18 years and above) across the islands of Maldives. The survey sample size estimated was 1181 and a total of 1024 respondents completed the survey accounting for a response rate of 86.7%. The questions to measure indicators of knowledge, attitude and practices regarding leprosy were adopted from existing validated instruments used for leprosy KAP studies. The findings show a low level of knowledge with a mean of 3.5 in the KAP measure, where the maximum score is eight. However, the attitude and practices score does not indicate a high level of negative attitudes and practices (below the mid-point). The mean score of EMIC-CSS is 12, slight inclination towards less negative attitudes (EMIC-CSS scale scores ranges from zero = no negative attitudes, to 30 = most negative attitudes). The mean score of SDS is 8.9 indicating moderate level of negative practices (SDS scale scores ranges from zero = no negative practices to 21 = most negative practices). As Leprosy in the Maldives is no longer a public health burden, and the disease prevalence is extremely low, it has created a situation where there is very little awareness and correct knowledge about the disease among the public as well as health care workers. The attitudes and practices from the family and community are not at alarming levels in terms of stigma and social distancing. However, the low level of knowledge raises the concern that cases may be missed and as patients may be missed as they may not seek healthcare for early diagnosis and treatment

Integrating in silico molecular docking, ADMET analysis of C.verticillata with diabetic markers and in vitro anti-inflammatory activity

BackgroundOver the past decade, various research studies have proved the interconnection between the inflammatory pathways and diabetes complication in clinical condition. The present study evaluated the anti-inflammatory and antioxidant activity. Further, the sample was tested for its pharmacokinetics properties and the best compounds were docked with the diabetic markers (DPP IV (PDB-ID: IJ2E) and SGLT2 (PDB-ID: 7VSI)).ResultsC.verticillata showed a good hydrogen peroxide (78.3 ± 0.34%, IC50 = 287.81 µg/ml) and superoxide scavenging activity (52.7 ± 1.26%, IC50 = 796.15 µg/ml). In addition, the sample was checked for its anti-inflammatory activity with protein denaturation (57.4 ± 0.19%, IC50 = 471.5 µg/ml) and proteinase inhibition assay (68.3 ± 0.48%, IC50 = 213.42 µg/ml). Further, the bioactive compounds detected from HPLC-ESI-MS/MS analyzed sample were checked for its drug likeliness by checking its ADME properties and toxicological parameters. It has been observed that except Loliolide, all the other compounds have followed the physicochemical parameters and proved to exhibit drug likeliness characteristics. The bioactive compounds that follow the Lipinski’s rule were taken further for in silico molecular docking analysis with the diabetic protein markers (DPP IV and SGLT2). Docking results revealed that Pyro pheophorbide a with DPP IV and Dihydromonacolin L acid with SGLT2 have recorded a maximum docking score of (− 9.4 kcal/mol) and (− 9.2 kcal/mol), respectively.ConclusionThe observed results suggest that the identified and selected bioactive compounds from C.verticillata can be considered as a potential target molecule for the management of oxidative stress induced diabetic condition. Furthermore, the study also provides an insight on the effectiveness of the compounds on reducing the inflammation as well.

Association of Stressful Life Events With Oral Health Among Japanese Workers.

Psychological stress can cause various mental and physical health problems. The previous results on stress and oral health are inconsistent, possibly because of the narrow stress measurements. We aimed to examine the association between a broader range of stressful life events and oral health among workers. This cross-sectional study analyzed anonymous individual data from a national survey in Japan. Data on stressful life events, oral health problems which are one or more of tooth pain, gum swelling/bleeding, and difficulty chewing, and covariates were obtained using a self-reported questionnaire. Covariates used included gender, age group, and disease under treatment. Logistic regression analysis was used to estimate the association between stressful life events and oral health problems. We then estimated the causal treatment effects of stress using the augmented inverse-probability weighting (AIPW) method. Among the 274,881 subjects, 152,850 men (55.6%) and 122,031 women (44.4%) with a mean age of 47.0 (standard deviation, 14.4) years, 4.0% reported oral health problems, with a prevalence of 2.1% among those without any stress. The prevalence increased with stress score, reaching 15.4% for those with the maximum stress score. The adjusted odds ratio of this group compared to those without any stress was 9.2 (95% confidence interval [CI], 8.2-10.3). The estimated prevalence of oral health problems by the AIPW analysis was 2.2% (95% CI, 2.1-2.3%) for those without any stress and 14.4% (95% CI, 12.1-16.7%) for those with the maximum stress scores. There was a clear dose-response association between stressful life events and oral health problems.

Using the 5-Item Medication Adherence Report Scale (MARS-5) to Screen for Non-adherence to Vitamin and Mineral Supplementation After Bariatric Surgery

IntroductionPoor adherence to recommended vitamin and mineral supplementation after bariatric surgery is common and challenging for healthcare professionals to identify. There are several questionnaires for self-reporting of adherence to chronic medication, but none has so far been evaluated for assessment of adherence to vitamin and mineral supplementation after bariatric surgery. The aim of this study was to assess the accuracy of the 5-item Medication Adherence Report Scale (MARS-5) in measuring adherence to vitamin and mineral supplementation post bariatric surgery (gastric bypass or sleeve gastrectomy).MethodThe psychometric properties of MARS-5 for vitamin and mineral supplementation were validated in two cohorts: one at 1 year post bariatric surgery (n = 120) and the other at 2 years post-surgery (n = 211). MARS-5 was compared to pharmacy refill data for vitamin B12 and combined calcium/vitamin D as reference.ResultsCorrelation analyses demonstrated that the MARS-5 had acceptable validity compared to objectively measured adherence rates from pharmacy refill data (calculated as continuous, multiple-interval measures of medication availability/gaps-coefficient ranged from 0.49 to 0.54). Internal reliability (Cronbach’s α) was high: 0.81 and 0.95, respectively. There was a clear ceiling effect where one out of three had a maximum score on MARS-5.ConclusionMARS-5 demonstrated acceptable psychometric properties for assessment of adherence to vitamin and mineral supplementation post bariatric surgery.Graphical

Health-Related Quality of Life in Adolescents during Quarantines Due to COVID-19 Pandemic: The Effect of Physical Activity and Gender

Given that deterioration of adolescents’ health status during pandemic is well documented, health related quality of life (HRQoL) assessment is very important, as it contributes in adolescents’ development and maturation into healthy adults. The main purpose of the study was to assess adolescents’ HRQoL during the two strict lockdowns due to COVID-19. Secondary aims were to examine differences in HRQoL with regard to gender, and physical activity/sport participation before and during lockdowns. It was a cross-sectional study and conducted during first and second strict lockdowns. Three hundred and sixty-three adolescents (Ν=363) from secondary schools, in the Greek territory (108 boys and 255 girls) filled in the TNO-AZL Questionnaire for Children’s Health-Related Quality of Life Children’s Form, online, once. Also, demographic and anthropometric data were collected. For all TACQOL-CF subscales results showed that scores were lower, than the maximum subscales scores. Also, adolescents’ responses to open questions supported further the low subscales scores. In addition, adolescents who participated in sport before lockdowns reported better scores in motor functioning/performance during lockdowns than their non-physically active peers (p&lt;0.05). Moreover, girls reported significantly lower scores compared to boys in general physical functioning/complaints subscale (p&lt;0.05). The findings of this study highlighted that during the two strict quarantines adolescents’ HRQoL was deteriorated. Sport participation before the pandemic influenced positive HRQoL during quarantines and also quarantines affected differently adolescents by gender. Thus, the results should give information in adopting preventive strategies by policy makers to alleviate long-term negative consequences, in order adolescents to gain pre-pandemic HRQoL levels, in the transitional post-COVID-19 era.

Optimized gated a SPECT-derived myocardial salvage index: its prognostic significance in predicting major adverse cardiac events following acute myocardial infarction percussion.

Estimate myocardial salvage index (MSI) using a single-gated Single-Photon Emission Computed Tomography (SPECT) myocardial perfusion imaging (GSMPI) early after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) and compare its predictive value with the traditional method especially for post-PCI left ventricular ejection fraction (LVEF) improvement and major adverse cardiac events (MACEs). GSMPI was performed in 62 patients with AMI early after PCI (3-10days). The MSI and the conventional parameters were obtained, including total perfusion deficit, LVEF, peak ejection rate (PER), and peak filling rate (PFR). The new calculation method (scoring evaluation method means the extent of abnormality is the percentage of the total scores of abnormal segments divided by the sum of the maximum scores of all myocardial segments using 4-point and 5-point scale semi-quantitative scoring method) and the reference method (number evaluation method means the extent of abnormality is the percentage of the number of abnormal segments divided by the total number of myocardial segments) were applied to acquire the MSI. We compared the predictive ability of the 2 methods based on the area under the receiver operating characteristic curve for LVEF improvement 6months after PCI using MSI. The Kaplan-Meier method was used for depicting survival curves for predicting MACEs by the 2 methods. Cox proportional-hazards regression was applied to confirm the independent predictors of MACEs. The MSI obtained by the new method indicated stronger prognostic significance in LVEF improvement [area under the curve (AUC): 0.793, 95% confidence interval (CI) 0.620-0.912, P < .001] compared with the reference method (AUC: 0.634, 95%CI 0.452-0.792, P = .187). Delong's test revealed a statistically significant difference in AUCs between the 2 methods (P < .05, 95%CI 0.003-0.316). The diagnostic value of the scoring evaluation method was higher than that of the number evaluation method. The Cox prevalence of MACEs was substantially higher in the < median MSI group than in the ≥ median MSI group (hazard ratio: 0.172; 95% CI 0.041-0.724; P < .05] using the new method, whereas no considerable differences were observed between the 2 groups using the reference method (P = .12). Further, the multivariate Cox regression analysis revealed that MSI was an independent indicator for predicting MACEs (P < .05). The MSI obtained from a simple GSMPI early after PCI, using the scoring evaluation method, was a reliable prognostic indicator for predicting LVEF improvement and MACEs in AMI. It remarkably improved the prognostic value compared with the previous reference methods.

Genetic evaluation of crossbred Bos indicus cow temperament at parturition.

Cow temperament at parturition may be mostly a measure of aggressiveness. The heritability of cow temperament at parturition in Bos taurus cows has been reported to be low. The objectives of this study were to estimate the heritability of cow temperament at parturition, conduct a genome-wide association analysis of cow temperament at the time of parturition, and estimate the correspondence of cow temperament at the time of parturition with cow productive performance and early-life temperament traits in Bos indicus crossbreds. Cow temperament was assessed from 1 to 5 indicating increasing levels of aggressiveness of cows (937 cows and 4,337 parturitions) from 2005 to 2022. Estimates of heritability and repeatability were 0.12 ± 0.024 and 0.24 ± 0.018. The estimates of proportion of phenotypic variance were 0.13 ± 0.019 and 0.02 ± 0.011 for permanent and maternal permanent environmental components, respectively. Estimates of heritability for maximum lifetime temperament score and proportions of temperament scores >1 were 0.18 ± 0.07 and 0.13 ± 0.072. Within cycles (generations), 2-yr-old cows had lower temperament score means than cows in most other age categories. There were low to moderate positive estimates of unadjusted correlation coefficients (r = 0.22 to 0.29; P < 0.05) of unadjusted temperament score with temperament measured on the same females when they were 8 mo old. There were low to moderate positive estimates of correlation coefficients (r = 0.09 to 0.37; P < 0.05) of unadjusted temperament score with calving rate, weaning rate, weaning weight per cow exposed, and weaning weight per 454kg cow weight at weaning. Cows with the lowest temperament score had lower (P < 0.05) calving and weaning rate than cows in other temperament categories. Within 3 of 5 cycles, cows with the lowest temperament score (totally docile) had lower (P < 0.05) weaning weight per cow exposed than cows in other temperament categories. There were 2 SNP on BTA 4 associated with maximum lifetime temperament score (FDR < 0.05). The non-genetic influence of a cow's mother was documented in her own temperament measured at the time of calving; this may be a consequence of learned behavior. Less aggressiveness displayed by cows at the time of calving may be accompanied by lower reproductive and maternal performance.

Association between game metrics in a simulation game and nursing students’ surgical nursing knowledge – a quasi-experimental study

BackgroundSimulation games are effective for acquiring surgical nursing knowledge during education by offering possibilities to learn theoretical knowledge through practical patient scenarios, thus preparing students for demanding surgical nursing care. Game metrics stored in the game system enable assessment of students’ behaviour while gameplaying. Combining game metrics with the assessment of a student’s surgical nursing knowledge allows versatile information to be obtained about the student’s learning outcomes. However, studies on game metrics stored in systems and their relationship with learning outcomes are scarce.MethodsThe aim here was to evaluate the association between game metrics in a simulation game and nursing students’ surgical nursing knowledge. Nursing students from three universities of applied sciences in Finland participated in a one-week simulation gameplaying intervention that included five surgical nursing scenarios. Students’ surgical nursing knowledge was investigated with a quasi-experimental, one-group, pre- and post-test design using a surgical nursing knowledge test. In total, 280 students filled in the knowledge tests. In addition, cross-sectional game data were collected at a single time point between pre- and post-tests. The data were analysed with descriptive statistics and multivariate analysis methods.ResultsStudents’ surgical nursing knowledge improved with the intervention. The total number of playthroughs was 3562. The mean maximum score was 126.2 (maximum score range 76–195). The mean playing time of all playthroughs by all players was 4.3 minutes (SD = 81.61). A statistically significant association was found between mean score and knowledge test total score (p < 0.0072), but no significant association emerged between mean playing time and knowledge test total score.ConclusionThe results indicated that the higher the mean score the better the students’ surgical nursing knowledge in the knowledge test. This study did not show that the time spent playing had an impact on students’ post-playing knowledge. Our findings support the idea that game metrics can be used in performance evaluation and the results can be used to improve nursing students’ readiness for challenging preoperative and postoperative clinical situations.

Pengaruh Pola Pikir Ibu Terhadap Kecenderungan Stunting di Desa Sidodadi

Stunting is a slowing of growth in children whose height is shorter than children of their age and also has an impact on the psychological, intellectual, mental, psychological, and motor. As many as 43.5% of cases of stunting in Indonesia are experienced by children under five with a vulnerable mother's age between 14-15 and ages between 16-17 years as much as 22.4% are the result of early marriages. The purpose of this study was to find out how the mother's mindset influences the tendency of stunting in Sidodadi Village. This study uses a quantitative approach to the type of research to measure the value of the variables studied. Primary data is in the form of mother's mindset and upbringing, secondary data on stunting events which are influenced by mother's upbringing. The research sample consisted of 62 toddlers from 7 hamlets with an age range of 0-59 months as of August 2022. Data collection used a simple random sampling technique. Data on maternal parenting patterns were obtained through interviews with village midwives. From the data using the SPSS program, the maximum score on the mother's mindset scale is 24, the minimum score is 12 and the average is 18.22, while the maximum score on the parenting scale is 21, the minimum is 13 and the average is 15.59. From the associative test obtained an F value of 84.961 and a significance value of 0.000. Stunting in Sidodadi village is caused by several factors, one of which is parenting style and mother's mindset.

Evaluation of Knee Radiograph and its Interrelation between Body Mass Index and Range of Motion in Osteoarthritic Knee

Abstract Context: Assessing knee osteoarthritis (OA) radiologically is a well-recognised investigation technique. Range of motion (ROM) measurement gives an idea about the functional status of the joint. Body mass index (BMI) increment is one of the risk factors of worsening knee OA. Aim: The aim of this study was to evaluate OA radiologically and to search the status of BMI, ROM and Kellgren–Lawrence (KL) score of osteoarthritic knee patients and find their interrelations. Settings: This study was conducted at the department of physical medicine and rehabilitation in a tertiary hospital of Bangladesh. Designs: This was a cross-sectional study. Methodology: Purposive selection of 66 primary OA knees was done. Compartmental distribution of osteoarthritic knee was determined. Radiographics were determined by KL score system. BMI was calculated conventionally. Maximum flexion, extension and total excursion were measured by a universal goniometer. Results: Fifty per cent of participants had tricompartmental OA. Patients with maximum KL score 2 had significantly more total excursion (127.44 ± 2.89) compared to maximum KL score 3 (121.51 ± 3.14) and 4 (110.00 ± 3.58). Subjects with normal BMI had significantly more total excursion (125.00 ± 4.21) compared to overweight (121.03 ± 6.84) and obese patients (122.54 ± 4.31) (P = 0.044). 60.9% of subjects with normal BMI had significantly more maximum KL score 2 compared to overweight (33.3%) and obese patients (7.7%). A positive correlation was present between BMI and maximal KL score (r = 0.345, P = 0.005). A significant strong negative correlation was found between maximal KL score and total excursion (r = −0.825, P &lt; 0.001). Conclusion: Different percentages of unicompartmental, bicompartmental and tricompartmental knee OA were found. Osteoarthritic patients with higher BMI had lower ROM and increased KL radiographic scores.

Study on psychological well-being and its determinants among elderly people attending geriatric clinic at Medical College, Kolkata

Background: Significant growth in the proportion of older people in India will lead to changes in the country’s society. If common psychological problems such as depression and anxiety are not addressed, they can have lasting effects on individuals, particularly older individuals. It has the potential to impair the management of ongoing chronic illnesses and result in both physical and mental limitations. Aims and Objectives: The objective was to assess the psychological well-being (PWB) of the study participants attending the geriatric outpatient department and its contributing factor(s). Materials and Methods: A descriptive, cross-sectional, hospital-based study was conducted in the Geriatric Clinic of Medical College, Kolkata, among 301 geriatric people during a 1-year time period. The assessment of PWB was done using Ryff’s PWB scales, 42-item version. The analysis of the data was done using SPSS version 16. Results: The mean age of the participants was 66.68 (±6.48) years. The mean PWB score was 156.2 ± 18.6 according to Ryff’s PWB scales. The minimum score was 94, and the maximum score was 226. Poor PWB was seen among 50.8% of the elderly. Conclusion: Poor PWB among seniors and several factors such as current living arrangements, socioeconomic status, employment history, history of recent injury, and patients’ spiritual history play an important role. To handle the issue, new and modified geriatric health policies are very much needed.

Small-sided-games with coaches' verbal encouragement have a positive effect on aerobic performance, mood state, satisfaction and subjective effort in male semi-professional soccer players

The study aimed to examine the impact of high-intensity Small-Sided Games (SSGs) with coaches’ verbal encouragement (VE) on soccer players’ aerobic performance, mood state, satisfaction and subjective effort. Forty-three semi-professional male soccer players were randomly assigned to three distinct groups: a control group (CG, n = 14), an experimental group with verbal encouragement (EGVE, n = 14), and an experimental group without verbal encouragement (EGNE, n = 15). Participants performed the VAMEVAL aerobic test, Total-Mood-Disorder (TMD), and the Satisfaction Scale for Athletes (SSA) tests before and following the 6-week SGGs program that included ten training sessions. Rating of Perceived Exertion (RPE) was collected 5-minutes post-training session. The SGGs program with coaches’ VE showed a significant improvement in maximal aerobic velocity (MAV) and TMD scores (p &lt; 0.05). Except for the SSA scores (p = 0.268), the percentage of change was higher for MAV (p = 0.001; d: 1.36–1.48 (large)) and TMD scores (p = 0.001; d: 1.45–1.48 (large)) in the EGVE group when compared with the other groups (i.e., EGNE and CG). Overall, RPE scores were significantly higher (p ˂ 0.05; d: 0.99–5.00 (large)) in the EGVE group than other groups. The present study highlights the positive effects of integrating SSGs with coaches VE to improve aerobic performance and mental well-being of semi-professional soccer players. Nevertheless, notably the SSA did not exhibit a statistically significant difference. Furthermore, the experimental EGVE group reported elevated RPE, potentially suggesting that SSGs may entail greater physical and mental challenges, yet may yield more sport-specific outcomes for soccer players.