Normal Range Research Articles

Executive function performance in persons with non-syndromic cleft lip and palate

Background: Executive functions (EFs) are crucial cognitive functions that mature from birth to adolescence. They are vital for daily task execution and overall success and also influence language and communication development. Children with EFs deficits often experience delays in language and speech abilities. These impairments are particularly prevalent among individuals with cleft lip and palate. Consequently, speech and language pathologists must address these impairments through assessments and interventions. Despite this urgent need for action, there is a scarcity of research on executive function performance in this population in Thailand, prompting an investigation to address this issue. This study explores executive function performance in this population to enhance the quality of life for individuals with cleft lip and palate. Materials and methods: Using a survey-based approach, executive function performance was assessed in 5- to 15-year-old volunteer with non-syndromic cleft lip and palate attending the speech therapy camp provided by the Princess Sirindhorn IT Foundation Craniofacial Center at Chiang Mai University in April 2024. Parents completed the Behavior Rating Inventory of Executive Function (Parent form), with scores ≥65 indicating executive function difficulties. Results: The study involved 29 participants, 14 males (48.28%) and 15 females (51.72%), with a mean age of 8 years and 9 months. Average scores for executive function abilities in BRI, MI, and GEC were 52.21, 56.48, and 58.90, respectively. There are several participants with abnormal executive function in each age group, along with their average T-scores across different domains. Children aged 5, 6-8, and 9-11 have T-scores for executive function performances falling into problematic levels for 1, 2, and 5 individuals, respectively. Conclusion: Most of the sample group demonstrated executive function skills within the normal range. However, a certain number of individuals experienced issues with executive function. These findings offer guidance for speech and language pathologists and emphasize the importance of executive function in individuals with cleft palates.

Symptoms of depression, anxiety and stress in women with chronic pelvic pain attended at a private hospital in São Luís, Maranhão: a cross-sectional study

ABSTRACT The study aimed to evaluate the relation between depression, anxiety stress symptoms, duration and pain intensity in women with chronic pelvic pain (CPP). This study consisted of a sample of women diagnosed with CPP from April 2021 to August 2023, including women aged 18 years or older who agreed in writing to participate in the study with the Free Informed Consent Form, who could understand the study’s objectives and participate. Women between 31 and 37 years old, married or in a stable relationship, with a higher education degree predominated. Were observed outside the normal range scale 58.8 percent of depression, 66.7 percent of anxiety and 59.8 percent of stress. The level of alteration most often observed in patients was extremely severe in 24 percent of with depression and 33.3 percent of anxiety, and the level was mild in 19.6 percent of stress symptoms. No statistical association was found between duration of pain and emotional states of anxiety, depression or stress. Regarding pain intensity levels, there was no significant association with the presence or absence of symptoms of depression outside the normal range or its levels. It’s was significantly associated with the presence or absence of anxiety symptoms outside the normal range (p = .003) and with their levels (p = .005). Also significantly associated with the presence or absence of stress symptoms outside the normal range (p = .007), as was its levels (p = .023). The symptoms of depression, anxiety and stress occur frequently in women with CPP and that the intensity of pain experienced is significantly associated with the presence of stress and anxiety but not with depression.

Psychosocial and executive functioning late effects in pediatric brain tumor survivors after proton radiation.

Pediatric brain tumor survivors can experience detrimental effects from radiation treatment. This cross-sectional, large cohort study examined late psychosocial and executive functioning effects in pediatric patients treated ≥ 3years after proton radiation therapy (PRT). Parents of 101 pediatric brain tumor survivors completed the Behavior Assessment System for Children and the Behavior Rating Inventory of Executive Function. Standard scores were compared to published normative means, rates of impairment (T-score > 65) were calculated, and demographic and clinical characteristics were examined. Mean age at PRT was 8.12years and mean interval from PRT to assessment was 6.05years. Half were female (49.5%), 45.5% received craniospinal irradiation (CSI), and 58.4% were diagnosed with infratentorial tumors. All mean T-scores were within normal range. Mean T-scores were significantly elevated compared to the norm on the withdrawal, initiate, working memory, and plan/organize scales. Rates of impairment were notably high in working memory (24.8%), initiate (20.4%), withdrawal (18.1%), and plan/organize (17.0%). Greater withdrawal was significantly associated with CSI and also with chemotherapy and diagnosis of hearing loss. Mean T-scores were significantly lower than the norm on the hyperactivity, aggression, conduct problems, and inhibition scales. No significant problems were identified with social skills or depression. Interval since treatment was not correlated with any scale. Although psychosocial and executive functioning was within the normal range, on average, social withdrawal and metacognitive executive functioning (working memory, initiating, planning/organizing) were areas of concern. Targeted yearly screening and proactive executive skill and social interventions are needed for this population.

Femoral version and its clinical relevance in adult hip preservation surgery for developmental dysplasia of the hip.

Femoral version (FV) is more widely adopted with the definition as the angle between the long axis of the femoral neck and the tangent line of the posterior femoral condyles on the axial plane, and the normal range between 5 and 20°. FV can be measured by imaging and functional tests. Cross-sectional CT including both the hip and the knee is the typically used imaging technique, yet variation exists according to the different landmarks used. As MRI investigations are routinely performed preoperatively, and protocols can be easily adopted to include version measurement, they are frequently used as an alternative to CT and offers several advantages. Abnormal FV has adverse effects on the biomechanics and musculoskeletal health of the whole lower limb. It affects the lever arm of muscles and the forces that the hip and patellofemoral joints suffer, and can lead to disorders such as osteoarthritis and impingement. In adult hip preservation surgery for developmental dysplasia of the hip (DDH), abnormal FV is sometimes accompanied by other morphological abnormities of the hip, a more severe DDH, and can help predict postoperative range of motion (ROM), and postoperative impingement. Currently, the most frequently used surgical technique for abnormal FV is femoral derotational osteotomy. Many controversies are left to be solved, including the specific origin of FV, the indication for femoral derotational osteotomy, especially in patients with combined DDH and abnormal FV, and the explicit compensation mechanism of abnormal FV by tibial torsion.

A cavalpulmonary assist device utilising impedance pumping enhanced by peristaltic effect.

Fontan procedure, the standard surgical palliation to treat children with single ventricular defects, causes systemic complications over years due to lack of pumping at cavopulmonary junction. A device developed specifically for cavopulmonary support is thus considered, while current commercial ventricular assist devices (VAD) induce high shear rates to blood, and have issues with paediatric suitability. To demonstrate the feasibility of a small, valveless, non-invasive to blood and pulsatile rotary pump, which integrates impedance and peristaltic effects. A prototype pump was designed and fabricated in-house without any effort to optimise its specification. It was then tested in vitro, in terms of effect of pumping frequency, background pressure differences and pump size on output performance. Net flow rate (NFR) and maximum pressure head delivery are both reasonably linearly dependent on pumping frequency within normal physiological range. Positive linearity is also observed between NFR and the extent of asymmetric pumping. The device regulates NFR in favourable pressure head difference and overcomes significant adverse pressure head difference. Additionally, performance is shown to be insensitive to device size. The feasibility of the novel rotary pump integrating impedance and peristaltic effects is demonstrated to perform in normal physiological conditions without any optimisation effort. It provides promising results for possible future paediatric cavopulmonary support and warrants further investigation of miniaturisation and possible haemolysis.

Testing for a causal role of thyroid hormone measurements within the normal range on human metabolism and diseases: a systematic Mendelian randomization

Variation in thyroid function parameters within the normal range has been observationally associated with adverse health outcomes. Whether those associations reflect causal effects is largely unknown. We systematically tested associations between genetic differences in thyrotropin (TSH) and free thyroxine (FT4) within the normal range and more than 1100 diseases and more than 6000 molecular traits (metabolites and proteins) in three large population-based cohorts. This was performed by combining individual and summary level genetic data and using polygenic scores and Mendelian randomization (MR) methods. We performed a phenome-wide MR study in the OpenGWAS database covering thousands of complex phenotypes and diseases. Genetically predicted TSH or FT4 levels within the normal range were predominately associated with thyroid-related outcomes, like goitre. The few extra-thyroidal outcomes that were found to be associated with genetic liability towards high but normal TSH levels included atrial fibrillation (odds ratio=0.92, p-value=2.13×10-3), thyroid cancer (odds ratio=0.57, p-value=2.97×10-4), and specific biomarkers, such as sex hormone binding globulin (β=-0.046, p-value=1.33×10-6) and total cholesterol (β=0.027, p-value=5.80×10-3). In contrast to previous studies that have described the association with thyroid hormone levels and disease outcomes, our genetic approach finds little evidence of an association between genetic differences in thyroid function within the normal range and non-thyroidal phenotypes. The association described in previous studies may be explained by reverse causation and confounding. This research was funded by the Swiss National Science Foundation (P1BEP3_200041). The Fenland study (DOI 10.22025/2017.10.101.00001) is funded by the Medical Research Council (MC_UU_12015/1, MC_PC_13046 and MC_UU_00006/1). The EPIC-Norfolk study (DOI 10.22025/2019.10.105.00004) has received funding from the Medical Research Council (MR/N003284/1, MC-UU_12015/1, MC_PC_13048 and MC_UU_00006/1).

Impact of Aficamten on Echocardiographic Cardiac Structure and Function in Symptomatic Obstructive Hypertrophic Cardiomyopathy.

Aficamten, a next-in-class cardiac myosin inhibitor, improved peak oxygen uptake (pVO2) and lowered resting and Valsalva left ventricular outflow (LVOT) gradients in adults with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) in SEQUOIA-HCM (Phase 3 Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Placebo in Adults With Symptomatic oHCM), a phase 3, multicenter, randomized, double-blinded, placebo-controlled study. The authors sought to evaluate the effect of aficamten on echocardiographic measures of cardiac structure and function in SEQUOIA-HCM. Serial echocardiograms were performed over 28weeks in patients randomized to receive placebo or aficamten in up to 4 individually titrated escalating doses (5-20mg daily) over 24weeks based on Valsalva LVOT gradients and left ventricular ejection fraction (LVEF). Among 282 patients (mean age 59 ± 13 years; 41% female, 79% White, 19% Asian), mean LVEF was 75% ± 6% with resting and Valsalva LVOT gradients of 55 ± 30mmHg and 83 ± 32mmHg, respectively. Over 24weeks, aficamten significantly lowered resting and Valsalva LVOT gradients, and improved left atrial volume index, lateral and septal e' velocities, and lateral and septal E/e' (all P≤ 0.001). LV end-systolic volume increased and wall thickness decreased (all P≤ 0.003). Aficamten resulted in a mild reversible decrease in LVEF (-4.8% [95%CI:-6.4 to-3.3]; P<0.001) and absolute LV global circumferential strain (-3.7% [95% CI: 1.8-5.6]; P< 0.0010), whereas LV global longitudinal strain was unchanged. Several measures, including LVEF, LVOT gradients, and E/e' returned to baseline following washout. Among those treated with aficamten, improved pVO2 and reduction in N-terminal pro-B-type natriuretic peptide (NT-proBNP) were associated with improvement in lateral e' velocity and septal and lateral E/e' (all P< 0.03), whereas improvement in Kansas City Cardiomyopathy Questionnaire Clinical Summary Scores (KCCQ-CSS) was associated with a decrease in both LVOT gradients (all P< 0.001). Compared with placebo, patients receiving aficamten demonstrated significant improvement in LVOT gradients and measures of LV diastolic function, and several of these measures were associated with improvements in pVO2, KCCQ-CSS, and NT-proBNP. A modest decrease in LVEF occurred yet remained within normal range. These findings suggest aficamten improved multiple structural and physiological parameters in oHCM without significant adverse changes in LV systolic function. (Phase 3 Trial to Evaluate the Efficacy and Safety of Aficamten Compared to PlaceboinAdults With Symptomatic oHCM [SEQUOIA-HCM]; NCT05186818).

Groundwater and indoor air quality of urban village housing: study in Janturan, Warungboto, Yogyakarta

Water and air are important elements for life. The presence of pathogenic bacteria in the surrounding environment can cause health problems resulting from the low quality of water and air. The purpose of this study is to measure the quality of groundwater and air based on microbiological parameters in urban village housing. This research was conducted in a descriptive survey, and a purposive sampling technique was carried out. Groundwater and air samples were taken from six residents' houses located in the Janturan area. The water quality test used the most probable number (MPN) method and the air quality test used the agar filter method using a microbiological air sampler (MAS) to trap microbes. The results of the MPN test for total coliform bacteria from six samples of groundwater showed that three samples were positive for coliform bacteria which exceeded the threshold according to Indonesian standard&amp;lt;50 MPN/100 ml. Assay of &lt;em&gt;E. coli&lt;/em&gt; bacteria showed that all samples of groundwater positively contained &lt;em&gt;E. coli&lt;/em&gt; bacteria which exceeded the threshold of 0 MPN/100 ml. The results of indoor air quality measurements from 6 residents' houses showed that five houses have air quality did not meet the standard for indoor air germ numbers based on Indonesian standard, less than 700 CFU/m3 (colony forming units per metres cubic) and 1 house that got the number of airborne germs, in the normal range, namely 356 CFU/m3. It was concluded that the water quality and air quality in the urban village did not meet health requirements.

Serum Albumin and Its Influence on Immediate Outcomes in Children with Congenital Heart Disease Undergoing Cardiac Surgery

Background: Hypoalbuminemia is associated with morbidity and mortality in critically ill children and is a well-recognized predictor of general surgical risk. It frequently occurs in patients with congenital heart disease (CHD). Moreover, cardiopulmonary bypass (CPB)-induces an inflammatory response, and the overall surgical stress can affect albumin concentration greatly Objective: To estimate pre-operative, per-operative and post-operative serum albumin level and to see its influence on immediate outcomes in children with congenital heart disease undergoing cardiac surgery with cardiopulmonary bypass Methods: This cross-sectional observational study was conducted in Paediatric cardiology department, BSMMU in a view to find out the influence of pre-operative, per-operative and post-operative serum albumin level on immediate outcomes in children with congenital heart disease undergoing cardiac surgery with cardiopulmonary bypass(CPB).The study included total 48 patients of CHD who underwent CPB. Patients were selected according to inclusion and exclusion criteria. Result: Mean pre-operative serum albumin was 3.5±0.9 mg/dl whereas per-operative and post-operative serum albumin was 3.3±0.7mg/dl and 3.1±0.7 mg/dl respectively.CPB time was a bit higher in study population (98.4± 29.1min) where as other outcome parameters were within normal range. Duration of hospital stay was 12.2±3.1days. 22 patient (45.8%) developed valvular regurgitation and 6 patient (12.5%) developed pericardial effusion in post-operative echocardiography. Infection was evident by positive blood culture in 7 patients (14.8%). Pre, per and post-operative hypoalbuminaemia was associated with poor outcome after CPB. Conclusion: Pre, per and post-operative hypoalbuminaemia is a prudent indicator for speculating poor immediate outcome following CPB in children with CHD. (Bangladesh Heart Journal 2024; 39(2): 121-126

Etiological Tracing Test and Drug Efficacy Test in a Case of Clinical Canine Toxic Liver Disease

This experiment is divided into three parts. A typical case report of canine toxic liver disease was recorded at the Huazhong Agricultural University Animal Hospital. The etiology tracing test focused on the daily life risk factors that induced the disease. The pathological model of toxic liver disease in mice was successfully established by the administration of household formaldehyde, floor cleaner and chlorine-containing disinfectant tablets. The drug efficacy test was carried out by the administration of self-made traditional Chinese medicine to the model mice, and to observe the therapeutic effect of traditional Chinese medicine prescription on the mice pathological model. It can be concluded that the daily life risk factors should be paid enough attention to in the dog's toxic liver disease. In comparison, within households that own dogs, the toxicity of chlorine-containing disinfectant is low in the normal dilution range, and its liver damage to mice is very light during the test. However, caution should be exercised when using floor cleaners and formaldehyde. Self-made traditional Chinese medicine has a good effect on this type of liver disease, but it should also pay attention to the dose, concentration and usage cycle.

Normative values of oxygen saturation by pulse oximetry (SpO2) in apparently healthy children from Eastern India - A cross-sectional study.

The primary objective was to determine normative values of oxygen saturation (SpO2) by pulse oximetry in apparently healthy children, aged 1 month to 14 years. The secondary objective was to explore any variation in oxygen saturation levels by age and gender. It was a cross-sectional study conducted at a tertiary care centre and schools in Bhubaneswar, Odisha, India, from January 2021 to December 2022. Apparently healthy children were enrolled. Using a standardized pulse oximeter and appropriately sized probes, SpO2 was recorded after stabilization of plethysmograph waves. Three consecutive readings were taken, and an average was noted. The 2.5th centile SpO2 value was taken as the lower limit of normal. The median (IQR) saturation of the sample population was 99.7% (99-100). The 2.5th, 5th, 25th, and 75th percentiles were 97.7%, 98%, 99%, and 100%, respectively. Median SpO2 and its percentiles were estimated for each age group. The 2.5th centile SpO2 for infantile age group was 96.4%. No significant age and gender-wise variations of SpO2 were noted. The present study established normal reference range oxygen SpO2 levels in apparently healthy children from an eastern India region that is situated at 62 m (204 ft) above the sea level.

Self-management in patients with metabolic dysfunction-associated steatotic liver disease: influencing factors and impact on readmission.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common chronic liver disease. This study aimed to investigate the self-management ability of patients with MASLD, analyse related factors that may affect self-management ability and evaluate the impact of this ability on readmission. The study recruited patients with MASLD admitted to the Department of Infectious Diseases, First Affiliated Hospital of Wenzhou Medical University, between February and October 2021 using the random sampling method. The MASLD diagnosis was based on the guidelines for the prevention and treatment of MASLD. An analysis of patients' self-management ability was conducted using the self-management ability scale for patients with MASLD. Multiple linear regression analysis was used to analyse the factors influencing this self-management ability, and the readmission rate within 1 year was tracked. The patients were rediagnosed as having MASLD upon readmission to the hospital. A total of 241 baseline data items and self-management scale scores for patients with MASLD were collected and investigated. In our study, the normal score range for the self-management scale was 31-155 points, and the self-management scale scores for patients with MASLD was 91.24 ± 16.98, with a low level of self-management accounting for 52.7% and a medium level accounting for 44.8%. The results of the multiple linear regression analysis revealed that marital status, smoking history, fatty liver severity and education were the main factors affecting self-management ability (P < 0.05). The readmission rates were 18.25%, 7.48% and 0%, respectively, after 1 year of follow-up; the difference in survival distribution was statistically significant (P < 0.05). The self-management ability of patients with MASLD is relatively low and is primarily influenced by factors such as marital status, smoking history, the severity of fatty liver disease and level of education, which also affect the readmission rate of patients within 1 year.

Mobile solution and chronic diseases: development and implementation of a mobile application and digital platform for collecting, analyzing data, monitoring and managing health care.

Technological advances based on mobile health (mHealth), the field of digital health (eHealth) aimed at managing health services and care and their concomitant transformations, have become increasingly important in the 21st century. In this context, care for individuals diagnosed with Chronic Non-Communicable Diseases (CNCDs) deserves to be highlighted. The aim of this study is to present the creation, development and implementation of the Telehealth Center of the Federal University of Viçosa (NUTELES - UFV), for the monitoring and management of health care for individuals with Arterial Hypertension (AH) and/or Diabetes Mellitus (DM). This study, carried out in 2022 and 2023, involved 374 patients diagnosed with AH and/or DM in the health micro-region of Viçosa/MG, Brazil, comprising nine municipalities. The research aims to describe the creation, development and implementation of a software (NutelesApp) for the collection, storage, management and analysis of epidemiological research in public health, focusing specifically, on the monitoring and management of health care for individuals with AH and/or DM monitored by Primary Health Care (PHC). The parameters collected and analyzed were obtained through a questionnaire applied to patients, consisting of 70 questions, subdivided into 12 classes of questions. The epidemiological survey data was collected using mobile devices and analyzed using computer techniques based on statistical analysis. Once the field teams had completed their work, the files were transferred to servers for general analysis processing, using estimates of means, prevalence and respective standard errors, calculated using the Statistical Package for Social Science (SPSS) program, which takes into account the planning variables and includes the basic weights resulting from the sampling process. This study was approved by the Human Research Ethics Committee and registered, prior to recruitment, by the Brazilian Registry of Clinical Trials (ReBEC), ID: RBR-45hqzmf (Last approval date: 11/30/2022). The information obtained through data collection with subsequent exploratory analysis of epidemiological data using the NutelesApp software suggests that mobile applications intended for the purpose of monitoring and managing healthcare for people with AH and/or DM should address the variables necessary to support a process of understanding the health conditions and/or disease of the individual as a whole and provide short- and long-term learning. Regarding the results of the survey using the software, the variables of 374 people were analyzed. Majority are female (73.2%) and white (43.5%). Most patients are elderly (average 64 years), with blood pressure levels within the normal range for this population, BMI indicates overweight, AC increased risk for cardiovascular events and CC within the recommendation value. All biochemical parameters analyzed were above normal limits. The description of the creation and development of the software includes practical examples of its implementation, the results collected and its applicability in real scenarios, presenting determining criteria that can provide assertive and timely interventions for monitoring and managing the health and/or disease parameters of patients with HA and/or DM. In addition, the beneficial consequences of using this application will extend to health units and their respective management, improving the services provided by PHC and enhancing strategies and actions for health promotion and disease prevention.

PEMBERIAN SAYUR PEPAYA MUDA TERHADAP KELANCARAN ASI PADA IBU NIFAS

Midwifery care is a complete series of care by midwives covering the entire maternity period, from antenatal to intranatal to neonatal and postnatal including family planning contraceptive counseling. The administration of lactagogue, a substance known to help increase breast milk secretion and production, which is naturally found in papaya, is a widely adopted strategy to overcome the problem of low, or even worse, lack of breast milk production (BMP) in breastfeeding mothers. This study aims to provide comprehensive information on, from antenatal to intranatal to neonatal and postnatal by including family planning. The methods used are interviews, observations and implementation. The subject was Mrs. S who was given boiled young papaya to increase BMP during postpartum care at Hj. Hospital. Bunda Halimah Batam in 2024. The results of the examination given to Mrs. S did not show any significant problems during the antenatal and intranatal periods (which were spontaneous vaginal delivery (SVD)), the weight of the newborn was within the normal range, postpartum care to increase BMP was also reported to be no problem, and the subject decided to become a contraceptive acceptor. In conclusion, which can be done independently, during antenatal, intranatal, neonatal, postnatal, and family planning counseling, no significant problems were found. As a suggestion, midwives are encouraged to implement standardized ones starting from antenatal care to contraceptive follow-up that can help monitor and anticipate possible problems or complications early on

Modified Calcanization of Tibia for Hindfoot Defect Reconstruction: Method and Preliminary Results.

To introduce our modified technique for calcanization of the tibia in managing massive bony loss of hindfoot and preliminary outcomes. From January 2015 to December 2021, modified calcanization of the tibia were performed in 10 patients with unilateral loss of the calcaneus. Clinical outcomes were assessed based on the American Orthopaedic Foot & Ankle Society score and Symptom Checklist-90-Revised questionnaire. Paired two-group t-test was applied to compare the parameters. The mean lengthened length of the tibia was 77.3 ± 3.0 mm (range, 74-83 mm). The mean external fixation time was 123.7 ± 52.1 days (range, 117-134 days) and the mean external fixation index was 1.601 ± 0.046 days/mm. All patients stuck to the postoperative follow-up plan with an average follow-up time of 29.7 ± 3.4 months (range, 24-35 months). Deformities of the injured limbs were well corrected. Based on American Orthopaedic Foot & Ankle Society score, eight good and two fair results were achieved. The mental status of all patients was within the normal range, and several indices of the Symptom Checklist-90-Revised questionnaire of each patient were improved after the whole procedure. We demonstrate that the modified calcanization of the tibia is qualified for total loss of calcaneus with limited complications. Early rehabilitation is attainable since external fixation time is shortened due to a simplified procedure.

Descriptions of Child Developmental Disorders Living Around Gold Mining

Living around the gold mining area, at risk of exposure to mercury (Hg). Pregnant women exposed to Hg alkyl can cause fetal brain damage so that the baby is born with d efects. This is due to the target toxicity of Hg, especially the organic metal compounds are the nervous system. Based on a child development screening questionnaire, ±100 children were questioned about their development, motor development, language and social interaction. This research was to see a picture of the development of children living around the Gold Mining village of Kalirejo, Kokap district, Kulon Progo District, Yogyakarta. The Longitudinal Observational Research Method with serial measurement measured the level of child development in five domains: cognitive, linguistic, motor, social, emotional and behavioral (adaptive behavior) with the Bayley Scale of Infant and Toddler Development Third Edition (BSID III) against 16 infants in the age range of 2-14 weeks (stage I) and 14-26 weeks. (tahap II). The baby's development observations resulted in an average composite development score of 85. Stage I obtained composite scores of cognitive domain; 102.81, language; 107.38, motor: 98.94, social emotional: 100,63 and behavioral: 90.00, while Stage II of each domain had the same scores as 105.94 : cognitive, 105.38: language, 104.81: motor, social-emotional: 98,69 and behavioural: 92.44. The conclusion that the composite child development score was in the average range of 90 - 109 for all domains, means that the child development composite score was still within the normal range (85-115), indicating that there is no developmental impediment. It is recommended to reduce Hg exposure, provide optimal nutrition to the baby and enhance developmental interventions with stimulation to stimulate auditorium, visual, tactile and kinesthetic, thereby improving the quantity and quality of brain cell synapses, to optimize brain function.

Language ability in 5–12-year-old children with new-onset epilepsy

Purpose This clinically based study aimed to explore and describe language ability in 5–12-year-old children with new-onset epilepsy. Participants and methods: Twenty-one consecutively recruited children (eleven boys, ten girls) with new-onset epilepsy, were assessed using Clinical Evaluation of Language Fundamentals, fourth edition (CELF-4) and additional tests for verbal fluency/word retrieval and phonology. In addition, caregivers rated their child’s speech, language, and communication in everyday context. Based on available tests and clinical observation, an overall evaluation of language ability was made to distinguish children with language disorders and children with language difficulties from those with language abilities within the normal range. Language disorder was diagnosed following the ICD-10 criteria. The cutoff for language difficulties was set at 1 standard deviation below the normative mean on the CELF-4 Core Language Score and additional indices. Results Out of twenty-one children, ten (47.5%) met the criteria for a language disorder diagnosis according to ICD-10. Another five (24%) had language difficulties but did not meet the criteria for a language disorder diagnosis according to ICD-10. Hence a total of fifteen (71.5%) children had an impaired language ability affecting different domains of language, including receptive language, language memory, and semantic processing. The remaining six (28.5%) children had average language ability. Conclusion In this group of children with new-onset epilepsy, a large over-representation of co-existing language disorder and language difficulties was found. The findings suggest that specific language assessments for children with new-onset epilepsy are needed, to ensure that adequate interventions and support can be offered.

Physical fitness and BMI in Men's Vocational Sailing School

The maritime industry is known for its high physical demands. Students in maritime vocational programs, who will eventually work on ships, must have a good level of physical fitness to perform demanding tasks. Without adequate physical fitness, the risk of injury and fatigue increases, which can ultimately affect workplace safety and operational efficiency. This study aims to determine the Body Mass Index (BMI) and physical fitness levels of male students at SMK Baruna Pemalang. The research design uses a descriptive quantitative method to determine BMI and physical fitness levels. The test instruments are based on the Guidelines for the Nusantara Student Fitness Test from the Ministry of Youth and Sports of the Republic of Indonesia, with a validity of 0.471 and a reliability of 0.232. A sample of 61 male students was selected from a total population of 90 students. Data analysis in this study uses SPSS 26 to describe the BMI and physical fitness levels of the male students. The results indicate that the Body Mass Index of the students falls within the normal (healthy) range for a total of 35 students, while the average physical fitness level of the students is categorized as poor, with 46 students falling into this category. The findings of this study are expected to serve as baseline data for further research to improve the physical fitness levels of maritime vocational students.

Long-term continuous terlipressin infusion improves cardiac reserve in patients with decompensated cirrhosis

Cardiac dysfunction is a key factor in the pathogenesis of hepatorenal syndrome, for which terlipressin is the recommended first-line treatment. This study investigates whether long-term terlipressin can ameliorate the subclinical cardiac dysfunction observed in decompensated cirrhosis. Twenty-two patients with decompensated cirrhosis and ascites enrolled in a prospective study of home continuous terlipressin infusion were included. Cardiac function was assessed using dobutamine stress echocardiogram before and after 12 weeks of terlipressin. The primary outcome was the impact of terlipressin on cardiac reserve; the change in cardiac output (CO) in response to stress. Median age was 61 years (IQR 56-64), median MELD score was 15 (IQR 12.3-17.0) and 72.7% were male. The increase in CO in response to low-dose dobutamine was significantly higher following terlipressin (↑4.0L/min [↑57.8%]) as compared to baseline (↑1.8L/min [21.3%], p=0.0001). The proportion of patients with impaired cardiac reserve (defined by ΔCO <25% after low-dose dobutamine) reduced from 81.8% at baseline to 40.9% after terlipressin, (p=0.02), driven primarily by improvement in inotropic function. Resting cardiac output (CO) decreased significantly after terlipressin from 8.9±2.2L/min to 7.2±1.8 L/min (p<0.001, normal range 5-6L/min), due to a decrease in stroke volume from 108 to 86mL/beat (p=0.006). Long-term continuous terlipressin infusion resulted in a significant increase in cardiac reserve and attenuation of the hyperdynamic state usually observed in decompensated cirrhosis. These data provide important mechanistic insight into the pathogenesis and reversibility of cardiac dysfunction in cirrhosis. Future studies are required to evaluate whether long-term terlipressin can prevent hepatic decompensating events such as hepatorenal syndrome in high-risk individuals. ANZCTR NUMBER: (http://www.anzctr.org.au/): ACTRN12619000891123.

Evaluation of Hormonal and Biochemical Profile of Ladakhi Cow during Estrous Cycle: The Future Perspective of Reproductive Management of Ladakhi Cow

The Ladakhi cow is an indigenous breed from Ladakh, India, and has a unique genetic makeup to adapt to high-altitude hypobaric stress. Furthermore, little study is available on examining the Ladakhi cow’s blood biochemicals and reproductive hormonal status during various stages of the estrus cycle. Hence, the current study was conducted on eight reproductively mature Ladakhi cows at the experimental dairy cattle unit in Leh-Ladakh, India, to determine the changes in serum biochemical and hormonal levels during the estrus cycle. The estrus behaviour was initially observed before the blood sampling on days 0 (the day the cow exhibited heat symptoms), 2nd, 8th, 17th, and 21st days. The serum was isolated for biochemical and hormonal profiling as per standard procedures using commercially available kits. The results revealed that serum biochemicals, viz. Ca, Fe, ALT, AST, ALP, TG, TP, Albumin, Glucose, UA, Creatinine, and Urea levels were within the normal range of cows at high altitudes. However, reproductive hormones, e.g. GnRH, FSH, LH, progesterone, estrogen, PGF2α, IGF-1, and Insulin varied from the reference level at different stages of the estrus cycle. This study’s findings have provided new insights into the serum biochemical and hormonal profiling of Ladakhi cows during the estrus cycle and this information may help to develop a reference range and baseline value for the serum biochemicals and hormonal levels of Ladakhi cows for other breeding programs and health monitoring.