Paired Sample T-test Research Articles

A - 105 Impact of COVID-19 on Executive Functioning and Processing Speed in Older Adults with Mild Cognitive Impairment

Abstract Objective COVID-19 can cause dopaminergic neuron senescence. Importantly, dopamine is instrumental in executive functioning (EF) and processing speed (PS). The current study investigated the impact of COVID-19 on EF and PS in older adults with mild cognitive impairment (MCI). It was hypothesized that older adults would have significantly worsened EF and PS post-COVID-19 infection. Methods Participants were drawn from a larger study of late-life brain health. The current sample included nine older males with MCI, ages 57–90 years (M = 77.78 ± 9.89). Participants were predominantly White (78%) and well-educated (55.5% had a bachelor’s degree or higher). The Stroop Color Word Test (SCWT) measured EF and PS at baseline (T1) and six months later (T2). All participants contracted COVID-19 between T1 and T2. Changes in cognition were assessed using paired sample t-tests. Results Post-COVID-19 infection, participants experienced a statistically significant decline on the SCWT color word trial (t = 3.15, p = 0.02). Participants evidenced nonsignificant change on the SCWT word trial (t = 1.70, p = 0.13) and the SCWT color trial (t = 1.94, p = 0.100). Conclusions In a sample of older adults with MCI, contracting COVID-19 potentially contributed to a significant decline in EF but not PS. Research has consistently highlighted the negative impact of Long COVID on EF. Current findings suggest that the COVID-19 infection negatively impacts EF, even in those without Long-COVID. Findings highlight the importance of monitoring cognitive function post-COVID infection in older adults with pre-existing cognitive impairment.

B - 91 Characterizing Memory Profiles of Movement Disorders: the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Recognition Subtests

Abstract Objective This study explores the utility of novel recognition memory composites integrating recently developed recognition subtests from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS; Duff et al., 2021) in characterizing memory profiles across Mild Cognitive Impairment (MCI) and Normal Cognitive Study (NCS) groups in patients with movement disorders. Methods Twenty patients with movement disorders (M = 69.4 years, SD = 6.3) were administered the RBANS including additional Story and Figure Recognition subtests as part of a comprehensive neuropsychological evaluation at an academic medical center. Samples were stratified by MCI (n = 15) and NCS (n = 5) groups based on clinician diagnoses. Z-score based composites were created for individual recognition measures (total, hits, false positives, and discriminability indices, d’) and “Total Delayed Recall” memory composites across list, story, and figure subtests. Results Mann–Whitney U test analyses revealed significant differences between MCI and NCS groups on Story recognition d’ performance, U = 9.50, p = <0.05. Within the MCI group, a paired samples t-test revealed significantly worse performance on recognition d’ compared to “Total Delayed Recall” (M = 1.63, SD = 2.22); t(14) = 2.84, p = <0.05. Conclusions Greater impairment in recognition discriminability compared to delayed recall suggests the involvement of memory processes that extend beyond retrieval deficits typically observed in movement disorders characterized by subcortical/frontosubcortical profiles. Further investigations are warranted in establishing implications of recognition memory composites in differentiating among MCI subtypes and neurodegenerative disease progression within movement disorder populations, as findings may have been influenced by unequal variances between groups.

A - 33 Impact of Cognitive Stimulation Therapy on Neuropsychiatric Symptoms and Everyday Functioning in a Veteran Sample

Abstract Objective Cognitive stimulation therapy (CST) is a well-supported nonpharmacological intervention, found to improve or maintain global cognition, daily functioning, and quality of life with persons with dementia. There are fewer studies assessing the effect of CST on neuropsychiatric symptoms; however, pilot studies have identified improvement in depression and anxiety in studies of persons with Alzheimer’s disease. The purpose of this program evaluation was to evaluate the impact of CST on neuropsychiatric symptoms and everyday functioning is a veteran sample. Method Twenty-six male veterans diagnosed with cognitive disorder (84.6% dementia, 15.4% mild cognitive impairment) completed a 7-week CST program. The sample was diverse (46.2% White/Caucasian, 42.3% Hispanic/Latino, 7.7% Black/African American; 38.5% bilingual). Most frequent etiologies included mixed (26.8%), Alzheimer’s (23.1%), and vascular (19.2%). Ages ranged from 43–86 (M = 74.5; SD = 7.6). Pre-group/post-group assessment included Geriatric Depression Scale-Short Form (GDS-SF), Geriatric Anxiety Inventory (GAI), Neuropsychiatric Inventory (NPI-informant), Everyday Cognitive (ECOG), and Texas Functional Living Scale (TFLS). Analyses included paired-samples t-test and Wilcoxon signed-rank test. Results Post-group GAI scores were significantly lower (Median = 1) than pre-group scores (Median = 3), z = −2.574, p = 0.01, r = −0.515. There were no significant declines or improvements across other measures of neuropsychiatric symptoms. Measures of IADLs/everyday functioning also remained stable. Conclusions Consistent with prior studies, CST was effective in reducing anxiety symptoms of veterans with cognitive disorders. While measures of everyday functioning did not improve, performance and informant-report remained stable. CST presents a unique opportunity to impact both cognition and neuropsychiatric symptoms that may cause significant distress in veterans with dementia and their caregivers.

Postural analysis and ergonomic intervention of unorganized workers in indian construction sectors.

In India's fast-growing economy, the construction sector offers significant developments with huge employment opportunities but poses risks due to poor working environments and uncomfortable postures. Traditional methods, such as manual material handling, can lead to health hazards and musculoskeletal disorders such as overexertion, low back pain, etc. The purpose of this study was to analyze the working postures of unorganized employees engaged in residential buildings using Ergofellow software and to recommend changes in their unsafe working postures. Participants' working positions were video recorded and the postures were analyzed using Rapid Upper Limb Assessment (RULA), Rapid Entire Body Assessment (REBA) and Ovako Working Posture Analysis (OWAS). Paired sample t-tests were used to analyze significant differences between the RULA and REBA scores after the ergonomic interventions were implemented. From the analysis of RULA, REBA and OWAS, the working postures showed a high risk of potential injury and required an immediate change in employees' working postures. The RULA and REBA scores were subsequently lower after the ergonomic interventions, which were based on ergonomic and safety principles. The paired sample t-tests with p-values of less than 0.05 demonstrated decreased risks after ergonomic interventions. Working postures of the construction workers exposed to musculoskeletal disorders were examined and the ergonomic interventions were implemented. According to the recommendations, working positions were changed, and employee well-being was enhanced by reduced operational risks.

Spirulina supplementation and circuit resistance training (CRT) reduce serum asprosin and appetite and improve energy balance in men with obesity and overweight.

The present study aimed to investigate the effects of 8 weeks spirulina supplementation and circuit resistance training (CRT) on asprosin, appetite, and energy balance in men with obesity and overweight. The study comprised a single-blind randomized controlled trial. Sixty men with obesity and overweight (BMI > 25) were selected and randomly divided into four equal groups (n = 15 each) of training plus spirulina, training plus placebo, spirulina, and placebo. The participants of the training groups performed 12 movements with 40-90% maximal repetition (three sessions per week) and the supplemental groups consumed 1000mg of spirulina per day for 8 weeks. Asprosin, appetite using visual analog scales, calorie intake, energy expenditure, and body composition were measured before and after the intervention. To analyze the data, the paired sample t-test, analysis of covariance, Bonferroni post-hoc, and Pearson correlation tests were employed using SPSS (version 20) at a significance level of p < 0.05. After the intervention, asprosin level (P = 0.015, P = 0.015, and P = 0.020, respectively), weight (P < 0.001, P < 0.001, and P < 0.001, respectively), calorie intake (P = 0.015, P = 0.011, and P = 0.004, respectively), and hunger (P = 0.011, P = 0.015, and P = 0.015, respectively) declined in the training plus spirulina, training plus placebo, and spirulina groups (p < 0.05). In addition, energy expenditure (P = 0.012 and P = 0.015, respectively) and fullness (P = 0.015 and P = 0.011, respectively) increased in the training plus spirulina and training plus placebo groups. The mean changes of the research indicators in the training plus spirulina group were significantly more than those of the other groups (p < 0.001). It was shown that 8 weeks of CRT and spirulina supplementation decreases the level of asprosin and improves appetite and energy balance in men with obesity and overweight.

Arterial Spin Labeling (ASL) MRI in Evaluating Pancreatic Blood Perfusion in Subjects With Different Glucose Tolerances.

The pancreas plays a central role in type 2 diabetes mellitus (T2DM), and its blood flow is usually associated with insulin release demand. To noninvasively assess pancreatic blood flow (PBF) changes and modulation in people with different glucose tolerance following a glucose challenge using ASL MRI. Prospective. Fourteen prediabetes, 22 T2DM, and 40 normal. Pseudo-continuous ASL with a turbo gradient spin echo sequence at 3.0 T. All normal and subjects (diagnosed by oral glucose tolerance test) underwent ASL after fasting for at least 6 hours. The normal and prediabetes groups additionally had ASL scans at 5, 10, 15, 20, and 25 minutes following oral glucose (50 mL, 5%). PBF maps were generated from the ASL data and measured at body and tail. The ability of baseline PBF (BL-PBF) of body, tail (BL-PBFtail), and their average to determine abnormal glucose tolerance and stage was assessed. ANOVA, Mann-Whitney U test, Kruskal-Wallis H test, paired sample t-test, intra-class correlation coefficient, repeated measures ANOVA, correlation analysis, receiver operating characteristic analysis, and logistic regression analysis. A P value <0.05 was considered significant. There were significant differences in BL-PBF among the three groups. The prediabetes group exhibited significantly lower PBF than the normal group at all time points; Both groups showed similar changing trends in PBF (peaking at the 15th minute and subsequently declining). The BL-PBFtail had the highest diagnostic performance when evaluating abnormal glucose tolerance or stage (area under the curves = 0.800, 0.584, respectively) and was an independent risk factor for glucose tolerance status. ASL can noninvasively assess changes in PBF among individuals with varying glucose tolerance and in response to glucose challenge, which could be linked to insulin release demand and might help characterize changes in pancreatic endocrine function. 2 TECHNICAL EFFICACY: Stage 1.

Assessment of nurse practitioners’ capacity of using the ABC/2 formula for intracranial lesion volume measurement

BackgroundThis study investigates the precision of nurse practitioners (NPs) in measuring intracranial lesion volumes using the ABC/2 method, a simple yet widely used technique in neurosurgical practices. Amidst physician workforce shortages, the role of NPs in clinical practice, including specialized tasks like lesion volume estimation, is gaining importance.MethodsWe conducted a retrospective study involving patients treated for intracranial meningiomas. NPs estimated tumor volumes using the ABC/2 method, which was then compared with automated ABC/2 estimations considered as the gold standard. Statistical analyses, including paired sample t-tests, Bland-Altman analysis, and Intraclass Correlation Coefficient (ICC) analysis, were employed to assess measurement accuracy and consistency.ResultsAmong the 265 meningioma patients included, NPs measured the average tumor volume as 36.95 ml, generally underestimating it compared to the 39.57 ml average obtained by the automated ABC/2 method. This underestimation, however, was clinically modest, indicated by an average percentage difference of 6.59% and a Cohen’s d value of 0.08. Consistency in measurements, assessed using Bland-Altman and ICC analyses, demonstrated a high level of agreement between NPs measurements and the automated method. Additionally, no significant differences in measurement accuracy were observed either among different NPs or across NPs with varying levels of work experience.ConclusionsNurse practitioners can effectively employ the ABC/2 method for estimating intracranial lesion volumes with reasonable accuracy and consistency, irrespective of their work experience. This finding is pivotal in enhancing the role of NPs in neurosurgical practices and could be significant in alleviating the strain caused by the global shortage of physicians. Future research may explore extending NPs’ roles in other clinical diagnostic and therapeutic tasks.

Exploring the impact of field shape on predicted dose distribution in breast cancer patients using deep learning in radiation therapy

BackgroundGeometrical information such as field shape is essential for dose calculation in radiation therapy. However, new methods of dose prediction based on deep learning only use CT images and contouring of patients. The aim of this study is to develop a deep learning method for three-dimensional dose prediction for breast cancer radiotherapy using field shape as well as CT and contouring images of patients. MethodsA total of 150 breast cancer patients' data treated with 3D conformal radiation therapy (CRT) technique were used to train and test 3D-U-Res-F-Net model. The model inputs were CT images, patients' contouring and field shape. The network output was the corresponding the patients’ dose distribution. Then, the dosimetric parameters extracted from the dose volume histograms related to the planned and predicted dose distributions were compared and were statistically analysed with the paired-samples t-test. These parameters include Dmean and Dmax for planning target volume and organs at risk, D95%, D50%, V47.5Gy for PTV, V30Gy and V25Gy for heart and V20Gy for left lung. The gamma index with 3%/3 mm criteria was calculated for PTV and OARs. ResultsThe average absolute difference of the Dmean relative to the prescribed dose for the PTV, heart, left lung, right lung and spinal cord were 1.37 ± 0.4%, 2.02 ± 2%, 2.12 ± 1%, 0.37 ± 0.3% and 0.41 ± 0.3%, respectively. The average absolute difference of the Dmax relative to the prescribed dose for the PTV and OARs varied from 0.23 ± 0.2% to 2.04 ± 2%. The 3D gamma pass rate with 3mm/3% criteria for planning target volume, heart, left lung, right lung, spinal cord and body were 89 ± 3%, 91 ± 5%, 93 ± 5%, 99 ± 3%, 99 ± 1% and 96 ± 2% respectively. ConclusionsThe results of the proposed model demonstrate that there is no significant difference between the predicted and planned dose distributions. The deep learning model can directly predict the 3D dose distribution faster than treatment planning systems. Further studies with more patients and on other cancer sites are essential to fully validate the proposed method.

The effects of low vs. high rating of perceived exertion clamp exercise on performance, neuromuscular, and muscle oxygen saturation responses in females.

This study examined the time course of changes in force, relative to critical force (CF), electromyographic amplitude (EMG AMP), neuromuscular efficiency (NE), and muscle oxygen saturation (SmO2), as well as time to task failure (TTF) and performance fatigability (PF) during isometric handgrip holds to failure (HTF) anchored to the rating of perceived exertion (RPE) at 3 and 7. Ten females completed pre-test maximal voluntary isometric contractions (MVICs), submaximal HTF at four percentages of MVIC, an HTF at RPE = 3 and 7, and post-test MVICs. Analyses included paired samples t-tests, repeated measures ANOVAs and planned comparisons. TTF was not different between RPE 3 (540.4 ± 262.1s) and 7 (592.2 ± 299.6s), but PF for RPE 7 (42.1 ± 19.1%) was greater than RPE 3 (33.5 ± 15.4%) (p < 0.05). There were RPE-dependent decreases in force, EMG AMP, and NE across three discernable phases during the HTF (p < 0.01), but there were no significant changes in SmO2 across time. Although there were overall similar patterns across time for force, neuromuscular, and muscle metabolic responses between the RPE holds, the greater PF at RPE 7 than RPE 3 may be explained by the longer sustained time above CF at RPE 7, resulting in greater accumulation of intramuscular metabolites and afferent feedback. Throughout each trial, it is possible that force was adjusted to avoid the sensory tolerance limit, and the task was ended when force could no longer be reduced to maintain the assigned RPE, resulting in a similar TTF for RPE 7 and RPE 3.

EFEKTIFITAS PENGGUNAAN APLIKASI QUIZIZZ TERHADAP MINAT DAN HASIL BELAJAR MATEMATIKA SISWA

This research aims to determine the effectiveness of using the Quizizz application on students' interest and learning outcomes in mathematics on exponents and root forms at Muhammadiyah 48 Medan Private Middle School. The background to this research focuses on the low interest and learning outcomes of students in mathematics subjects, which are often considered difficult and boring by many students. The method used is quantitative with a pre-experimental research design, namely one group pretest posttest design where the sample consists of 50 students selected using total sampling techniques. The results of the research show that there is a significant increase in student interest and learning outcomes after using the Quizizz application, namely scores The average interest in learning mathematics after using the Quizizz application is 76.54 with a gain value in the medium category of 0.448 and the average score for learning mathematics after using the Quizzizz application is 78.60 with a gain value in the medium category 0.478. The paired sample t-test produced a significance value of less than 0.05, namely 0.001, indicating that the use of the Quizizz application was effective in increasing students' interest and learning outcomes in mathematics. So it can be concluded that the integration of technology in learning, especially through the Quizizz application, has been proven to be able to make mathematics learning more interesting, fun and interactive, thereby increasing students' interest and learning outcomes in mathematics.

Enhancing the starting performance of elite swimmers through eight weeks of lateral entry training

ABSTRACT This study aims to explore the effects of 8 weeks of lateral entry training on the start performance of elite athletes and its impact on ordinary entry performance. Data were collected from 12 elite-level participants before and after the training using Kistler(9691A1) system with 3D force platform and high-speed cameras. 19 parameters of ordinary and lateral entry were assessed and analysed using paired samples t-tests. Compared to ordinary entry, the lateral entry performance was characterised by: decrease of both vertical force (5.77%) and maximum depth (6.09%) at a significance level (p < .01), and increase of flight distance (4.33%), first kick distance (3.90%) and push force (14.06%) at (p < .05). The results show that, compared to an ordinary entry technique, the lateral entry technique provides a 3.93%, 6.14%, and 8.29% reduction in time to reaching a 5 m, 10 m and 15 m distance (p ≤ .01), showing performance improvements at start times. The 8-week training on the lateral entry technique did not have a significant impact on the time performance of the ordinary entry technique (p > .050). The findings presented herein offer pertinent insights for elite-level athletes, coaches and future investigations aimed at enhancing swimming start techniques and performance.

PENGARUH PEMBELAJARAN MATEMATIKA BERBASIS PROYEK TERHADAP KEMAMPUAN PEMECAHAN MASALAH SISWA KELAS X SMAN 1 PEGAJAHAN

This study aims to examine the impact of Project-Based Learning (PjBL) on the problem-solving abilities of tenth-grade students at SMA Negeri 1 Pegajahan within the context of the Merdeka Curriculum. The research employs a quantitative method with a quasi-experimental approach, utilizing a Pretest-Posttest Only One Group Design. The population includes all tenth-grade students, with samples selected using Cluster Random Sampling techniques. Data were collected through pretests and posttests and analyzed using descriptive and inferential statistical tests, including normality tests, homogeneity tests, and the Paired Sample t-Test. The results indicate a significant improvement in students' problem-solving abilities following the implementation of PjBL. The t-test results demonstrate a positive effect of PjBL on students' problem-solving skills. Based on these findings, it is concluded that PjBL is an effective teaching method for enhancing students' mathematical problem-solving abilities. This study provides valuable contributions to the development of more innovative and relevant teaching methods, particularly in supporting the implementation of the Merdeka Curriculum in Indonesia.

ANALISIS KEPUASAN DAN MINAT BELAJAR MAHASISWA PADA PERKULIAHAN KALKULUS MENGGUNAKAN MODEL NUMBER HEAD TOGETHER

The aim of this research is to describe the differences in the average scores of student satisfaction and interest in learning in Calculus lectures using the Number Head Together (NHT) type learning model. This research uses an experimental method using One Group Pretest Posttest Design. The data analysis used in this research is the paired t-test (Paired Sample t-Test). The research subjects were 42 people, namely students of the Industrial Engineering study program, semester one of the 2022-2023 Academic Year. The research results showed that the average pretest score from the student satisfaction questionnaire was 18.3810, while the average posttest score from the student satisfaction questionnaire was 35.4524. This shows that the average posttest score for student satisfaction is higher than the average pretest score for student satisfaction using the NHT model in calculus lectures. Furthermore, the average pretest score from the student interest in learning questionnaire was 20.1429. Meanwhile, the average posttest score resulting from the student interest in learning questionnaire was 35.6905, this shows that the average posttest score for student interest in learning was higher than the average pretest score for student interest in learning using the NHT model in calculus lectures. Next is the data from the analysis of pretest and posttest scores on student satisfaction and student interest learning in calculus lectures using the NHT model using the Paired Sample T-Test showing a Sig value. (2-tailed) is .000 0.05 so H0 is rejected, which means that there is a significant difference between satisfaction using the NHT model in pretest and posttest data.

The effectiveness of hyperoxygenation in preventing oxygen desaturation in intubated infants treated with endotracheal suctioning

Endotracheal suctioning is an effective nursing intervention for intubated infants undergoing invasive mechanical ventilation. However, this intervention has the potential to cause side effects, such as hypoxemia, which typically requires hyperoxygenation. Despite the widespread use of hyperoxygenation in clinical practice, there are limited reports on its effectiveness in infants. This study aims to determine the effect of hyperoxygenation on oxygen saturation of intubated infants.The study procedures were carried out using a quasi-experimental method with a cross-over approach. In addition, the sample population comprised 22 intubated infants who were treated at the perinatology unit of Dr. Cipto Mangunkusumo Hospital in Jakarta from March to April 2018. The participants were then divided into 2 groups based on their condition, and oxygen saturation level was assessed. The intervention comprised endotracheal suctioning with and without hyperoxygenation, with a 3-hour washing period. Data collection was performed at different measurement intervals, namely before, during, and after suctioning, followed by statistical analysis.The paired-sample t-tests and Wilcoxon test showed that there was a significant difference in oxygen saturation at certain measurement intervals (p=0.006; p=0.010; p=0.001; p=0.001; p=0.001). In addition, Friedman test also showed the presence of a significant difference in the reduction of oxygen saturation between the control and intervention groups (p=0.001).In conclusion, hyperoxygenation had the potential to prevent the reduction of oxygen saturation during endotracheal suctioning in intubated infants. However, individual assessment of the need for suctioning and hyperoxygenation was necessary for a safe and effective procedure.

Analisis Perbandingan Perilaku Konsumen Dalam Pengambilan Keputusan Berbelanja Di Toko Madura dan Minimarket Di Kabupaten Bangkalan

This research aims to determine differences in consumer behavior in making shopping decisions at Madura Stores and Minimarkets in Bangkalan Regency. This type of research is quantitative research. The population in this research is all consumers who shop at Madura Stores and Minimarkets in Bangkalan Regency, an unknown number. Meanwhile, for the sample in this study, researchers used 50 respondents. The data collection techniques used were questionnaires and observation. Data analysis techniques in this research used validity tests, reliability tests, Kolmogov-Smirnov normality tests, and paired sample t-tests using IBM SPSS 23. Based on the results of research that has been carried out, it is known that there is no significant difference between consumer behavior in making shopping decisions at Madura Stores and Minimarkets in Bangkalan Regency. With this information, it is hoped that it will be able to provide insight to the entire community in making policy decisions regarding the existence of Madura Shops and Minimarkets for shopping for necessities.

Examining Real-World Evidence of Depression-Related Symptom Reduction Through a Comprehensive Holistic Lifestyle Intervention

Depression is a global health concern, with various treatments available. In this study, participants (n = 430) were self-selected or medically referred to a residential lifestyle program at the Black Hills Health &amp; Education Center (BHHEC), with a mean stay of 19 days. Individualized treatment plans included structured physical activity sessions, counseling sessions, and the provision of a vegan diet. Beck Depression Inventory-II, self-reported total exercise minutes, resistance exercise minutes, and sleep, along with the number of holistic treatments and counseling sessions, were evaluated. Paired samples t-tests indicated a significant decrease in depression scores over time (MT1 = 20.14, MT2 = 6.17, P &lt; .001). Results from the multiple linear regression that evaluated total exercise minutes, resistance exercise, number of treatments and counseling sessions, and average reported hours of nightly sleep on depression scores at time 2 indicated that average reported hours of nightly sleep were the only significant predictor of depression scores at time 2 ( P &lt; .05). While depression scores significantly improved from baseline to post-assessment for all participants, it is possible that an unmeasured variable, or the synergistic intervention effect of the wellness program, accounted for changes in depressive symptoms over time. Future studies should incorporate sleep quality and assessing time spent in nature to explore these relationships further.

An Evaluation Of The Treasury Single Account (TSA) As An Instrument Of Financial Prudence and Management In Nigeria: Methodology Analysis (OAGF) 2015-2024.

This paper examines the Office of the Accountant General of the Federation and the relationship between the Nigerian economy and the Treasury Single Account Policy (2015-2024). The Nigerian economy has developed slowly over the years, which has led to little to no improvement in the country's residents' standard of living. The study's overall goal was to determine how the Treasury Single Account Policy affected Nigeria's economic developments between 2015 and 2024. Its specific goals were to determine whether the human development index, Gini coefficient, and poverty rate of the country's economy differed significantly between the pre-and post-implementation periods. The research utilized the design of the quantitative study. Nigerian citizens make up the study's population, while the citizens of Nigeria for the years 2015–2024 make up the sample size. The study employed secondary data that came from the World Bank's National Accounts Data, the National Bureau of Statistics, and the Central Bank of Nigeria's Statistical Bulletin. The paired sample t-test was used to assess the data. The outcome showed that, except the variable of human development index, which showed a significant difference between the periods before and after the implementation of the treasury single account policy, economic development indicators (gini coefficient and poverty rate) did not differ significantly between the periods before and after the policy. Consequently, the analysis found that the Treasury Single Using the poverty rate and Gini coefficient as stand-ins for economic development, account policy had no discernible effect on the Nigerian economy. Additionally, it was determined that the Treasury Single Account Policy had a major influence on Nigeria's economic development using the Human Development Index as a proxy for economic progress. Therefore, it was advised that government programs for human development be maintained and improved, particularly in the fields of health and education.

Clinical evaluation of the convolutional neural network‑based automatic delineation tool in determining the clinical target volume and organs at risk in rectal cancer radiotherapy.

Delineating the clinical target volume (CTV) and organs at risk (OARs) is crucial in rectal cancer radiotherapy. However, the accuracy of manual delineation (MD) is variable and the process is time consuming. Automatic delineation (AD) may be a solution to produce quicker and more accurate contours. In the present study, a convolutional neural network (CNN)-based AD tool was clinically evaluated to analyze its accuracy and efficiency in rectal cancer. CT images were collected from 148 supine patients in whom tumor stage and type of surgery were not differentiated. The rectal cancer contours consisted of CTV and OARs, where the OARs included the bladder, left and right femoral head, left and right kidney, spinal cord and bowel bag. The MD contours reviewed and modified together by a senior radiation oncologist committee were set as the reference values. The Dice similarity coefficient (DSC), Jaccard coefficient (JAC) and Hausdorff distance (HD) were used to evaluate the AD accuracy. The correlation between CT slice number and AD accuracy was analyzed, and the AD accuracy for different contour numbers was compared. The time recorded in the present study included the MD time, AD time for different CT slice and contour numbers and the editing time for AD contours. The Pearson correlation coefficient, paired-sample t-test and unpaired-sample t-test were used for statistical analyses. The results of the present study indicated that the DSC, JAC and HD for CTV using AD were 0.80±0.06, 0.67±0.08 and 6.96±2.45 mm, respectively. Among the OARs, the highest DSC and JAC using AD were found for the right and left kidney, with 0.91±0.06 and 0.93±0.04, and 0.84±0.09 and 0.88±0.07, respectively, and HD was lowest for the spinal cord with 2.26±0.82 mm. The lowest accuracy was found for the bowel bag. The more CT slice numbers, the higher the accuracy of the spinal cord analysis. However, the contour number had no effect on AD accuracy. To obtain qualified contours, the AD time plus editing time was 662.97±195.57 sec, while the MD time was 3294.29±824.70 sec. In conclusion, the results of the present study indicate that AD can significantly improve efficiency and a higher number of CT slices and contours can reduce AD efficiency. The AD tool provides acceptable CTV and OARs for rectal cancer and improves efficiency for delineation.

Investigating the effect of manipulatives on mathematics achievement: The role of concrete and virtual manipulatives for diverse achievement level groups

This study investigates the impact of integrating both concrete and virtual manipulatives on the mathematics achievement of fifth-grade students across different achievement levels (low, average, and high). Utilizing a quasi-experimental design with pre- and post-tests, a convenience sample of fifth-grade students was randomly assigned to either a control or experimental group. The data collection instruments, consisting of separate pre- and post-tests on the same mathematical concepts, underwent thorough validity and reliability testing. Initial assessments demonstrated that the achievement levels between the control and experimental groups were comparable prior to the intervention. The experimental group received instruction that incorporated both concrete and virtual manipulatives, whereas the control group followed traditional teaching methods. Following a 12-week intervention period, a post-test was administered. The data were analyzed using parametric paired-sample t-tests and one-way ANCOVA, ensuring that all underlying assumptions were satisfied. The findings revealed significant improvements in post-test scores among students in the experimental group, regardless of their initial achievement levels. Although low-achieving students in the control group also showed progress, their gains were less substantial compared to those in the experimental group. This study highlights the potential benefits of incorporating both concrete and virtual manipulatives in fifth-grade mathematics instruction to enhance academic achievement.

Using a Board Game to Learn a Physical Assessment Course in Nursing Education: A Randomized Controlled Study

Objective: Nursing students are expected to acquire the skills necessary to provide competent patient care in complex healthcare settings. This study aimed to explore the effect of a physical assessment board game on nursing students’ knowledge level and determine their opinions about the game. Methods: A randomized controlled study design was used. The study was conducted from December 2019 to January 2020 among 56 nursing students (game group= 28, control group= 28) enrolled in an undergraduate nursing program in Türkiye. The data were collected using the Kolb’s Learning Styles Inventory to determine students’ learning styles, the Knowledge Evaluation Form for physical assessment, and the Student Opinion Form for students’ opinions about the game. Mean scores for the pre-test and post-tests were compared using independent and paired sample t-tests. Results: A significant difference was found between the pre-test and post-test knowledge scores of the game group (P&amp;lt;.05). The mean post-test knowledge score of the students in the game group was higher than that of the students in the control group, and the difference between the groups was statistically significant (P&amp;lt;.05). Conclusion: The game was beneficial for teaching physical assessment course. Future studies should incorporate different game samples, such as the development of a web-based game, as this study focused on a board game that supported physical assessment skills.