Non-parametric Wilcoxon Test Research Articles

Food Labels (Quality, Origin, and Sustainability): The Experience of Czech Producers

Food labels allow producers to promote the unique selling points of their products and help consumers buy products with value-adding qualities. The aim of the present article is hence to explore Czech food producers’ expectations and experience with selected food labels. The selection was narrowed down to enterprises that had succeeded in the certification processes within the food labeling systems of European quality and origin labels (protected designation of origin (PDO), protected geographical indication (PGI), and traditional specialty guaranteed (TSG)), as well as schemes that fall under the remit of the Ministry of Agriculture of the Czech Republic, such as Klasa (Česká potravina/Czech food, Regionální potravina/regional food, and BIO). The research was made using an online questionnaire in January–February 2018, and was focused on determining possible discrepancies in expectations that the companies had before applying for quality/origin labels and their actual experience with the labelling systems, the benefits they had gained, and their overall experience with the labels. To compare the respondents’ expectations and their actual experience, both the non-parametric Wilcoxon test and t-test were used. The results show that the respondents positively evaluated the effects of marketing communication, but their expectations had been higher than what they experienced.

INFLUENCE OF DIFFERENT THROMBOPROPHYLAXIS REGIMENS WITH ENOXAPARIN ON THE COURSE AND OUTCOMES IN PATIENTS WITH SEVERE CORONAVIRUS DISEASE

Disorders of the hemostasis system play one of the key roles in the mechanism of pathogenesis of coronavirus disease. The prevalence of thromboembolic complications in patients with severe COVID-19 reaches 20–30%. Key guidelines provide guidance on the need for prophylactic doses of enoxaparin. However, the results of intensive care remain unsatisfactory and the search for the optimal dosing regimen of enoxaparin continues. The aim of the study was to compare the effect of different regimens of enoxaparin on the results of intensive care in patients with acute respiratory distress syndrome (ARDS) caused by SARS-nCoV.Materials and methods. A single-center prospective comparative study was conducted, which for the period May-October 2020 included 91 patients with severe coronavirus disease with the development of bilateral pneumonia and ARDS. Depending on the dosage regimen of enoxaparin, patients were divided into three groups. Patients of group 1 (n = 14) received 4000 anti-Xa MO of enoxaparin per day, group 2 (n = 20) – 8000-1200 anti-Xa MO, group 3 (n = 57) – 1600–2000 anti-Xa MO / days. Statistical analysis of the results was performed using the program «Statistica 10». Estimated median, minimum and maximum values, standard deviation. Significance of differences in indicators was assessed using the nonparametric Wilcoxon test. The results were considered reliable at values of p <0.05. Data are presented as M ± SD [min-max]. The relative risk (RR) and the odds ratio (OR) of adverse events (thromboembolic complications and mortality) were assessed.Results. In group 1, 9 episodes of pulmonary embolism were recorded, which corresponds to 64.3%, in group 2 – 7 episodes (35.0%), and in group 3 – 13 (22.4%), (p13 = 0.04 ). The overall mortality rate was 69.23% and was significantly lower in group 3 – 56.9% than in group 1 – 92.9%, and group 2 – 85.0%.Conclusions. The use of therapeutic doses of enoxaparin is one of the key areas of therapy and has a positive effect on outcomes in patients with coronavirus disease, reducing the incidence of thromboembolic complications.

The value of time‐series data for conservation planning

Abstract Protected areas (PAs) are increasingly being used world‐wide for the conservation and management of wildlife. Systematic conservation planning (SCP) aims at ensuring biodiversity persistence while minimizing the threats faced by the species and/or the economic costs related to protection. To account for spatio‐temporal interactions between species and human threats, conservation planning for mobile wildlife requires time‐series data derived from monitoring of species and human threats, a process that is costly and technically challenging. Therefore, assessments of the monitoring period needed to ensure sufficient data input in the design of efficient, adequate and representative networks of PAs are crucial. We demonstrated the value of time‐series data in conservation planning by implementing SCP and data from different monitoring periods to identify priority conservation areas for highly mobile marine megafauna accounting for their main threat: commercial fishing. Two analyses of 10 reserve‐design scenarios each, replicated as many times as the data composing each scenario permitted were run in Marxan. The best solutions of the planning scenarios were statistically compared using the Cohen's Kappa test. We also assessed differences in spatial similarity among and within scenarios using the Wilcoxon nonparametric test and a non‐metric multidimensional scaling analysis. Finally, we compared the necessary cost and the area selected for each scenario. Our study highlights the importance of time‐series ecological and socioeconomic data for the robust selection of priority conservation areas. The results revealed different thresholds of the minimum temporal data required to design efficient networks of PAs for highly mobile species, demonstrating that the incorporation of data covering longer periods to the scenarios produce a more robust selection of priority conservation areas. Conservation plans using data covering <3 years were missing important priority areas. Synthesis and applications. We provide a method for estimating the minimum number of years of monitoring required to design efficient networks of protected areas that ensure the persistence of highly mobile species such as cetaceans and seabirds. This method can be used within an adaptive management framework to evaluate whether a network of protected areas performs as planned, and to test whether management strategies should be altered or adjusted in response to local and global changes.

PELATIHAN MINDFULNESS UNTUK MENURUNKAN TINGKAT STRES PADA SISWI KELAS X

This study aims to determine the effect of mindfulness training to reduce the stress levels of 7 students in SMK X Pundong who have moderate to severe stress levels. The stress level was measured using the DASS scale. This research is categorized into experimental research type with one group pretest-posttest design. The data obtained were then analyzed using the non-parametric Wilcoxon test method to see the difference between students’ stress levels before and after the intervention through the IBM SPSS Statistics 25 for windows program. The results showed that there were significant differences in students’ stress levels before and after the intervention was given with a value of p = 0.018 (p <0.05). This proves that mindfulness training can reduce the stress levels of students in class X.

Peningkatan Kemampuan Keterampilan Basic Life Support (BLS) Melalui Pelatihan BLS Pada Perawat dan Bidan

Background: In Hospital Cardiac Arrest (IHCA) is a major problem of patient safety and public health. the rescue action taken is Basic Life Support with CPR. BLS training needs to be provided to nurses and midwives in order to increase the ability of BLS skills. The purpose of this study was to analyze the effect of Basic Life Support (BLS) Training on the ability of BLS skills of Nurses and Midwives. Methods: This research is an experimental study with a Pre-Test-Post Test Group design approach through through testing the research hypothesis. The population of this study was nurses and midwives, amounting to 51 respondents with a total sampling technique so that the number of respondents was 51. Statistical tests in the paired group used the nonparametric Wilcoxon test. Results: Based on the Wilcoxon test results obtained a p value of 0,001 which means there is a difference between pre and post training, Conclusion: BLS training has an effect on improving the BLS skills of nurses and midwives. BLS skills training needs to be carried out on an ongoing basis so that nurses and midwives have good skills in conducting BLS.

Exercício físico remoto e fadiga em sobreviventes do câncer de mama: uma intervenção em tempos do COVID-19

O objetivo do presente estudo foi verificar os efeitos de um programa de exercício físico supervisionado remotamente sobre a percepção de fadiga de sobreviventes do câncer de mama durante a pandemia da COVID-19. Participaram do estudo dez mulheres (56,30 ± 14,00 anos) fisicamente ativas, participantes de um programa de extensão universitário e que foram diagnosticadas com câncer de mama entre os estágios I-III (5,65 ± 2,19 anos de diagnóstico). O programa de exercício físico foi realizado de forma supervisionada por meio de chamada de vídeo durante 12 semanas, com duas sessões semanais de 30 minutos, em dias não consecutivos. Os treinos foram compostos por exercícios de mobilidade articular, de força, aeróbios e de equilíbrio, sendo modificados a cada três semanas. A percepção de fadiga relacionada ao câncer foi medida pela Piper Fatigue Scale por meio de chamada telefônica, antes e após as 12 semanas de intervenção. Os dados foram analisados utilizando o teste não-paramétrico Wilcoxon. Os resultados demonstraram valores de todos os domínios da fadiga relacionada ao câncer (fadiga total: p = 0,463; comportamental: p = 0,655; afetiva: p = 0,593; sensorial: p = 0,223; cognitiva: p = 0,141) estatisticamente semelhantes entre os momentos pré e pós intervenção. Conclui-se que, após 12 semanas de um programa de exercício físico supervisionado remotamente por chamada de vídeo, durante o distanciamento social devido a pandemia da COVID-19, a percepção de fadiga de mulheres sobreviventes do câncer de mama permaneceu estável.

The Impact of Educational Intervention Based on Theory of Planned Behavior for Promoting Physical Activity Among Middle-Aged Women Referring to Karaj (Iran) Health Centers.

Physical activity is the most critical determinant of physical health which reduces the health risks during life. This designed study aims to evaluate the effect of educational intervention based on the theory of planned behavior on promoting physical activity among middle-aged women attending the health centers in Karaj city during 2017-2018. This research was a quasi-experimental controlled trial, and the study incorporated 140 Middle-Aged Women Referring to Karaj Health Centers assigned randomly to a control and intervention group (70 each group). Participants enrolling in the survey were asked to complete the International Physical Activity Questionnaire and also the theory of planned behavior measures at the baseline and the end of the study. The SPSS software were used, to analyze the data. The study applied Nonparametric Wilcoxon and Mann-Whitney tests and ANCOVA to interpret the results. The results revealed participants' age range between 30 to 50 years with the mean and standard deviation scores 40.07 (8.750) in training and 45.81 (8.513) at the control group. The intervention improved the theory of planned behavior measures and the physical activities of participants. The results showed a significant difference in the attitude score, the perceived behavioral control score, and the level of subjective norms between two training and non-training groups (P < 0.001). The followed-up physical activity score also showed an improvement in the IPAQ score of participants in the training group (p < 0.001). The results of this specific study support the effectiveness of the theory of planned behavior for promoting the physical activity of women.

Risk Factors, Mortality & Cost Analysis of Sinusoidal Obstructive Syndrome in Pediatric Hematopoietic Stem Cell Transplant Recipients: A Multi-Institutional Review

Background: Sinusoidal obstructive syndrome (SOS) is a life-threatening complication of hematopoietic stem cell transplant (HSCT) characterized by hepatomegaly, jaundice, weight gain, and hyperbilirubinemia. SOS can be associated with prolonged hospitalizations and significantly increased health care costs in HSCT patients. However, studies evaluating the healthcare burden associated with SOS are limited. In this study we used a large inpatient Pediatric Health Information System database (PHIS) to complete a comprehensive review of pediatric patients undergoing HSCT to identify risk factors for SOS development and morbidity, mortality and healthcare resource utilization associated with this complication. Methods: PHIS is an administrative database containing data from 49 US children's hospitals. We identified patients under 21 years admitted between 01/01/2016 - 12/30/2019 with a primary or secondary ICD-10 diagnosis of SOS and procedure code for HSCT. We collected the following: 1) Demographics: age, sex, race, geographic location; 2) Length of stay (LOS); 3) ICU admission; 4) Infections; 5) Graft-versus-host disease (GVHD); 6) Mortality; 7) Hospitalization costs; 8) Hospital resource utilization; and 9) Medications including defibrotide use. Differences in outcomes between patients with and without SOS were assessed by Chi-square tests or Wilcoxon nonparametric test for categorical and continuous variables respectively. Univariate and multivariate regression models were used to identify risk factors associated with SOS and the association of SOS on outcomes. P-values &amp;lt;0.05 were considered significant. Results: In 6,153 patients undergoing HSCT 263 patients (4.3%) experienced SOS. Median age at diagnosis was 5 years and males represented 60.8% of patients with SOS. The majority of patients experiencing SOS identified as white, though patients identifying as Asian or American Indian disproportionately experienced SOS. Allogeneic HSCT represented 81.75% of patients with SOS. Patient age, gender and race were not associated with significantly increased odds of SOS, the odds of SOS were 3 times greater in patients undergoing allogeneic transplantation (OR 3.0, 95% CI 2.2-4.1). Average LOS was significantly higher in patients diagnosed with SOS (71 days vs 43 days, p&amp;lt;0.001). ICU admission was more common in patients with SOS (68% vs 22%) with significantly longer ICU LOS as well (16.6 days vs 4.3 days, p&amp;lt;0.001). Mean hospitalization costs were greater in patients diagnosed with SOS ($803,956 vs $326,853, p &amp;lt; 0.001). Patients who experienced SOS had increased odds of developing GVHD (OR 2.7, 95%CI 1.9-3.8) and infection (OR 4.4, 95% CI 3.4-5.7). Mortality was greater in patients who developed SOS (17.5% vs 3.7%, p&amp;lt;0.001). However, SOS was not associated with a significant increase in mortality after adjusting for GVHD, infection and ICU admission (OR 1.4, 95% CI 0.9-2.1). In patients with medication data available (n=1956), defibrotide was administered to 67.1% of patients who experienced SOS and 5.8% of patients who did not. There was no significant difference in mortality between patients who received defibrotide and those who did not in patients with SOS (p=0.4). Conclusions: In this largest inpatient cohort of pediatric HSCT recipients to date, morbidity and healthcare resource utilization remain high among patients who experience SOS. This stresses the importance of early recognition and treatment of SOS, and the importance of novel therapeutic approaches to decrease the morbidity and improve quality of life in these patients. Disclosures No relevant conflicts of interest to declare.

Online Patient Recruitment in Clinical Trials: Systematic Review and Meta-Analysis.

BackgroundRecruitment for clinical trials continues to be a challenge, as patient recruitment is the single biggest cause of trial delays. Around 80% of trials fail to meet the initial enrollment target and timeline, and these delays can result in lost revenue of as much as US $8 million per day for drug developing companies.ObjectiveThis study aimed to conduct a systematic review and meta-analysis examining the effectiveness of online recruitment of participants for clinical trials compared with traditional in-clinic/offline recruitment methods.MethodsData on recruitment rates (the average number of patients enrolled in the study per month and per day of active recruitment) and conversion rates (the percentage of participants screened who proceed to enroll into the clinical trial), as well as study characteristics and patient demographics were collected from the included studies. Differences in online and offline recruitment rates and conversion rates were examined using random effects models. Further, a nonparametric paired Wilcoxon test was used for additional analysis on the cost-effectiveness of online patient recruitment. All data analyses were conducted in R language, and P<.05 was considered significant.ResultsIn total, 3861 articles were screened for inclusion. Of these, 61 studies were included in the review, and 23 of these were further included in the meta-analysis. We found online recruitment to be significantly more effective with respect to the recruitment rate for active days of recruitment, where 100% (7/7) of the studies included had a better online recruitment rate compared with offline recruitment (incidence rate ratio [IRR] 4.17, P=.04). When examining the entire recruitment period in months we found that 52% (12/23) of the studies had a better online recruitment rate compared with the offline recruitment rate (IRR 1.11, P=.71). For cost-effectiveness, we found that online recruitment had a significantly lower cost per enrollee compared with offline recruitment (US $72 vs US $199, P=.04). Finally, we found that 69% (9/13) of studies had significantly better offline conversion rates compared with online conversion rates (risk ratio 0.8, P=.02).ConclusionsTargeting potential participants using online remedies is an effective approach for patient recruitment for clinical research. Online recruitment was both superior in regard to time efficiency and cost-effectiveness compared with offline recruitment. In contrast, offline recruitment outperformed online recruitment with respect to conversion rate.

Evaluating the Quality of Rigid Optic Videolaryngoscopy Image Taken Through Dental Protection Cap and Its Feasibility as Additional Barrier Method Against COVID-19

Videolaryngoscopy screening is essential to help assessing human larynx. The use of 70° optical fiber in association with image recording by analog or digital cameras is one of the methods adopted to perform this examination. Endoscopic exams can contaminate the equipment with several microorganisms. The pandemic caused by the new coronavirus reinforces the importance of developing efficient barrier methods to be adopted in videolaryngoscopy procedures. Although dental intraoral camera covers are a barrier method authorized by Brazilian health organs, it has not yet been used in videolaryngoscopy examinations. The aim of the current longitudinal, individualized, single-blind, prospective, self-controlled, and accurate study is to evaluate the quality of images generated through, and confidence level of, diagnosis based on videolaryngoscopy performed with intraoral dental camera equipped with disposable protection cap and connected to 70° rigid laryngoscope in vocally healthy individuals. Videolaryngoscopy examinations based on 70° rigid optics were performed in 13 euphonic and asymptomatic volunteers at an otorhinolaryngology specialist clinic; only 1 patient was excluded from the study. Images were taken with, and without, disposable intraoral dental camera protection cap; high-grade disinfection protocol was applied between examinations. Recorded videos were randomly distributed in a single-blind manner in order to be evaluated by four otorhinolaryngologists, who answered a questionnaire comprising three questions. Statistical analysis was used to compare groups – which were defined by the use, or not, of protection cap – based on Wilcoxon nonparametric test. Statistical significance was set at 5% with 95% confidence interval. There was no statistically significant difference in image quality between examinations performed with, and without, protection cap (P= 0.646) or in the diagnosis confidence level of examinations performed with, or without, the barrier method. The use of disposable protection cap on intraoral dental camera did not significantly change the quality of images taken through videolaryngoscopy performed with 70° rigid optics in vocally healthy patients.

USAGE OF DIGITAL D CHART TEST AS A MODIFICATION OF AMSLER GRID IN OPHTHALMOLOGY AND OPTOMETRY.

Metamorphopsia is important symptom of macular disease. The most common simple detection method of metamorphopsia is Amsler grid. Usually it is used monocularly with best correction for near. Patient should evaluate grid deformation adescribe position of the deformity. This method is based on qualitative principle. For quantitative evaluation we can use Software D Chart (Thomson Software Solution). This instrument enables evaluate degree and position of the metamorphopsia in central visual field. Our goal was to establish M-score values in group of young healthy subjects without correction (M-score natural), with cylindrical spectacle lens (M-score SL) and in group of patients with age related degeneration (M-score ARMD). We had 33 probands divided into 2 samples. The first sample contains 15 young probands with average age 23 years without any eye pathology. The second sample contains 18 patients with ARMD (7 with dry form and 11 with wet form). In our study we used software D Chart (Thomson Software Solution). This software was use in Acer PC with touchable screen. We note total M-score in right eye of all probands. Level for statistic evaluation was set on p = 0.05. Natural M-score values for young probands was: median 0, minimum 0, maximum 2.3. With cylindrical lens we got these values: median 25.2, minimum 3.6, maximum 41.6. In second sample with probands suffer from ARMD we got these values: median 0.8, minimum 0, maximum 29.4. Wilcoxon non-parametric test was used for statistical evaluation. We proved statistically significant difference between all variables. M-score natural vs. M-score SL showed p &lt; 0.001, M-score natural vs. M-score ARMD showed p = 0.04 and M-score SL vs. M-score ARMD showed p &lt; 0.001. Our study showed statistically significant differences between variable M-score natural, M-score SL and M-score ARMD. We found that printed Amsler grid as well as its digital modification D Chart are suitable for determining metamorphopsia in central visual field. The main advantage of D Chart is quantitative evaluation of the test with M-score and digital registration of retinal changes during patient´sfollow up.

Influence of Different Postpolymerization Strategies and Artificial Aging on Hardness of 3D-Printed Resin Materials: An In Vitro Study.

To investigate the influence of different postpolymerization strategies and artificial aging periods on the Martens hardness parameters of 3D-printed resin materials indicated for temporary use. Disks made of four 3D-printed resin materials (n = 30 each) were additively manufactured and postpolymerized with three different postpolymerization devices (n = 10 specimens of each material per device). Disks cut from a prefabricated milling material served as a control. The Martens parameters (ie, Martens hardness [HM] and indentation modulus [EIT]) were measured initially and after 14- and 28-day storage periods in 37°C distilled water. The data were statistically analyzed using univariate analysis, Kolmogorov Smirnov test, and nonparametric tests, including Kruskal-Wallis, Mann-Whitney U, and Wilcoxon tests (α = .05). The highest impact on the Martens parameters was exerted by material (HM: ηP2 = 0.957, EIT: ηp2 = 0.967, P < .001), followed by postpolymerization device (HM: ηP2 = 0.557, EIT: ηP2 = 0.496, P < .001) and duration of water storage (HM: ηP2= 0.068, EIT: ηP2= 0.038, P < .001). The values for HM ranged between 108 and 282 N/mm2, and for EIT between 2.89 and 7.73 kN/mm2. The materials 3Delta Etemp and Temp PRINT showed the highest HM and EIT values regardless of the postpolymerization device and water storage duration (P < .001). In contrast, NextDent C&B, followed by Freeprint Temp, showed the lowest HM and EIT values (P < .001). The milled control group Telio CAD ranged between the two lower groups. Postpolymerization strategy has a high impact on the mechanical properties of 3D-printed resin materials. Materials with a higher filler content showed better results regarding the Martens parameters. Such materials might be an alternative to conventional materials for the milling procedure.

Comparison of electronic systems with sensory analysis for the quality evaluation of parenica cheese

The applicability of electronic systems for the quality evaluation of parenica cheese was investigated in fresh smoked and unsmoked cheeses and after seven days of storage. These data were then compared with sensory evaluation results. Fresh samples had stable colour profiles determined by the electronic eye, while the differences in brown colour intensity were confirmed by sensory evaluation. A significant difference in the aroma profiles of samples was recorded by the electronic nose in samples produced in February, April, December (unsmoked cheese) and September (smoked cheese). Based on sensory analysis results using the Wilcoxon nonparametric test, a significant difference was confirmed in February (smoked cheese) and March (unsmoked cheese), when stored cheese had a stronger aroma than fresh cheese (P &amp;lt; 0.05). The suitability of electronic nose and electronic eye for monitoring of parenica cheese quality was confirmed.

A new deep learning ensemble credit risk evaluation model with an improved synthetic minority oversampling technique

In recent years, research has found that in many credit risk evaluation domains, deep learning is superior to traditional machine learning methods and classifier ensembles perform significantly better than single classifiers. However, credit evaluation model based on deep learning ensemble algorithm has rarely been studied. Moreover, credit data imbalance still challenges the performance of credit scoring models. Therefore, to go some way to filling this research gap, this study developed a new deep learning ensemble credit risk evaluation model to deal with imbalanced credit data. First, an improved synthetic minority oversampling technique (SMOTE) method was developed to overcome known SMOTE shortcomings, after which a new deep learning ensemble classification method combined with the long-short-term-memory (LSTM) network and the adaptive boosting (AdaBoost) algorithm was developed to train and learn the processed credit data. Then, area under the curve (AUC), the Kolmogorov–Smirnov (KS) and the non-parametric Wilcoxon test were employed to compare the performance of the proposed model and other widely used credit scoring models on two imbalanced credit datasets. The experimental test results indicated that the proposed deep learning ensemble model was generally more competitive when addressing imbalanced credit risk evaluation problems than other models.

Factores asociados con estancia hospitalaria prolongada en una unidad geriátrica de agudos

Objetivo: Analizar los factores asociados con estancia hospitalaria prolongada en una Unidad Geriátrica de Agudos de un hospital general.&#x0D; Material y métodos: Incluyó 2014 pacientes ≥60 años hospitalizados entre enero 2012 y septiembre 2015. La variable dependiente fue la estancia hospitalaria (&gt;10 días vs ≤10 días). Variables independientes incluyeron las sociodemográficas, de laboratorio, comorbilidad, estado funcional y mental. Para análisis bivariado se empleó la prueba de Chi2 para variables categóricas y de Wilcoxon Two-Sample no-paramétrico para las cuantitativas. Se realizó un modelo multivariado de regresión logística.&#x0D; Resultados: El 51,1% fueron mujeres y la edad promedio fue 82,3 años (DE ± 7,2 años). El 50,6% tuvieron estancia prolongada, con un promedio de estancia de 14.7 días (DE ± 14 días). La asociación más fuerte con la estancia hospitalaria prolongada fue el desarrollo de Úlceras por Presión (OR 2,30 IC 95% 1,56-3,39). El deterioro cognitivo moderado o severo, la dependencia funcional, anemia, hipoalbuminemia y niveles elevados de reactantes de fase aguda (PCR) se asociaron con hospitalizaciones prolongadas. Ser mujer estuvo asociado a menos días de hospitalización. La estancia prolongada no se relacionó con las variables sociales. &#x0D; Conclusión: Los principales factores independientes asociados a la estancia prolongada fueron las ulceras por presión, la dependencia funcional, la hipoalbuminemia y los niveles elevados de PCR.

Patient Reported Pain Improvement following Palliative Radiotherapy and Immune Checkpoint Blockade

An increasing number of patients with metastatic cancer are being treated with combinations of palliative radiotherapy (RT) and immune checkpoint blockade (ICB) in an attempt to achieve disease control and alleviate symptoms. Patient reported outcomes measures (PROM) are increasingly used to evaluate treatment effectiveness but there are few data in the metastatic setting that evaluate impacts of combined RT/ICB on PROM. We performed a retrospective chart review of patients treated with palliative RT and ICB at 5 affiliated institutions between 2015-2020 who completed PROM before and between 5 and 90 days after RT. Patient and treatment data were abstracted from the electronic medical record. PROM consisted of questions drawn from the MD Anderson Spine Index Score (MDASI) and Patient Reported Outcome Measurement Information System Global Health (PROMIS). We focused specifically on the patient reported “pain over the last week” question (rated 1-10) for this analysis. Associations between patient reported pain improvement and timing of ICB were determined using a non-parametric Wilcoxon test and Fisher’s exact test. We identified 23 patients who received 26 courses of palliative radiation. Seven patients had lung cancer, 6 had genitourinary cancers, 2 had head and neck cancer, 2 had breast cancer and 6 had other cancers. The most common indication for radiation was pain in 18 instances. Sites irradiated included bone (n = 17), spine (n = 3), WBRT (n = 2), lung and regional lymph nodes (n = 2) and multiple sites (n = 2). The most common fractionation regimens were 3Gyx10 (n = 10), 4Gyx5 (n = 6), 8Gyx1 (n = 7) and other (n = 3). Types of ICB administered were PD-1 inhibitors (n = 12) and PD-L1 inhibitors (n = 11). ICB was administered within 30 days of RT in 15 cases (63%). Post-treatment PROM were collected a median of 30 days following the last fraction of radiotherapy (IQR 26-34). In 15 out of 26 instances (58%) there was improvement in pain scores (median improvement 3, IQR 1-7). Improvement in pain score was associated with receipt of ICB in the interval between RT and post treatment PROM (p = 0.03). Specifically, 67% (n = 10) of patients who received ICB after RT and before PROM reported improvement in pain, as compared to 17% (n = 2) who did not (p = 0.02). In this retrospective review, the majority of patients treated with palliative RT and ICB had improvement in their pain scores over the last week and the receipt of ICB after RT and before PROM was associated with a greater likelihood of reported pain improvement. Although our study is limited by size and potential treatment bias, these findings should prompt further investigation as to potential synergies between ICB and pain relief provided by palliative radiotherapy.

BIOELECTRIC ACTIVITY OF THE BRAIN IN PUPILS WITH DIFFERENT ACADEMIC SUCCESS. REPORT 2. THE RELATIONSHIP BETWEEN THE ACADEMIC SUCCESS AND PATTERNS OF BIOELECTRIC ACTIVITY OF THE CORTEX

Background. The paper presents the study of the factors of academic success and failure in students, which is a relevant and socially significant problem. Academic failure often results in behavior deviations, drug abuse and other types of dangerous behavior. Therefore, it is of utmost importance to establish the reasons of academic failure, as well as the ways to improve academic performance. Aim. The paper aims to establish the features of responses of academically successful and unsuccessful 12-year-old children to cognitive load based on EEG data. Materials and methods. Twelve-year-old schoolchildren (n = 51) from Ekaterinburg participated in the study. Participants were divided into two groups depending on their academic performance. EEG recording was performed using the CONAN-m equipment (Informatics and Computers, Russia). Monopolar EEG recordings were obtained from 10 symmetrical leads in different conditions: during resting wakefulness (for eyes open and closed) and when solving experimental tasks of three types (simple arithmetic task, verbal and logical task, spatial thinking task). The differences between the samples of academically successful and unsuccessful children were assessed using the Wilcoxon nonparametric test. Results. Differences were revealed in a number of EEG indicators both at rest and when solving experimental tasks between academically successful and unsuccessful schoolchildren. The responses of academically successful children to cognitive load were characterized by predominant ctivation of the anterior cortical areas with a focus of activity in the left frontal area. Academically unsuccessful children were characterized by a more generalized type of EEG response with a focus of activity in the caudal areas of the cortex, especially when solving a figure rotation task. It was also found that successful children made mistakes when solving a figure rotation task and unsuccessful ones-when solving verbal and logical tasks. Conclusion. Children with low academic success were found to have characteristic features of the functioning of the cerebral cortex, which hampered the perception of educational material presented in the form of a logically structured message. However, these children were able to brilliantly operate with visual-spatial information. This must be taken into account when working with such children to improve their academic performance.

Comparação da eficácia do fluoreto de sódio a 4% e do LASER de baixa potência no tratamento da hipersensibilidade dentinária cervical

Objetivo: Avaliar a eficácia do uso da solução de fluoreto de sódio a 4% para o tratamento da Hipersensibilidade Dentinária Cervical (HSDC) em comparação ao LASER de baixa potência. Método: Foi realizado um ensaio clínico controlado randomizado, constituído por um grupo teste (47 dentes) e grupo controle (47 dentes). Para o grupo teste foi realizada aplicação do fluoreto de sódio a 4%, e o grupo controle recebeu irradiação do LASER de baixa potência. As terapias dos dois grupos foram realizadas em três sessões com intervalo de uma semana entre elas. Previamente ao tratamento (T0), imediatamente após a aplicação das terapias em cada sessão (T1, T2 e T3), e nos tempos de 1 (T4), 3 (T5) e 6 (T6) meses, os elementos dentários foram submetidos aos estímulos táctil e térmico-evaporativo e as respostas foram obtidas através da Escala Visual Numérica (EVN). A análise estatística dos dados foi realizada através dos testes não paramétricos Wilcoxon, Friedman e Mann-Whitney. Resultados: Em T6, a média de dor do grupo teste passou de 5,93 para 1,73 (p &lt; 0,05) ao estímulo evaporativo e de 3,63 para 0,804 ao estímulo táctil (p &lt; 0,05). Para o grupo controle, a média da dor passou de 6,020 para 1,854 (p &lt; 0,05) ao estímulo evaporativo e de 3,50 para 0,937 (p &lt; 0,05) ao estímulo táctil. Não houve diferença entre as duas modalidades de tratamento em T6. Conclusão: O fluoreto de sódio a 4% foi tão eficaz quanto o LASER na redução da HSDC.

Relationship between pediatric asthma and psychosocial status of caregivers

ObjectiveTo determine the relationship between psychosocial caregiver disorders and childhood asthma. Study designWe performed a matched case–control study with asthmatic children (6-14 years of age) from two different clinics in Zaragoza, Spain, between 2010 - 2016. Clinical data were collected from medical records and psychosocial disorders were assessed by interviewing the caregiver using validated questionnaires (Goldberg, CES-D, SF-12, PSS and SPIN). General analysis of cases and controls was performed using McNemar, Chi2 and Wilcoxon nonparametric tests. A logistic regression model to predict more severe asthma, adjusted by caregiver psychosocial disorders was performed. Results208 children were evaluated (104 cases). Mean age was 9.7 ± 2.4 years, with a male predominance (62.5%). Anxiety, social phobia, depression, acute and chronic psychological disorders, and poor quality of life related to mental health were significantly more prevalent in caregivers of asthmatic children (p<0.05). On multivariate analysis, all of the above disorders significantly increased the risk of uncontrolled asthma, where anxiety, acute psychological disorders, and chronic psychological disorders were the most significant (OR 8.54, 95%CI 3.46-21.05, p<0.001; OR 6.05, 95%CI 2.39-15.28, p<0.001; and OR 4.86, 95%CI 1.97-12.02, p=0.001, respectively). ConclusionThe prevalence of psychosocial disorders in caregivers of asthmatic children is high, when compared to caregivers of healthy children. The presence of anxiety, social phobia, depression, and poor quality of life is associated with an increased risk of worse controlled asthma. Perhaps, early detection and treatment of these disorders could positively impact childhood asthma control.

Torsemide Is Associated with Higher Levels of Urinary Biomarkers of Tubular Injury Compared to Furosemide

Introduction In patients with heart failure (HF), loop diuretics including torsemide and furosemide are a cornerstone of therapy for volume overload. Torsemide may be associated with enhanced natriuresis which could hemodynamically lead to worsening renal function (WRF). If renal hypoperfusion is persistent and severe, renal tubular injury (RTI) may occur but WRF does not always correlate with renal tubular injury. Urinary biomarker analysis can help identify when renal tubular injury occurs. Hypothesis In patients with chronic HF, use of torsemide is associated with higher biomarker levels of urinary RTI compared to furosemide. Methods Urine samples were collected from patients with chronic HF who had been treated for at least one month with furosemide (n=15) or torsemide (n=10). Urinary concentrations of the following biomarkers were compared between groups: albumin, β-2 microglobulin (β2M), CystatinC, epidermal growth factor (EGF), neutrophil gelatinase-associated lipocalin (NGAL), osteopontin (OPN), and uromodulin. Results One patient in the furosemide group had outliers in several biomarkers and was excluded from the analysis. All urinary markers were present in higher concentration in the torsemide group. Using a nonparametric Wilcoxon test, statistically significant differences were found in the distribution of urinary albumin (p=0.001), β-2M (p=0.03), and NGAL (p=.04) between the two groups. Conclusion Significantly higher levels of RTI biomarkers in the torsemide group suggest that there may be a greater degree of WRF with torsemide compared with furosemide. More significant differences between other urinary biomarkers may be seen with a greater sample size. This study was limited by sample size and inability to compare concentration of urine. Further study is warranted to explore the difference in these groups.