Quantitative Variables Research Articles

Dual-layer spectral detector CT: A noninvasive preoperative tool for predicting histopathological differentiation in pancreatic ductal adenocarcinoma

PurposeTo predict histopathological differentiation grades in patients with pancreatic ductal adenocarcinoma (PDAC) before surgery with quantitative and qualitative variables obtained from dual-layer spectral detector CT (DLCT). MethodsTotally 128 patients with histopathologically confirmed PDAC and preoperative DLCT were retrospectively enrolled and categorized into the low-grade (LG) (well and moderately differentiated, n = 82) and high-grade (HG) (poorly differentiated, n = 46) subgroups. Both conventional and spectral variables for PDAC were measured. The ratio of iodine concentration (IC) values in arterial phase(AP) and venous phase (VP) was defined as iodine enhancement fraction_AP/VP (IEF_AP/VP). Necrosis was visually assessed on both conventional CT images (necrosis_con) and virtual mono-energetic images (VMIs) at 40 keV (necrosis_40keV). Forward stepwise logistic regression method was conducted to perform univariable and multivariable analysis. Receiver operating characteristic (ROC) curves and the DeLong method were used to evaluate and compare the efficiencies of variables in predicting tumor grade. ResultsNecrosis_con (odds ratio [OR] = 2.84, 95% confidence interval [CI]: 1.13–7.13; p < 0.001) was an independent predictor among conventional variables, and necrosis_40keV (OR = 5.82, 95% CI: 1.98–17.11; p = 0.001) and IEF_AP/VP (OR = 1.12, 95% CI:1.07–1.17; p < 0.001) were independent predictors among spectral variables for distinguishing LG PDAC from HG PDAC. IEF_AP/VP (AUC = 0.754, p = 0.016) and combination model (AUC = 0.812, p < 0.001) had better predictive performances than necrosis_con (AUC = 0.580). The combination model yielded the highest sensitivity (72%) and accuracy (79%), while IEF_AP/VP exhibited the highest specificity (89%). ConclusionVariables derived from DLCT have the potential to preoperatively evaluate PDAC tumor grade. Furthermore, spectral variables and their combination exhibited superior predictive performances than conventional CT variables.

P248 Feasibility, accuracy and reproducibility of the ultrasound measurement of psoas muscle compared to bioelectrical impedance analysis for the evaluation of skeletal muscle mass in patients with IBD

Abstract Background Sarcopenia is characterized by the loss of muscle mass and it is a strong predictor of disability and poor outcomes in several chronic gastrointestinal diseases such as inflammatory bowel diseases (IBD). Therefore, it is useful to evaluate muscle mass in patients with chronic gastrointestinal diseases at risk for sarcopenia. Radiological evaluation of muscle mass is obtained with computed tomography (CT), magnetic resonance (MRI) and bioelectrical impedance (BIA). We aimed at assessing the feasibility, reproducibility and diagnostic accuracy of ultrasound (US) measurement of psoas muscle thickness adjusted for body mass index (BMI) compared to skeletal muscle mass (SMM) evaluated with BIA normalized to height2 in the quantification of muscle mass among patients with IBD. Methods We enrolled a total of 86 consecutive patients with IBD (males 68.6%, mean age 50.4 ± 17.6, 7.4% with Crohn’s disease) who underwent US evaluation of psoas muscle thickness and BIA during the same day. US measurement (Philips Epiq, Bothell, USA) was performed by two sonographers, blind to each other. BIA was performed with the Seca mBCA 525 (Hamburg, Germany). A cut-off of 6.68 and 8.97 of SMM normalized to height2 was considered as normal value for women and men respectively. Sensitivity, specificity, positive and negative predictive values(PPV and NPV), positive and negative likelihood ratios (LR+ andLR−) were calculated, all with the respective 95% confidence inter-vals (95% CI). The reproducibility between the US operators was evaluated by intra-class correlation coefficient(ICC) for the quantitative variables of psoas muscle. The study was approved by our local ethics committee and partially funded by the Italian Ministry of Health. Results US psoas muscle thickness measurement was feasible in all the 86 enrolled patients. There was a significant correlation between US measurement and BIA with a Pearson r coefficient of 0.54 (p= &amp;lt;0.0001). Among men a cut off of 108.18 cmxkg/m*2 showed a sensitivity of 93.5% and a specificity of 53,6% in the detection of low SMM at BIA (Figure 1). Among women a cut off of 66.9 cmxkg/m*2 showed a sensitivity of 78.5% and a specificity of 69.2% in the detection of low SMM at BIA (Figure 2). Reproducibility among the operators had an ICC of 0.95 (CI 0.93-0.96). Conclusion Sarcopenia is a prognostic factor of poor outcomes in IBD, therefore it is important to identify patients at risk for it. Nowadays, assessment of muscle mass and eventually sarcopenia relies on radiological techniques (CT/MRI and BIA). At this purpose we propose a simple, non-ionizing, fast and reproducible US technique that compared to BIA showed a high sensitivity and thus can be used in clinical ractice to screen for muscle mass reduction in IBD patients.

Translation, cultural adaptation and assessment of psychometrics properties of the Extended Version of the Nordic Musculoskeletal Questionnaire (NMQ-E) in Persian language speaking people

BackgroundTo translate and cross-culturally adapt the Extended Version of the Nordic Musculoskeletal Questionnaire (NMQ-E) into Persian (NMQ-E-P) and evaluate the psychometric properties in a general population with different occupational tasks across nine body regions.MethodsThis cross-sectional study was designed according to the standard guidelines and the COSMIN checklist. The NMQ-E-P was achieved through forward and backward translation methods and consensus to produce the final draft. A Persian-speaking population (n = 571, age 38.24 ± 7.65 years, female = 46.2%) was recruited from industries and office workers with three occupational task inclusion criteria: assembly, office, and lifting. Psychometric properties included validity for face (from confirmed clarity, simplicity, and readability), content (via the content validity index); and construct (through known group validity); additionally, the properties of internal consistency (Cronbach’s α); and test-retest reliability (Kappa coefficient of agreement) were considered.ResultsNo significant issues during the translation process were found. The NMQ-E-P showed adequate internal consistency for all regions (α ≥ 0.87). The test-retest reliability was examined with Kappa agreement correlation coefficient and all items, except ankle regions, showed very good agreements (Kappa coefficient = 0.87-1.0). Excellent ICC values were obtained for quantitative variables (ICC > 0.88) and good construct validity was revealed (p < 0.001).ConclusionThe Persian version of the NMQ-E has very good validity and reliability and can be used by researchers and professionals to evaluate the prevalence of MSDs in nine body regions simultaneously.

Profile of hospitalised maltreated children aged 0 to 3 years and their families.

Maltreatment adversely affects children's health and development. Knowledge of child maltreatment in early childhood is limited. We studied the demographic factors and health issues in children aged 0-3 years who were hospitalised for maltreatment. In this retrospective cohort study, health and demographic information was extracted from the electronic medical records of children hospitalised in KK Women's and Children's Hospital between January 2018 and June 2019. High-risk groups were children with developmental delay (DD), missed vaccination (MV), low outpatient attendance, high dependency unit (HDU) or intensive care unit (ICU) admission and Child Protection Service (CPS) referral. Chi-square or Fisher's exact test was used for categorical variables. Mann-Whitney U test was used for skewed quantitative variables. Among the 101 children included in the study, the most common type of abuse and alleged perpetrator were physical abuse and parents, respectively. In addition, 35.6% of the children had pre-existing health conditions before hospitalisation, 58.4% had new health conditions diagnosed during hospitalisation requiring follow-up and 26.7% had maltreatment-related injuries. One-fifth of the children had DDs and another one-fifth had MVs. About 20% of them had defaulted all outpatient appointments. High-risk children mostly lived in rented housing. Their mothers mostly had primary education or lower. Most children admitted to ICU or HDU were <6 months old (8/12 [66.7%] vs. 6-24 months 3/12 [25%] vs. 24-47 months 1/12 [8.3%], P = 0.001). A higher number of children with DD were referred to CPS (63.2%, P = 0.049) than to other agencies. Maltreated children have significant health needs that are not fully met through routine surveillance practices. They are at risk of defaulting their hospital appointment. It is imperative that families at risk of child maltreatment are identified early and their needs holistically evaluated, with care coordinated within the hospital-community support system.

Sistema Único de Saúde (SUS) e National Health Service (NHS)

The work is a comparative analysis combined with an exploratory research methodology between the Unified Health System (SUS) and the National Health Service (NHS) in relation to actions for public health care. The integrative review was performed by searching for articles in the Lilacs and Scielo databases, using the descriptors: Unified Health System (SUS), Collective Health, Public Health. The descriptors were crossed with the quantitative variables contained in the Brazilian (DATASUS) and the British (DATASETS NHS Digital).

Prediction for distributional outcomes in high-performance computing input/output variability

Abstract Although high-performance computing (HPC) systems have been scaled to meet the exponentially growing demand for scientific computing, HPC performance variability remains a major challenge in computer science. Statistically, performance variability can be characterized by a distribution. Predicting performance variability is a critical step in HPC performance variability management. In this article, we propose a new framework to predict performance distributions. The proposed framework is a modified Gaussian process that can predict the distribution function of the input/output (I/O) throughput under a specific HPC system configuration. We also impose a monotonic constraint so that the predicted function is nondecreasing, which is a property of the cumulative distribution function. Additionally, the proposed model can incorporate both quantitative and qualitative input variables. We predict the HPC I/O distribution using the proposed method for the IOzone variability data. Data analysis results show that our framework can generate accurate predictions, and outperform existing methods. We also show how the predicted functional output can be used to generate predictions for a scalar summary of the performance distribution, such as the mean, standard deviation, and quantiles. Our prediction results can further be used for HPC system variability monitoring and optimization. This article has online supplementary materials.

Morphological diversity in varieties of Catharanthus Roseus [L.] G. Don.

Catharanthus roseus is a prominent medicinal plant containing quantities expressive of alkaloids vincristine and vinblastine in its tissues. For this reason its use has been used in the treatment of cancer patients. Also it plays a significant role with use in floriculture, due to its variety of flower colors, because they are used more and more in landscaping projects. To potentiate its use, know its genetic diversity becomes important to optimization of the improvement of species. Thus, this work aimed to analyze the effect of 17 quantitative morphological variables to the distinction genotypes of C. roseus and to evaluate the genetic variability. Therefore, an experiment was carried out, evaluating ten commercial varieties of C. roseus, in greenhouse, in a randomized block design, with three replications. After 100 days of planting, the morphological profiles of the varieties were analyzed using image phenotyping. Through the analysis of genetic dissimilarity, the varieties were categorized into three groups, and the leaf traits were the ones that most contributed to this categorization. Therefore, the morphological characterization was efficient to characterize the phenotypic variability of the evaluated genotypes.

Lung clearance index short-term variability in cystic fibrosis: a pre-post pulmonary exacerbation study

BackgroundMultiple Breath washout (MBW) represents an important tool to detect early a possible pulmonary exacerbation especially in Cystic Fibrosis (CF) disease. Lung clearance index (LCI) is the most commonly reported multiple breath washout (MBW) index and in the last years was used as management measure for evaluation. Our aim was to analyze clinical utility of LCI index variability in pulmonary exacerbation in CF after intravenous (IV) antibiotic therapy.MethodsA single-center study was conducted at CF Unit of Bambino Gesù Children’s Hospital among hospitalized > 3 years patients for pulmonary exacerbations and treated with antibiotic IV treatment for 14 days. MBW and spirometry were evaluated within 72 h of admission to hospital and at the end of hospitalization. Descriptive analysis was conducted and correlations between quantitative variables were investigated.ResultsFifty-seven patients (M22/F35) with an average age 18.56 (± 8.54) years were enrolled. LCI2.5 was significantly reduced at the end of antibiotic treatment in both pediatric and adult populations with an average reduction of -6,99%; 37/57 patients denoted an improvement, 20/57 are stable or worsened in LCI2.5 values and 4/57 (7.02%) had a significant deterioration (> 15%) at end of treatment. On the contrary a significative elevation of FEV1 and FVC were found, respectively of + 7,30% and of + 5,46%. A positive good correlection among LCI 2.5 and Scond (rho = + 0,615, p = 0.000) and LCI 2.5 and Sacin (rho = + 0,649, p = 0.000) and a negative strong correlation between FEV1 and LCI 2.5 were found in post treatment period. A similar modification of LCI 2.5 and FEV1 was noticed in both adult and pediatric population.ConclusionsLCI may have a role in the routine clinical care of both adult and pediatric CF patients as a good tool to assess response to IV antibiotic end-therapy in the same way as FEV1.

A Comparison of Ureterorenoscopy and Extra-Corporeal Shock Wave Lithotripsy for the Treatment Of Upper Ureteric Stone Measuring Less than 1cm.

Objective: To compare the efficacy of Extracorporeal Shock Wave Lithotripsy (ESWL) and Ureterorenoscopy (URS) in the management of upper ureteric stone measuring &lt;1cm. Methodology: Randomized clinical trial (RCT) was conducted by targeting the patient admitted in urology ward, Jinnah Hospital Lahorethrough a period of one year. A sample size of 132 patients fulfilling inclusion criteria were selected by employing Non-probability consecutive sampling technique was employed to select 132 (sample size) patients fulfilling inclusion criteria. Patients were randomly allocated into two groups (66 in each group A&amp;B) using lottery method. In group-A, stones were treated using ESWL, while in group-B, URS was performed, and stones were broken with pneumatic energy. Data were analyzed using SPSS version 27, and a Chi-square test was conducted to compare the proportions of qualitative variables, while an independent sample t-test was applied to assess mean differences between two groups of quantitative variables. Asignificance level of ≤0.05 was adopted for determining statistical significance. Results: The sociodemographic profile of the two groups was comparable. It was seen that stone free rate nextto first session was higher in URS (81.8%) as compared to ESWL (63.6%) which later increased to 87.7% after completion of three session. The complaint of pain in ESWL was more as compared to URS (22.7% vs 12.1% p= 0.05)while the differences betweenthe rate of complications like fever, UTI, mucosal abrasion, hematuria or perforation were not statistically significant in both group. (p&gt; 0.05) Conclusion: ESWL outperforms URS for the treatment of upper ureteric stones measuring &lt;1cm in terms of efficacy and safety.Although not statistically significant, ourfindings suggest that URS achieves stone-free rates earlier than ESWL. However, according to our findings, ESWL is recommended as the treatment of choice for the majority of patients due to better compliance. Keywords: Extra-corporeal Shock Wave Lithotripsy, Nephrolithiasis, Ureterorenoscopy

Response of a pan-European fish index (EFI+) to multiple pressures in rivers across Spain

Rivers are ecosystems highly threatened by human activities and fish are an invaluable tool to measure and communicate environmental degradation and restoration. Fish bioassessment is crucial but notoriously difficult in Mediterranean-climate streams for a number of reasons, including low local species richness, faunas with high spatial turnover and generalist species, and scarcity of reference sites. In this study, we conducted the most comprehensive test of the pan-European fish index (EFI+) in the Iberian Peninsula, analysing its response to multiple anthropogenic pressures. We compiled a database, which we provide online, with 2970 electrofishing samples across Spain, involving 100,732 fish of 69 species. Principal component analyses of many quantitative variables were used to create new synthetic anthropogenic pressure indices. Correlation and multiple linear regression analyses were used to test the relationship between these pressures and the fish index (EFI+) and its four individual metrics scores (i.e., density of species intolerant to oxygen depletion, density of fish ≤150 mm of species intolerant to habitat degradation, richness of species of rheophilic reproduction habitat, and density of species of lithophilic reproduction habitat). We also obtained the same models but including the river basin district to test for spatial or methodological differences. Our results indicate that both the EFI+ index and its individual metrics respond to various anthropogenic pressures. These pressures explained about 36% of the variance of EFI+ values. Notably, downstream and mainstream reaches with higher agricultural or urban land uses, increased hydrologic alteration, and water and habitat quality impairment exhibited lower EFI+ values. Although less variance was explained for the individual metrics than for the fish index, they responded as expected to the different pressures. For instance, the richness of rheophilic species and the number of lithophilic fish decreased with hydrologic alteration, while the number of fish intolerant to oxygen depletion decreased with water quality impairment. Similar correlations were observed when river basin district was included in the model, but with higher explained variation and greater significance of the pressures. While it is possible to develop regional indices with more metrics and a stronger correlation with anthropogenic pressures, EFI+ is the only fish index that has been validated throughout the Spanish peninsular territory. Our results support the use of EFI+ in intercalibration exercises across Spain until better regional indices are developed.

Relationship of supplier development and proactive product recall with quality performance

A few manufacturers outsource their productions, making the assurance of the health and well-being of manufactured items more difficult. The limited capacity of existing regulatory bodies, the constant increase in bulk imports, and the complexity of global sourcing have caused severe quality performance problems in the supply chain. Therefore, the relationship between supplier development and proactive product recall with quality performance was examined. Quantitative variables were used in this research because of the nature of the topic. This study is explanatory and assumed based on established hypotheses. Supplier development and quality performance were analyzed using regression. The findings found that the two sorts of quality management practices that we studied in this research are proactive product recall and supplier development. Proactive product recall, if utilized appropriately, may alleviate the company's harmful effects as it is a cure activity that happens once a quality problem has occurred, or, in other words, it is a reactive approach.

Transcutaneous Posterior Tibial Nerve Stimulation: An Adjuvant Treatment for Intractable Constipation in Children.

Functional constipation can lead to painful defecations, fecal incontinence, and abdominal pain, significantly affecting a child's quality of life. Treatment options include non-pharmacological and pharmacological approaches, but some cases are intractable and require alternative interventions like neuromodulation. A subtype of neuromodulation, called Transcutaneous Posterior Tibial Nerve Stimulation (TPTNS), comprises electrical stimulation at the ankle level, by means of electrodes fixed to the skin. TPTNS is a minimally invasive, easy-to-apply technique that can potentially improve constipation symptoms in the pediatric population by stimulating the sacral nerves. To evaluate the clinical results and applicability of TPTNS as an adjuvant treatment for children and adolescents with functional constipation. Between April 2019 and October 2021, 36 patients diagnosed with functional constipation according to the Rome IV Criteria were invited to participate in the study. The study followed a single-center, uncontrolled, prospective cohort design. Patients received TPTNS for 4 or 8 weeks, with assessments conducted immediately after the periods of TPTNS and 4 weeks after the end of the intervention period. The data normality distribution was determined by the Shapiro-Wilk test. The Wilcoxon test and Student's t-test for paired samples were used to compare quantitative variables, and the McNemar test was used to compare categorical variables. Of the 36 enrolled patients, 28 children and adolescents with intractable function constipation completed the study, receiving TPTNS for 4 weeks. Sixteen patients (57.1%) extended the intervention period for 4 extra weeks, receiving 8 weeks of intervention. TPTNS led to significant improvements in stool consistency, frequency of defecation, and bowel function scores, with a reduction in abdominal pain. Quality of life across physical and psychosocial domains showed substantial enhancements. The quality of life-related to bowel habits also improved significantly, particularly in lifestyle, behavior, and embarrassment domains. The positive effects of this intervention are seen relatively early, detected after 4 weeks of intervention, and even 4 weeks after the end of the intervention. TPTNS was well-tolerated, with an adherence rate of approximately 78%, and no adverse effects were reported. TPTNS is an adjuvant treatment for intractable functional constipation, improving bowel function and quality of life. The effects of TPTNS were observed relatively early and sustained even after treatment cessation.

Phenotypic and Quantative Characterization of Ber (Ziziphus mauritiana Lamk.) Germplasm under Eastern Region of Uttar Pradesh, India

Eastern region of Uttar Pradesh is very rich in biodiversity for ber but still less harnessed. The agro-climatic conditions of eastern region do have great potential for its commercial cultivation. Keeping these in view, fruit sample with shoot were collected from fourty genotypes of ber in diverse areas of eastern region of Uttar Pradesh and analysed for various physiological attributes and results of study shows a wide range of variability in morphological and quantitative parameters. Among the parameters leaf shape of different genotypes show a wide variation and mainly Cordate, Oval, Obovate and Elliptic shape are found. The stone shape recorded showed Obtuse, acute, oblong, showed round stone shaped. Among the quantitative variability of different genotypes stone weight (0.56 g to 1.58 g), stem girth (25.90 cm to 62.63 cm) and hight of tree (3.43 m to 5.50 m) varivility was also recorded. Therefore, on the basis of morphological and quantitative attributes, genotypes–7,14,15, 18, 21and 30 were screened as promising genotypes can be recommended for commercial multiplication, growing at farmer’s field and conservation in the field gene bank for further evaluation and crop improvement.

Targeted 1−H-NMR wine analyses revealed specific metabolomic signatures of yeast populations belonging to the Saccharomyces genus

This study aimed to explore the non-volatile metabolomic variability of a large panel of strains (44) belonging to the Saccharomyces cerevisiae and Saccharomyces uvarum species in the context of the wine alcoholic fermentation. For the S. cerevisiae strains flor, fruit and wine strains isolated from different anthropic niches were compared. This phenotypic survey was achieved with a special focus on acidity management by using natural grape juices showing opposite level of acidity. A 1H NMR based metabolomics approach was developed for quantifying fifteen wine metabolites that showed important quantitative variability within the strains. Thanks to the robustness of the assay and the low amount of sample required, this tool is relevant for the analysis of the metabolomic profile of numerous wines. The S. cerevisiae and S. uvarum species displayed significant differences for malic, succinic, and pyruvic acids, as well as for glycerol and 2,3-butanediol production. As expected, S. uvarum showed weaker fermentation fitness but interesting acidifying properties. The three groups of S. cerevisiae strains showed different metabolic profiles mostly related to their production and consumption of organic acids. More specifically, flor yeast consumed more malic acid and produced more acetic acid than the other S. cerevisiae strains which was never reported before. These features might be linked to the ability of flor yeasts to shift their metabolism during wine oxidation.

An Epidemiological Profile of Previously Treated Patients Registered in Tuberculosis Units in Urban Visakhapatnam

Background: Tuberculosis (TB) remains a major global public health problem. Retreatment patients havehigher risk of drug resistance compared with new cases. The objective of the study is to describe the typesof retreatment (previously treated) patients and assess the Socio demographic characteristics, co morbidand behavioural conditions of retreatment patients and to identify the factors associated with relapseunder Revised National Tuberculosis Control Program ( RNTCP) in the tuberculosis units located in UrbanVisakhapatnam. The main aim of the study is to study epidemiological profile of previously treated patientsto identify the factors which make tuberculosis patients prone for retreatment so that necessary action canbe taken.Methods: This is an Observational Analytical Cross-sectional study done in Tuberculosis units in GVMC. All thesubjects(193) who were registered as Previously treated patients in TUs during the second and third quarter ofthe year 2016 i.e April to September 2016. A pretested semi structured schedule was administered. Categoricaldata was analysed by Chi square test. Quantitative variables were represented as means and standard deviation.Unpaired t test was used for testing statistical significance in quantitative data.Results : Among 193 study subjects 168 (87%) were having pulmonary TB and remaining 25 (13%) were havingextra pulmonary TB. Majority of the study participants, 141 (73%) were males whereas only 52 (27%) were females.Relapse patients were 125(64.9%) Defaulters were 12 (6.2%), Treatment failure was 9 (4.6%) and Others previouslytreated were 47 (24.3%). Chi square test was used for testing statistical significance of association betweencategorical variables.Conclusion: Socio demographic factors, behavioural and co morbid factors have an effect on Relapse andmodifying these risk factors may bring about favourable outcomes. There is further need for exploring the reasonsfor high rates of relapse.

Pelvic floor function after third and fourth degree perineal lacerations: a case-control study on quality of life

BackgroundThe primary aim of this study was to compare the quality of life between women with obstetric anal sphincter injury (OASI) and women with intact perineum or minor vaginal tears following their first vaginal birth through a validated urogynaecological questionnaire. As a secondary aim, we wanted to identify the specific symptoms for pelvic floor dysfunction after a vaginal birth.MethodsOne hundred thirty-three cases (III- and IV-degree vaginal tears) and 133 controls (intact perineum or I- and II-degree vaginal tear) were asked to fill the PFDI-20 condition-specific and quality of life survey at three and 12 months after vaginal delivery. The survey evaluates pelvic floor dysfunction symptoms through three subsections: the Pelvic Organ Prolapse Distress Inventory (POPDI), the Colorectal-Anal Distress Inventory (CRADI), and Urinary Distress Inventory, (UDI). The scoring system ranges from 0 (no distress) to 100 (maximum distress) for each subsection, subsequently summed up to obtain the summary score (0 to 300). The patients recruited were asked to complete the survey at 3- and 12-months follow-up visit. Accordingly, data collection started. Categorical variables were subjected to Chi-square test or Fisher’s Exact test. Quantitative variables were compared through Student’s t-test or Mann-Whitney test.ResultsAll surveys have shown statistically significant differences when comparing the cases to the control group. Consequently, PFDI-20 has shown a strong correlation between III- and IV-grade lacerations and pelvic floor dysfunction persistence at 12 months after delivery. Intestinal symptoms were the most reported disturbances among women with previous OASI.ConclusionsMajor vaginal tears have demonstrated to have a strong impact on women’s quality of life up to a follow-up of 12 months. The use of PFDI-20 questionnaire is a useful and valid tool in the diagnosis and follow-up of genital prolapse, fecal and urinary incontinence in primiparous women with a history of OASI. Thus, its application in clinical practice can help offering the most adequate rehabilitative treatment.

An Assessment of the Influence of Special Needs Education Resources on Management of Inclusive Education in Public Primary Schools in Nakuru East Sub-County, Kenya

Inclusive education has become a worldwide practice because it boosts child rights, especially the right to basic education. Management of inclusive education in primary schools is critical if the education sector is to realize set objectives. The purpose of the study was to examine the influence of special needs education (SNE) resources on the management of inclusive education in public primary schools in Nakuru East Sub-County, Kenya. The specific objectives included establishing the influence of available teaching and learning resources for SNE and SNE teachers' competence in the management of inclusive education in public primary schools in Nakuru East Sub-County. The study was supported by two theories, namely Classical Liberal Theory of Equal Opportunity and Social Darwinism and Systems Theory. The research used a mixed-methods approach. This study used a descriptive, explanatory research design. The target population was 520 respondents, including 437 pupils with disabilities, one quality assurance officer, 4 guidance and counselling teachers, and 4 head teachers. A sample of 170 respondents was selected. Questionnaires for Headteachers, Guidance and counselling Teachers, and Pupils with disabilities and interview schedules for Quality assurance officers were adopted to collect primary data. After cleaning this data by looking for errors in the entries, different descriptive statistics like the variation of coefficient, frequencies, standard deviation, mean score and percentages were assessed for all the quantitative information and variables presented using tables. Inferential statistics such as regression analysis were computed using Statistical Package for Social Sciences version 27. On the other hand, qualitative information was analyzed through the use of content analysis. Regarding the availability of teaching and learning resources for SNE, the study found that the schools had adequately adapted textbooks and hearing aids for SNE. Further, regarding the SNE teachers' competence, the study established that it was uncertain whether many of the teachers at their schools had received special education training. The study concluded that SNE teachers' competence (β=0.737, p-value=0.006&lt;0.05) had the greatest influence on the management of inclusive education in public primary schools in Nakuru East Sub-County, while available teaching and learning resources for SNE (β=0.541, p-value=0.003&lt;0.05) had the least influence on the management of inclusive education in public primary schools in Nakuru East Sub-County. The study recommended that head teachers and teachers should be taken for some SNE management training by the government through seminars organized by the Ministry of Education in order to be able to cater to the learners with special needs in regular schools. The findings might be used by the Ministry of Education and education stakeholders to enhance the quality of inclusive education in public primary schools in Nakuru East Sub-County, Kenya.

Is YouTubeTM a reliable source of information regarding ultra-thin ceramic laminates?

An aesthetic smile is usually associated with healthy appearance and success in many areas of life. Currently, individuals access the internet and social media in search of health information. The aim of this study was to analyse the quality and reliability of information in videos available on the YouTubeTM platform about ultra-thin ceramic laminates. Methods: YouTubeTM was searched using the therms “dental ceramic laminates” and “dental contact lens” for videos uploaded on ultra-thin ceramic laminates. The first 100 videos in Portuguese were selected and rated for quality and reliability. The content and source of videos were also noted. The quality of the videos was determined by evaluating the presence or absence of reliable information and distributed into seven domains. To compare the distributions of quantitative variables between the classifications of source, content, and quality, the Kruskal-Wallis and Dunn’s post-hoc tests were performed. Results: Seventy-two videos were included for qualitative analysis. Regarding quality rating, most videos were rated with poor quality. The reliability of the evaluated videos was low. Conclusion: YouTubeTM showed a large number of videos with many views on the topic, but it does not contribute with good quality and reliable information to the population.

Sexual Dimorphism in Decompensated Non Ethanol-related Chronic Liver Disease: A Retrospective Cohort Study

Introduction: Women exhibit a distinct natural history of chronic liver disease compared to men, particularly regarding progression and outcomes. Although liver disease prevalence is generally higher in men, the incidence of non ethanol-related liver disease is increasing among females. Metabolic syndromes and their consequences are less recognised in the female population until they develop end-stage cirrhosis. Limited studies have explored the differences between male and female cirrhosis. The present study aimed to address the knowledge gap in female Decompensated Chronic Liver Disease (DCLD). Aim: To identify the differences in presentation and outcomes between females and males with non ethanol-related cirrhosis. Materials and Methods: The present retrospective cohort study was conducted in the Department of Medical Gastroenterology and Hepatology,Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India, involving 27 males and 33 females with non ethanol-related decompensated cirrhosis. A comparison was made between the aetiologies, presenting symptoms, complications, laboratory values, Model for End-stage Liver Disease (MELD) score, and in-hospital mortality during the first decompensation. Data analysis was performed using Statistical Packages for Social Sciences (SPSS) version 24.0 Quantitative variables were expressed as mean and Standard Deviation, while qualitative variables were expressed as frequency and percentage. The association between categorical variables was analysed using the Chi-square test, and the comparison of continuous variables between the two groups was analysed using independent sample t-test. A p-value of &lt;0.05 was considered statistically significant. Results: The mean age of decompensation was 56.5 years for men and 50.9 years for women. The most common aetiology in men was Non Alcoholic Fatty Liver Disease (NAFLD) (63%), while in females, it was NAFLD (45%) and cryptogenic cirrhosis (45%) (p=0.020). Diabetes Mellitus (DM) was more prevalent in males (55.6% versus 33.3%). Variceal bleed was more common in females (66.7% versus 48.1%). Jaundice was more frequently observed in males (44.4% versus 21.2%) (p=0.05). Ascites was more prominent in males (70.4% versus 45.5%) (p=0.05). Hepatic Encephalopathy (HE) was more prevalent in males (22.2% versus 15.2%). Females had a lower MELD scores compared to males (12.4±6.1 versus 15.2±6.4). Mortality was higher in males (22.2% versus 12.1%). Conclusion: Women with Decompensated Chronic Liver Disease tend to decompensate at a younger age compared to males and have a higher risk of Upper Gastrointestinal (UGI) bleeding. NAFLD was the most common aetiology in both groups. Ascites and HE were more commonly observed in men. Females had lower MELD scores, resulting in a longer waiting period on the transplant list compared to males. Mortality was higher in males.

Clinicoradiological Profile of Endobronchial Tuberculosis: A Cross-sectional Study

Introduction: Tuberculosis (TB) is a disease that causes severe mortality and morbidity worldwide, including India. Endobronchial Tuberculosis (EBTB) is an uncommon form of TB, which is often underdiagnosed due to the difficulty in diagnosis. This form of TB often has a poor prognosis and long-lasting sequelae. Aim: To study the proportion of EBTB in clinically diagnosed pulmonary TB and to study the clinicoradiological and bronchoscopic profile of EBTB. Materials and Methods: This study was a hospital-based recordbased cross-sectional study that included patients with sputum smear negative for Acid-Fast Bacilli (AFB) and Mycobacterium tuberculosis (M. tuberculosis) not detected on Nucleic Acid Amplification Test (NAAT), who were clinically diagnosed with TB. Bronchoscopy was performed on such patients, and samples were sent for investigations, including histopathology and NAAT. Demographic characteristics, bronchoscopy and radiology findings , and microbiology results were documented. Quantitative variables were summarised as means, and categorical variables were presented as percentages. Results: A total of 198 underwent bronchoscopy, of which 20 (10%) were diagnosed with EBTB. The mean age was 22 years, and 65% were females. The most common clinical feature in these patients was fever, the most common radiological presentation was lobar collapse, and the most common bronchoscopy feature was a tumorous lesion. NAAT detected M. tuberculosis in the bronchial wash in 50% of patients diagnosed with EBTB. A total of 45% of patients had TB which was diagnosed on histopathology. Conclusion: EBTB was diagnosed in 10% of smear-negative, NAAT-negative cases. The use of NAAT on bronchoscopy wash samples resulted in a high yield in diagnosis.