Paired Wilcoxon Test Research Articles

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 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 the ECLS initiation does not decrease MAP or carotid flow. Future studies may evaluate augmenting low flow ECLS with CPR.

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.

Effects of cholecalciferol supplementation on depressive symptoms, C-peptide, serotonin, and neurotrophin-3 in type 2 diabetes mellitus: A double-blind, randomized, placebo-controlled trial

The coexistence of depression and type 2 diabetes mellitus (T2DM) can significantly worsen disease prognosis and lower quality of life. Emerging evidence suggests that vitamin D deficiency contributes to the progression of T2DM and is closely associated with the development of depression. The aim of this study was to investigate the effects of cholecalciferol on depression in patients with T2DM, exploring its mechanisms by analyzing its impact on C-peptide, serotonin, and neurotrophin-3 levels. A double-blind, randomized, placebo-controlled clinical trial was conducted at Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, from April 2021 to September 2022. Patients with T2DM and depressive symptoms were randomly assigned to two groups: received 4000 IU of cholecalciferol daily and received a placebo for 12 weeks. Depression was assessed using the Beck Depression Inventory-II (BDI-II) before and 12 weeks after the intervention. The levels of C-peptide, serotonin, and neurotrophin-3 were measured at the end of the fourth week of intervention using the enzyme-linked immunosorbent assay (ELISA) method. Between-group comparisons were made using independent Student t-tests and Mann-Whitney U tests. Paired Student t-tests or Wilcoxon tests were applied for within-group comparisons between pre- and post-intervention. A total of 70 T2DM patients with depression were included in this study, comprising 38 patients in the cholecalciferol group and 32 in the placebo group. C-peptide levels increased significantly in the cholecalciferol group compared to the placebo group (p=0.006). No significant differences were observed in serotonin and NT-3 levels between the cholecalciferol group compared to the placebo group. The cholecalciferol group had a significantly greater reduction in BDI-II scores compared to the placebo group (p<0.001). This trial highlights that taking cholecalciferol might help ease mild to moderate depression symptoms in patients with T2DM by enhancing c-peptide levels, though its effects on serotonin and neurotrophin-3 are still unclear.

Impact of cooking knowledge refresher classes on improving the cooking skills of university students

Objective: To develop, apply and evaluate the impact of cooking knowledge refresher classes (CKRC) on the cooking skills of university students. Participants: University students who participated in the first phase of the Nutrition and Culinary in the Kitchen (NCK) intervention. Methods: A quasi-experimental cooking class intervention was conducted to reinforce cooking skills. Participants completed a validated online survey before and after the intervention. Paired t-tests or Wilcoxon test were used (p < 0.05). Results: Of the 33 students who answered the survey, 13 participated in the CKRC intervention. Participants reported increased interest in learning how to prepare snacks. Their Self-Efficacy for Using Fruits, Vegetables, and Seasonings (while cooking) increased after the intervention (3.63 ± 0.65 vs. 3.93 ± 0.76; p = 0.032). Conclusions: Even among students who have improved their cooking skills through a cooking intervention program, participation in refresher cooking classes tailored to their needs can reinforce positive outcomes.

Physiological adaptations in small-side games combined with speed-endurance training: analyzing heart rate and rate of perceived exertion

Background and Study Aim. Monitoring physiological responses during training is crucial for understanding how athletes adapt to various exercise intensities. However, the specific effects of combining Small-Sided Game (SSG) and Speed-Endurance Training (SET) on these parameters require the search for more effective solutions. This study aims to determine the effect of combined SSG and SET on heart rate (HR) and rate of perceived exertion (RPE). Material and Methods. This quantitative research employed an experimental method with a weekly pretest-posttest design. The study population consisted of eighty-two members of the Unesa Soccer Student Activity Unit. A sample of eighteen individuals was selected through simple random sampling. The sample had the following characteristics: age 20±0.69 years, weight 65±9.54 kg, height 165.22±4.31 cm, and BMI 22.82±1.92. Data were collected using the Polar H-10 device, and RPE interviews were conducted ten minutes after each training session. Data analysis was performed using paired sample t-tests and Wilcoxon tests. Results. The results showed a significant difference in HR for pair 1 (p = 0.037), but no significant differences for pair 2 (p = 0.058) or pair 3 (p = 0.076). However, the results for RPE indicated significant differences in pair 1 (p = 0.001), pair 2 (p = 0.004), and pair 3 (p = 0.002). The combination of SSG and SET led to an increase in HR during the first and second weeks. In the third week, HR decreased. RPE increased from the first to the second week. It then stabilized in the third and fourth weeks, indicating a consistent level of effort. The decrease in HR during the third week, despite the same effort level, suggests that the athletes successfully adapted to the training program. Conclusions. The combination of SSG and SET demonstrates potential as an effective training method for improving both physiological performance and adaptation in athletes. These findings offer valuable insights into how athletes respond to structured training programs, providing a foundation for future research and practical applications in sports training. The results contribute to a deeper understanding of the role that specific training combinations play in athlete development and recovery.

Effectiveness of platelet-rich fibrin in third molar extractions: a randomized controlled split-mouth study

ObjectivesTo date, studies have only investigated the use of platelet-rich fibrin (PRF) after removal of third molars from the mandible or maxilla. Removal of the upper and lower third molars is typically combined into one session per side; therefore, this study aimed to investigate influence on PRF.Materials and methodsThis prospective, single-blinded, randomized controlled, clinical trial (split-mouth design) included 25 patients. After third molar removal, the test group’s sockets were treated with solid PRF clots, whereas the control group’s sockets were conventionally treated. The primary outcome was swelling, which was measured digitally and analogously. Secondary outcomes included trismus, pus, hematoma, and clinical attachment loss (CAL) of the second molars on days 1, 3, 7, and 14. Patient-centered outcome measures and the consumption of painkillers and antibiotics were recorded on days 0–7. The t-test for paired samples, Wilcoxon test, and Chi-Square test were used for statistical analyses.ResultsSwelling was significantly lower on day 14 in the test group (p < 0.05). No statistically significant differences were observed in pain, trismus, and CAL. In the test group, the number of painkillers taken and the number of days of intake were significantly lower (p < 0.05).ConclusionsPRF caused a reduction of painkiller consumption and in the days painkillers were needed. PRF significantly considerably reduced swelling after 14 days. Owing to the lack of differences in other parameters, the integration of PRF application into routine wisdom tooth removal is critical.Clinical relevancePRF affects the long-term outcomes of third molar removal by reducing swelling and reducing as well as shortening painkiller consumption.Trial registrationclinicaltrials.gov (NCT05089812).

Semaglutide improves contractile function in isolated human atrium

Abstract Background Recently, the results of the STEP-HFpEF trial were announced, in which high-dose treatment with the antidiabetic glucagon-like-peptide 1 agonist semaglutide resulted in a significant improvement of HFpEF-associated symptoms and reduction of NT-proBNP levels. Interestingly, treatment effects were independent of initial body weight and left-ventricular ejection fraction, sparking interest regarding the precise mechanism of action. Purpose We tested the effects of acute semaglutide treatment in isolated human right-atrial trabeculae. Methods Trabeculae were prepared from right atrial appendage biopsies from 32 patients undergoing elective coronary artery bypass grafting and/or valve surgery. Regular contractions were elicited by electrical field stimulation (1Hz, 5V/50ms, 37°C). Paired experiments were performed simultaneously per patient with a control group and one exposed to semaglutide (100 or 300nM). Developed tension was analysed at steady state after 30 min. Arrhythmias were defined as deviations from baseline not arising from electrical stimulation. L-type calcium channel blockade was achieved with nifedipine (2µM) in some experiments. Rapid cooling contraction was elicited to assess sarcoplasmic reticulum Ca2+ content (RCC1) by rapidly superfusing the trabeculae with chilled solution (2°C). After a short rewarming period of 10s to 37°C, RCC was repeated to assess the Na+/Ca2+ exchanger function (RCC2). Statistical analysis was conducted using paired t-test or Wilcoxon test as appropriate (for 2 groups) and one-way ANOVA with test for trend (for &amp;gt;2 groups). Results Exposure to semaglutide increased developed tension by over 3-fold in human atrial trabeculae in a dose-dependent manner: from 3.14±1.14 for control to 5.43±2.35mN/mm2 for 100nM semaglutide (p=0.03 vs. control) to 12.5±3.53 for 300nM semaglutide (p=0.004 vs. control, mean±SEM, fig. A-D, p=0.005 for linear trend). L-type calcium channel blockade with nifedipine blunted developed tension overall but did not abolish the effect of semaglutide (fig. E, p=0.02). In contrast, the developed tensions upon RCC1 and RCC2 were increased by semaglutide (300nM) compared to control, while the ratio of RCC2:RCC1 was elevated by semaglutide, indicating both increased SR Ca2+ reuptake and less external Ca2+ removal in the presence of semaglutide (fig. H-J). Relaxation time to 50% of baseline was unaltered (not shown), while relaxation time to 90% of baseline was mildly prolonged by semaglutide at 300 nM (fig. F). No increase in the rate of arrhythmias was observed by semaglutide treatment (fig. G). Conclusion Acute exposure of human atrial trabeculae to semaglutide results in a strong positive inotropic effect in a dose-dependent manner without increasing the propensity for arrhythmias. This effect is most likely due to increased SR Ca2+ reuptake. Treatment of heart failure patients with high-dose semaglutide can improve atrial function, which may ameliorate symptoms.

Cross-cultural adaptation of the Czech version of the core outcome measures index for low back and neck pain.

The Core Outcome Measures Index (COMI) is a short, multidimensional instrument translated into several languages that covers five domains recommended in the assessment of outcome in patients with low-back and neck pain. The purpose of this study was to cross-culturally adapt the COMI from English to Czech language and to test the face and construct validity and reproducibility of its results in patients with low-back and neck pain. Participants (n = 125) were included from primary and secondary care. The participants reported moderate pain and disability levels. All participants filled in the COMI forms before and after surgery. Descriptive statistics, Wilcoxon paired test, Crombach's alpha, principal component analysis and information entropy calculation were used. The instrument was successfully forward and back-translated. It can be seen that the questionnaire applied as part of our intervention study produces answers with a sufficient degree of variability and with a satisfactory degree of representation of extreme values. It can be also seen that the questionnaire can diagnose an objectively occurring change associated with the surgeon within the intervention procedure. Our other findings support the idea of ​​a possible reduction in the number of questions that measure the same latent variable. Our investigations also showed that it is possible to reduce the range of the point scale of the perception of pain to 5 degrees of intensity and thus unify the range with the other questions. The Czech COMI shows acceptable properties and is thus suitable to use as a short instrument for measuring important domains in patients with low-back and neck pain.

Therapeutic results of three-dimensional aortic valve anatomic repair for regurgitant bicuspid aortic valve

Objective: To explore the surgical technique and results of three-dimensional aortic valve anatomic repair for bicuspid aortic valve (BAV) with aortic regurgitation (AR). Methods: This is a retrospective case series study. From August 2021 to December 2023, 130 consecutive patients with BAV-AR underwent aortic valve anatomic repair at the Department of Cardiothoracic Surgery, Zhongshan Hospital, Fudan University,and the data were retrospectively analyzed. There were 115 males and 15 females, aged (38.6±11.7) years (range: 15 to 67 years). All patients received modified aortic root reconstruction, to do three-dimensional root remodeling, including the basal ring, sinus of Valsalva and sino-tubular junction simultaneously. Perioperative and follow-up data were collected and analyzed. Comparisons between groups were performed using independent samples t-test, Wilcoxon paired signed-rank test, or χ² test. Results: No patient transferred to valve replacement during the operation. The cardiopulmonary bypass time (M(IQR)) was 109 (34) minutes (range:67 to 247 minutes), and the aortic cross-clamp time was 76 (26) minutes (range: 32 to 158 minutes). Preoperative transesophageal echocardiography showed 123 patients (94.6%) presented with moderate or severe regurgitation. Immediately postoperative transesophageal echocardiography showed no regurgitation in 22 patients (16.9%), trace regurgitation in 81 patients (62.3%) and mild regurgitation in 27 patients (20.8%). Follow up was complete in all patients, with a follow-up of 5.5 (9.4) months (range: 0.1 to 27.6 months). No mortality was observed during follow-up. Echocardiography was obtained in 112 patients at the latest follow-up, including no regurgitation in 4 patients (3.6%), trace regurgitation in 58 patients (51.8%), mild regurgitation in 45 patients (40.2%), moderate regurgitation in 4 patients (3.6%), and severe regurgitation in 1 patient (0.9%). Conclusion: For patients with BAV-AR who have good valve quality and no severe aortic sinus dilation, the recent outcomes of three-dimensional anatomical repair technique, focusing on overall remodeling of the aortic root, are satisfactory.

Ethical self-efficacy among healthcare professionals caring for people with dementia: a brief pre- and post-report on the CARE intervention

BackgroundInterventions targeting healthcare professionals’ confidence in managing ethical issues in dementia care are limited despite documented positive effects of educational programs on staff knowledge and self-efficacy. However, inconsistencies in the literature regarding the impact of educational programs underscore the need for targeted interventions. The CARE intervention, specifically designed to enhance confidence in ethical decision-making, aims to address this gap. This study evaluates the effectiveness of the CARE intervention in enhancing the ethical self-efficacy of healthcare professionals caring for people with dementia, particularly those with initially low levels of self-efficacy.MethodsUsing a non-experimental pre-post evaluation design, the CARE intervention was administered to healthcare professionals (n = 86), measuring ethical self-efficacy pre-and post-intervention. We hypothesized significant differences in ethical self-efficacy mean scores pre- and post-intervention for all participants, particularly those with low pre-measurement scores, whom we expected to benefit most from the intervention. Statistical analysis included paired t-tests and Wilcoxon tests for the low pre-measurement subgroup analysis.ResultsWhile no significant change was observed in the entire sample, participants with low initial self-efficacy showed a statistically significant improvement post-intervention.ConclusionsThe CARE intervention holds promise in improving ethical self-efficacy among healthcare professionals with initial low confidence levels. Targeted interventions are essential in addressing confidence gaps in managing ethical challenges in dementia care, with implications for professional well-being and quality of care. Further research should explore long-term effects and expand sample size to enhance generalizability and sustainability of findings.

A-098 Reducing Hemolyzed Specimen Rejection for Aspartate Aminotransferase (AST): A Quality Improvement Initiative to Further Optimize Concentration-Specific H-index Thresholds

Abstract Background Serum aspartate aminotransferase (AST) is a commonly ordered test useful for diagnosing and monitoring hepatocellular damage. The hemolysis (H) index interference threshold for the Roche Cobas AST reagent is H=20, which is the lowest of all tests on Roche chemistry platforms (Cobas c701, c502, and e801). Previous optimization studies supported the implementation of an AST concentration-specific tiered hemolysis interference threshold schema: AST&amp;lt;100 U/L (H=50), AST=100-200 U/L (H=100), AST=201-300 U/L (H=200) and AST&amp;gt;301 U/L (H=500). This schema significantly reduced redraws; however, a significant number of rejected samples were noted to have AST results within the reference interval (RI). The aim of this study was to establish an H-index threshold for samples with AST results within the RI. Methods Twelve pools of residual serum samples were created with AST concentrations ranging from 17-66 U/L. Each pool was split into 2 aliquots, receiving either 10% of a lab-produced hemolysate solution generating H-indices from 62-508 or 10% of a 0.9% saline control. Aliquots were mixed in equal portions to create a series of 5 samples with increasing hemolysis according to CLSI guideline EP-07 and analyzed in EP Evaluator. Median(interquartile range (IQR)) H-index thresholds were calculated for error limits beginning at +5 U/L and increasing incrementally (+1 U/L) to +10 U/L. Clinical cases with an H-index slightly above the hemolysis interference threshold (50≤H≤70) and results within the RIs (Male:8-48U/L; Female:8-43U/L) were reviewed by the Chemistry Resident/Fellow on-call (n=68) over a period of 8 months. Results were released with a comment if risk of clinical misinterpretation due to a falsely elevated result was low. Previous, non-hemolyzed AST results were compared within 45 days, if available, by paired-Wilcoxon test (Graphpad Prism). Results The median(range) of initial AST results in the serum pools was 20(17-66) U/L. The calculated H-index thresholds (median(IQR)) using error limits of +5, +6, +7, +8, +9, +10 U/L were 49(43-53), 56(52-63), 66(61-78), 78(72-81), 91(84-91) and 101 (96-107), respectively. All slightly hemolyzed AST results (50≤H≤70) within the RI were released with a comment upon chart review. Previously reported AST values (n=23) were compared to current (hemolyzed) concentrations and found to be statistically significantly increased relative to previous results from the same patient (median(range) difference: 3.7(-3.6-11)U/L, p=0.009). However, the median difference was &amp;lt;5U/L or 10%, the laboratory’s criteria used to define a clinically significant difference. Conclusions A median H-index limit of up to 100 can be applied to samples when AST is within the RI. The risk of misinterpretation for results with mild-moderate hemolysis was low in the cases reviewed. Sample rejection rates and reporting delays can be diminished by implementing this practice. Interpretation can be further enhanced by appending the following comment to hemolyzed samples: “Specimen was received with hemolysis slightly above the accepted threshold. This degree of hemolysis is associated with a false increase of approximately 5-10 U/L. Interpret in conjunction with other laboratory and clinical findings.”

Comparison of intramuscular medetomidine versus medetomidine–vatinoxan sedation in bearded dragons (Pogonavitticeps)

ObjectiveTo assess sedation following intramuscular (IM) administration of medetomidine versus medetomidine–vatinoxan in bearded dragons. Study designProspective, randomized, experimental, crossover study. AnimalsA group of 10 (five males and five females) bearded dragons (mean mass ± standard deviation 172 ± 28 g). MethodsAll animals were administered both medetomidine (0.2 mg kg–1) (MED) and medetomidine (0.2 mg kg–1)–vatinoxan (4 mg kg–1) (MED-VAT) IM, with a 14–16 day washout period between treatments. Sedation was assessed using an adapted version of a sedation scale for bearded dragons (scale range 0–12) before (T0), and every 5 minutes from 10 to 45 minutes after treatment administration (T10–T45). Sedation scores were compared: 1) between time points (within treatments) using a Friedman test and Dunn’s post hoc test; and 2) between treatments at each time point using a Wilcoxon paired test. Heart rate and respiratory rate (fR) were analyzed descriptively. At T45, atipamezole was administered IM. ResultsCompared with T0, sedation scores were significantly higher at most time points for both treatments. Highest median (range) scores occurred at T30 for MED [T0, 0 (0–0); T30, 2.5 (1–5); p = 0.0001] and at T35 and T40 for MED-VAT [T0, 0 (0–0); T35, 2 (1–5); p = 0.002; T40, 2 (1–5); p = 0.001]. No significant differences in sedation scores were identified between treatments at any time point. The two protocols caused bradycardia and reduction in fR. All animals were active and ate 1 hour after reversal administration. Conclusions and clinical relevanceBoth medetomidine and medetomidine–vatinoxan caused similar mild sedation in bearded dragons (median < 3/12). Inclusion of vatinoxan did not enhance sedation in this species.

Seguridad y eficacia de un programa de ejercicio terapéutico en jóvenes intervenidos de hernia diafragmática congénita

Introduction and objectivePatients with congenital diaphragmatic hernia (CDH) can have up to 40 times more frequency of muskuloskeletal deformities and decreased perception of physical activity tan their pairs. The objective of this study is to evaluate the safety and efficacy of an individualized exercise program in late adolescents and young adults with repaired CDH, as well as a description of their basal status. Material and methodsNon randomized prospective trial of 13 patients with repaired CDH between 1997-2005. An initial physical exploration and a pre-post assessment of bioimpedance (BIA), dynamometry, maximal inspiratory and expiratory pressure (MIP/MEP), 6-minute walk test (6MWT), physical activity level (IPAQ) and quality of life (QoL) was made. The training program last for 4 weeks. For the statistical analysis, the Student's t test for paired samples and Wilcoxon test were used. Results77% (n=10) were male with a mean age of 19.23±2.13 years. In baseline BIA, 62% (n=8) had truncal sarcopenia that improved in −0.43±0.58, and P=.016. MIP, MEP, 6MWT and QoL tests increased by −7.27±8.26 cmH2O, P=.008; −11.91±10.20 cmH2O, P=.002; −70.63±17.88 m, P=.001; −42,19±26.79, P=.00 respectively. The IPAQ did not change significantly (P=0.86), however the time dedicated to muscle strengthening increased. No adverse effects were reported. ConclusionsA personalized rehabilitation program is safe and could improve the respiratory muscle strength and truncal sarcopenia as well as the submaximal effort capacity in late adolescents and young adults with repaired CDH.

A multifunctional scannable mounting device for computer guided implant surgery: An in vitro study

As part of the growing digitization of the dental field, clinicians are looking for ways to simplify digital workflow, reduce chairside time, and provide new work patterns for future applications. Whether scanning with a multifunctional apparatus (MFA) scan body results in improved scanning is unclear. The purpose of this in vitro study was to compare the horizontal, vertical, and angular deviations with the MFA scan body with a commercially available scan body (SBIO). Sixteen identically printed edentulous maxillary models were used to plan two Ø3.8×11.5-mm implants in the right maxillary first molar and left maxillary central incisor locations. Two implants in each model were installed using a surgical guide. The models were scanned using an intraoral scanner with MFA and then rescanned twice, with SBIO using the intraoral scanner and a laboratory 3D scanner. The implants were digitally positioned according to the scanned MFA and SBIO locations in standard tessellation language (STL) files. These STL files were superimposed on the reference laboratory 3D scanner STL files. Linear measurements included implant apex/cervical horizontal/vertical deviations, as well as implant axis angular deviations. Normality was evaluated with the Shapiro-Wilk test. Paired samples t tests (2 sided) were used for the mean SBIO-MFA deviation difference. To compare the molar/incisor sites, paired samples Wilcoxon tests were used (α=.05 for all tests). No statistically significant differences were found between the MFA/ SBIO deviations, for each of the 10 sites × deviation combinations (P>.05). Overall, the lowest endpoint of the 95% confidence intervals among the 8 linear measurement comparisons was -0.107 mm (coronal vertical deviation, right maxillary first molar site) and -0.30 degrees between the 2 angular measurement comparisons. The current in vitro study demonstrated high accuracy for the novel MFA device, similar to that of the standard SBIO scan body. Furthermore, the current study offers an alternative technique to evaluate the accuracy of implant placement by using scanning and back programming over the traditional postplacement cone beam computed tomography (CBCT) scanning.

EFFECT of ADMINISTRATION of BAY LEAF EXTRACT (Eugenia polyantha) ON TOTAL CHOLESTEROL and TRIGLYCERIDE LEVEL S IN PATIENTS WITH HYPERTENSION and TYPE 2 DIABETES MELLITUS AT IMAN CLINIC MEDAN

Cholesterol is a fat component that stabilizes cell membranes and is a precursor of bile salts and steroid hormones. The HMG-CoA reductase enzyme has an important role in the cholesterol synthesis process. Triglycerides are the primary fats found in food that undergo emulsification in the small intestine by bile salts and are digested by lipase. The flavonoids in bay leaves will react with the hydroxyl groups in cholesterol. Saponins will increase the binding of cholesterol to fiber. Tannins can inhibit fat absorption in the intestine. This study examined the effect of administering bay leaf extract (Eugenia polyantha) on total cholesterol and triglyceride levels in patients with hypertension and Diabetes mellitus type 2 in Clinic Iman Medan. This research is a Quasi-experimental design using 32 samples consisting of 16 samples from the control group and 16 from the experimental group. This study used bay leaf extract in 200 mg bay leaf capsules with 3 doses given to each group. Based on the results of the hypothesis test using the Paired T-test and Wilcoxon test, giving bay leaf extract had no effect on total cholesterol and triglyceride levels with a P-value &lt; 0.05. There was no effect of giving bay leaf extract (Eugenia polyantha) on total cholesterol and triglyceride levels in patients with hypertension and DM type 2

TRANSFORMASI GIZI BALITA STUNTING: PENGARUH BISKUIT TINGGI PROTEIN BERBASIS WHEY PROTEIN TERHADAP KADAR SCFA

Stunting, characterized by impaired growth and development in children under five, is a major health issue caused by chronic malnutrition and recurrent infections during the first 1000 days of life. Protein intake is crucial for the provision of essential amino acids necessary for optimal growth and immune function. This study aimed to analyze the effect of whey protein-based high-protein biscuits on short-chain fatty acids (SCFA) levels in stunted children. A quasi-experimental design with a pre-post test group was used. Thirty-six stunted children were divided into two groups: the intervention group received whey protein-based high-protein biscuits, while the control group received an equivalent protein source from eggs and tempeh. SCFA levels were measured before and after the intervention. Paired T-tests and Wilcoxon tests were used for statistical analysis. The study found that high-protein biscuits significantly increased SCFA levels (acetate, propionate, and butyrate) in the intervention group (p-value &lt; 0.001). These findings suggest that high-protein biscuits can positively influence gut microbiota and overall health in stunted children. High-protein biscuits can effectively increase SCFA levels in stunted children, contributing to improved gut health. Future studies should explore the long-term effects and potential risks associated with this intervention

Permanent left bundle branch area pacing improves mitral regurgitation and cardiac function in patients with right bundle branch block

BackgroundPermanent left bundle branch area pacing (LBBAP) has been established as an effective means to correct left bundle branch block. Right bundle branch block (RBBB), emerge as a distinct form of cardiac conduction abnormality, can be seen in the context of LBBAP procedure. However, the correction potential of LBBAP in patients with RBBB remains largely unexplored.ObjectiveThe objective of this study was to evaluate the efficacy and safety of permanent LBBAP in patients with RBBB.MethodsNinety-two consecutive patients who underwent successful permanent LBBAP were recruited from May. 2019 to Dec. 2022 in Fuwai Central China Cardiovascular Hospital. Among them, 20 patients with RBBB were included in our analysis. These patients were followed up at 1, 3, 6 and 12 months post-LBBAP. The QRS duration (QRSd) on the V1 lead of the 12-lead elctrocardiogram was measured and compared before and after the LBBAP procedure. Additionally, mitral regurgitation, tricuspid regurgitation and cardiac function were assessed using transthoracic echocardiography, specifically focusing on left ventricular ejection fraction (LVEF) and mitral regurgitation severity. The acute pitfills and delayed complications associated with the LBBAP procedure were recorded to evaluate its safety. SPSS 23.0 was used to perform statistical analysis with Student’s t test or one way ANOVA or nonparametric tests (paired Wilcoxon test). A p value less than 0.05 was defined as significant.ResultsThe demographic breakdown of the RBBB cohort revealed a mean age of 66.35 ± 11.55 years, 60% being male. Comorbidities were prevalent, including severe atrioventricular block (AVB) in 75%, sick sinus syndrome (SSS) in 20%, heart failure in 25%, atrial fibrillation in 30%, coronary heart diseases in 45%, hypertension in 35%, and diabetes mellitus in 15%. Regarding the LBBAP procedure, the average operation time was 106.53 ± 2.72 min, with 45% of patients (9 individuals) requiring temporary cardiac pacing during the surgery. Notably, the LBBAP procedure significantly narrow the QRS duration in RBBB patients, from 132.60 ± 31.49ms to 119.55 ± 18.58 ms (P = 0.046). Additionally, at the 12-month follow-up, we observed a marked improvement in LVEF, which increased significantly from 55.15 ± 10.84% to 58.5 ± 10.55% (P = 0.018). Furthermore, mitral regurgitation severity improved, with a median reduction from 4.46 (0.9, 7.3) to 2.29 (0, 3.49) cm2 (P = 0.033). Importantly, no cases of ventricular septum perforation or pericardial effusion were reported during the LBBAP procedure or during the follow-up period.ConclusionLBBAP provides an immediate reduction in QRS duration for patients suffering from RBBB, accompanied by improvements in mitral regurgitation and cardiac function as evident in the 12-month follow-up period.

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.

O97 RESPONSE TO AEROBIC TRAINING MAY DIFFER BETWEEN ELDERLY MEN AND WOMEN WITH TREATED HYPERTENSION

Background and objective. Hypertension incidence increases with aging, with expressive enhancement in women after the menopause due to the important physiological changes induced by the estrogen levels decline. Aerobic training is recommended for lowering blood pressure (BP) in men and women with hypertension. However, the possible gender-related differences in training responses have been poorly investigated, especially in elderly patients. Therefore, the objective of this study was to analyze responses to aerobic training in elderly men and women with treated hypertension. Methods: Thirty-one elderly hypertensives (15 women, 68±6ys and 16 men, 66±7ys) who were taking regular antihypertensive medication for at least 4 months participated in the study. They underwent 10 weeks of an aerobic training designed in accordance with the guidelines’ recommendations for hypertension (i.e. 3 session/week, cycle ergometer, 30-45 min, moderate intensity). Before and after the training period, peak oxygen uptake (VO2peak, cardiopulmonary exercise test), BP (auscultatory), systemic hemodynamics (CO2 rebreathing technique) and vascular function (brachial doppler ultrasound) were assessed. In each group (men and women), the training effects were evaluated using paired t-tests or Wilcoxon tests, considering p&lt;0.05 as significant. Results: Aerobic training increased aerobic capacity in both sexes (men = 20.8±4.2 vs. 21.8±4.8 ml.kg-1.min-1, p=0.04 and women = 15.3±2.6 vs. 16.4±2.3 ml.kg-1.min-1, p=0.01). In men, systolic BP and systemic vascular resistance decreased (129±13 vs. 125±12 mmHg, p=0.003 and 21.0±3.8 vs. 18.9±4.1 u, p=0.02), while flow mediated dilation increased (5.5±2.9 vs. 7.2±3.1%, p=0.01) after the training period. On the other hand, in women, none of these variables changed with the training (124±15 vs. 126±12 mmHg, p=0.92; 23.2±5.5 vs. 23.5±5.6 u, p=0.80; and 4.2±3.2 vs. 5.4±3.5%, p=0.10). The other variables assessed did not change in either group. Conclusions: The proposed aerobic training program increased aerobic capacity in both male and female elderly hypertensives, but improved BP, systemic vascular resistance, and endothelial function only in males. Key-words: aerobic training, gender, blood pressure, hypertension. Financial Support: CAPES-0001, CNPq-302309/2022-5, and FAPESP- 2022/12605-3.

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