Paired T-test Research Articles

Effects of Time-Restricted Eating on Actigraphy-Derived Sleep Parameters: Post-Hoc Analysis of a Randomized, Isocaloric Feeding Study.

Time-restricted eating (TRE) is a novel dietary intervention targeting weight loss and cardiometabolic risk factors. The impact of TRE on sleep patterns remains under-explored. This was a post-hoc analysis of a parallel-arm, controlled feeding trial in 41 adults with obesity and prediabetes/diabetes, randomized to TRE (8am-6pm) or usual eating pattern (UEP; 8am-12am) for 12 weeks. We objectively determined sleep/wake patterns from 7-day wrist actigraphy data obtained at baseline and week-12. From this data, we derived total sleep time (TST) and sleep midpoint over a 24-hour period, sleep onset/offset, and sleep continuity measures. We used paired t-tests or Wilcoxon signed rank tests to compare data between baseline and week-12 within intervention arms and Mann-Whitney U tests or Wilcoxon signed rank tests to compare changes between intervention arms. 38 participants (20 UEP; 18 TRE; 93% of those randomized in the parent trial) with adequate actigraphy data (mean age 59.6 ± 7.3 years, 92% female, 92% Black, mean BMI 36.3 ± 4.7kg/m2) were analyzed. Compared to UEP, TRE increased TST by 55 minutes (p=0.03). TRE shifted sleep midpoint to 44 minutes earlier, from 3:24am to 2:40am (p=0.01), while UEP maintained the same sleep midpoint at 3:15am. Sleep onset shifted from a median of 12:22am to 11:52pm in TRE (p=0.03) while it remained stable in UEP (p=0.97). There were no differences in sleep offset and sleep continuity within and between intervention arms. TRE increased sleep time and caused earlier sleep onset compared to UEP, revealing how timing of eating may affect sleep timing and duration.

Analysis of the intervention effects of skill training for parents with autism child on toddlers with autism spectrum disorder

Objective: To explore the intervention effects of the skill training for parents with autism child (STPAC) on toddlers with autism spectrum disorder (ASD). Methods: A multicenter non-randomized concurrent controlled study design was conducted. Thirty children with ASD aged 15-30 months, first diagnosed at the Children's Hospital of Fudan University, the First Hospital of Jilin University, and Chengdu Women's and Children's Central Hospital from 2019 to 2020, were enrolled in the STPAC group. Thirty children with ASD who visited the same hospitals during the same period but refused the STPAC intervention were selected as the control group. The STPAC group received an 8-week intervention (3 h/week) followed by quarterly follow-ups for 1 year, while the control group voluntarily chose community-based routine interventions. The Griffiths development scales-Chinese (GDS-C) was used to assess the developmental levels, and the communication and symbolic behavior scales developmental profile infant-toddler checklist (CSBS-DP-ITC) was completed by the primary caregivers to evaluate social, language and symbolic behavior. The independent samples t-tests or Mann-Whitney U tests, etc.was used for inter-group comparison. The paired t-tests or Wilcoxon signed-rank tests, etc. was used for inter-group pre-post intervention comparison. Results: The STPAC group included 30 children (22 males and 8 females, aged (23.9±2.2) months), and the control group included 30 children (20 males and 10 females, aged (24.2±2.6) months). Before the intervention, there were no statistically differences in GDS-C development quotient (DQ) and CSBS-DP-ITC scores between groups (all P>0.05). After 1-year intervention, GDS-C DQ in personal-social, hearing-language, hand-eye coordination, performance domains of STPAC group and GDS-C DQ in personal-social, hearing-language domains of control group were all increased (all P<0.01). After 1-year intervention, CSBS-DP-ITC scores of both groups were all improved in socia, language, symbolic behavior, and total scores (all P<0.001). GDS-C DQ changes before and after 1 year of intervention in hearing-language, hand-eye coordination, performance domains of the STPAC group were all higher the those of control group (34(15, 48 vs. 10(-4, 39), 11±20 vs. -1±19, 23±25 vs. 8±22, all P<0.05). CSBS-DP-ITC scores changes before and after 1 year of intervention in social and total scores of the STPAC group were both higher the those of control group (10(5, 30) vs. 3(1, 7), 26±17 vs. 11±8, both P<0.001). Conclusion: Compared with the community routine interventions, the STPAC better improves the language, hand-eye coordination, visual-spatial, social communication, and play skills in ASD toddlers.

Optical coherence tomography (OCT) parameters in amblyopia

ABSTRACT Background: Publications on optical coherence tomography (OCT) parameters in amblyopic eyes compared to fellow eyes are discordant. Our study not only compares OCT data of fellow and amblyopic eyes, but is the first study to deliver pilot results on OCT parameter changes after long-term electronic monitoring of occlusion therapy. Methods: Thirty eyes with strabismic, anisometropic or mixed amblyopia and the corresponding fellow eyes underwent OCT of the macula and optic disc with a Topcon 3D-OCT-2000. In a subgroup of six patients, the same examinations were additionally performed at the end of long-term objectively measured occlusion therapy with Occlusion-Dose-Monitoring (ODM) of ≥2135 hours. Paired t-tests or matched pairs Wilcoxon tests were performed to compare optic disc values, macular thickness, as well as thickness of different layers of the macula of the amblyopic eye versus the fellow eye. Specifically, the Ganglion Cell Layer (GCL) with the Inner Plexiform Layer (IPL) designated as GCL+, as well as combined with the Retinal Nerve Fiber Layer (RNFL) designated as GCL++, were analyzed. For the subgroup of patients with follow-up OCT, the same tests were performed to compare the values in both eyes before and after occlusion therapy. Results: Average thickness (AT) and total volume (TV) of the macula of amblyopic eyes (282.0 ± 13.0 µm; 7.98 mm3 ±0.37) were increased (marginally significant p=0.0495 for both) compared to fellow eyes (278.6 µm ± 13.3; 7.88 mm3 ±0.37), all other parameters did not differ. In the group with follow-up OCT, the AT and TV of the amblyopic eyes significantly decreased after occlusion (278.8 µm before vs. 268.3 µm after and 7.89 mm3 before vs. 7.59 mm3 after; p = .031 for both). The thicknesses of inner retinal layers were not significantly different between amblyopic and fellow eyes or after therapy. Conclusions: Our results suggest that the macula of amblyopic eyes may be thicker than in fellow eyes, particularly in eyes with moderate-to-severe amblyopia. Occlusion therapy may lead to a thinning of the macula in the amblyopic eye or both eyes. The layers included in GCL+ and GCL++ do not seem to be the substrate of the observed structural changes.

Efficacy and safety of ultrasound-guided peripheral nerve blocks in management of chronic resistant migraine

BackgroundMigraine is a common primary headache disorder with different treatment modalities emerging as ultrasound guided peripheral nerve blocks. We compared the efficacy and safety of ultrasound guided bilateral sphenopalatine ganglion (SPG) block versus bilateral greater occipital nerve (GON) block, in chronic resistant migraine patients and controls.MethodsThis study was an interventional randomized controlled trial, including 53 patients, 22 in sphenopalatine ganglion arm, 21 greater occipital nerve arm and 10 in sham group. All patients were assessed initially by headache diary (for 3 months), HIT-6 and MIDAS scales. The patients (blindly allocated) underwent nerve block ultrasound guided, then followed up after one month by headache diary and HIT- 6 scale and three months by MIDAS. Results were analysed on SPSS, using mixed AVOVA and Tukey’s Post-Hoc analysis, Fisher’s exact and paired t-test.ResultsThe two groups were matched as regards the gender, age, type of migraine, frequency and years lived with headache. The study revealed that GON and SPG block, were equally effective (p < 0.05) as regards reducing the headache diary parameters, as well as the total pain index and the functional impact on HIT-6 and MIDAS scale. SPG block was more effective in patients with autonomic manifestations and temporal location of pain.ConclusionUltrasound guided SPG is as effective as GON as a treatment modality for chronic resistant migraine and may be more useful in the presence of autonomic manifestations and temporal location of pain.

Engaging leadership and work recovery among key personnel of a major health-care and social services reform

PurposeThe purpose of this paper is to investigate the experiences of engaging leadership and work recovery among preparers of a major health-care and social services reform in Finland in 2022; to investigate whether engaging leadership was associated with work recovery; and to investigate whether engaging leadership alleviated the harmful effect of job demands on work recovery.Design/methodology/approachAltogether 258 reform preparers participated in four job well-being surveys. Means and paired t-test were used to measure engaging leadership and work recovery during the study period. Hierarchical multiple linear regression analysis was used to analyze associations between engaging leadership, job demands and recovery from work.FindingsExperiences of engaging leadership and recovery from work decreased during the study period. A change in engaging leadership had a small positive association with work recovery at endpoint. A change in job demands had a stronger association with work recovery at endpoint. Engaging leadership did not alleviate the association between job demands and recovery from work.Originality/valueThis study expands previous work recovery literature by demonstrating that engaging leadership style can improve work recovery during health and social care reforms. However, engaging leadership style alone is insufficient to alleviate job demands, and therefore more effective management of job demands is needed. Practically, the findings can be used to plan and lead future reforms.

Ulnar Extrinsic Ligament Tears: Clinical Presentation, Surgical Management, and Outcomes of Surgical Repair Extending Into Long-term Follow-up.

Injury to the ulnar extrinsic ligaments often causes significant pain without obvious instability. This study aims to further investigate the clinical presentations and outcomes following ulnar extrinsic ligament repair. A retrospective analysis of 113 patients who underwent ulnar extrinsic ligament surgery was conducted. Collected data included demographics, clinical presentation, intraoperative findings, and postoperative outcomes, such as grip strength, Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) scores, complications, and reoperations. Continuous variables were represented by the mean and standard deviation, whereas categorical variables were expressed as counts and percentages. A matched pair T-test was performed for grip strength and Q-DASH changes from pre-op to post-op for patients who had data available at both time points. Preoperative symptoms primarily included wrist pain (100%), difficulties in rotation (16%), and weakness (16%). Intraoperatively, split tears (75%) and avulsions (11%) were common, often accompanied by triangular fibrocartilage complex (TFCC) pathology (83%). Postoperatively, grip strength improved significantly (P < .001), with a mean reduction of 30.3 points in Q-DASH scores (P < .001). Eighty percent of patients returned to work fully, 14% returned in a limited capacity, and 6% were unable to return to work. The overall complication rate was 9%. Reoperation rate was 8.8%. At final follow-up, 83% of patients reported that they would elect to undergo the same surgery again. Ulnar extrinsic ligament injuries frequently present with wrist pain and TFCC pathology. Surgical repair of ulnar extrinsic ligament injuries improves grip strength and functional outcomes with high patient satisfaction.

Effectiveness of personalized oral health education with behavioural modification using HAPA-MI constructs and oral care kit in residents of informal settlements

BackgroundOral health is a crucial determinant of overall well-being, yet ‘residents of informal settlement’, previously referred as ‘slum dwellers’, face significant barriers to maintaining it. Personalized oral health education and behavior modification using models like the Health Action Process Approach (HAPA) and Motivational Interviewing (MI) can address these barriers. While HAPA and MI have shown promise, their individual limitations highlight the need for a combined approach. Integrating these models with personalized education and oral care kits provides a holistic solution to address both motivational and practical barriers. This study evaluates the effectiveness of such an intervention on oral health behaviors and outcomes in residents of informal settlement.MethodologyA quasi-experimental pre and post interventional study was conducted among 45 participants aged 18–60 years from three wards in Bhubaneswar. The study was conducted between October 24, 2023, to December 24, 2023. Participants were recruited through dental camps organised by our institute. Baseline oral health behavior was assessed using a validated questionnaire based on four behavioral constructs: outcome expectancy (OE), self-efficacy (SE), intention (I), and perceived barriers (PB) by faculty and postgraduate students of public health dentistry department. Participants also received personalized oral health education and an oral care kit. Plaque index (PI), Oral Hygiene Index-Simplified (OHI-S), and behaviour towards oral health were recorded both at baseline (T0) and one-month post-intervention (T1) by same examiners. Statistical analyses included paired t-tests, chi-square tests, and Cronbach’s alpha for internal consistency of the questionnaire, with p ≤ 0.05 considered significant.ResultsPost-intervention, significant improvements were observed in all behavioral constructs. The mean outcome expectancy (OE) increased from 2.49 ± 0.20 to 4.15 ± 0.07 (p = 0.000), self-efficacy (SE) from 1.90 ± 0.14 to 3.81 ± 0.14 (p = 0.000), intention (I) from 1.92 ± 0.11 to 4.30 ± 0.33 (p = 0.001), and perceived barriers (PB) from 1.85 ± 0.11 to 4.04 ± 0.03 (p = 0.002). Clinical outcomes also showed significant improvements: the mean plaque index (PI) decreased from 1.9 ± 0.8 to 0.9 ± 0.4 (p = 0.000), and the mean oral hygiene index-simplified (OHI-S) decreased from 2.3 ± 1.4 to 1.5 ± 0.9 (p = 0.003). Internal consistency of the questionnaires was good across constructs, with Cronbach’s alpha values ranging from 0.715 to 0.751.ConclusionThis study demonstrates that a holistic behavioural intervention combining personalized education, behavior modification using HAPA and MI models, and oral care kit distribution significantly improves oral hygiene behavior and clinical outcomes among residents of informal settlement. The model addresses both motivational and access barriers, providing a scalable framework for improving oral health in underserved populations. Future research should explore the long-term sustainability of this approach and its applicability to other settings.

Digital pathology in tau research: A comparison of QuPath and HALO.

The application of digital pathology tools has expanded in recent years, but non-neoplastic human brain tissue presents unique challenges due to its complexity. This study evaluated HALO and QuPath tau quantification performance in the hippocampus and mid-frontal gyrus across various tauopathies. Percent positivity emerged as the most reliable measure, showing strong correlations with Braak stages and CERAD scores, outperforming object and optical densities. QuPath demonstrated superior correlations with Braak stages, while HALO excelled in aligning with CERAD scoring. However, HALO's optical density was less consistent. Paired t-tests revealed significant differences in object and optical densities between platforms, though percent positivity was consistent across both. QuPath's threshold-based object density showed similar agreement with manual counts compared to HALO's AI-dependent approach (all ρ > 0.70). Reanalysis of QuPath further improved its agreement with manual measurements and correlations with Braak and CERAD scores (all ρ > 0.70). HALO offers a user-friendly interface and excels in certain metrics but is hindered by frequent software malfunctions and more limited flexibility. In contrast, QuPath's customizable workflows and superior performance in Braak staging make it more suitable for advanced and larger-scale analyses. Overall, our study highlights the strengths and limitations of these platforms, helping guide their application in neuropathology.

The impact of a blended learning approach on students’ academic achievement in Ethiopia: Jimma College of Teacher Education in focus

ABSTRACT This study aims to investigate the impact of a blended learning approach on students’ academic achievement at Jimma College of Teacher Education. Second-year English and Citizenship department students from Jimma College of Teacher Education were study participants. A non-equivalent group pre–post quasi-experimental design was used in the study. Second-year English department students were assigned as the treatment group in this study, which featured interventions in intact classrooms. Citizenship department students assigned as the control group were chosen at random to use the conventional method. A test that included pre- and post-treatment phases for both groups was the approach employed to acquire the data. In the data analysis, both descriptive and inferential statistics were used. The study utilized ANOVA to compare the means of two groups on the dependent variable, and a paired t-test to examine differences between pre-test and post-test. A one-way ANOVA necessitates that the data requirements meet specific assumptions. The blended learning approach significantly enhanced student academic achievement levels in the treatment group compared to conventional learning, as demonstrated by post-test mean scores. It follows that to improve student academic achievement; blended learning approaches have to be implemented in higher education.

Evaluation of a 3D-printed nanohybrid resin composite versus a milled resin composite for flexural strength, wear and color stability

BackgroundControversial properties and performance of commercially available 3D-printed resin composite for permanent restorations. So, the purpose of this study was to assess the flexural strength, microhardness, wear, and color stability of 3D-printed versus milled nanohybrid resin composites for permanent restoration.MethodsA total of 70 samples of nanohybrid resin composites were used; 38 bar-shaped (14 mm ⋅ 2 mm ⋅ 2 mm) and 32 disc-shaped samples (10 mm ⋅ 2 mm) of Tetric CAD™ blocks (TC) and Flexcera Smile Ultra plus™ (FSU) were fabricated (n = 35). Flexural properties were tested using 3-point bending test. The Vickers test was used for microhardness evaluation. Volumetric wear analysis and color changes were assessed after simulated aging via Geomagic Control X software and a Vita Easyshade spectrophotometer, respectively. Color changes were calculated via the CIEDE2000 formula. A paired t-test was used for dependent variable analysis, and the Mann‒Whitney U test was used for independent variables (α = 0.05).ResultsTC resulted in significantly higher flexural strength (247.7 ± 29.1 MPa) and microhardness (94.6 ± 3 gf/um2) than did FSU (97.2 ± 10.2 MPa and 31 ± 4.6 gf/um2, respectively) (P < 0.0001). Compared with FSU (–36.3 mm3), TC resulted in significantly lower wear rates (–17.6 mm3)(P < 0.0001). TC had a ΔE00 value of 2.4 ± 0.5, whereas FSU had a value of 2.1 ± 0.7 (P = 0.532), with no significant difference between the groups, but both values were above the acceptability limit (1.8).ConclusionsCompared with 3D-printed nanohybrid resin composites, milled nanohybrid resin composites have better flexural strength, microhardness and wear properties.Clinical relevanceMilled nanohybrid resin composites exhibit superior flexural strength, microhardness, and wear resistance, making them potentially more durable for clinical dental restorations compared to 3D-printed nanohybrid resin composites.

Why do International Health Regulations self-assessment capacities (SPAR) scores not predict COVID-19 control outcomes? – analysis of the relationship between SPAR scores and COVID-19 resilience scores in 2021

IntroductionThis study analyses the relationship between SPAR and the COVID-19 resilience score (CRS) in 80 countries in 2021 to achieve its objective.MethodsWe adopted the concept of Bloomberg’s COVID Resilience Ranking to form the CRS, which encompasses three indicators: Reopening Status, COVID Status, and Quality of Life. The average scores of 13 SPAR capacities focused on infectious disease control in 2021 were calculated. Paired t-tests were applied to evaluate the significance of monthly changes in countries’ CRSs. Then, we conducted univariate and multivariate linear regressions to examine the relationship between the SPAR and CRS scores and each CRS indicator.ResultsThe CRS in 80 countries fluctuated throughout 2021. Linear regression revealed a significant relationship between countries’ SPAR scores and CRS (B = 0.03, 95% CI = 0.001, 0.06). Among the CRS indicators, the SPAR was significantly associated with only the Quality of Life indicator (B = 0.01, 95% CI = 0.002, 1.52) and not the Reopening Status and COVID Status indicators. An increase in SPAR score, along with an increase in Governmental Effectiveness, was associated with increased CRS (Adjusted R2 = 0.52, p < 0.05). Moreover, an increase in countries’ SPAR scores was significantly linked to an improvement in people’s Quality of Life (Adjusted R2 = 0.37, p < 0.05).ConclusionThe significant relationship between the SPAR and COVID Resilience Scores, particularly the Quality of Life indicator indicates that the lack of accuracy in the ability of the SPAR score to predict COVID-19 control outcomes is attributed to the reliance of the measurement solely on the disease perspective and the limited inclusion of social aspects in the SPAR capacity assessments.Clinical trial numberNot Applicable

Do Bank Mergers Improve Performance? Evidence from Indian Bank’s Operational and Financial Metrics

Bank mergers are a common strategy to enhance operational and financial performance in the banking industry. This study aims to evaluate the impact of mergers on banks in India by measuring various financial and operational metrics before and after the merger. This research employs a quantitative approach using secondary data analysis from financial reports of merged banks. Data from the pre-merger and post-merger periods were collected to compare key performance indicators, such as Return on Assets (ROA), Return on Equity (ROE), Net Interest Margin (NIM), and operational efficiency ratio. A total of 10 merger cases over the last 10 years were analyzed using descriptive statistics and paired t-tests. The findings indicate that mergers positively impact several financial performance indicators. The average ROA increased from 0.85% to 1.25% within two years post-merger. ROE also rose by 2.5 percentage points. Additionally, operational efficiency improved, with the cost-to-income ratio decreasing from 48% to 43%. However, some banks experienced a decline in NIM from 3.2% to 2.9%, indicating challenges in maintaining profitability from interest-earning assets. These findings suggest that bank mergers in India generally provide benefits in terms of operational efficiency and profitability. However, the positive impact is not uniform, as some banks struggle to maintain net interest margins. Factors such as operational synergy, risk management, and regulatory policies play a role in post-merger outcomes. Bank mergers in India have a positive impact on financial and operational performance, despite certain challenges that need to be addressed. The findings of this study can serve as a reference for policymakers and bank management in designing more effective merger strategies in the future.

Effects of Non-Surgical Treatment on Hematological Indices in Stage III/IV Grade C Periodontitis.

To investigate the short-term effects of non-surgical periodontal treatment (NSPT) on clinical and hematological indices in stage III/IV grade C periodontitis patients. A total of 121 systemically healthy patients with generalized stage III/IV, grade C periodontitis were enrolled. Clinical indices (plaque index, probing depth, bleeding index, attachment loss) and hematological biomarkers [white blood cell count (WBC), mean platelet volume (MPV), neutrophil count (NEUT), neutrophil percentage (NEUT%), lymphocyte percentage (LYM%)] were measured before and 6-8 weeks after NSPT. Patients were divided into younger (≤ 35 years) and elder (> 35 years) groups, further stratified by systemic antibiotics usage. Analyses were performed using chi-squared tests, paired t-tests, and Pearson's correlation. NSPT resulted in clinical indices improvement, as well as a reduction in WBC, NEUT, NEUT%, and an increase in MPV and LYM% in both groups. SRP-with-antibiotics subgroups showed more significant changes. SRP-without-antibiotics subgroups showed six significant correlations in both groups (p < 0.05); SRP-with-antibiotics subgroups showed 11 correlations in the younger and five in the elder group (p < 0.05). NSPT improved clinical and hematological outcomes in stage III/IV grade C periodontitis patients over 6-8 weeks. Younger patients exhibited more significant changes than elder patients, especially in the SRP-without-antibiotics subgroup.

Primary care online training on multifactorial breast cancer risk: pre-post evaluation study.

It is estimated that>250,000 women in the United Kingdom (UK) are at increased risk of breast cancer, but only a small fraction are identified. Digital tools, such as CanRisk, enable multifactorial breast cancer risk assessment. Implementation of such tools within primary care would allow primary care professionals (PCPs) to reassure women at population-level risk and identify those at increased risk who will benefit most from targeted prevention or early detection. Previous studies suggest that PCPs will require educational resources to support the delivery of multifactorial breast cancer risk assessments. To develop and evaluate a new 'Multifactorial breast cancer risk assessment in primary care' online training for UK PCPs. 35 PCPs from across the UK participated in the evaluation and data collection was completed online between May and July 2024. Evidence-based training development and mixed-methods pre-post evaluation study. Statistical analysis for the evaluation focused on the primary outcome of objective knowledge and mean changes were analysed with a paired sample t-test. Qualitative feedback was analysed using content analysis. Objective knowledge showed a significant mean increase (P=0.011,95% CI). Subjective knowledge and confidence scores also showed significant mean increases (P<0.001, 95% CI). Results on satisfaction, engagement, and relevance of the training were positive. The 'Multifactorial breast cancer risk assessment in primary care' online training significantly increases PCPs' knowledge and confidence to conducting multifactorial breast cancer risk assessments, and it was well received by PCPs.

Plasma extracellular cold inducible RNA-binding protein levels are elevated for 1 month post-colectomy which may promote metastases.

Cold-inducible RNA-binding protein (CIRP) is related to a family of stress-induced RNA-binding proteins. It is primarily found in the nucleus, where it regulates transcription. Under stress, CIRP translocates to the cytoplasm where it modulates translation; a subset is secreted as extracellular CIRP (eCIRP) which is a damage-associated molecular pattern (DAMP) molecule that stimulates the production of inflammatory mediators. Elevated blood eCIRP levels may foster immune tolerance and facilitate tumor growth. Increased CIRP levels have been noted in various malignancies including colorectal cancer (CRC). This study's objective was to determine plasma eCIRP levels before and after minimally invasive colorectal resection (MICR) for CRC. To assess plasma eCIRP levels prior to and following minimally invasive colorectal resection in the context of cancer pathology. MICR patients from an IRB-approved data/tissue bank for whom plasma samples were available were eligible. Plasma specimens were obtained preoperatively (preop) and at least 3 time's postop [between postoperative day (POD) 1-41]; late samples were grouped into 7-day blocks and were considered separate time points. eCIRP levels were assessed via enzyme-linked immunosorbent assay (pg/mL) and results presented as mean ± SD, analysis with Wilcoxon paired t-test). A total of 83 CRC patients who underwent MICR [colon 66%, rectal 34%; laparoscopic-assisted (LA), 70%; hand-assisted laparoscopic (HAL), 30%] were studied. The mean preop eCIRP level was 896.8 ± 757.0 pg/mL. Elevations in mean plasma levels (P = < 0.001) were noted on POD1 (2549 ± 2632 pg/mL, n = 83), POD3 (1871 ± 1362 pg/mL, n = 77), POD7-13 (1788 ± 1403 pg/mL, n = 57), POD14-20 (1473 ± 738.8 pg/mL, n = 30), and POD21-27 (1681 ± 1375 pg/mL, n = 21). No significant differences were noted at POD 28-41. Higher values were noted in the HAL's (vs LA) group, however, there were more rectal cancers in the former. Elevated plasma eCIRP levels persist for a month post MICR for CRC (change from baseline, 77%-184%); highest values seen on POD1. The initial surge may be due to the acute inflammatory response while later elevations may be related to wound healing and remodeling. The higher levels noted in the HAL's group (with greater IL and more rectal cases) suggest the extent of surgical trauma impacts eCIRP levels. Further investigations are needed.

Effect of nursing application of emotion freedom technique on perceived stress, resilience and sexual satisfaction among women after mastectomy

BackgroundA breast cancer diagnosis extends beyond physical health concerns, profoundly impacting a woman’s psychological well-being, resilience and sexual satisfaction. Mastectomy intensifies these challenges, potentially affecting overall quality of life and long-term well-being. Understanding the interrelationships between perceived stress, resilience and sexual satisfaction is crucial for designing targeted interventions that effectively support mastectomized women. This study evaluates the effectiveness of the Emotional Freedom Technique in mitigating stress, enhancing resilience and improving sexual well-being post-mastectomy.MethodsA quasi-experimental pretest-posttest design was employed with a convenient sample of 112 Egyptian women who had undergone mastectomy. Participants were recruited from the Outpatient Oncology Clinic at Beni-Suef University Hospital. Data were collected over six months (January–June 2024) and analyzed using SPSS version 26.0. The intervention consisted of six structured EFT sessions delivered over six weeks. Paired t-tests assessed pre- and post-intervention differences, while Pearson and Spearman correlation analyses examined relationships between variables to accommodate different data distributions.ResultsPost-intervention assessments revealed statistically significant improvements. Perceived stress scores decreased from 32.42 ± 1.70 to 17.27 ± 2.96 (t = 49.130, p < 0.001, Cohen’s d = 3.2), resilience scores increased from 11.53 ± 1.67 to 31.46 ± 5.48 (t = 36.454, p < 0.001, Cohen’s d = 2.8) and sexual satisfaction scores improved from 17.03 ± 1.55 to 31.00 ± 4.31 (t = 13.245, p < 0.001, Cohen’s d = 2.5). Strong negative correlations were found between perceived stress and both resilience (r = -0.692, p < 0.001) and sexual satisfaction (r = -0.835, p < 0.001), while resilience and sexual satisfaction were strongly positively correlated (r = 0.890, p < 0.001).ConclusionEFT is a cost-effective, non-invasive intervention that significantly reduces stress, enhances resilience and improves sexual satisfaction in women post-mastectomy. To optimize clinical integration, healthcare institutions should develop structured EFT training programs for nurses, incorporating theoretical foundations, hands-on practice and competency assessments. Standardized protocols should be established to guide EFT implementation in post-mastectomy care. Further research should explore long-term effects and broader applicability across diverse healthcare settings.Clinical trial numberNCT06583629 on 4/9/2024.

IOP changes and correlation with alterations in corneal biomechanics and time of useful consciousness following controlled hypobaric hypoxic exposure.

PurposeTo evaluate changes in intraocular pressure (IOP), central corneal thickness (CCT) and corneal biomechanics before and after exposure to hypobaric hypoxia, accounting also for Time of Useful Consciousness (TUC) as a parameter of short time exposure to systemic hypoxia.MethodsThis prospective, observational study recruited 45 healthy individuals training in Hypobaric Chamber. IOP, CCT and corneal biomechanics were evaluated before and immediately after the end using the Corvis ST. Comparisons of score values before and after hypoxia were performed with paired t-test for normally distributed differences. Difference between the IOP measurements was correlated with differences in CCT, corneal biomechanics and TUC with multivariate mixed effect linear regression models.ResultsBiomechanically corrected IOP (bIOP-Corvis) and pneumotonometry IOP as produced by Corvis ST (NCT) showed statistically significant higher values before hypoxia (p = 0.048 and p = 0.047 respectively). We observed a strong negative correlation of the difference between bIOP-Corvis before and after hypoxia with the difference in Deformation amplitude ratio (DARatio) (p < 0.001) and a significant positive correlation with the difference in Integrated Inverse Radius(IntegrRadius) (p = 0.01), Stiffness parameter at the first applanation (SPA1) (p < 0.001) and TUC (p = 0.023). We observed a strong negative correlation of the difference between NCT before and after hypoxia with the difference in DARatio (p < 0.001) and a significant positive correlation with the difference in IntegrRadius (p = 0.023), SPA1 (p < 0.001) and TUC (p = 0.025). The R-squared values of the regression models were 0.6420 and 0.6626 for the bIOP and NCT respectively.ConclusionWe demonstrated reduction in IOP after hypoxia exposure. A combination of alterations in corneal biomechanics explain a degree of this IOP reduction, whereas CCT did not have a significant role in IOP changes.TUC was found to significantly correlate with IOP changes.

Seven years of pediatric robotic-assisted surgery: insights from 105 procedures

Robotic-assisted surgery (RAS) has recently expanded its role in pediatric patients. We conducted a retrospective review of 105 cases over 7 years (2017–2024) to evaluate outcomes, efficiency, and training experiences. A total of 105 children (58 boys, 47 girls) aged 2–15 years underwent robotic-assisted procedures using the Da Vinci Xi system. The most common indications were ureteropelvic junction obstruction (n = 33), varicocele (n = 29), and primary obstructive megaureter (n = 16). Two senior surgeons performed the procedures, training seven junior surgeons via the dual-console system. Statistical analysis included paired t-tests for docking time and operative duration comparisons, and Fisher’s exact test for categorical variables. Docking time significantly improved over time from 45 to 15 min (median 25 min) (p = 0.001). The total operative time significantly decreased over time (p = 0.001), with a median of 125 min (range 50–250). Robotic system-related issues were reported in 3/105 (2.8%). Conversion to laparoscopy was necessary in 1 (0.9%). Postoperative complications (Clavien grade 3b) occurred in 2/105 (1.8%) patients, requiring reintervention. The median hospital stay was 2 days (range 1–7). Monthly case volume increased from 1–2 to 4–7. Our 7 year experience with pediatric RAS demonstrates its safety, effectiveness, and growing role, especially in pediatric urology. It offers ergonomic advantages and facilitates training but is still limited by cost, larger instrument size (8 mm), and longer setup times compared to laparoscopy. Future developments, such as smaller robotic instruments and single-port technology, may help overcome these limitations and expand the applicability of RAS to younger and smaller patients.

Enhancing clinical faculties’ knowledge, attitudes, and performance in clinical supervision: a workplace-based faculty development program using proctor’s model

BackgroundClinical supervision is crucial for developing medical trainees’ independence. Faculty development programs can enhance faculty performance by changing their faculty attitudes and knowledge. This study examined the impact of such programs on pediatric faculty members’ supervisory knowledge, attitudes, and performance.MethodsThis was a quasi-experimental, pre-post, single-group study. The participants included 20 pediatric faculty members conveniently selected from the Isfahan University of Medical Sciences in Iran. The program’s design used the Proctor model and ASSURE instructional design model. The 34-day program was delivered in a blended format (online and workplace) and included feedback. An observational checklist was used to assess faculty performance, and a self-report questionnaire was used to measure faculty members’ knowledge and attitudes toward clinical supervision. Paired t-tests, independent t-tests, Spearman correlation coefficients, Cohen’s -d values, and descriptive statistics were used.ResultsThe mean self-reported scores of knowledge (before: 5.55 ± 2.31, after: 8.25 ± 1.53) and attitudes (before: 4.07 ± 0.52, after: 4.28 ± 0.43) among faculty members increased significantly after the development program. Additionally, 90.63% of the faculty members applied the components of the Proctor model of clinical supervision.ConclusionThese results suggest that structured faculty development programs can improve faculty knowledge, attitudes, and performance in clinical supervision.

Comparison of 18F-FDG and 68Ga-DOTA-IBA in detecting bone metastases: a lesion-basis study

Gallium 68 (68Ga)-labeled DOTA-conjugate ibandronic acid (DOTA-IBA) has been successfully synthesized and utilized for bone metastasis imaging. This study compares the diagnostic efficacy between 68Ga-DOTA-IBA and fluorine 18 (18F)-labeled fluorodeoxyglucose (FDG) in detecting bone metastases. This prospective study, conducted from October 2022 to September 2023, analyzed images from participants who underwent 68Ga-DOTA-IBA PET/CT and 18F-FDG PET/CT scans. Lesions were classified into five groups based on anatomical location (limbs, vertebrae, pelvis, ribs, and skull). Morphological bone changes were categorized as osteolytic, osteoblastic, or mixed. The semi-quantified radiotracer uptake, measured by the maximum standardized uptake value (SUVmax), was compared using a paired t-test. Detection rates between the two scans were analyzed using the McNemar test. A total of 46 participants (median age: 64 years [interquartile range: 53–68 years], 28 men) were evaluated. 68Ga-DOTA-IBA demonstrated higher diagnostic efficacy than 18F-FDG in detecting bone metastases in the limbs (73.2% vs. 64.1%), vertebras (78.1% vs. 67.4%), ribs (86.6% vs. 62.2%), pelvis (78.6% vs. 68.9%), and skulls (80.0% vs. 38%). For osteoblastic lesions, the detection rate for 68Ga-DOTA-IBA and 18F-FDG was 83.3% and 51.5% respectively (P < 0.001). The SUVmax of 68Ga-DOTA-IBA was 7.88 (95% CI 7.09–8.66), which was higher than that of 18F-FDG at 3.96 (95% CI 3.57–4.35) (P < 0.001). In participants with prostate cancer, the detection rate of 68Ga-DOTA-IBA and 18F-FDG was 84.7% and 55.0% respectively (P < 0.001). The SUVmax of 68Ga-DOTA-IBA was 10.44 (95% CI 8.57–12.30), which was higher than that of 18F-FDG 4.29 (95% CI 3.51–5.07) (P < 0.001). 68Ga-DOTA-IBA PET/CT demonstrates superior diagnostic performance over 18F-FDG PET/CT in detecting bone metastases, particularly in osteoblastic lesions and prostate cancer cases.