Paired Test Research Articles

Earthquake Disaster Simulation on Increasing Knowledge and Preparedness Attitudes of Elementary School Students in Padang City

The earthquake in West Sumatra in 2009 caused 1,195 people to die, where the majority of victims were the elderly and children. The factor that causes the large number of fatalities during earthquake disasters is the lack of knowledge and attitudes of the community and children regarding earthquake disaster management preparedness. This research aims to determine the effect of earthquake simulation on increasing knowledge and attitudes about earthquake disaster preparedness among elementary school students in Padang City. The research method uses Quasi-experimental with One Group Pre test and Post design, the research location is Lubuk Lintah State Elementary School 21. The population is 80 grade 5 elementary school students with 44 samples taken by proportionate random sampling. The data collection technique uses a questionnaire. The earthquake disaster simulation educational intervention was carried out twice in one meeting for 2x120 minutes. Data analysis used the Paired T-dependent test. The research results showed that there was an effect of increasing knowledge and attitudes before and after being given an earthquake simulation to elementary school students with P-value = 0.000. The research conclusions show that earthquake simulations can be used to increase knowledge and attitudes about earthquake disaster preparedness among elementary school students. If earthquake simulation is used as an activity program in schools, it can make students resilient to disasters.

Assessment of quality of life, pain, depression, and body-image in breast cancer patients in neoadjuvant therapy

ABSTRACT Breast cancer is the leading cancer type among women globally, and its chemotherapy often results in multiple side effects, compromising the patient’s quality of life. Our study aimed to analyze the impact of neoadjuvant chemotherapy on the quality of life in Brazilian women with breast cancer within the public health system. This research was a one-year, observational, longitudinal study, conducted at a charitable health facility, examining the effect of neoadjuvant chemotherapy on these women’s quality of life. Sociodemographic and clinical data were extracted from medical records. Quality of life parameters were gauged using Portuguese-validated questionnaires: EORTC.QLQ – C30 version 3.0, EORTC.BR-23, Body Image Scale (BIS), BPI-SF pain scale, and Beck Depression Inventory (BDI). These tools were utilized at three intervals: before the start of systemic treatment, after three months (before initiating paclitaxel), and upon concluding neoadjuvant therapy. Qualitative variables were tested for normality using the Kolmogorov-Smirnov test. As the continuous variables referring to the questionnaires did not show normal distribution, non-parametric tests were used: Friedman tests for paired pairs, and Wilcoxon and Mann-Whitney tests for multiple comparisons. In all tests, the significance level adopted was 5%. The software used for the analysis was SPSS. Our findings revealed a decline in quality of life, observing deterioration in the role, social, and cognitive functioning domains. Additionally, symptoms like fatigue, hyporexia, constipation, and diarrhea became more pronounced during the treatment. The presence of minimal depressive symptoms, associated with systemic therapy side effects also contributed to this worsening. Notably, there were no improvements in any quality of life-related parameters, and no discernible differences were observed in pain levels or body image across the evaluated periods.

Regenerating Sustainable energy and environmental solutions: Challenges and Opportunity in Belt and Road Initiative Countries

This study examines financial development, economic growth, energy consumption, trade openness, urbanization, and environmental degradation in 47 Belt and Road Initiative (BRI) countries from 1980 to 2022. Panel unit root tests (IPS, LLC, PP, and ADF) ensured data correctness and stationarity. Three co-integration tests examined the variables' connections. Difference of means (DOLS) and functional moment (FMOLS) tests examined BRI economies' co-integration. A paired Granger causality test found bidirectional correlations between CO2 emissions, urbanization, financial development, economic growth, and the creation of gross fixed capital. Trade openness only correlated with ecological well-being. International study suggests regional, state, and federal policy implications. The empirical investigation used a panel causal heterogeneous test, dynamic ordinary least squares(DOLS), and fully modified ordinary least squares (MOLS) with fixed and random effects. Trade openness negatively affected CO2 emissions, but all other regressors positively affected environmental quality. Good governance and country-specific policies are needed to maximize BRI advantages. Despite conflicting energy statistics, the study found that economic development hurt the environment in all 47 countries. Industrialized nations generally use renewable energy, which minimizes ecological issues, hence their omission from the BRI full panel may explain the negative coefficient. Since most BRI economies are in emergent and growing countries, environmental preservation and renewable energy technologies need more time and money. Instead of coal, the Chinese government and other BRI nations are urged to invest in wind, hydro, solar, and biomass. Sharing green energy technology might help BRI economies. Cross-national urbanization strategy should incorporate eco-friendly solutions. The panel and governments may utilize the paper's substantial policy recommendations.

The The Influence of Breastfeeding Education on the Effectiveness of Breastfeeding in the Bajoe Community Health Center Work Area, Bone Regency

The effectiveness of the breastfeeding process is defined as an interactive process between mother and baby that results directly in the transfer of milk from the mother's breast to the baby, in a behavior that reflects the fulfillment of the needs of the mother and baby. This research was conducted in the Bajoe Community Health Center, Bone Regency, with a research time design starting from June-September 2020 which aims to determine the effect of breastfeeding education on the effectiveness of postpartum maternal breastfeeding. This research method uses a pre-experimental design approach with one group pre-post test design approach. In this study, before the intervention was given, a pre-test was given which aimed to assess the effectiveness of breastfeeding. After the intervention was given, a post-test was given with a total sample of 46 people. The sampling technique used total sampling. The data analysis used was univariate and bivariate analysis presented in the frequency distribution table. For statistical tests, the level of significance used was p <0.05. The analysis used to determine the effect of breastfeeding education on the effectiveness of breastfeeding was a paired statistical test with a nonparametric test, namely the Wilcoxon test. Based on the results of statistical tests, it was found that the p value was 0.001 <0.05, which means that there was a significant effect of breastfeeding education on the effectiveness of breastfeeding for postpartum mothers in the working area of ​​the Bajoe Community Health Center, Bone Regency.

Impact of adalimumab on erectile dysfunction, sperm parameters and hormonal profile in male psoriasis patients: a six-month observational study.

Psoriasis, a chronic inflammatory skin disease, is associated with systemic complications that extend beyond cutaneous lesions, including cardiovascular risks and sexual dysfunction. Erectile dysfunction (ED) is notably more prevalent in male psoriasis patients, likely driven by both systemic inflammation and psychological stress. Adalimumab (ADA), a tumor necrosis factor-alpha (TNF-α) inhibitor, has been shown to effectively reduce psoriasis severity, but its effects on sexual and reproductive health remain underexplored. This study investigates the impact of ADA on erectile function, sperm parameters, and hormonal profiles in male psoriasis patients. This six-month prospective observational study included 33 biologic-naïve male patients aged 18-50 years with moderate-to-severe plaque psoriasis (Psoriasis Area and Severity Index [PASI] > 10). Patients received ADA according to standard clinical protocols. Erectile function was assessed using the International Index of Erectile Function (IIEF-5). Sperm parameters, including ejaculate volume, sperm concentration, total sperm count, motility, vitality, and morphology, were analyzed following World Health Organization (WHO) 2010 criteria. Hormonal profiles (testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, and prolactin) were measured via standardized assays. Statistical analyses were performed using paired t-tests or Wilcoxon signed-rank tests, with p-values < 0.05 considered significant. ADA significantly improved erectile function, as the mean IIEF-5 score increased from 21.3 ± 2.2 to 22.2 ± 1.9 (p = 0.03). The percentage of patients with ED decreased from 51.5% at baseline to 36.4% post-treatment (p < 0.001). Progressive sperm motility and vitality showed statistically significant improvement post-treatment (p = 0.02 and p = 0.04, respectively), while other sperm parameters remained unchanged. Total testosterone levels significantly increased from 3.4 ± 0.4 ng/ml to 3.5 ± 0.4 ng/ml (p = 0.02), while LH, FSH, estradiol, and prolactin levels showed no significant changes. The anti-inflammatory properties of adalimumab, through the inhibition of TNF-α, not only reduce psoriasis severity but also appear to exert positive effects on male sexual and reproductive health. Our study demonstrated significant improvements in erectile function, sperm motility, vitality, and testosterone levels in male psoriasis patients after adalimumab therapy. These findings suggest that beyond its role in controlling psoriatic skin lesions, adalimumab may help mitigate the systemic inflammatory burden that contributes to sexual dysfunction and impaired spermatogenesis. Future long-term studies are essential to further explore the sustained impact of TNF-α inhibition on male fertility and reproductive outcomes.

Effectiveness of Maximum Voluntary Contraction Using Surface Electromyography on Erector Spinae and Tensor Fascia Latae Muscle Along With Muscle Energy Technique in Chronic Non-Specific Low Back Pain

Background: Low Back Pain (LBP) one of the major health issues over the world. It affects quality of life and work absentness leads to disability. Non-specific Low Back Pain (NSLBP) does not have specified problem. In this type, muscle imbalance, distributed muscle strength, endurance, movement co-ordination impairment, poor posture might enhance the nociceptor stimuli.Muscle energy technique (MET) is an active manual technique focused over muscle stretching, strengthening, relaxing. Aims to restore normal joint mobility and reduce pain.Aim: To determine the effect of muscle energy technique in chronic non-specific low back pain.To study the effectiveness of muscle energy technique in subjects with chronic non-specific low back pain on pain, functional disability and Surface electromyography (SEMG) measures.Material and Method: A total of 40 subjects were included in the study. 20 subjects with CNSLBP were allocated in a group A. whereas group B was allocated with Core Muscle Strengthening exercises (CMSE) for three weeks. All the participants were clearly explained about the procedure and informed consent attained.In group A, MET was applied over four muscle groups namely quadratus Lumborum (QL), erector spinae (ES), iliopsoas, tensor fascia latae (TFL). SEMG study was done over the two muscles, ES and TFL. At rest period measurement was done after their maximum voluntary contraction was recorded. Results: Pre-post-test comparison was analysed by Wilcoxon’s matched pair test. Between group analysis done by Mann Whitney U test, the experimental groups exhibit VAS, ODI, SEMG-ES (Rt and Lt), TFL (t and Lt) shown significance at p value = 0.001. Conclusion: MET was effectively reducing functional disability, decreases pain, muscle strength improved in ES and TFL muscles of both sides evaluated through SEMG.

Cervical Disc Arthroplasty for the Treatment of Adjacent Segment Disease after Anterior Cervical Discectomy and Fusion

Study Design. A retrospective chart review was conducted at a single institution. Objective. The purpose of this study was to investigate clinical outcomes of cervical disc arthroplasty (CDA) used for the treatment of symptomatic adjacent segment disease (ASD) developed after anterior cervical discectomy and fusion (ACDF). Summary of Background Data. A major clinical concern following ACDF is the development of ASD. ASD after ACDF is often treated with an additional fusion, but risks include pseudoarthrosis and further ASD. CDA is a motion preserving alternative that addresses these concerns, and therefore, has been proposed as an alternative treatment for ASD after ACDF. Methods. CDA patients with prior adjacent-level ACDF (n=120) were identified from a consecutive series of CDA patients at one institution. Pre- to post- CDA patient-reported outcome measures were compared using the paired Wilcoxon signed-rank test. Results. A total of 142 devices were implanted – 98 patients underwent a one-level CDA, and 22 patients underwent two-level CDA. The mean follow-up duration after CDA was 32.11 months. Neck pain, arm pain, and Neck Disability Index (NDI) scores significantly improved from the preoperative to postoperative timepoint (respectively: 6.14 to 3.02, 4.42 to 1.61, 44.28 to 28.62, all P&lt;0.001). In total, 7 patients underwent reoperation (5.83%). One of these patients underwent reoperation for pseudarthrosis at the level of ACDF following a hybrid procedure. The indications for index level reoperations (n=3) were foraminal stenosis, osteolysis, and postoperative hematoma. All patients with an adjacent level reoperation (n=3) received surgery at levels adjacent to the prior fusion, not the more recent CDA. Conclusion. The results of this study found CDA was effective for the treatment of ASD following ACDF. CDA appears to be a viable treatment option for ASD after ACDF in appropriately selected patients.

Impact of deep inspiration breath hold, surface-guided radiotherapy, and daily CBCT on the organs at risk in breast cancer radiotherapy

The goal of the study was to assess the impact of deep inspiration breath hold technique (DIBH), surface-guided radiotherapy (SGRT), and daily kilovoltage cone-beam computed tomography (kV-CBCT) on the dose to organs at risk (OAR) in left-sided breast cancer radiotherapy. Twenty-six consecutive left-sided breast cancer patients treated using Volumetric Intensity Modulated Arc Therapy (VMAT), DIBH, SGRT, and a hypofractionated regimen were retrospectively evaluated in this study. Dose parameters were extracted from dose-volume histograms (DVH). The Wilcoxon Matched Pairs test was used to test dose parameters obtained in free breathing (FB) and DIBH for statistical significance. Multivariable analysis of variance (ANOVA) and receiver operating characteristics (ROC) analysis were used to identify parameters and cut-off points associated with the reduction of the mean heart dose (MHD) by DIBH. Based on published models, the risk of cardiac and lung toxicity (pneumonitis) using SGRT or daily kV-CBCT was estimated and compared. DIBH substantially reduced the MHD (median, 43.6%; range, 4.2% to 75.1%; P < 0.00001). The risk of cardiac toxicity using SGRT increased by 1%, compared to 3.6% to 20.5% using daily kV-CBCT. No significant difference in the risk of radiation-induced pneumonitis using SGRT versus daily kV-CBCT was detected. The ANOVA revealed the relative increase of the left lung volume by DIBH as the only significant impact factor for the MHD. The ROC analysis of this parameter showed an area under the curve (AUC) of 0.89 (95%CI, 0.71 to 0.98; P < 0.0001). DIBH can substantially reduce the MHD in left-sided breast cancer patients treated with modern radiotherapy techniques and hypofractionation. Patient setup using SGRT compared to daily kV-CBCT may be the preferred option for many patients. In our patient cohort, the relative reduction of the left lung volume by DIBH can be used as a predictor to select patients who benefit from DIBH.

DNAR-16. TARGETING APOBEC CYTIDINE DEAMINASES TO ENHANCE RADIOSENSITIVITY IN GLIOMA

Abstract Glioma is the most common and aggressive primary adult brain tumor. Radiation therapy (RT) is a critical part of glioma treatment, but radioresistance severely limits its therapeutic efficacy. To better understand how radioresistance develops, we analyzed 212 paired primary and recurrent gliomas from the Glioma Longitudinal Analysis Consortium. We found a significant increase in mutational signatures associated with the activity of the Apolipoprotein B mRNA-editing enzyme catalytic polypeptide-like (APOBEC) family of cytidine deaminases in RT-treated recurrent gliomas (p&amp;lt;0.001, paired Wilcoxon signed-rank test). Further analysis of post-treatment mutations showed that RT increased APOBEC mutational signatures independent of other factors (p&amp;lt;0.001, multivariable log-linear regression), suggesting that APOBEC proteins become activated by radiation. However, their role in promoting tumor evolution and treatment resistance is currently unknown. Further analyses of extended signature contexts and expression data nominated APOBEC3B (A3B) and APOBEC3G (A3G) as candidates for creating these mutational signatures. To investigate their roles in RT response, we knocked out (KO) A3B and A3G individually in patient-derived glioma cell lines before RT. Compared to Control cells, irradiated A3B-KO and A3G-KO cells acquired significantly fewer APOBEC mutational signatures by whole genome sequencing (p&amp;lt;0.05, Kruskal–Wallis test) and exhibited enhanced radiosensitivity in vitro. Interestingly, the KO cells displayed a significant decrease in mutational signatures associated with Non-Homologous End-Joining (NHEJ), one of the main pathways for repairing the RT-induced DNA damage (p&amp;lt;0.05, Kruskal–Wallis test), suggesting that APOBEC deletion impaired DNA repair. This was further supported by persistent gH2AX DNA damage foci 48h post-RT and reduced autophosphorylation of DNA-dependent protein kinase (DNA-PK), a vital component of the NHEJ pathway, particularly in A3G KO cells. Overall, our results identify APOBEC proteins as potential targets for radiosensitizing gliomas and highlight the clinical utility of using mutational signatures to predict and monitor response to treatment.

Effect of chest compressions in addition to extracorporeal life support on carotid flow in an experimental model of refractory cardiac arrest in pigs

BackgroundExtracorporeal life support (ECLS) provides organ perfusion in refractory cardiac arrest but during the initiation of ECLS mean arterial pressure (MAP) and carotid flow may be suboptimal due to hypotension and/or insufficient flow. We hypothesized that cardiopulmonary resuscitation (CPR) in addition to ECLS may increase carotid flow and MAP compared to ECLS alone. MethodsObservational pilot study comparing hemodynamic parameters before and after CPR cessation in pigs supported by ECLS for experimental refractory cardiac arrest. Pigs were anesthetized, ventricular fibrillation was induced for 3 min, automated CPR performed for 30 min, ECLS was initiated then CPR stopped.Variables averaged over 3 s were compared between the last 3 s of CPR + ECLS and 3, 6, 30 s, and 5 and 10 min of ECLS alone. Data are expressed as medians (25–75 interquartile range) and compared using paired samples Wilcoxon test. ResultsNine pigs were included, ECLS was initiated at 2.7 (2.3–2.8) L/min. MAP during CPR + ECLS was 56(53.0–59.2) mmHg, versus 50(45–57)mmHg, 52(46–59)mmHg, 61(50–63)mmHg, 57 (54–66)mmHg, 54 (47–58)mmHg of ECLS alone, p = 0.50, 0.61, 0.70, 0.44, 0.73 respectively. Carotid flow was 113(78–119) ml/min during CPR + ECLS versus 99(79–110)ml/min, 100(81–110)ml/min, 96(60–122)ml/min, 118 (101–130)ml/min, 124 (110–141)ml/min, p = 0.41, 0.52, 0.73, 0.33, 0.20 respectively. When ECLS was initiated at lower flow, 1.5 L/min (one pig), MAP decreased from 59 to 45 mmHg, and carotid flow from 78.2 to 32.5 ml/min after 3 s of ECLS alone. ConclusionStopping CPR after effective ECLS initiation does not decrease MAP or carotid flow. Future studies may evaluate augmenting low flow ECLS with CPR.

Predictors of Post-operative ABG Changes to Pre-operative Levels in Kidney Transplant Patients, a Cross-Sectional Study

Background: Kidney transplant is the treatment of choice for chronic renal failure (CRF), significantly improving patient outcomes. Fluid administration during surgery can lead to the accumulation of acid ions and electrolytes, inducing pH changes from the pre-operative to post-operative period, which may compromise transplant success. The impact of acid-base balance changes on transplant outcomes is crucial, yet research on predictors and arterial blood gas (ABG) changes post-kidney transplant is limited. Understanding ABG changes can enhance perioperative management, early detection of complications, and long-term graft function, thereby optimizing patient care and increasing transplant success rates. Objectives: To assess ABG changes before and after kidney transplant and identify predictors of post-operative acidosis in patients with renal failure through cross-sectional studies. Methods: In a retrospective cohort study, we included 97 patients who had undergone kidney transplant. During surgery, patients received crystalloid fluids, with 49 receiving only normal saline and 48 receiving only Ringer's lactate. Data collection involved the insertion of an arterial line after anesthesia induction, and the first ABG sample was obtained as a pre-operative measure. A post-operative measure was taken at the end of the surgery. Ethical considerations were followed throughout the study. Statistical analysis included paired t-test or Wilcoxon signed-rank test to compare pre- and post-operative ABG measures, with a significance level set at a P-value less than 0.05. Results: Total of 97 patients, which 65 (69.4%) were male and 32 (30.6%) were female and mean age was 38.6 ± 12.2. Variables significantly associated with post-op acidosis were fluid administered (OR: 3.25, 95% CI: 1.45 - 4.58), post-op central venous pressure (CVP) (OR: 2.31, 95% CI: 1.23 - 2.62, p &lt; 0.05), post-op base excess (BE) (OR: 2.16, 95% CI: 1.50 - 2.95, P &lt; 0.05). HCO₃ (P = 0.010), BE (P = 0.002), pH (P = 0.023) were significantly lower in the normal saline group compared to the Ringer's group. Post-op pH and BE was also associated with increased post-op CVP. Post-op acidosis and post-op CVP were significantly associated with post-op BE. Conclusions: Post-operative ABG changes, including decreases in pH and HCO3, are key indicators of transplant outcomes, reflecting graft function and patient stability. These findings highlight the critical need for prompt management of ABG abnormalities to optimize transplant success and minimize complications, making vigilant monitoring a vital part of post-transplant care.

Adaptation and validation of the Turkish version of the Bolton Compassion Strengths Indicators scale among nursing students: A psychometric analysis.

The study used a methodological design to adapt a Turkish translation and validate the Bolton Compassion Strengths Indicators scale. The sample of the study consisted of 500 nursing students. Partial least squares structural equation modelling was used to analyze the construct and internal validiy. The values of average variance explained were analyzed for convergent validity. Tukey's test of additivity examined the additivity, and Hotelling's T2 test examined the mean difference between items. Internal consistency and test-retest reliability were ensured for reliability. Test and retest scores were compared by applying the paired samples t-test and Wilcoxon test, and the fit was analyzed through the intra-class correlation coefficient. The Turkish version of the scale consisted of 34 items and 8 subscales. The Cronbach's alpha coefficient of the overall scale was 0.954. The scale was highly reliable and displayed psychometric solid properties. It has been determined that the Turkish version of the Bolton Compassion Strengths Indicators scale is a comprehensive, easy-to-understand measurement tool with a broad perspective that can be safely applied to future nurse candidate students. The scale has been evaluated as a reliable measurement tool that can provide cross-cultural measurement.

Evaluating the effectiveness of a new curriculum for transcultural nursing education: a mixed-method study

BackgroundIn recent years, limited studies have evaluated the development of cultural awareness, sensitivity, skills, communication and competence among nursing students using different models and curricula.ObjectivesThis study aimed to evaluate the effectiveness of a new internationally developed curriculum for transcultural nursing education.MethodsThis mixed methods study was conducted on nursing students (n = 83) who attended a transcultural nursing course from 2021 to 2022 during the fall semester. A paired samples test was used to compare total scores, and the related-samples Wilcoxon signed-rank test was used to compare subscale scores.ResultsThe vast majority (94.0%) of the participants mentioned Islam as their religion. Turkish was the mother tongue of 91.6% of them, while 10.8% were able to speak English and 6.0% were able to speak Kurdish fluently. The mean score for the achievement of cultural competence subdimension posttest was significantly greater (p < 0.001). Posttest mean scores for challenges and barriers in providing culturally competent care subdimensions were significantly lower (p = 0.003). The mean score on the culturally sensitive communication subdimension pretest was 21.00 ± 4.76, and the mean score on the posttest increased to 23.02 ± 6.05, which was a statistically significantly greater difference (p = 0.024). According to the qualitative results of our study, five main themes were analyzed: transcultural nursing as an opportunity, transcultural nursing as a didactic process, transcultural nursing as a professional field, transcultural care as a safe environment, and transcultural care as an obligation.ConclusionsIn this study, after a semester of continuing education, nursing students developed respect for cultural diversity, cultural competence, and culturally sensitive communication.

The impact of early surgery on mortality and functional recovery in older adults with traumatic intracranial lesions: a propensity score-based analysis.

There is skepticism about the benefit of surgery in elderly patients affected by traumatic brain injury (TBI) due to the negative effect of age on the outcome and surgical complications. However, there are few studies that have investigated differences in patient's outcome between surgically and conservatively managed patients after adjusting for the imbalance in preinjury characteristics and clinical and radiological features. The primary aim of this study was to evaluate the effect of early surgery on mortality and functional recovery in a cohort of older adults with acute traumatic intracranial lesions after adjustment by Propensity Score (PS) matching. MATERIALS AND METHODS: We conducted a retrospective cohort study on older adult patients (≥ 65 years) admitted for TBI between 2013 and 2023 to a single level 1 trauma center. Patients were categorized based on whether they underwent early surgery (< 48h after TBI) for a space-occupying lesion evacuation. PS model was constructed based on age, frailty, comorbidities (Charlson comorbity index and American Society of Anaesthesiologists score), anticoagulants, hypoxia, shock, pupillary abnormalities and GCS motor response upon admission, midline shift, basal cistern effacement, volume of subdural and intracerebral hematomas, and limitation of life-sustaining treatment decisions.The effect of early surgery on 30-day mortality and unfavorable functional outcomes (GOSE 1-3) at 6 and 12 months were investigated after matching by paired test. We identified and reviewed 301 patients who met all inclusion criteria and contained no exclusions. After matching, 62 patients (31 pairs of conservative and surgical patients) remained as the matched datasets. Our key finding was that older adult TBI patients who underwent early surgery had a statistically significant reduction in the risk of 30-day mortality (OR 0.313, 95% CI 0.114-0.853, p = 0.023) and unfaourable outcome at 12 months after TBI (OR 0.286, 95% CI 0.094-0.868, p = 0.027). Early surgery was associated with decreased 30-day mortality and better functional outcome at 12 months after TBI in older adults with few comorbidities and good functionality when clinically affected by acute traumatic intracranial lesions with mass effect.

Effect of Melatonin on the Production Performance, Blood Biochemical Parameters, Nutrient Digestibility, and Gastrointestinal Microbiome of Liaoning Cashmere Goats

Melatonin’s capacity to improve cashmere production and quality in goats is well established, but its underlying mechanisms, particularly those concerning the gastrointestinal microbiome, remain inadequately understood. This study aims to elucidate the effects of melatonin implantation on the production performance, blood biochemical parameters, nutrient digestibility, and gastrointestinal microbiome of Liaoning cashmere goats. Thirty newborn Liaoning cashmere goat lambs were selected and randomly assigned to control and melatonin groups using a paired test design. The melatonin group received three melatonin implantations at 15, 75, and 135 days of age, respectively, with a dosage of 2 mg/kg body weight, while the control group received no treatment. Digestive metabolism tests were conducted at 150 and 300 days of age; prior to these tests, blood, rumen fluid, and rectal feces were collected. Apparent nutrient digestibility and blood biochemical indexes were determined, and rumen fluid and rectal feces were analyzed using microbial 16S rRNA sequencing. The results indicated that melatonin significantly reduced daily weight gain and body weight at 60 days (p &lt; 0.05) while significantly increasing daily weight gain at 300 days (p &lt; 0.05). Additionally, it significantly increased cashmere length and reduced its fineness (p &lt; 0.05). Melatonin significantly enhanced nitrogen deposition (p &lt; 0.05), elevated plasma levels of T-AOC, CAT, GSH-PX, and BUN (p &lt; 0.05), and reduced plasma levels of MDA, GOT, GPT, and AKP (p &lt; 0.05). Moreover, melatonin significantly elevated the microbial Ace and Chao1 indices in rectal feces (p &lt; 0.05), increasing genera beneficial for feed digestion and absorption, including Prevotella, Lachnospiraceae, Ruminococcus, and Synergistaceae (p &lt; 0.05); the abundance of these beneficial genera were positively correlated with improved cashmere production performance, antioxidant activity, and liver and kidney function. In conclusion, melatonin enhances cashmere production by modulating gastrointestinal microbiota, antioxidant activity, liver and kidney function, and nitrogen metabolism in cashmere goats. This study provides a theoretical foundation for melatonin’s role in microbiota modulation, which is essential for promoting high-quality and sustainable development in the cashmere goat industry.

A Novel Unilateral Bi/Multi-Portal Endoscopic Transforaminal Interbody Fusion Utilizing Uniaxial Spinal Endoscope Instead of Arthroscope: Technical Note and Preliminary Clinical Results.

Currently, traditional UBE surgery, which is based on arthroscope, has been increasingly employed for complex lumbar degenerative diseases. However, this approach is associated with complications such as intraoperative dural sac tears, nerve root injuries, and postoperative epidural hematomas. In response to these challenges, we propose a novel technique utilizing uniaxial spinal endoscope to replace arthroscope-Unilateral Bi/Multi-Portal Endoscopy (UME). This new method has successfully treated complex lumbar disc herniation and spinal stenosis, resulting in improved postoperative outcomes and a reduction in complications. Based on the previous findings, we utilized uniaxial spinal endoscopy as the primary operating method, with the assistance of multi-portal endoscopic techniques (UME-TLIF), to perform transforaminal lumbar interbody fusion. The feasibility and preliminary clinical results have been presented in this paper. A total of 18 patients (8 men and 10 women, aged 52.6 ± 15.29 years) diagnosed with lumbar degenerative diseases, such as giant lumbar disc herniation, severe lumbar spinal stenosis, or lumbar spondylolisthesis, were included in this study from January 2022 to March 2023. Various parameters including operation time, ambulatory time, intraoperative fluoroscopy times, hospitalization days, and complications were recorded during the perioperative period. Clinically relevant symptoms were evaluated and documented 1, 3, 6, and 12 months postoperatively. Visual analogue scale (VAS) scores for lower back pain and leg pain, as well as the Oswestry disability index (ODI), were measured. The extent of lumbar interbody fusion was assessed using lumbar X-ray and CT scans at the 12-months follow-up. MRI was performed to assess the degree of nerve decompression in patients at the same time points. The paired t-test or Wilcoxon signed-rank test were used as statistical methods. The single-segment UME-TLIF procedure had an average operation time of 211 ± 53.3 min, and the average number of X-rays taken during the operation was 11.78 ± 5.32. Patients were able to walk and perform functional exercises approximately 35.11 ± 8.41 h post-surgery, and the average duration of hospital stay was 8.5 ± 2.27 days. The VAS and ODI values at each time point post-surgery were significantly lower than the respective pre-surgery values (p < 0.05). Two patients developed postoperative sensory disturbances which significantly improved with conservative treatment. Furthermore, a follow-up CT scan conducted 12 months post-surgery showed 100% fusion rate of the surgical segments in all patients. UME-TLIF is an endoscopy-assisted fusion procedure that minimizes muscle damage in patients and allows early rehabilitation. This technique broadens the surgical applications of uniaxial spinal endoscope as a surgical tool, particularly benefitingpatients diagnosed with severe lumbar disc herniation and lumbar instability.

Effect of Physiotherapy on Pain Intensity and Disability in Patients with Chronic Low Back Pain: A Call for Patients’ Awareness to Focus on Physiotherapy Treatment in Cameroon

Background: This study aimed at evaluating the effects of conventional physiotherapy (CPT) treatment on pain and disability among patients with Chronic low back pain (CLBP) Methods: we conducted a quasi-experimental study in some major physiotherapy units in Cameroon from December 2022 to April 2023, patients following physiotherapy treatment for CLBP were enrolled. A structured questionnaire was used to collect general characteristics of participants; the level of pain was assessed with the VAS (Visual Analog Scale) and the impairment of physical function with the EIFEL scale (Echelle d’Incapacité Fonctionelle du Patient Lombalgique). The data collected were analyzed using SPSS. The paired Student test was used to compare the initial and final VAS and EIFEL scores. The Leverne test was used to compare treatment outcomes between patients who received CPT alone and those who received non-conventional traditional medicine (TM). Statistical significance was calculated at P˂ 0.05. Results: Were included in this study 158 patients with CLBP with a mean age of 46.3 ±14.3. Female were more represented (106/157, 67%). The patients underwent CPT for a mean duration of 8.9 ±15.8 months at a weekly mean session frequency of 3.8±1. Of the 158 participants, 35 (22.2%) underwent additional TM. Conventional physiotherapy significantly reduced pain (Initial VAS:7.4± 1.3; Final VAS: 3.9± 1; P=0.000) and physical impairment of participants (Initial EIFEL: 15.7± 4.5; Finale EIFEL: 6.8 ± 3.2; P=0.000). The study found no significative difference in pain (P= 0.317) and physical impairment (P=0.302) in patients following exclusively CPT and those following physiotherapy additionally to non-conventional TM. Conclusion: Physiotherapy treatment reduces pain and improve physical function of patients with chronic low back pain and additional non-conventional TM did not have improve further pain and disability in these patients.

Comparison of ultraviolet C light and isopropyl alcohol for the disinfection of cellular phones in a paediatric intensive care unit setting.

A considerable proportion of cellular phones (cell phones) used by healthcare workers (HCWs) have been shown to be contaminated with pathogenic micro-organisms, making these devices reservoirs to infect susceptible patients. Although many units have well-defined infection control protocols, methods for the decontamination of cell phones are scarce. To compare the efficacy of ultraviolet C (UVC) light with that of 70% isopropyl alcohol in disinfecting cell phones used by HCWs in a paediatric intensive care unit (ICU). A randomised controlled study in a paediatric ICU setting was conducted. Cell phones of HCWs or other personnel entering the ICU were swabbed prior to and after decontamination with either the 70% isopropyl alcohol or UVC light method. The reduction ratio of colony-forming units (CFUs) before and after intervention was analysed using the Mann-Whitney U-test. In addition, the effectiveness of the disinfection methods was compared using the Wilcoxon signed-rank paired test. A total of 74 cell phones were acquired from HCWs working in the paediatric ICU. After excluding 5, 69 samples were therefore available for statistical analysis, with 34 samples subjected to disinfection using 70% isopropyl alcohol-based swabs and 35 samples treated with UVC light disinfection. Disinfection with 70% isopropyl alcohol (z=5.16; p<0.000001) and with UVC light (z=3.28; p<0.005) were individually statistically significantly effective in reducing CFUs. The CFU reduction ratio indicated that disinfection using a 70% isopropyl alcohol solution was 67% more effective than UVC light disinfection (Mann-Whitney U-test score 968; p<0.001). Although both 70% isopropyl alcohol and UVC light disinfection effectively reduced CFUs following decontamination, 70% isopropyl alcohol was determined to be much more effective.

The utilization of cytology for intraoperative diagnosis of primary central nervous system lymphoma

To investigate the diagnostic value of intraoperative cytology and rapid immunocytochemistry in primary central nervous system lymphoma. 254 cases of lymphoma and 82 cases of non-lymphoma were collected from 2010 to 2023. Frozen section(FS) was using alone in 44 cases during 2010–2014, FS and intraoperative cytology(IC) were using in 251 cases during 2015 to 2022. Rapid immunocytochemical(RICC, CD20, GFAP) were using with FS + IC in 41 cases during 2021 to 2023. Method One: According to the results of archives, statistic the diagnostic accuracy of lymphoma during three time periods. Method Two: All cases were randomly renumbered, 4 neuropathologists compared the accuracy of independent histology and that of combining cytology. The archives showed the diagnostic accuracy of FS in PCNSL was 77.27%, FS + IC was 86.06%, FS + IC + RICC was 92.68%. The retrospective study demonstrated the diagnostic accuracy of FS was 79.76%, FS + IC was 87.33% and FS + IC + RICC was 92.68%. The positive predictive value, negative predictive value, sensitivity, specificity and accuracy of CD20 were 100%, 76.92%, 90.32%, 100% and 92.68%, respectively. The results of the paired χ2 test was no statistically significant difference (0.05 < P < 0.1) between FS + IC + RICC and immunohistochemical (IHC) diagnosis of paraffin sections. The integration of IC + RICC + FS diagnosis can significantly enhance the intraoperative diagnostic accuracy of PCNSL and rectify potential errors that may occurred when relying solely on FS diagnosis.

An Economic and Reliable PCR Approach to Distinguish the Primary Pathogens Armillaria mellea and A. ostoyae From Other European Armillaria Species

ABSTRACTArmillaria is a soil‐borne genus of basidiomycetes whose species can cause stem and root rot in woody plants. The effects of plant‐pathogenic Armillaria species are well known in forests, but are underestimated in urban areas, where cases causing damage to trees and shrubs in green spaces have been steadily increasing in Switzerland since the 1980s. In this study, we present a simple, rapid, and cost‐effective protocol for high‐throughput diagnostics of the two primary pathogens A. mellea and A. ostoyae based on partial PCR amplification of the RPB2 gene. The specificity and sensitivity of the presented duplex PCR‐I and single‐plex PCR‐II were evaluated using different methods: (i) testing both PCRs on tree pathogenic or soil‐borne fungi of genera other than Armillaria, (ii) using dilution series of Armillaria‐DNA to determine a minimum detection limit, and (iii) sequencing the selected RPB2 region to verify the primer sequences and positions. The utility of PCR‐I and PCR‐II as a high‐throughput method was successfully tested on 65 DNA samples of Armillaria from Switzerland. Finally, an uninvolved person compared both classical methods, pairing test and sequencing, with PCR‐I and PCR‐II in a blind test. This study provides a reliable and alternative protocol for the rapid diagnosis of A. mellea and A. ostoyae causing root rot of woody plants.