Mean Research Articles

Long-term outcomes in sacral agenesis.

Sacral agenesis (SA) includes a range of clinical presentations of varying severity, with implications for function and quality of life (QoL). Diagnosis is often made perinatally, and prognostic discussions become an important aspect of parental counselling. This study engaged SA sufferers and their caregivers to obtain objective, long-term patient reported outcome data. Patients with radiologically confirmed SA from a single tertiary spinal unit underwent retrospective medical record review. Patients were then contacted by telephone to complete QoL questionnaires including EQ-ED-5L for adults and EQ-ED-Y for < 16-year-olds. Additional information including Renshaw grade, employment, living situation and bladder function was also collected. Twenty-six patients with SA were identified. Mean age is 23.35years (range 0.92-63.53), 13M:17F. Renshaw grade ranged from 1 to 4. Sixty-eight percent had associated kyphoscoliotic deformities. The majority (70%) had either impaired or absent bladder control, and 80% need walking aids to mobilise. Twenty patients completed the questionnaire (10 adults and 10 < 16-year-olds). Mean EQ-ED-5L index for adults was +0.474 (range -0.1 to +0.089, 1 = best), with a lower mean value of +0.287 (range -0.54 to +1) for the < 16-year cohort. Those undergoing spinal fusion procedures had significantly lower scores (-0.08 v +0.44, p = 0.022). This study provides an objective record of the QoL of individuals with SA, illustrating a wide variety of outcomes, with differences between younger and older individuals which may reflect the results of a long-term adaptive process. The implications for individuals should be carefully tailored to the specific deformity and the likely underlying neurological deficits.

A structural after measurement approach to structural equation modeling.

In structural equation modeling (SEM), the measurement and structural parts of the model are usually estimated simultaneously. In this article, we revisit the long-standing idea that we should first estimate the measurement part, and then estimate the structural part. We call this the "structural-after-measurement" (SAM) approach to SEM. We describe a formal framework for the SAM approach under settings where the latent variables and their indicators are continuous. We review earlier SAM methods and establish how they are specific instances of the SAM framework. Decoupled estimation for the measurement and structural parts using SAM possesses three key advantages over simultaneous estimation in standard SEM. First, estimates are more robust against local model misspecifications. Second, estimation routines are less vulnerable to convergence issues in small samples. Third, estimates exhibit smaller finite sample biases under correctly specified models. We propose two variants of the SAM approach. "Local" SAM expresses the mean vector and variance-covariance matrix of the latent variables as a function of the observed summary statistics and the parameters of the measurement model. "Global" SAM holds the parameters of the measurement part fixed while estimating the parameters of the structural part. Our framework includes two-step corrected standard errors, and permits computing both local and global fit measures. Nonetheless, the SAM approach is an estimation strategy, and should not be regarded as a model-building tool. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Effects of Post-Exercise Cold Water Immersion on Neuromuscular Control of Knee.

To date, most studies examined the effects of cold water immersion (CWI) on neuromuscular control following exercise solely on measuring proprioception, no study explores changes in the brain and muscles. The aim of this study was to investigate the effects of CWI following exercise on knee neuromuscular control capacity, and physiological and perceptual responses. In a crossover control design, fifteen participants performed an exhaustion exercise. Subsequently, they underwent a 10 min recovery intervention, either in the form of passively seated rest (CON) or CWI at 15 °C. The knee proprioception, oxygenated cerebral hemoglobin concentrations (Δ[HbO]), and muscle activation during the proprioception test, physiological and perceptual responses were measured. CWI did not have a significant effect on proprioception at the post-intervention but attenuated the reductions in Δ[HbO] in the primary sensory cortex and posterior parietal cortex (p < 0.05). The root mean square of vastus medialis was higher in the CWI compared to the CON. CWI effectively reduced core temperature and mean skin temperature and improved the rating of perceived exertion and thermal sensation. These results indicated that 10 min of CWI at 15 °C post-exercise had no negative effect on the neuromuscular control of the knee joint but could improve subjective perception and decrease body temperature.

#492 Ten-year experience treating osteoporosis with bisphosphonate in hemodialysis patients

Abstract Background and Aims The treatment of osteoporosis in patients undergoing hemodialysis (HD) has not been established, as there is insufficient evidence regarding the treatment of osteoporosis. The Kidney Disease: Improving Global Outcomes (KDIGO) 2017 guidelines suggest that determining the bone marrow density (BMD) of HD patients is useful. In 2011, we began treating HD patients' osteoporosis with alendronate. Herein, we describe the effects of the treatment based on our 10-year experience. Method This was a single-center prospective observational study of 85 HD patients (age 67.8 ± 11.0 yrs; 47 females, 38 males) treated for osteoporosis with alendronate at our hospital during the 10 years 2011–2021. The average observational period was 3.9 ± 2.9 years. The patients' BMD values including those at the lumbar spine, femoral neck, and total hip were determined by dual-energy X-ray absorptiometry. The patients whose first T-score was ≤ −2.5 were treated with alendronate. We evaluated the patients' yearly BMD measurements and their yearly values of bone metabolism markers, i.e., parathyroid hormone (PTH), bone alkaline phosphatase (BAP), and tartrate-resistant acid phosphatase 5b (TRACP-5b). Results We compared the data before and after the start of alendronate treatment by dividing the patients into a responder group (the patients whose T-score had improved at 1 year after treatment started; n=44) and a non-responder group (the patients whose T-score had not improved; n=32). The mean observational period of the responder group was significantly longer than that of the non-responder group (p&amp;lt;0.01). In a multiple regression analysis, a longer observational period was significantly associated with the improvement of T-scores (p=0.02). Only the mean T-score of the lumbar spine gradually improved during the study period; those of the femoral neck and total hip did not. Conclusion A long-term use of alendronate for the treatment of osteoporosis may be effective in hemodialysis patients, especially for the lumbar spine. Decisions regarding the effect of alendronate treatment for osteoporosis patients undergoing HD should not be made within only a year after the treatment initiation; rather, a longer observation period is necessary.

Total hip and knee arthroplasty after lower extremity amputation in a military population

IntroductionThe military includes lower extremity amputees requiring arthroplasty; however, there is little literature on this population. The primary aim of this study was to report demographics and clinical factors in...

Few-shot class incremental learning via robust transformer approach

Few-Shot Class-Incremental Learning (FSCIL)presents an extension of the Class Incremental Learning (CIL)problem where a model is faced with the problem of data scarcity while addressing the Catastrophic Forgetting (CF)problem. This problem remains an open problem because all recent works are built upon the Convolutional Neural Networks (CNNs)performing sub-optimally compared to the transformer approaches. Our paper presents Robust Transformer Approach (ROBUSTA)built upon the Compact Convolutional Transformer (CCT). The issue of overfitting due to few samples is overcome with the notion of the stochastic classifier, where the classifier's weights are sampled from a distribution with mean and variance vectors, thus increasing the likelihood of correct classifications, and the batch-norm layer to stabilize the training process. The issue of CFis dealt with the idea of delta parameters, small task-specific trainable parameters while keeping the backbone networks frozen. A non-parametric approach is developed to infer the delta parameters for the model's predictions. The prototype rectification approach is applied to avoid biased prototype calculations due to the issue of data scarcity. The advantage of ROBUSTAis demonstrated through a series of experiments in the benchmark problems where it is capable of outperforming prior arts with big margins without any data augmentation protocols.

Microhardness and elemental analysis of ion-releasing restoration/ dentin interface following enzymatic chemomechanical caries excavation

BackgroundThis study was conducted to compare chemical, elemental and surface properties of sound and carious dentin after application of two restorative materials resin-modified glassionomer claimed to be bioactive and glass hybrid restorative material after enzymatic chemomechanical caries removal (CMCR) agent.MethodsForty carious and twenty non-carious human permanent molars were used. Molars were randomly distributed into three main groups: Group 1 (negative control) - sound molars, Group 2 (positive control) - molars were left without caries removal and Group 3 (Test Group) caries excavated with enzymatic based CMCR agent. After caries excavation and restoration application, all specimens were prepared Vickers microhardness test (VHN), for elemental analysis using Energy Dispersive Xray (EDX) mapping and finally chemical analysis using Micro-Raman microscopy.ResultsVickers microhardness values of dentin with the claimed bioactive GIC specimens was statistically higher than with glass hybrid GIC specimens. EDX analysis at the junction estimated: Calcium and Phosphorus of the glass hybrid GIC showed insignificantly higher mean valued than that of the bioactive GIC. Silica and Aluminum mean values at the junction were significantly higher with bioactive GIC specimens than glass hybrid GIC specimen. Micro-raman spectroscopy revealed that bioactive GIC specimens showed higher frequencies of v 1 PO 4, which indicated high level of remineralization.ConclusionsIt was concluded that ion-releasing bioactive resin-based restorative material had increased the microhardness and remineralization rate of carries affected and sound dentin. In addition, enzymatic caries excavation with papain-based CMCR agent has no adverse effect on dentin substrate.

ECMWF Ensemble Forecasts of Six Tropical Cyclones That Formed during a Long-Lasting Rossby Wave Breaking Event in the Western North Pacific

The ECMWF‘s ensemble (ECEPS) predictions are documented for the lifecycles of six tropical cyclones (TCs) that formed during a long-lasting Rossby wave breaking event in the western North Pacific. All six TC tracks started between 20° N and 25° N, and between 136° E and 160° E. All five typhoons recurved north of 30° N, and the three typhoons that did not make landfall had long tracks to 50° N and beyond. The ECEPS weighted mean vector motion track forecasts from pre-formation onward are quite accurate, with track forecast spreads that are primarily related to initial position uncertainties. The ECEPS intensity forecasts have been validated relative to the Joint Typhoon Warning Center (JTWC) Working Best Track (WBT) intensities (when available). The key results for Tokage (11 W) were the ECEPS forecasts of the intensification to a peak intensity of 100 kt, and then a rapid decay as a cold-core cyclone. For Hinnamnor (12 W), the key result was the ECEPS intensity forecasts during the post-extratropical transition period when Hinnamnor was rapidly translating poleward through the Japan Sea. For Muifa (14 W), the key advantage of the ECEPS was that intensity guidance was provided for longer periods than the JTWC 5-day forecast. The most intriguing aspect of the ECEPS forecasts for post-Merbok (15 W) was its prediction of a transition to an intense, warm-core vortex after Merbok had moved beyond 50° N and was headed toward the Aleutian Islands. The most disappointing result was that the ECEPS over-predicted the slow intensification rate of Nanmadol (16 W) until the time-to-typhoon (T2TY), but then failed to predict the large rapid intensification (RI) following the T2TY. The tentative conclusion is that the ECEPS model‘s physics are not capable of predicting the inner-core spin-up rates when a small inner-core vortex is undergoing large RI.

Low back pain, work overload, and associated factors among hospital caregivers.

Caregivers assist patients in treatment based on their care needs and living activities. Very few studies have been conducted specifically on the occupational health and safety of hospital caregivers. This study aimed to investigate the prevalence of excessive workload and low back pain among hospital caregivers and to identify potential associated factors. This cross-sectional study included caregivers working at Gazi University Hospital. Socio-demographic and working-life characteristics were assessed. The Role Overload Scale was used to determine excessive workload and the Roland-Morris Disability Questionnaire was used to evaluate low back pain. The study included 528 participants. A total of 18.7% had work accidents in their department. 49.0% had sharp injuries. 68.9% of the participants performed tasks such as positioning, turning, lifting, or helping patients to walk. 72.2% stood for a long time during the workday. 52.8% thought that they worked under stress. 57.6% had low back pain in the last year and 38.6% in the last month, Significant differences exist in low back pain according to gender, body-mass index, standing for a long time and working under stress. Those who worked at night, had a work accident, positioned patients, stood for a long time, and worked under stress had higher mean scores on the Role Overload Scale. Tools should be used to lift and transport patients. In addition to occupational health and safety training, awareness of musculoskeletal risks should be increased. Employee well-being can be improved through exercise and stress reduction techniques.

Different doses of hyaluronic acid injections in patients with knee osteoarthritis: A multicenter, randomized, prospective, single-blind, clinical study.

Many formulations and dosing regimens are available for hyaluronic acid (HA). To compare different doses of linear, high-molecular weight (HMW) HA injections among patients with knee osteoarthritis (OA). Hundred patients were included in this randomized, single-blinded trial and randomly divided into three HA injection groups. The first group received five weekly 20mg HA injections, the second group received three weekly 32mg HA injections, and the third group received a single 48mg HA injection. Patients were evaluated at baseline, 1, 3, and 6months after the last injection for pain, stiffness, and function using the visual analog scale (VAS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire. Quality of life, patient's global assessment, and Timed Up and Go (TUG) test scores were also evaluated. There was significant improvement in the WOMAC, VAS-pain, quality of life, patient's global assessment, and TUG test mean scores at all follow-up time points (p< 0.001). However, the groups showed no significant differences in WOMAC, VAS-activity pain, and patient global scores at any follow-up point. Intra-articular injections of different doses of linear HMW HA can improve pain, stiffness, function, and quality of life in patients suffering from knee OA over a six-month period.

Vitamin D level and low-energy fracture risk in children and adolescents: a population-based case-control study of 45 cases.

The objective of this study is to document the rate of vitamin D deficiency and insufficiency among children with low-energy fractures and compare it to fracture-free control group. We included all children under 15 years presenting to the emergency department with low-energy fractures; controls were children without history of fractures from the outpatient department. Conventional X-ray and laboratory blood tests were performed. Vitamin D deficiency was defined as serum level ≤20 ng/ml, and the mean values were compared through two-sample t -tests. The influence of vitamin D on the fractures was defined using Chi-square test, significance with P -value < 0.05. The relationships between variables and odds of fracture occurrence were examined using logistic regression models. The final sample included 37 cases (30 males, 7 females, 7.4 ± 3.7 years) and 70 control individuals (42 males, 28 females, 7.8 ± 4.6 years) without significant differences regarding age, sex, and month of inclusion. Children with fractures had lower levels of vitamin D (21.87 ± 8.40 ng/ml vs. 25.89 ± 7.62 ng/ml) ( P = 0.01). Vitamin D played a protective role against low-energy fractures (OR, 1.08; 95% CI, 1.01-1.14; P = 0.02), boys showed three times greater fracture risk than girls (OR, 3.00; 95% CI, 1.12-8.07; P = 0.03). Finally, vitamin D deficiency correlated with almost five times increased risk of pediatric low-energy fractures (OR, 4.63; 95% CI, 1.92-11.18; P = 0.001). This is the first MENA study establishing a relation between vitamin D deficiency and low-energy fractures among children and adolescents. The findings show the protective role of vitamin D on the pediatric bone and may help physicians preventing morbidity on children and costs on their families and the socioeconomic health system.

Adaptive dynamic programming and distributionally robust optimal control of linear stochastic system using the Wasserstein metric

SummaryIn this paper, we consider the optimal control of unknown stochastic dynamical system for both the finite‐horizon and infinite‐horizon cases. The objective of this paper is to find an optimal controller to minimize the expected value of a function which depends on the random disturbance. Throughout this paper, it is assumed that the mean vector and covariance matrix of the disturbance distribution is unknown. An uncertainty set in the space of mean vector and the covariance matrix is introduced. For the finite‐horizon case, we derive a closed‐form expression of the unique optimal policy and the opponents policy that generates the worst‐case distribution. For the infinite‐horizon case, we simplify the Riccati equation obtained in the finite‐hozion setting to an algebraic Riccati equation, which can guarantee the existence of the solution of the Riccati equation. It is shown that the resulting optimal policies obtained in these two cases can stabilize the expected value of the system state under the worst‐case distribution. Furthermore, the unknown system matrices can also be explicitly computed using the adaptive dynamic programming technique, which can help compute the optimal control policy by solving the algebraic Riccati equation. Finally, a simulation example is presented to demonstrate the effectiveness of our theoretical results.

A comparison of the phonation quotient between patients with voice disorders caused by benign vocal fold lesions and normal adults 20-80 years of age

Background: A voice evaluation is an important first step in analyzing voice symptoms and determining appropriate treatment plans. The phonation quotient is a valid aerodynamic parameter in voice evaluations which is an indirect source of information for evaluating the valve function of the vocal folds of patients with voice disorders, especially patients with voice disorders caused by tumors of the vocal folds which is the most common cause in the patients with voice disorders. Objective: The present study aims to determine and compare the phonation quotient between patients with voice disorders caused by benign vocal fold lesions and normal adults between 20-80 years of age. Materials and methods: The participants comprised 40 adults with voice disorders caused by benign vocal fold lesions and 40 with normal voices. All participants’ voices were evaluated in the Speech Clinic at Ramathibodi Hospital, Bangkok. The phonation quotient (PQ) was calculated by the ratio of vital capacity (VC) to the maximum phonation time (MPT). VC and MPT were measured using a phonatory aerodynamic system (PAS). Results: The results of the present study indicated that the mean value of the PQ of adults with normal voices was 122.60 cc/sec (SD=16.36). The mean value of the PQ of adults with voice disorders caused by benign vocal fold lesions was 292.08 cc/ sec (SD=97.14). The mean value of the PQ in the group with voice disorders caused by benign vocal fold lesions was significantly more significant than the mean value of the PQ in the group with normal voice. Conclusion: The significant difference between the phonation quotient of adults with voice disorders caused by benign vocal fold lesions and adults with normal voice was that the PQ might be an indicator for indirect evaluation of the airflow leakage related to the efficiency of vocal fold movement during phonation. The PQ can be the optional voice measurement for monitoring and analyzing the outcomes of voice therapy.

Changes in Calcaneal Bone Density and Correlation With Clinical Outcomes Following Ankle Fractures

Introduction: The study investigates the long-term bone quality and its influence on clinical results after surgical treatment of Weber B-type fractures. Methods: Surgery treated isolated Weber B-type fractures between 2006 and 2016 were included. Bone density was determined by ultrasonography densitometry of the calcaneus. American Orthopedic Foot and Ankle Society (AOFAS), Foot Function Index, Olerud-Molander-Ankle-Score, Hannover-Score, and Short Form Health Survey SF 36 were recorded. Results: Sixty patients were followed up. Mean follow-up was 6.6 years (range, 2 to 12 years). Mean bone density T-score of the treated foot was significantly lower than that of the contralateral untreated side (−0.6 versus −0.3; P = 0.05). Higher T-scores on the injured side were significantly and positively correlated with improved outcomes in the AOFAS, Olerud-Molander-Ankle-Score, and SF-36 physical component summary but negatively correlated with the Hannover score (P ≤ 0.05). A significant correlation existed only between the pain scores of the AOFAS and Foot Function Index. Controlling for potential confounding variables, such as age and smoking status, in a linear regression model, increased bone density was only associated with the AOFAS score. Discussion: A significant reduction in bone density persists for more than eight years in some individuals. Statistically significant correlation between reduced bone density and clinical outcomes was found only for the AOFAS scoring system.

Association of Contrast Sensitivity with Eye Disease and Vision-Related Quality of Life

To investigate contrast sensitivity (CS) as a screening tool to detect eye disease and assess its association with both eye disease and vision-related quality of life. Cross-sectional study. Setting and population: Adults receiving care from a free clinic and a Federally Qualified Health Center in Michigan. Screening positive for eye disease and Visual Function Questionnaire (VFQ) score. Participants received a vision exam reviewed via telemedicine for disease, completed a demographic survey, and the 9-item VFQ. The ability of CS to predict eye disease was explored and area under the curve (AUC) is reported. Logistic and linear regression were used to investigate the continuous effect of CS on the probability of screening positive for eye disease and VFQ score, respectively, adjusting for age and visual acuity. 1159 included participants were, on average, 54.9 ± 14.5 years old, 62% identified as female, 34% as White, 54% as Black, 10% as Hispanic/Latino, and reported mean VFQ score of 79.7 ± 15.3. CS ranged from 0.00 to 1.95 log units (mean = 1.54 ± 0.24), 21% of eyes had glaucoma, 19% cataract, 6% DR, and 2% AMD. AUCs were 0.53 to 0.73. A 0.3 log unit decrease in better eye CS was associated with increased odds of glaucoma (odds ratio [OR] = 1.35, confidence interval [CI] = 1.09-1.67), cataract (OR = 1.35, CI = 1.05-1.72), DR (OR = 2.05, CI = 1.51-2.77), and AMD (OR = 2.08, CI = 1.10-3.91). A 0.3 log unit increase in better eye CS was associated with a 5.9 unit increase in VFQ. While CS alone is not sufficient to identify people with eye disease, it is an important measure of visual function that can add value to comprehensive eye screening.

What Do Nurses Working in Primary Health Care Services Know About Medical Waste Management?

With the increase in population, the need for health services also uprises the production of medical waste. Nurses have important responsibilities in the management of medical waste with great risks for human and environmental health. The search was conducted as a descriptive study in order to evaluate the know ledge level of nurses working in primary health care units about medical waste. The research was conducted with nurses (N=80) working in primary health care units in a province in Türkiye/Central Anatolia Region, between January 5 and February 5, 2020, actively working, not on leave/report and volunteering to participate in the search (n=75). The data of the study were collected with the “Medical Waste Information Level Determination Form”. The form consisted of three parts, including socio-demographic characteristics, separation of waste types, and knowledge level of medical waste use, and 49 questions. In the results of the study, the mean score of nurses' knowledge of sorting waste types was 9.9±2.7 (min: 3, max:15 points), while the mean of medical waste use knowledge score was 19.2±2.7 (min:10, max:23 points).In order to meet the knowledge need of nurses, it should be ensured that the level of knowledge is determined, the practices in the field are supervised and developed, and in-service trainings should be provided within this scope.

Focal brain oxygen, blood flow, and intracranial pressure measurements in relation to optimal cerebral perfusion pressure.

Different paradigms for neurocritical care of traumatic brain injury (TBI) have emerged in conjunction with advanced neuromonitoring technologies and derived metrics. The priority for optimizing these metrics is not currently clear. The goal of this study was to determine whether achieving cerebral perfusion pressure (CPPopt) also improves other metrics like brain oxygenation and brain blood flow. The authors performed a retrospective analysis of high-frequency data from patients with TBI who were treated at a single center and who had partial pressure of brain oxygen (PbtO2) measurements and/or brain blood flow measurements, while also undergoing intracranial pressure (ICP) monitoring. CPPopt was not calculated or targeted during patient care, but was retrospectively computed, as was the difference between the observed CPP and CPPopt. A total of 22 patients with ICP, PbtO2, and/or brain blood flow monitoring were included in the analysis, and 245.7 days of measurements obtained every second were analyzed including 6,748,866 PbtO2 measurements, 3,296,405 blood flow measurements, and 10,264,770 ICP measurements. The data obtained every second were averaged by minute for analysis. In summative data, PbtO2 measurements peaked near CPPopt and were not improved above CPPopt. Blood flow measurements remained stable near CPPopt, decreased below it, and increased when CPP exceeded CPPopt. ICP decreased linearly with CPP without a specific relationship with CPPopt. In an inverse analysis, the percentage of CPP values at CPPopt, although significantly higher on the favorable side of contemporary treatment thresholds of PbtO2, ICP, and blood flow, was not found to be strongly correlated with the mean values of the physiological measurements obtained every minute (r = 0.27, r = 0.11, and r = 0.47 for ICP, PbtO2, and blood flow, respectively; p < 0.0001). Although CPPopt was not targeted in the patients in this study, CPPopt was a physiologically significant value based on concurrent measurements of PbtO2 and blood flow. In summative data, achievement of CPPopt was associated with optimized PbtO2 and blood flow. Conversely, the correlation between achievement of CPPopt and the mean measurement value was not strong, strengthening the significance of CPPopt. In individual patients, achieving CPPopt is not always associated with optimal PbtO2 or blood flow. Further research should explore these relationships in treatment paradigms that specifically target CPPopt. These data do not support the premise that targeting and achieving CPPopt obviates the need for concurrent PbtO2 and blood flow monitoring. Although these data suggest that targeting CPPopt may be an appropriate initial treatment strategy, they do not provide evidence that CPPopt should be targeted with highest priority.

교양교육에서 AI 창작품을 활용한 융복합 시 교육 실제

This study aims to explore and argue the significance of using AI and new me dia to promote new reading and creative expression among liberal arts education learners. After exposing liberal arts education learners to the AI poetry book “Why Write Poetry” and the AI poetry drama “Paphos,” this study was designed to create “video poems” using new media based on the above experiences. This is because it is assumed that through AI creations, liberal arts education learners will approach works using AI with interest, and furthermore, they will continue to ‘write’ their thoughts and imagination as an opportunity to explore ‘me’ by analyzing the mean ing and expression inherent in AI creations. More specifically, this study asked learners who read AI creations to create poetry texts based on their impressions and to write and revise video poetry plans using new media. We chose video poetry production using new media for the following reasons. The learners were exposed to A.I. poetry and poetry theater, and understood the im ages in poetic texts and stage performances. However, it is not possible to produce enough poetry texts and poetry plays for learners to gain educational efficacy im mediately based on the contents of the class. Therefore, this study introduced a new creative method that incorporates video. Since learners have had many opportuni ties to encounter video texts through social media and online, the teaching method of creating video poems using new media is a new writing method designed in line with the modern IT era that allows learners to take a break from traditional literary writing and gain a sense of accomplishment. To summarize the results of this class In this study, liberal arts education learn-ers were asked to write an essay through the production and presentation of video poems using A.I. creations, and analyzing their essays, many changes occurred, unlike before when they were not interested in poetry or poetry plays. Furthermore, the learners were able to share the video poems with their fellow learners’ inner concerns, and sincerely acquire interest and enjoyment in the medium and genre of literature. Ultimately, through the above liberal arts education, learners were able to break away from their self-centered perspective, understand the feelings of others, and develop a mutual respectful attitude through other people’s writings and videos. The educational process designed in this study is a method designed to empa thize and communicate with each other’s inner ‘subjectr’ and ‘valuesr’ despite the fact that the learners are from various majors. In particular, what is expected from this study is that it can help the development of liberal arts education by realizing creative, fusion and convergent educational theories and analyses in response to the future society that has already arrived, and realizing them in university education classes.

Life Function Analysis of a Two-Parameter Exponential Distribution Using Robust Rank Regression

In this research, a proposed method is presented to estimate the life function of the two-parameter exponential distribution by using the robust rank regression on the dependent variable, which depends on the robust variance-covariance matrix (the FMCD and OGK method) and the robust mean vector through which the rank regression coefficients are estimated using the method of ordinary least squares and employing it in estimating the scale and location parameters of the exponential distribution and thus analyzing the life function on its basis. A comparison was also made between the proposed method and the classical method of rank regression on the dependent variable of life data at different sample sizes (from 10 to 25) to show the efficiency of the proposed method based on the mean square error of the estimated parameters, through a program prepared by the researcher in MATLAB language dedicated to this purpose. The practical application results concluded that the proposed robust method of rank regression on the dependent variable in estimating the parameters of the exponential distribution was more efficient than the classical method. Paper type: Research paper.

The Relationship between Nurses’ Attitudes towards Evidence-Based Nursing and Barriers to Research Utilization: A Cross-Sectional Survey

Objective: This study was conducted to determine the relationship between nurses’ attitudes towards evidence-based nursing and barriers to the use of research. Methods: This study was a descriptive cross-sectional survey. The study carried out with 500 nurses working in a state hospital in Turkey. The data were collected with using a Nurse Descriptive Form, the Evidence‐Based Nursing Attitude Questionnaire and the Barriers to Research Utilization Scale. The analysis of data was used the independent sample t-test, ANOVA test, Kruskal Wallis analyses, post hoc test (Tamhane’s), Mann Whitney U-test, and Pearson’s product moment correlation. Results: The mean age of the nurses was 31.50 ± 7.57 years, 72.6% of them were female, and 54.4% had bachelor degree level education. The nurses’ Attitude Scale item total mean score was 3.58 ± 0.48. The belief subscale of this scale has the highest score with 3.80 ± 0.59. The nurses’ Barriers Scale item total mean was 2.65 ± 0.28. On this scale, the subscale with the highest score was setting, with 3.04 ± 0.47. Nurses’ between attitude and barriers scale item total mean was found a weak correlation (r = 0.199, p &lt; .05). Conclusion: Nurses had highly positive attitudes towards evidence-based nursing. They had a medium level of barriers to the use of research. The nurses’ greatest barriers came from the subscale of setting. Even though nurses’ scores on attitudes towards evidence-based nursing were high, it was seen that there were barriers to the use of research. For this reason, a plan should be developed to increase nurses' knowledge and awareness of the research process that will increase compliance with future protocol practices, through the implementation of evidence-based nursing and identifying barriers to research use.