Parametric Statistical Tests Research Articles

Machine Learning-Based Radiomics Analysis for Identifying KRAS Mutations in Non-Small-Cell Lung Cancer from CT Images: Challenges, Insights and Implications

Kirsten Rat Sarcoma viral oncogene homolog (KRAS) is a frequently occurring mutation in non-small-cell lung cancer (NSCLC) and influences cancer treatment and disease progression. In this study, a machine learning (ML) pipeline was applied to radiomic features extracted from public and internal CT images to identify KRAS mutations in NSCLC patients. Both datasets were analyzed using parametric (t test) and non-parametric statistical tests (Mann–Whitney U test) and dimensionality reduction techniques. Afterwards, the proposed ML pipeline was applied to both datasets using a five-fold cross-validation on the training set (70/30 train/test split) before being validated on the other dataset. The results show that the radiomic features are significantly different (Mann–Whitney U test; p < 0.05) between the two datasets, despite the use of identical feature extraction methods. Model transferability is therefore difficult to achieve, which became evident during external testing (F1 score = 0.41). Oversampling, undersampling, clustering and harmonization techniques were applied to balance and harmonize the datasets, but did not improve the classification of KRAS mutation presence. In general, due to only a single moderate result (highest test F1 score = 0.67), the accuracy of KRAS prediction is not sufficient for clinical application. In future work, the complexity of KRAS mutation might be addressed by taking submutations into consideration. Larger multicentric datasets with balanced tumor stages, including multi-scanner datasets, seem to be necessary for building robust predictive models.

THE IMPLEMENTATION OF INCLUSIVE EDUCATION MODEL ON SOCIO-EMOTIONAL DEVELOPMENT OF CHILDREN WITH SPECIAL NEEDS IN EARLY CHILDHOOD EDUCATION

Inclusive education not only aims to provide learning space for children with special needs, but also encourages collaboration and understanding between students with diverse backgrounds. The application of an inclusive model is expected to be able to overcome social, cultural, and academic barriers that often hinder children's participation in formal education. This study uses a quantitative approach with a quasi-experimental design (quasi-experiment) with a nonequivalent control group design, Data analysis was carried out using parametric statistical tests paired sample t-test and independent sample t-test with a significance level (?) of 0.05 to determine significant differences in social emotional development before and after the intervention, Epistemologically, this study makes a significant contribution to the theory of inclusive education by showing that the social emotional development of children with special needs is greatly influenced by the quality of the design of the learning environment, social interaction, and systemic responsiveness to the diversity of individual needs

Применение параметрических критериев однородности дисперсий в условиях нарушения стандартных предположений

When analyzing measurement series in various applications, it becomes necessary to ensure that the scattering characteristics of the measured quantities have not changed over time, or that the accuracy of measurements carried out by different laboratories in similar tests meets the necessary requirements. For these purposes, it is advisable to use various k-sample parametric criteria for testing hypotheses about the homogeneity of variances (about the equality of variances). The prerequisite for the possibility of using parametric criteria is that the analyzed samples belong to normal distribution laws, which is not always the case. When the assumption of normal distribution of statistics is violated, parametric criteria usually change significantly, which excludes the possibility of using classical results when testing hypotheses. The best parametric tests have a significant advantage in power over nonparametric tests. This advantage is usually retained when the standard assumption of normality is violated. The paper shows how the distributions of parametric test statistics change under conditions of violation of the standard assumption. It is shown that using simulation modeling based on the Monte Carlo method and with appropriate software support, it is possible to find the distributions of the statistics of the applied criteria under non-standard conditions corresponding to specific applications. The use of the results of such modeling makes it possible to make correct statistical conclusions based on the criteria used. The methodology of applying parametric criteria of homogeneity of variances under conditions of violation of the standard assumption is considered. The method involves, at the first stage, testing the hypothesis about the belonging of the analyzed samples to normal laws using a set of special criteria. In case of a negative result, at the second stage a law is selected that describes the combined sample. At the third stage, using the results of the modeling under this law, a conclusion is formed based on the applied criteria. Examples of the implementation of the methodology within the framework of the developed software system are given.

Radiological Study of the Normal and Anatomical Variants of the Celiac Trunk and Its Branches: Clinical Implications

The abdominal aorta enters the diaphragm at the level of the 12th thoracic vertebra and gives branches such as the celiac trunk (CT), superior mesenteric, and inferior mesenteric arteries. The main aim of the present research study was to observe the CT with regard to (i) variations in the dimensions among different age groups compared to gender, (ii) the vertebral level of origin, and (iii) the variation in the branching pattern. This cross-sectional retrospective study was performed on 116 subjects (n = 91 males, n = 25 females) over one year. The CT was interpreted by using contrast-enhanced computed tomography angiography. The results were assessed using parametric and non-parametric statistical tests. The length and diameter between gender and the three age groups (i.e., 29 years and below, 30–39 years, and more than 40 years) were compared and a p-value of less than or equal to 0.05 was considered significant. There was a significant difference in the length (p = 0.016) and diameter of the CT (p = 0.05) among males and females, respectively. Moreover, there was a significant difference in the length (p = 0.038) and diameter (p = 0.013) of the CT among the three age groups. Individuals aged 30–39 years had the highest mean for the length of the CT, while patients aged 29 years and younger had the highest diameter. The most common level for CT origin was at the vertebral level of the 12th thoracic vertebra (73.3%). Anatomical knowledge of the CT is important for diagnostic imaging, organ transplantations, and surgical and laparoscopic interventions.

APPLICATION OF PARAMETER STATISTICAL TESTS AND DATA ENVELOPMENT ANALYSIS METHODS IN MODERN BUSINESS

In the absence of a sufficient amount of information for quality business decision-making, i.e. successful performance of activities without unnecessary losses in the consumption of inputs, recently the non-parametric DEA method (Data Envelopment Analysis) is most often used through the linear programming technique. In the event that company managers have enough information to make business decisions, parametric statistical tests are used that compare the company's current performance with optimal performance, i.e. those that are on the edge of efficiency. However, this situation is very rare, so before making business decisions, non-parametric and then parametric statistical tests are carried out in detail. The subject of research of this paper is primarily focused on the simultaneous application of parametric and non-parametric statistical tests in the assessment of the economic efficiency of an economic entity. After the conducted research and analysis of the obtained results, it was determined that the null hypothesis, which claims that the relative efficiency of the warehouse obtained by parametric statistical tests and the DEA method is identical and that the trends have the same direction, could not be fully accepted. Namely, it was found out that the results of one and the same economic situation using the mentioned two types of analysis differ to the extent that they are not adequate for economic decision-making, however identical results were obtained in the assessment of the trend. It can be concluded that the simultaneous application of both methods, as well as its implementation in several iterations, can provide enough quality information for effective decision-making. Stochastic processes that occur during the implementation of business decisions using the DEA technique can be minimized through the simultaneous application of statistical parametric methods and tests for evaluating the expected efficiency of DEA. The effectiveness of this method in any case depends on the size of the sample implemented in the aforementioned statistical analysis. The aforementioned statistical tests enable the measurement and detection of those input parameters that will most effectively contribute to the efficiency of business systems.

An empirical analysis: The impact of project-based learning on students' mathematical reflective thinking skills and self-concept

Mathematical reflective thinking skills and self-concept are essential aspects of 21st-century learning to address global challenges. This study analyzes the effect of Project-Based Learning (PjBL) on students' mathematical reflective thinking skills and self-concept. The experimental research involved 75 tenth-grade students in Bandar Lampung using a posttest control group design. Data were collected through mathematical reflective thinking skills tests and self-concept questionnaires and analyzed using parametric and non-parametric statistical tests. The results showed that the implementation of PjBL did not significantly affect students' mathematical reflective thinking skills and self-concept compared to conventional learning. However, the indicators of mathematical reflective thinking skills achievement in the PjBL class were higher. This study implies the need for a longer implementation of PjBL to achieve significant results and its potential contribution to developing students' collaboration, creativity, and social skills as part of holistic learning.

Buckling behavior of orthotropic thin plates using analytical and machine learning methods

Designing plate structures poses challenges due to potential instabilities and the complexities involved in obtaining accurate analytical solutions, especially for non-Lévy-type boundary conditions. This study employs the finite integral transform method to analyze the buckling behavior of orthotropic thin plates with complex boundary conditions. In solution procedure, the governing high-order partial differential equations are transformed into a system of linear algebraic equations, yielding exact and rapidly converging analytical solution. The method is simple and general and does not need to predetermine the deflection function. The correctness of the method is validated by comparison with numerical simulations performed using the ABAQUS software. Furthermore, Gene Expression Programming (GEP) is utilized to develop empirical models that predict buckling coefficients of isotropic and orthotropic plates under classical and non-classical boundary conditions. Material properties, aspect ratio, rotating fixed coefficient, and boundary conditions are used as input parameters, with simplified mathematical formulations to predict the buckling coefficient. Model performance is assessed using parametric analysis and statistical tests to ensure accuracy and generalization. Further investigation shows aspect ratio and rotating fixed coefficient are significant variables influencing buckling coefficients under classical and non-classical boundary conditions, respectively, followed by boundary conditions and material property. The performance of the GEP model is further assessed by comparing with linear and non-linear regression models. The results show that GEP outperforms the regression models, showing its higher prediction accuracy. This study not only addresses the challenges of designing thin plates with complex boundary conditions, but it also presents an effective machine-learning method for predicting buckling behavior. The analytical solution can be used as a benchmark for validating new analytical and numerical methods. The equations developed using GEP to predict the buckling coefficient of plates provide a useful tool for extrapolating results beyond the scope of this study.

Pengaruh Model Game Based Learning Terhadap Aktivitas dan Hasil Belajar Komputer Siswa Kelas V di SD Plus Marhamah

The variation of the game-based learning model and aims to determine its influence on the activities and learning outcomes of grade V students at SD Plus Marhamah. The research method applied in this study is quantitative with a quasy experiment design. The sampling technique uses purposive sampling. The sample was represented by class V.B as the control group and class V.C as the experimental group, each totaling 25 students. Data was collected through questionnaires for learning activities and tests for learning outcomes. Data analysis included normality test, homogeneity test, and t-test at a significance level of 0.05 to see the difference between the control group and the experiment. The results of the study showed that there was a significant influence of the application of the game-based learning model on student activities and learning outcomes. Based on this parametric statistical test (one tailed test), significant differences can be seen between the experimental class and the control class, both in activities and learning outcomes. Thus, it can be concluded that the game-based learning model has a positive and significant impact on the activities and learning outcomes of grade V students at SD Plus Marhamah

Self Help Groups as a Support System: Their Influence on Stress Levels in New Nursing Students

New students must adapt to a new environment because of the differences in the nature of education in Senior High School (SMA) and college. If students are unable to meet the demands in college, it can cause stress. One of the therapeutic activities that aims to improve and maintain mental health in students is Self Help Group (SHG) therapy . The purpose of this study was to determine the effect of Self Help Group (SHG) on stress levels in new students of the Nursing Study Program at the University of Muhammadiyah Gresik. This study uses a one group pretest-posttest approach. The population is 48 new students of the Nursing Study Program, Muhammadiyah University of Gresik, class of 2023. The sampling technique uses total sampling , with the research sample being all new students of the Nursing Study Program. Data collection uses questionnaires and Self Help Group (SHG) therapy observation sheets. Data analysis uses the parametric statistical test of the paired T-test (Paired Sample T-Test). The results of the study on stress levels before being given Self Help Group (SHG) therapy were that almost half of the students experienced severe stress as many as 21 (48.8%) and after being given Self Help Group (SHG) therapy, almost half of them experienced a decrease in severe stress levels in new students as many as 16 (37.2%) students. The results of the Paired Sample T-Test statistical test obtained a ρ value of 0.038 <α 0.05. There is an influence of Self Help Group (SHG) on stress levels in new students of the Nursing Science Study Program, Muhammadiyah University of Gresik.

The relationship between cause of death and skeletal markers of physiological stress in the Hamann-Todd collection.

Socioeconomic status, past stress events, and other factors may contribute to the cumulative burden of physiological stress, which influences an individual's susceptibility to mortality and cause of death (COD). Here, we explore the association between skeletal evidence of stress and COD in the Hamann-Todd Osteological Collection (HTOC), a predominantly low socioeconomic status sample from the late 19th and early 20th century. Skeletal markers of stress including linear enamel hypoplasia (LEH), stature, and antemortem tooth loss (AMTL) were analyzed in 298 individuals in the HTOC. Recorded CODs were grouped into six broad categories and contrasted with stress indicators, ages-at-death, and demographic variables, using various parametric and non-parametric statistical tests. COD varied by socially ascribed race and sex within the sample. Overall, infectious diseases were more prevalent than degenerative diseases. Individuals that died of infectious diseases had significantly lower ages-at-death compared to degenerative diseases (p < 0.001). There was no association between LEH and COD (χ2 = 4.449, p = 0.487). Stature varied significantly across COD categories for males (F = 2.534, p = 0.032), but not females (F = 1.733, p = 0.132). Controlling for age-at-death, AMTL prevalence was associated with COD (H = 18.53, p = 0.002), with cardiovascular disease being associated with higher prevalence of AMTL. These findings show that some skeletal stress indicators are associated with COD in the HTOC, but the causal pathways of these relationships are not clear. This study adds to growing bodies of literature exploring relationships between past stress events and susceptibility to mortality and long-term consequences of poor living conditions for past individuals.

The Effectiveness of Cognitive Behavioral Therapy Using Cognitive Restructuring Techniques in Group Settings to Reduce Smoking Behavior in Adolescents

There are numerous factors that drive adolescents to smoke, one of which is the presence of negative or irrational thoughts related to smoking behavior itself. Such thoughts include beliefs that smoking makes them appear more masculine, more accepted within their social circles, among other irrational perceptions. This study aims to evaluate the effectiveness of cognitive behavioral therapy (CBT) using cognitive restructuring techniques in a group setting to reduce smoking frequency in adolescents by addressing their irrational thought patterns. A quantitative experimental method was employed, using a pretest-posttest control group design. A total of 8 students were randomly assigned to two groups. Data analysis was conducted using parametric statistical tests, specifically the independent sample t-test and the correlated/paired sample t-test. The results indicate that cognitive restructuring techniques applied in group setting significantly reduce smoking behavior among adolescents.

A Comparative Study of the Morals of PAI IAIN Kerinci Students Who Participate in the Ma'had Al-Jamiah Program with Non-Participants

This research was conducted to determine the difference in moral levels between Islamic Education (PAI) students who participated in the Ma'had al-Jamiah program at IAIN Kerinci and those who did not participate (non-participants). The method used was a quantitative research method with a survey approach. The questionnaire consisted of 10 items containing indicators of morality towards Allah SWT, morality towards fellow human beings, and morality towards the environment. The total sample size was 70 PAI students, comprising 35 students who participated in the Ma'had al-Jamiah program and 35 non-participants. This study conducted normality tests and statistical tests using SPSS. Based on the normality test, the morality of PAI students who participated in the program was normally distributed (significance value 0.071 &gt; 0.05), while PAI students who did not participate in the program were not normally distributed (significance value 0.00 &lt; 0.05). Therefore, data analysis was conducted using parametric statistical tests with Mann Whitney U. The results of the statistical tests showed that the significance value for morality (0.682) was greater than 0.05. Thus, it can be concluded that there is no significant difference between PAI students who participated in the Ma'had al-Jamiah program at IAIN Kerinci and PAI students who did not participate in the program. However, based on the interval questionnaire scores, the moral level of PAI students who participated in the program was categorized as Good (3.07), while students who did not participate were categorized as Fairly Good (2.82). Therefore, it can be said that both groups of PAI students have good moral levels.

Remineralizing capacity of zinc oxide eugenol sealer following the addition of nanohydroxyapatite-tyrosine amino acid: An in vivo animal study

ObjectiveAlthough several sealers have been developed, the zinc oxide eugenol (ZOE) sealer is still used in many private dental clinics. This study aimed to compare the biocompatibility and remineralizing capacity οf ZOE sealer with the addition of nanohydroxyapatite-tyrosine amino acid. MethodsThis study was conducted on Twenty rabbits. The rabbits were divided into four groups based on the test observation period (3, 7, 21, and 28 days) following surgical implantation. General anesthesia was administered to each rabbit, and a subcutaneous incision of approximately 1 ± 0.5 cm was made along the symphyseal area of the mandible of each rabbit. Four bone cavities were generated in the interdental space of the lower jaw between the central and molar teeth of each rabbit, with one longitudinal subcutaneous incision. The ZOE sealers were mixed according to the manufacturer's guidelines and directly inserted within the cavities generated at the end of each test period. The animals were sacrificed, and bone biopsy was carried out at the site of testing. The biopsy samples were obtained and subjected to histological analysis using a low-power light microscope (Olympus C ⅹ 21, Japan) and immunohistochemistry using Ki67 antibody. ResultsThe collected information was examined by parametric statistical tests using SPSS software version ‘‘22.” One-way ANOVA and post-hoc Duncan's tests were used to measure the significance among various groups, with statistical significance set, when “P ≤ 0.01”. ConclusionThe 20% mixed endodontic sealer displayed excellent outcomes compared to other experimental groups, as identified by higher new bone formation at every evaluation period.

Development of Augmented Reality Learning Media to Introduce Musical Instruments for Deaf Elementary School Student

This research aims to develop Augmented Reality learning media for deaf children at the elementary school level in recognizing musical instruments and measuring their effectiveness on learning outcomes. The research method used is research and development (R&amp;D) and uses the Multimedia Development Life Cycle development method. The effectiveness of the media was tested using pretest-posttest. Data analysis techniques use the parametric statistical test. The results of testing by media and content experts concluded that the application was declared suitable for use as a learning medium. From the beta test, it was discovered by 33 deaf students that Augmented Reality learning media was well received. The t-test comparison test shows that there is a difference, which means that the use of Augmented Reality learning media as a medium for introducing musical instruments to deaf students has a positive impact on learning outcomes.

Exploring the Evolution of Research Connectivity and Funding in Global Neurosurgical Publications

There are critical disparities in the neurosurgical care provided around the globe due to challenges in resource allocation, training, and infrastructure. Global neurosurgical collaborations have replaced classical mission trips to address these disparities. However, the development of these collaborations and the impact of research funding on their growth has not yet been systematically studied. In this article, we use a graph theoretical approach to investigate trends in funding and co-authorship between and among authors from high-income countries (HICs) and authors from low- and middle-income countries (LMICs). A bibliometric search of the global neurosurgical literature returned 307 articles between 1985 and 2020. A connectivity analysis was conducted to compute the number of co-authorships between HIC-HIC, LMIC-HIC, and LMIC-LMIC authors. The number of connections, summarized as either a global sum of connections or an average number of connections per manuscript, were analyzed in the context of time and funding through parametric statistical tests. An exponential increase in co-authorship collaboration was observed over time, especially after 2015. Notably, LMIC-LMIC collaborations appear to be rising at over twice the rate of other collaboration types. The presence of funding, in general, was associated with increased co-authorship of manuscripts by LMIC and HIC authors together (p = 0.033). A significant majority of the funding associated with LMIC-HIC co-authorships was supplied through charitable organizations and government grants (p = 0.034, p = 0.009, respectively). Most LMIC-LMIC co-authorships had no funding. This work shows significant and rapid growth in international neurosurgical partnerships, especially in HIC-LMIC and LMIC-LMIC collaborations. Also, a significant positive relationship exists between research funding and LMIC-HIC co-authorship trends. This work encourages us as a community to continue to expand our translational collaborations with LMIC neurosurgeons and establish funding mechanisms independent of HIC authors.

Safety, Efficacy, and Feasibility of Nebulized Long-Acting Bronchodilators vs Short-Acting Bronchodilators in Hospitalized Patients With Acute Exacerbations of COPD: A Phase IV, Randomized, Parallel-Group Clinical Trial

BackgroundLong-acting bronchodilators are preferred over short-acting bronchodilators in patients with stable COPD, but prospective studies are needed to determine the safety and efficacy of nebulized long-acting bronchodilators in hospitalized patients with exacerbations of COPD (ECOPD). MethodsWe conducted a prospective, randomized, parallel-group study comparing a nebulized formoterol/revefenacin combination with an albuterol/ipratropium combination among n = 60 hospitalized patients (n = 30 in each group) with ECOPD who tested negative for COVID-19. Treatments were administered q12 to 24 hrs (formoterol/revefenacin), or q6 hrs (albuterol/ipratropium) by jet nebulizers for up to 7 days. Safety and efficacy assessments were recorded on days 1, 3, and 7, or at hospital discharge. Assessment of dyspnea by the Modified Borg dyspnea scale was the primary outcome. Data were analyzed with parametric or non-parametric statistical tests, and generalized estimating equations with an identity link function were used to analyze differences in the two groups. Statistical significance was assumed at an unadjusted two-sided alpha value of 0.05. ResultsParticipants’ mean age was 63.2 (SD 9.30) years, and 39 (65.0%) were current smokers. Patients' age, sex, race, smoking history, body mass index, Charlson Comorbidity Index, supplemental oxygen requirements, and length of hospital stay were similar in the two groups (p>0.05 for all). Patients receiving formoterol/revefenacin had similar Modified Borg dyspnea scores (p = 0.95) and required fewer total drug doses (P<0.001), but there was a non-significant trend for more frequent rescue treatments (p=0.08) compared to those receiving albuterol/ipratropium. There were no serious adverse events or treatment failures in either group. ConclusionIn non-ventilated hospitalized patients with ECOPD, the institution of nebulized formoterol/revefenacin in combination within 24 to 36 hours of hospital admission provided convenient dosing and required fewer drug doses to achieve comparable efficacy and safety with the standard short-acting nebulized albuterol/ipratropium combination.

Quality of Life Assessment in Romanian Patients with Spinal Muscular Atrophy Undergoing Nusinersen Treatment.

Spinal muscular atrophy (SMA), identified over a century ago, is characterized by severe muscle wasting and early mortality. Despite its rarity, the high carrier frequency of the responsible genetic mutations and the variability in its manifestations make it a significant research focus. This prospective cross-sectional descriptive study evaluated health-related quality of life (HRQoL) across eight health domains in 43 Romanian SMA patients treated with nusinersen, using the SF-36 questionnaire to analyze influencing factors. The survey was conducted online with informed consent, and the data were analyzed using MedCalc software, employing both parametric and non-parametric statistical tests for accurate interpretation. The results revealed significant variations in HRQoL. Most patients were non-ambulatory (74.4%), reflecting SMA's impact on mobility. Urban residents reported better outcomes, particularly in physical functioning (p = 0.014), which may be attributed to improved access to healthcare services. Younger participants (under 14), represented by proxy responses, noted better general health (p = 0.0072) and emotional well-being (p = 0.0217) compared to older participants. These findings suggest that younger patients or their proxies perceive a better health status, highlighting the need for age-specific approaches in SMA management and the potential optimistic bias associated with proxy reporting on perceived health outcomes.

Exploring Teacher Awareness of Artificial Intelligence in Education: A Case Study from Northern Cyprus.

This study investigates the level of awareness among teachers regarding the use of artificial intelligence (AI) in education, focusing on whether this awareness varies according to socio-demographic characteristics, access to technology, and specific knowledge and beliefs about AI. Conducted in Northern Cyprus during the 2023-2024 academic year, this study employed a survey model with purposive and snowball sampling methods, involving 164 teachers. Teachers at different levels, namely, primary school, secondary school, high school, and university, were included in this study. The "Artificial Intelligence Awareness Scale", developed by Ferikoğlu and Akgün (2022), was used to measure AI awareness. Data normality was verified through skewness and kurtosis values, allowing for parametric statistical tests such as t-tests, one-way ANOVA, logistic regression, and chi-square analysis. This study explored the distribution of AI use across different school types and educational levels and assessed the impact of sub-dimensions of AI awareness on its application in teaching. Findings revealed no significant influence of teacher demographics (age, gender, education level, type of school, institution level, and monthly income) on AI awareness. However, usage patterns indicated that university lecturers were more likely to incorporate AI in their teaching, followed by primary and high school teachers, with secondary school teachers using it the least. A Multilayer Neural Network Analysis identified practical knowledge as the most critical factor influencing the use of AI in teaching (importance weight of 0.450), followed by beliefs and attitudes (0.298), relatability (0.148), and theoretical knowledge (0.104). These results highlight the importance of practical knowledge for fostering AI integration in educational practices, underscoring significant implications for teacher training and professional development programs.

2287 Residents with dementia had an increase in BMI after the introduction of an extra meal in nursing homes in Norway

Abstract Introduction The past decade, many nursing homes in Norway have introduced an extra meal daily, with a hot lunch, and pushing dinner to later in the day. This initiative aims to reduce the long-time interval between breakfast and supper. This study examines how an extra meal affects the residents’ body mass index (BMI) at nursing homes in Norway. Research questions include how an extra meal affects BMI among residents in the dementia unit. Method We used a cross-sectional design to analyse data from residents over 65 years old in dementia care units. Both parametric and non-parametric statistical tests were used to evaluate changes in BMI. Results The results of the study show that the dementia unit experienced an increase in BMI following the introduction of an extra meal. At most, we saw a weight gain of up to 7 kg over two years among residents. Our study reveals that the introduction of an extra meal resulted in a slight increase in BMI among the residents with dementia, which does not correspond with previous studies indicating malnutrition among these residents. The dementia disease reduces functional abilities, and challenges related to mealtime behaviour, restlessness, and depression can lead to weight loss. The fact that our results show a slight increase in BMI at the dementia units may be related to these residents often being troubled with restlessness and not finding the peace to consume a full meal. By introducing an extra meal, the total food intake increases since residents still eat a little at each meal, and focusing more on accommodating each resident might have influenced the increase in BMI values. Conclusion The study indicates that the introduction of an extra meal has a positive effect on the BMI value of residents with dementia in nursing homes.

Effectiveness of Tendo-Muscular Massage for Pain Reduction and ROM Improvement Post-Injury Knee Joint

This study aims to determine the effectiveness of tendo-muscular massage. The method used in the research is descriptive quantitative. The sample in this study amounted to 30 people who had mild to moderate knee injuries during sports and other physical activities. The order of data collection, namely starting with the pretest measurement, then given a one-time tendo-muscullar massage treatment which is carried out for 8 minutes and ends with a posttest measurement. The research data that has been obtained is then analysed with descriptive quantitative. Interval and ratio scale data that met the normality test were analysed using the paired sample t-test parametric statistical test, while data that did not meet the normality test using the wilcoxon non-parametric statistical tests. The results of measurements with the Visual Analogue Scale (VAS) experienced an average pain reduction of 2.5 and a significance of 0.000 &lt;0.05, while the range of motion measured with a goniometer experienced an average increase of 6 degrees, T count of 6,819 and Significance 0.000 in flexion movements and an average increase of 0.88 degrees, T count of 7,848 and Significance 0.000 in extension movements, as well as an increase in joint motion function of 28.83%. So it can be concluded that Tendo-muscular massage has a significant effect on reducing pain and increasing the range of motion (ROM) of the knee joint. Keyword. Effectiveness, Tendo-Muscular Massage, Pain Reduction, ROM Improvement, Knee