Paired Test Research Articles

ADAPTATION TRAINING FOR MENTAL RESILIENCE OF ADOLESCENTS USING THE ROY ADAPTATION MODEL APPROACH

Introduction: Adolescence is a key period for mental health, as over half of mental health problems begin during this stage and often persist into adulthood. Many adolescents, however, lack access to specialized care. This research aims to examine the impact of adaptation training on mental health resilience in adolescents, utilizing the Roy Adaptation Model. Method: This quasi-experimental study followed a pre-test-post-test control group design. The sample consisted of 100 adolescents, divided into an experimental group (50 respondents) and a control group (50 respondents), selected using purposive sampling. The experimental group participated in six weeks of adaptation training, with one session held each week. The training aimed to help adolescents better adapt to stressors, fostering mental resilience. The Adolescent Resilience Questionnaire (ARQ) was used to measure resilience, specifically evaluating the capacity to achieve positive outcomes despite facing challenges. The Wilcoxon Paired test was applied to assess differences within each group before and after the intervention, and the Mann-Whitney test was used to compare outcomes between the two groups. Both tests utilized an ordinal scale for analysis. Results: The Mann-Whitney test results showed a significant difference between the experimental and control groups, with a p-value of 0.000. This indicates that adaptation training had a positive effect on increasing adolescent mental resilience. Conclusion: Adaptation training is effective in improving adolescents' mental resilience. It has the potential to be integrated into school programs to support mental health promotion and prevention, offering a proactive approach to addressing adolescent mental health challenges.

Evaluation of peroxide release during nonvital bleaching using three different coronal barriers: An in vitro study.

Peroxide from bleaching agents can cause external cervical resorption. An intracoronal barrier is used to prevent leakage of bleaching agents into the periradicular space. This study aims to determine and compare the amount of peroxide released, during non vital bleaching at the end of 1st and 3rd day using Glass ionomer cement (GIC), Mineral Trioxide aggregate (ProRoot MTA) and Biodentine as intracoronal barriers. Forty-five single-rooted teeth were selected for the study and root canal therapy was performed. Three millimeters of the coronal gutta-percha were removed and according to the coronal barrier placed, samples were divided into Group A: GIC, Group B: ProRoot MTA, and Group C: Biodentine. Nonvital bleaching was done using sodium perborate and 30% H2O2. Peroxide released at the end of the 1st and 3rd day was analyzed using potassium iodide and ultraviolet spectrophotometer. This was done using the Wilcoxon matched pair test and the Kruskal-Wallis test. No significant difference in intergroup comparison at the end of 1st and 3rd day, respectively (P > 0.05), a significant difference was found in the MTA group at follow-up dates (P < 0.05). All the three tested materials (GIC, MTA, and Biodentine) may be preferred as intracoronal barrier for nonvital bleaching.

The Impact of Feedback on First-Year University Students' Writing Development: A Study at A University in Hanoi, Vietnam

This study investigates the impact of feedback on the writing development of first-year university students, employing a mixed-methods approach to provide a comprehensive analysis. The quantitative phase involved pre- and post-tests of 118 students, revealing significant improvements in coherence, clarity, grammar, and overall writing quality. The paired samples test results showed mean differences of -2.076 for coherence, -1.983 for clarity, -0.441 for grammar, and -2.119 for overall quality, all with p-values of 0.000, indicating substantial enhancements due to the feedback intervention. The qualitative phase explored students' perceptions of feedback through surveys and semi-structured interviews with 20 students. Findings indicated that detailed, constructive, and timely feedback positively influenced students' motivation, engagement, and reduced writing anxiety. Conversely, vague or overly critical feedback had detrimental effects on these aspects. This study provides valuable insights into the feedback mechanisms that best support first-year students' writing development, offering evidence-based recommendations for educators to enhance teaching strategies and improve academic outcomes.

Cognitive outcomes following unilateral magnetic resonance-guided focused ultrasound thalamotomy for essential tremor: findings from two cohorts.

Magnetic resonance-guided, focused ultrasound thalamotomy is a neurosurgical treatment for refractory essential tremor. This study examined cognitive outcomes following unilateral magnetic resonance-guided, focused ultrasound thalamotomy, targeting the ventral intermediate nucleus of the thalamus for essential tremor. The research was conducted at two sites: Sunnybrook Research Institute in Toronto, Canada, and West Virginia University School of Medicine Rockefeller Neuroscience Institute in West Virginia, USA. The study focused on cognitive changes at both the group and individual levels. Patients with refractory essential tremor completed cognitive testing before and after magnetic resonance-guided, focused ultrasound thalamotomy at both sites. The cognitive testing assessed domains of attention, processing speed, working memory, executive function, language and learning/memory. Postoperative changes in cognition were examined using paired t-tests and Wilcoxon signed-rank tests, as appropriate. Reliable change indices were calculated to assess clinically significant changes at the individual level. A total of 33 patients from Toronto and 22 patients from West Virginia were included. Following magnetic resonance-guided, focused ultrasound thalamotomy, there was a significant reduction in tremor severity in both cohorts. At the group level, there were no significant declines in postoperative cognitive performance in either cohort. The reliable change analyses revealed some variability at the individual level, with most patients maintaining stable performance or showing improvement. Taken together, the results from these two independent cohorts demonstrate that unilateral magnetic resonance-guided, focused ultrasound thalamotomy significantly reduces tremor severity without negatively impacting cognition at both the group and individual levels, highlighting the cognitive safety of magnetic resonance-guided focused ultrasound thalamotomy for essential tremor.

Indirect effectiveness of a novel SARS-COV-2 vaccine (SCB-2019) in unvaccinated household contacts in the Philippines: A cluster randomised analysis

BackgroundThough observational evidence supports indirect effects of SARS-CoV-2 vaccines, randomised experiments are lacking. To address this gap, the double-blinded, prospective follow-up of the household contacts (HHCs) of Philippine participants of the individually-randomised, placebo-controlled trial of the adjuvanted-subunit protein COVID-19 vaccine, SCB-2019, (EudraCT, 2020–004272–17; ClinicalTrials.gov, NCT04672395) was analyzed in a cluster-randomised fashion. MethodsOver an eight-week period, HHCs were followed by rRT-PCR and paired rapid antibody tests (RATs) to detect symptomatic (SCI, primary) and all (ACI, secondary) SARS-CoV-2 infection. A standard analysis estimated the indirect effectiveness of SCB-2019 for each endpoint, excluding HHC RAT-positive at enrollment. A secondary analysis employed enzyme-linked immunosorbent assay (ELISA) results to correct for suspected bias. FindingsSCB-2019 (N=3470) and placebo (N = 3225) exposed HHCs contributed to at least one analysis. The standard analysis estimated that SCB-2019 reduced the risk of SCI by 83% (95% confidence/credible interval [CI: 32% to 96%), with no effect against ACI. The bias-corrected relative risk reduction was 97% (95% CI: 74% to 100%) for SCI and 79% (95% CI: 14% to 96%) for ACI, with an estimated one SARS-CoV-2 infection prevented per 4.8 households where one member received SCB-2019. InterpretationSCB-2019 demonstrated bias-corrected indirect effectiveness against SARS-CoV-2 infection among HHC, even at a modest coverage level in the household (approximately 25%). Further research into the indirect effects of SARS-CoV-2 vaccines is needed to optimize the impact of limited doses in low and middle-income settings. FundingClover Biopharmaceuticals and the Coalition for Epidemic Preparedness Innovations

Accuracy of ultra-high resolution and virtual non-calcium reconstruction algorithm for stenosis evaluation with photon-counting CT: results from a dynamic phantom study

BackgroundWe compared ultra-high resolution (UHR), standard resolution (SR), and virtual non-calcium (VNCa) reconstruction for coronary artery stenosis evaluation using photon-counting computed tomography (PC-CT).MethodsOne vessel phantom (4-mm diameter) containing solid calcified lesions with 25% and 50% stenoses inside a thorax phantom with motion simulation underwent PC-CT using UHR (0.2-mm slice thickness) and SR (0.6-mm slice thickness) at heart rates of 60 beats per minute (bpm), 80 bpm, and 100 bpm. A paired t-test or Wilcoxon test with Bonferroni correction was used.ResultsFor 50% stenosis, differences in percent mean diameter stenosis between UHR and SR at 60 bpm (51.0 vs 60.3), 80 bpm (51.7 vs 59.6), and 100 bpm (53.7 vs 59.0) (p ≤ 0.011), as well as between VNCa and SR at 60 bpm (50.6 vs 60.3), 80 bpm (51.5 vs 59.6), and 100 bpm (53.7 vs 59.0) were significant (p ≤ 0.011), while differences between UHR and VNCa at all heart rates (p ≥ 0.327) were not significant. For 25% stenosis, differences between UHR and SR at 60 bpm (28.0 vs 33.7), 80 bpm (28.4 vs 34.3), and VNCa vs SR at 60 bpm (29.1 vs 33.7) were significant (p ≤ 0.015), while differences for UHR vs SR at 100 bpm (29.9 vs 34.0), as well as for VNCa vs SR at 80 bpm (30.7 vs 34.3) and 100 bpm (33.1 vs 34.0) were not significant (p ≥ 0.028).ConclusionStenosis quantification accuracy with PC-CT improved using either UHR acquisition or VNCa reconstruction.Relevance statementPC-CT offers to scan with UHR mode and the reconstruction of VNCa images both of them could provide improved coronary stenosis quantification at increased heart rates, allowing a more accurate stenosis grading at low and high heart rates compared to SR.Key PointsEvaluation of coronary stenosis with conventional CT is challenging at high heart rates.PC-CT allows for scanning with ECG-gated UHR and SR modes.UHR and VNCa images were compared in a dynamic phantom.UHR improves stenosis quantification up to 100 bpm.VNCa reconstruction improves stenosis evaluation up to 80 bpm.Graphical

Occurrence of Low Cardiac Index During Normotensive Periods in Cardiac Surgery: A Prospective Cohort Study Using Continuous Noninvasive Cardiac Output Monitoring.

Continuous cardiac output monitoring is not standard practice during cardiac surgery, even though patients are at substantial risk for systemic hypoperfusion. Thus, the frequency of low cardiac output during cardiac surgery is unknown. We conducted a prospective cohort study at a tertiary medical center from July 2021 to November 2023. Eligible patients were ≥18 undergoing isolated coronary bypass (CAB) surgery with the use of cardiopulmonary bypass (CPB). Cardiac output indexed to body surface area (CI) was continuously recorded at 5-second intervals throughout surgery using a US Food and Drug Administration (FDA)-approved noninvasive monitor from the arterial blood pressure waveform. Mean arterial blood pressure (MAP) and central venous pressure (CVP) were also analyzed. Low CI was defined as <2 L/min/m2 and low MAP as <65 mm Hg. We calculated time with low CI for each patient for the entire surgery, pre-CPB and post-CPB periods, and the proportion of time with low CI and normal MAP. We used Pearson correlation to evaluate the relationship between CI and MAP and paired Wilcoxon rank sum tests to assess the difference in correlations of CI with MAP before and after CPB. In total, 101 patients were analyzed (age [standard deviation, SD] 64.8 [9.8] years, 25% female). Total intraoperative time (mean [SD]) with low CI was 86.4 (62) minutes, with 61.2 (42) minutes of low CI pre-CPB and 25.2 (31) minutes post-CPB. Total intraoperative time with low CI and normal MAP was 66.5 (56) minutes, representing mean (SD) 69% (23%) of the total time with low CI; 45.8 (38) minutes occurred pre-CPB and 20.6 (27) minutes occurred post-CPB. Overall, the correlation (mean [SD]) between CI and MAP was 0.33 (0.31), and the correlation was significantly higher pre-CPB (0.53 [0.32]) than post-CPB (0.29 [0.28], 95% confidence interval [CI] for difference [0.18-0.34], P < .001); however, there was substantial heterogeneity among participants in correlations of CI with MAP before and after CPB. Secondary analyses that accounted for CVP did not alter the correlation between CI and MAP. Exploratory analyses suggested duration of low CI (C <2 L/min/m2) was associated with increased risk of postoperative acute kidney injury (odds ratios [ORs] = 1.09; 95% CI; 1.01-1.13; P = .018). In a prospective cohort of patients undergoing CAB surgery, low CI was common even when blood pressure was normal. CI and MAP were correlated modestly. Correlation was higher before than after CPB with substantial heterogeneity among individuals. Future studies are needed to examine the independent relation of low CI to postoperative kidney injury and other adverse outcomes related to hypoperfusion.

Assessing the Effectiveness of a Game-Based Method for Enhancing Kangkang Jump Skills in Students

The kangkang jump is one of the basic movements in artistic gymnastics, which is the primary focus of this research. Observations conducted at school revealed that the material related to the kangkang jump was not delivered effectively by the teacher due to inadequate facilities required for the learning process. As a result, students exhibited poor kangkang jumping skills, stiff movements, and a lack of confidence due to fear of failure. This study aims to improve students' kangkang jumping skills through a game-based approach. The research employed an experimental method with a one-group pretest-posttest design. The population included all 140 students in grade V at SDN 2 Ciherang, Kadugede District, for the 2023/2024 academic year, with a research sample of 23 students selected through purposive random sampling. The instrument used was a kangkang jump skill assessment test. Data analysis was conducted using a normality test, which indicated that the pretest data (sig = 0.305) and posttest data (sig = 0.27) were normally distributed. A homogeneity test was conducted with sig = 0.451, and a paired sample t-test hypothesis test showed significant results with sig = 0.00. The results of the study demonstrated that the application of a game-based approach in learning significantly improved students' kangkang jumping skills. Future research on learning the kangkang jump can be conducted by integrating technology as an innovation of the Industrial Revolution 4.0.

Treatment of Fourth Metatarsal Brachymetatarsia Using Distraction Osteogenesis with External Fixator: Surgical Techniques, Outcomes and Complications.

Surgical technique in distraction osteogenesis for the treatment of brachymetatarsia can influence the final prognosis. However, there are currently no standardized guidelines for surgical procedures and complication management. The aim of this study is to investigate the effect of bone lengthening with external fixation by minimally invasive osteotomy based on Ilizarov technique in the treatment of congenital brachymetatarsia. A retrospective study was conducted on patients with congenital brachymetatarsia treated by metatarsal lengthening, from June 2017 to December 2020. There were 11 patients with 17 shorted fourth metatarsals, including 10 females and 1 male, with age of 24.6 ± 4.5 years (16-31 years). Six patients were bilaterally involved. Orthofix external fixator mini track was installed through dorsal approach and the fourth MTP joints were temporarily fixed by Kirschner wire. Bone lengthening was performed after a minimally invasive osteotomy at the proximal metatarsals. American Orthopedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal (MTP-IP) scores, metatarsal length, complications were recorded. Statistical comparison was performed using the paired t-student test for pre- and postoperative AOFAS MTP-IP scores. Patients were followed up for 55 ± 10.8 months. The mean length of the fourth metatarsal bone was 49.9 ± 2.9 mm preoperatively. The mean metatarsal shortage was 18.8 ± 3.1 mm. The mean lengthening achieved was 19.8 ± 3.3 mm, with a lengthening ratio of 39.7% ± 6.6%. The lengthened callus ossified completely at 3-4 months after operation. All patients were satisfied with the results of lengthening. The AOFAS scores were improved significantly from 83.7 ± 4.2 preoperatively to 93.2 ± 2.7 postoperatively (t = -10.27, p < 0.001). One patient with traumatic metatarsophalangeal joint subluxation was treated by joint reduction and Kirschner wire fixation. One patient had metatarsophalangeal joint release and Kirschner wire fixation due to flexion contracture. Pin tract infections were controlled by wound care and antibiotics in 6 patients. All patients had no nonunion, necrosis of toes, and sensory disturbance of toes. Metatarsal lengthening by minimally invasive osteotomy with external fixator had satisfactory results in the treatment of congenital brachymetatarsia.

DIFFERENCES IN FIRM FINANCIAL PERFORMANCE BEFORE AND DURING THE COVID-19: A STUDY ON FNB SECTOR

&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;: Covid-19 has had a major impact on the global economy, including in Indonesia. One of the most notable impacts has been felt by food and beverage firm. Indonesia government gives more attention for this sector due to its importance for public needs. This research is used to obtain the difference ROA ratio before and during Covid -19 period using statistical approach. This approach was chosen for finding is there a significant differences firm performance between before and during Covid-19 period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective&lt;/strong&gt;: This approach was chosen for finding is there a significant differences firm performance between before and during Covid -19 period and analyze the differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research Methodology&lt;/strong&gt;: Paired test approach for this research uses non-parametric Wilcoxon Ranks test by measuring return on assets (ROA). The population in this research were all firm operating in food an beverages sector from 2018-2021 which were listed on Indonesia for four consecutive years by classifying these four years in to before (2018-2019) and during Covid-19 (2020-2021).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research Findings&lt;/strong&gt;: This research gained significantly different firm performance between before and during Covid-19. Wilcoxon Rank test performing this research gained a significant value 0.001&amp;lt;0.05. This difference is because the firm's ROA level tends to decline and suffer losses, the effect of implementing Perlakuan Pembatasan Kegiatan Masyarakat (PPKM) which seeks to reduce transmission through community mobility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Originality/Novelty of Research&lt;/strong&gt;: This research provides a difference in firm financial performance with extended period data over two years before (2018-2019) and two years during Covid-19 (2020-2021).&lt;/p&gt;

Management of patellar and trochlear cartilage lesions with matrix-induced autologous chondrocyte implantation in conjunction with patellofemoral realignment procedures improves patient-reported outcomes and magnetic resonance image appearance

ObjectivesThe aim of this study is to evaluate the relationship between the achievement of clinically significant improvement in patient-reported outcome measures (PROMs) and the postoperative magnetic resonance image (MRI) appearance of matrix-associated chondrocyte implantation (MACI), in conjunction with patellofemoral realignment procedures, for the treatment of grade-IV chondral defects about the patellofemoral joint. MethodsA retrospective review of patients undergoing MACI for grade-IV chondral defects of the patella or trochlea by a single sports-medicine-fellowship-trained surgeon from 2017 to 2020 was performed. Concomitant realignment procedures, including tibial tubercle osteotomy and medial patellofemoral ligament reconstruction, were also performed as needed. Patients with preoperative and minimum 1-year postoperative PROMs and postoperative knee MRI were included. MRI scans were obtained at 6.3 (interquartile range: 5.8, 7.5) months postoperatively. A fellowship-trained musculoskeletal radiologist assigned a Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score (range: 0–100, with 100 equating to complete graft healing) to each MRI. Achievement of the minimal clinically important difference (MCID) for International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Score—Quality of Life, and Kujala scores were determined for each patient. Paired t-tests or Wilcoxon rank-sum tests were used to evaluate for an association between achievement of the MCID for each PROM and MOCART score. The average follow-up time and time from surgery to PROMs were 2.7 ​± ​1.5 years and 1.7 ​± ​0.66 years, respectively. ResultsThirty patients were included. There was a significant improvement in all PROMs from preoperative to postoperative (p ​< ​0.001). More than two-thirds of patients achieved the MCID for each PROM. Patients who achieved the MCID for IKDC had significantly higher MOCART scores (66.5 ​± ​16.2) than those who did not meet the MCID for IKDC (50.6 ​± ​23.6, p ​= ​0.043). ConclusionMACI for the treatment of patellofemoral chondral injuries is associated with clinically significant improvement in PROMs at short-term follow-up. Clinically significant improvements in IKDC scores are associated with a more mature MRI appearance of the autologous chondrocyte implantation graft on postoperative MRI, as indicated by higher MOCART scores. Level of evidenceIV—Case Series.

More molar distal movement than pretreatment cone-beam computed tomography posterior space available at the root level in mandibular dentition distalization with microimplants.

To compare the mandibular posterior space available before treatment and the distance of molar distalization achieved after mandibular dentition distalization with microimplants. A total of 66 Class I or III adult patients (mean age = 24.46 ± 4.89 years) who underwent molar distalization using microimplants were retrospectively included. The posterior space available distal to the second molar before treatment and the distance of distalization achieved after treatment were measured using axial cone-beam computed tomography images (0, 2, 4, and 6 mm apical to the second molar root furcation). Changes in lingual cortical thickness and molar root length after treatment were examined. Paired t-test or Wilcoxon signed-rank test was performed to compare measurements before and after treatment. Spearman correlation analysis was performed to assess the relationship between thinning of the cortical plate and root resorption. Achieved distalization distance was significantly greater than pretreatment posterior space available by 0.8 mm at all root levels (P < .001). The difference was greater toward the root apex level and greater in the Class III group than the Class I group. Lingual cortical thickness was significantly decreased after treatment along with resorption of the second molar distal root (P < .001). In addition, a positive correlation was found between thinning of the cortical plate and distal root resorption of the molar (P < .001). Achieved distalization distance of the mandibular molar using microimplants was greater than the pretreatment posterior space available. Thinning of the lingual cortex and root resorption were observed after distalization.

Evaluation of a Multi-Site Cancer Health Disparities Research Training Program for Underrepresented Undergraduate and Medical Students.

Diversifying the biomedical research workforce is crucial for eliminating cancer health disparities. To address this need, Moffitt Cancer Center and Louisiana State University Health Sciences formed the Southeast Partnership for Improving Research and Training in Cancer Health Disparities (SPIRIT-CHD). A key component of SPIRIT-CHD is the Cancer Research Education Program (CREP), designed to train underrepresented undergraduate and medical students in biomedical science research. The CREP featured an 8-week summer internship with a web-based curriculum, community outreach, and mentored research experiences. Three cohorts (n = 39) completed the CREP. Students were evaluated before and after the internship using the Goal Attainment Scale (GAS), Science Teaching Efficacy Belief Instrument (STEBI), and Research Appraisal Inventory (RAI), modified to assess CREP outcomes. These scales measured students' intentions to pursue cancer research careers, self-efficacy in communicating scientific information, and perceived research abilities. Paired test results showed significant increases (p < 0.001) in scores across the scales (GAS, STEBI, RAI) pre- and post-training. Trainees reported heightened intentions to pursue cancer research careers (GAS; mean increase of 5.3, p < 0.001) and greater self-efficacy in relaying scientific information (STEBI; mean increase of 9.2, p < 0.001). They also showed increased self-confidence in conducting research (RAI; mean increase of 58.2, p < 0.001). These findings demonstrate the program's success in fostering interest in cancer research careers and enhancing research confidence. Results support the development of programs like CREP to positively impact the academic and professional trajectories of underrepresented students, ultimately creating a more diverse and inclusive biomedical research workforce equipped to address health disparities.

PENGGUNAAN CHATGPT PADA PROSES PEMBELAJARAN PADA MATA KULIAH PEMASARAN DIGITAL UNTUK MENINGKATKAN KEMANDIRIAN MAHASISWA DI STMA TRISAKTI

New technologies, like ChatGPT, are changing the way we learn in school. Some people really like it, but others don't like it as much. Many people are talking about how ChatGPT affects education. The purpose of this study is to examine how the use of ChatGPT in the learning process can increase student independence at STMA Trisakti. This is really important because students are one of the people who use ChatGPT. The type of research used is descriptive-quantitative. The sample used is the pre-test and post-test results of all STMA Trisakti students in digital marketing courses, totaling 34 respondents. The data analysis techniques used in the study were a validity test, a reliability test, a prerequisite test, and a hypothesis test (a paired sample test) to see which one had the biggest increase. The results showed that there was a significant difference between the pre-test and post-test scores on whether the use of Chat GPT in the learning process can increase student independence at STMA Trisakti. These results can be used to conclude that the knowledge score in the learning process increases student independence at Stma Trisakti.

Health System Guidance as Nursing Intervention for Ineffective Health Management in Aggregate Adults with Hypertension

Introduction: Hypertension is a type of non-communicable disease that can significantly cause morbidity and mortality of sufferers. Adult age is a risk factor that has a great influence on hypertension. Interventions that can be given to the community are Health System Guidance to identify hypertension problems in the community and develop the ability to overcome existing health problems, namely hypertension problems. Objective: To determine the effectiveness of nursing interventions for health system guidance. Method: Descriptive and analytical research design with a sample of 50 productive age who have hypertension in the RW 08 area of Patrang Village and 5 health cadre. This research carried out implementation in the form of primary prevention (health education), secondary prevention (hypertension screening and cadre empowerment) and tertiary prevention (education and demonstration of giving star fruit juice). Data collection used respondent characteristic instruments, hypertension knowledge questionnaire, hypertension diet questionnaire, standart operating procedure for blood pressure measurement, standart operating procedure for making star fruit juice. Data analysis used paired sample t-test, wilcoxon test, and mann whitney test. Results: There was a significant difference between knowledge before health education and after health education (p = 0.000). In cadre empowerment, there was an increase in the percentage of cadre ability and the mean of cadre knowledge. In tertiary prevention, there was a significant difference between blood pressure after giving star fruit juice therapy between the intervention and control groups (p &lt; 0.05). Conclusion: Health system guidance is effective in improving health management of hypertension.

Comparative analysis of national and foreign players' performance in Euroleague Basketball.

This study aimed to quantitatively assess the statistical contributions between foreign and national players in men's Euroleague Basketball. Data from 588 games in the 2021-2022 regular season and 612 games in the 2022-2023 regular season were analyzed through non-participant observation. Paired t-tests and Wilcoxon tests were employed to analyse variables with normal and non-normal distributions, respectively. The analysis indicated significant differences (p<0.05) between local and foreign players across several key variables, including Minutes, Points, Average Points, Usage Percentage, Individual Offensive Rating, Individual Defensive Rating, and True Shooting Percentage. These findings suggest pronounced distinctions between foreign players and national players concerning game volume indicators and game performance efficiency. Foreign players exhibited dominance in critical areas, such as playing time, total points scored, and average points per game, underscoring their substantial contributions to their respective teams. Consequently, these results offer practical implications for players, coaches, and fitness trainers, allowing for the design of more tailored training programs that account for distinct offensive and defensive needs, as well as the heightened physical demands experienced throughout the season.

The Study of the Effectiveness of Engklek Game in Vocabulary Learning at Primary Schools in Mojokerto

This study aims to measure the effectiveness of using the traditional game "engklek" for teaching English vocabulary mastery of grade 6 students at SDN Mlaten, Mojokerto. This research used a quantitative approach with a one group pretest-posttest design. The research sample consisted of students in grades 6A and 6B at SDN Mlaten. Data was collected through pretest and posttest to measure students' vocabulary mastery before and after intervention. Data analysis was conducted using paired t-test statistical test to determine the significance of the value results. The results showed that there was a significant change in students' English vocabulary mastery after participating in learning using the traditional game "engklek". The average score of the pretest was 56.73 and the average score of the posttest was 82.65. The test carried out also produced positive results because the sig level. is below or less than alpha (0.00 &lt; 0.05). This has implications for rejecting the null hypothesis (H0) and accepting the alternative hypothesis (Ha). The use of the traditional game "engklek" has proven effective for teaching English vocabulary mastery at primary school.

Acceptability, engagement, and preliminary efficacy of a college human physiology course with integrated mindfulness practice to support student wellbeing.

To evaluate the acceptability of and engagement with an undergraduate human physiology course embedded with mindfulness practice. To assess its preliminary efficacy on student mindfulness and wellbeing. Students (N = 36, 17% freshman, 33% sophomore, 22% junior, and 28% senior) answered online surveys at course completion. Primary outcomes were course ratings, assignment and assessment completion rates, minutes, types of mindfulness practice, changes in trait mindfulness (Mindful Attention Awareness Scale, MAAS), and self-reported wellbeing outcomes. We ran Chi-square goodness of fit tests and paired Wilcoxon signed-rank tests to decide if the outcomes differed significantly post-class. We tested the dose-response relation between mindfulness practice time and trait mindfulness and whether the out-of-class practice time was consistent across the weeks with generalized linear mixed-effect models. All participants reported finding the course enjoyable and that they would recommend it to their friends. They practiced for an average of 66 (SD = 27) min per week in the class and 112 (SD = 59) min on their own. The most common out-of-class practices were mindful movements, sitting meditation, and breathing. Per self-reports, the course increased student understanding of specific mindfulness practices and appreciation for their body. It improved wellbeing and trait mindfulness (MAAS mean within-person change = 1.2, SD = 0.8, p < 0.00001). We found no does-response relation between practice time and trait mindfulness. This pilot study supports that incorporating mindfulness practice into college-level courses may promote student wellbeing and such approaches warrant further investigation.

The Impact of Directly Observed Therapy of Weekly Iron Supplementation Program in Female Adolescent Hemoglobin Status

In adolescents, nutrition is an important factor in the growth and development process, especially during the growth spurt period that occurs in early adolescence and is characterized by physical, cognitive, and reproductive organ growth and maturation of reproductive organs. Inadequate nutrition during adolescence will cause various problems, one of which is anemia. Anemia has negative impacts, including impaired growth and development, decreased learning achievement, and impaired immunity, thus increasing the occurrence of infections and reproductive disorders. This research is quasi-experimental with a one-group pretest-posttest approach. The research was conducted at Muhammadiyah I Lamongan Vocational School with a total of 44 female students. The sampling technique used in this research was total sampling. Research data analysis was carried out using the paired T-test statistical test. The results of the study showed that carrying out Directly Observed Therapy (DOT) while administering Fe tablets for 12 weeks was able to significantly increase Fe levels in adolescents, with a p-value of 0.000 (p&lt;0.05).

A phase I/II study of nanoliposomal irinotecan and carboplatin in patients with advanced or metastatic, poorly differentiated gastroenteropancreatic neuroendocrine carcinoma characterized by tissue and liquid next-generation sequencing.

52 Background: For locally advanced or metastatic gastroenteropancreatic neuroendocrine carcinomas (GEP-NECs), standard chemotherapy typically incorporates etoposide or irinotecan plus platinum agents. Herein, we initiate a phase I/II trial to apply Nal-IRI in combination with carboplatin as the 1st line treatment in patients with GEP-NECs to define the dose-limiting toxicity (DLT) and recommended phase II dose (RP2D). Methods: In the phase I part, traditional 3+3 design was applied. Enrolled patients would receive escalating dose of 60 (level -1), 80 (starting dose, level 0) or 100 (level 1) mg/m2 salt-form nal-IRI plus carboplatin AUC=4 with maximum total dose of 600 mg on D1, every 21 days as a cycle. DLTs were evaluated during the first one cycle of treatment with tumor assessment every 6 weeks. Prophylaxis G-CSF was not allowed in the first cycle Paired testing of tissue (TBx) and liquid biopsy (LBx) was done by Illumina TSO500 platform before treatment. The second LBx would be repeated for confirmed partial responders when progression. Results: Totally 6 GEP-NEC patients with primary sites of colon in three, and each one in esophagus, ampulla of Vater and pancreas were enrolled to level 0. One patient had DLT of grade 4 neutropenia lasting for 3 days even under salvage G-CSF. Treatment-related adverse events showed grade 3/4 neutropenia (33.4%), grade 2 anemia (16.7%), grade 3 fatigue (16.7%), and grade 2 skin rash (16.7%). Four patients achieved confirmed partial response and 2 patients got stable disease, with the objective response rate of 66.7% (95% confidence interval: 22%-96%). After the data and safety monitoring board meeting, level 0 was decided as RP2D but not escalation to level 1 because of acceptable toxicity profiles and promising efficacies. Comprehensive genomic profiling showed that driver mutations were identified in three cases including two harboring BRAFV600E mutation and one with KRASG12D mutation. The other three cases lacking driver mutation showed frequent copy number alteration including 1 with MDM2 amplification (copy number 27) and a wild-type TP53. Homologous recombination deficiency (HRD), as determined by GIS score, was identified in a colon GEP-NEC who remained to be HRD-positive at progression but a higher TMB (from 4.7 to 10.2 Muts/Mb) and a higher BRAFV600E mutation allele frequency (from 24.1% to 43.6%) in tumor tissue, compared to the baseline profiling. Conclusions: Based on current data, the RP2D is 80 mg/m2 of nal-IRI (salt-form) and carboplatin of AUC=4, every 3 weeks. The extension phase II study in GEP-NEC is ongoing. Clinical trial information: NCT05385861 .