Sample Z-test Research Articles

THE APPLICATION OF PROBLEM BASED LEARNING (PBL) MODEL TO IMPROVE THE LEARNING OUTCOMES OF HISTORY CLASS X SMK PGRI AIR BELITI

This research aims to determine the completensess of the learning outcomes of class X students at SMK PGRI Air Beliti after using the Problem Based Learning (PBL) model. The method used is a quantitative method with a pseudo-experimental research desing. The population in this study were clas X students consisting of two classes. The sampling technique used was random sampling technique, where the sample was chsen randomly after being given a lottery number and shaken which become the research sample for clas X.B of 28 Students. The data collection technique used was pre-test and post-test using a test in the form of multiple choice questions. Tne analisys requirements testing technique uses a one sample z-test. The results of this study showed the average pre-test scor was 51,71 with a completeness percentage of completeness 0% or none of the students were complete, while the average post-test score was 74,89 with a completion percentage of 78,57% or 22 students completed. The z-table results obtained calculated Z value 3,11) ≥ Z table (2,052). The conclusion is that the application of problem based learning model on the history learning outcommes of class X SMK PGRI Air Beliti is significantly complete.

Optimizing the oncology ecosystem: Addressing barriers between community and academic oncologists.

e13580 Background: Oncology practice is becoming more complex and collaboration between academic and community practices is necessary to optimize care for patients. This qualitative analysis explores perceived gaps between academic and community practices and proposed solutions to a more cohesive oncology ecosystem for optimal quality and care delivery. Methods: A 10-question mixed-methods quantitative and qualitative survey was developed (SurveyMonkey) to identify practice setting, methods of collaboration, perceived barriers, and strategies for improvement. Both open-ended and multiple-choice questions were used. Survey was distributed via social media outreach on Facebook, X, and email. Individual responses were coded by AK, then compared using two sample z-test for proportions. Results: 68 responses were collected, comprising 45.5% community and 44.1% academic physicians. Non-clinician respondents (2.9%) were excluded. Respondents had been in practice: >20 years (16.42%), 10-20 years (40.3%), 5-9 years (19.4%) and < 5 years (23.9%). Collaboration commonly occurred via conferences (73.68%), shared Electronic Medical Records (EMRs, 59.65%) or research (38.6%). The main barriers perceived are summarized (Table). Community oncologists describe lack of appreciation from academics, time constraints, difficulty communicating. Main barriers to collaboration perceived by academic oncologists include delayed referral, time constraints, difficulty communicating, lack of shared EMRs, fear of patient displacement from the primary referring practice, and administrative red tape. Proposed solutions from both groups include engaging community oncologists in academic tumor boards (n=8/68,11.8%) and regional education events (n=2/68, 2.9%). Improved communication. Additionally, both groups were interested in expanding clinical trials in the community. Both groups noted the need for financial incentives and institutional support for successful cooperation (n=3/68, 4.4%). Conclusions: Our data unveiled the nuances of collaboration. Barriers mainly consist of lack of acknowledgement, poor communication, and barriers in EMR utilization. Both groups struggle with time constraints. This data can inform multi-shareholder groups working for systems-based process improvement, expanding collaboration between community and academic oncology. [Table: see text]

Early Lessons From Implementation of Holistic Review for Pediatric Surgery Fellowship Applicants

PurposeHolistic review (HR) considers applicants’ unique identities and experiences rather than focusing on academic metrics. Though several residency programs have demonstrated increases in women and those underrepresented in medicine (URiM), this is the first study to examine HR in pediatric surgery (PS). MethodsUsing a retrospective review of applicants, demographic, academic, and non-academic metrics of traditional review (TR) [2015–2017] were compared to HR [2018–2022]. HR initiatives include expansion of faculty reviewers, implementation of a pre-screening rubric, and greater prioritization of non-academic factors. Chi-squared/Fisher's exact tests, Wilcoxon rank-sum tests, and two sample z-test for proportions were used where appropriate. ResultsFor 635 applicants (TR: 268, HR: 367), the proportion offered interviews in the TR and HR cohorts were similar (31.7 vs 36%, p = 0.30). Candidates selected for interview pre- and post-HR most commonly graduated from residency programs affiliated with PS fellowships (56.5 vs 50%, p = 0.65). After HR implementation, no change in proportion of women interviewees (TR: 52.9 vs HR: 54.5%, p = 0.93) was observed. Though URiM residents applying to PS remained consistently low (TR: 14.6 vs HR: 10.9%, p = 0.21), significantly more received interviews with HR (30.8 vs 42.5%, p = 0.001). The median number of peer-review publications per interviewee increased (17 vs 22, p = 0.02) as did non-academic achievements (leadership, service, athletic awards, etc.) per applicant (1.0 vs 1.5, p = 0.104), though the latter did not reach significance, demonstrating similar qualification of interviewees in HR and TR. ConclusionHolistic review of PS fellowship applications increased the proportion of URiM interviewees, despite a persistently low URiM proportion in the applicant pool. Furthermore, implementing HR did not sacrifice the caliber of interviewees, as publications and non-academic achievements increased by over 25% in the HR cohort. Level of EvidenceIV.

Digital Transformation in Cambodian Higher Education and Its Impact on Teaching and Learning Outcomes

Innovation is the need of the hour for an organization to stay ahead of the competition. It’s a critical factor that can make or break an organization’s success. The factors influencing innovation, whether tangible or intangible, are complex and multifaceted. The factors that drive innovation need further research as proper tools are unavailable to determine the quantum of influence the factors have on innovation. Building on their previous research, the authors identified key factors that significantly influence innovation through a comprehensive literature review. This study, however, took a different approach, conducting an empirical investigation using a survey as a measuring tool. The study then performed statistical analysis on the data, identifying and shortlisting the factors that play a crucial role in driving innovation within an organizational context. The study employed a statistical analysis, including a large sample z-test for proportions and hypothesis testing for each of the 25 factors. This approach led to the shortlisting of 13 factors that significantly influence innovation. Furthermore, the study used Correlation analysis to understand the interdependency among the innovation factors, adding another layer to the research. Further research may be directed toward devising a mathematical model for the innovation index for use as a measuring tool to assess an organization’s innovation potential. Keywords: Innovation; Interdependency; Technology; Competition; Organizational Structure

Assessing Adoption of Standard of Care and Comparing Clinical and Demographic Differences in First-Line (1L) Treatment (Tx) of Chronic Lymphocytic Leukemia (CLL)

Assessing Adoption of Standard of Care and Comparing Clinical and Demographic Differences in First-Line (1L) Treatment (Tx) of Chronic Lymphocytic Leukemia (CLL)

Management and treatment of patients (pts) with stage III unresected non-small cell lung cancer (NSCLC) at UPMC: A quality initiative by Integra Connect PrecisionQ.

579 Background: In 2019, the University of Pittsburgh Medical Center (UPMC) and Integra Connect (IC) initiated a QI to improve immunotherapy (IO) use post CRT. Baseline analysis assessed scanning and treatment patterns post-CRT and duration of treatment (DOT) with durvalumab (durva). Drawing on this analysis, IC and UPMC conducted a focus group to address gaps in care and initiated improvements. This real-world study aims to assess the change in IO use post-CRT, the time to scan (TTS), time to treatment (TTT), DOT compared to baseline. The DOT of durva was compared between pts initiated <14 days of CRT and those who started ≥14 days. Methods: From the UPMC and IC real-world databases, we identified 555 pts with stage 3 unresectable NSCLC for manual chart abstraction. Pts received CRT between 2/16/2018 and 12/31/2021. TTS was calculated from the last day of CRT to the 1st scan and the TTT obtained from the last day of CRT to the 1st durva dose. The baseline period was from 2/16/2018 to 8/31/2020 and the post-intervention stage from 9/1/2020 to 12/31/2021 based on CRT start date. Pts were excluded if they had no scan data, a 1st scan ≥90 days post CRT (TTS analyses), a duration of zero days (DOT analyses) or a TTT >120 days (TTT analyses). At least 1 yr of follow up was required for DOT comparisons. Descriptive analyses were used. A two-tailed 2 sample z-test was used for proportions and the nonparametric Wilcoxon rank sum test was used for TTS, TTT and DOT comparisons. Results: The baseline pts were 46% female with an average age of 67.7 years; post-intervention patients were 47% female with an average age of 69.4 years. The rate of durva use post CRT in pts who did not progress increased from 66% (n =128/194) at baseline to 83% (n =96/116) post intervention (p < 0.01). The baseline median TTS decreased from 22.5 days (n=174) to 20 days (n=121) post intervention (p <0.05), and median TTT decreased from 35 days (n=121) to 28 days (n=90) (p < 0.05). The median DOT increased from 6 (n=127) to 8.2 months (n=76) (p >0.05). During the study period, 8% (n =17/223) of pts started durva < 14 days post CRT and 92% started ≥14 days (n =206/223). The median DOT in the < 14 days group was 10.8 months versus 6.2 months in ≥14 days (p >0.05). Median overall survival (OS) was 36.5 months in the <14 days vs. 27.8 months in the ≥14 days group (p > 0.05). Conclusions: NSCLC QIs are effective tools to improve IO utilization, TTT, and DOT in eligible pts. Practices that assess clinical performance can identify gaps in care and act. In this Stage III study, a superior OS, though lacking statistical significance, was seen in the group that started IO <14 days post CRT compared to ≥14 days. Further studies with larger sample size are needed to validate these findings.

Silver diamine fluoride modified atraumatic restorative treatment compared to conventional restorative technique on carious primary molars–A randomized controlled trial

ObjectiveTo compare the success of silver diamine fluoride-modified atraumatic restorative technique (SMART) with that of the conventional drill and fill method in restoring carious lesions in primary molars. MethodChildren (4–8years old) reporting to a tertiary care hospital setting with asymptomatic cavitated dentinal carious lesions in primary molars were randomly allocated to two groups; SMART and Conventional; and subsequently restored with Glass Ionomer Cement (GIC). Follow-up evaluations were carried out by blinded independent evaluator at 6-months intervals to assess the status of restorations. Primary outcome was the success of restorations at 24 months and the secondary outcome was the child's behaviour and acceptance of the treatment at the time of interventions. Two sample Z-test of proportion, logistic regression analysis and Chi-square test were used to compare the outcomes in two groups. ResultsA total of 226 children (SMART group, 112 and conventional, 114) were included with 280 and 282 GIC restorations placed by the SMART and the conventional method respectively. At 24-months, 459 (81.6 %) primary molars were available for evaluation. Success rates of restorations was 38.4 % and 45.8 % % in SMART and conventional groups respectively (p = 0.105). The rate of acceptability of treatment in the SMART and conventional group was 79 % and 56 % (p<0.001) respectively. ConclusionThere was no significant difference in the success rates of GIC restorations by SMART and conventional technique in carious primary molars at 24 months. SMART was better accepted by children as compared to the conventional restorative technique. Clinical significanceSMART can be an alternative option to treat the asymptomatic carious lesions in primary molars and is well accepted by children than the conventional drill and fill technique thus implying that it has a useful role in un-cooperative children.

Management and treatment of patients with stage III unresected NSCLC at UPMC: A quality initiative by Integra Connect Precision Q.

e20588 Background: The PACIFIC trial led to improved OS in patients (pts) with unresectable stage 3 NSCLC who received durvalumab (durva) post chemoradiation (CRT).1 In 2019, the University of Pittsburgh Medical Center (UPMC) and IC initiated a QI to improve immunotherapy (IO) use post CRT. A baseline analysis was done to assess scanning and treatment patterns post-CRT, and duration of treatment (DOT) with durva. Drawing on this analysis, IC and UPMC conducted a focus group to address gaps in care and initiated improvements. This real-world study aims to assess the change in IO use post-CRT, the time to scan (TTS), time to treatment (TTT), and duration of treatment (DOT) compared to baseline. The DOT of durva was compared between pts initiated &lt;14 days of CRT and those who started ≥14 days. Methods: From the UPMC and IC Precision Q real-world databases, we identified 555 pts with stage 3 unresectable NSCLC for manual chart abstraction. Pts received CRT between 2/16/2018 and 12/31/2021. TTS was calculated from the last day of CRT to the 1st scan and the TTT obtained from the last day of CRT to the 1st durva dose. The baseline period was from 2/16/2018 to 8/31/2020 and the post-intervention stage from 9/1/2020 to 12/31/2021 based on CRT start date. Pts were excluded if they had no scan data, a 1st scan ≥90 days post CRT (TTS analyses), a duration of zero days (DOT analyses) or a TTT &gt;120 days (TTT analyses). At least 1 yr of follow up was required for DOT comparisons. Descriptive analyses were used. A two-tailed 2 sample z-test was used for proportions and the nonparametric Wilcoxon rank sum test was used for TTS, TTT and DOT comparisons. Results: The baseline pts were 46% female with an average age of 67.7 years and the post-intervention were 47% female with an average age of 69.4 years. The rate of durva use post CRT in pts who did not progress increased from 66% (n =128/194) at baseline to 83% (n =96/116) post intervention (p &lt; 0.01). The baseline median TTS decreased from 22.5 days (n=174) to 20 days (n=121) post intervention (p &lt;0.05), and median TTT decreased from 35 days (n=121) to 28 days (n=90) (p &lt; 0.05). The median DOT increased from 6 (n=127) to 8.2 months (n=76) (p &gt;0.05). During the study period, 8% (n =17/223) of pts started durva &lt; 14 days post CRT and 92% started ≥14 days (n =206/223). The median DOT in the &lt; 14 days group was 10.8 months versus 6.2 months in ≥14 days (p &gt;0.05). The median overall survival (OS) was 36.5 months in the &lt; 14 days vs. 27.8 months in the ≥14 days group (p &gt; 0.05). Conclusions: QIs in NSCLC are effective tools that can improve appropriate durva utilization, TTT and DOT in eligible pts. Practices that assess their clinical performance can identify gaps in care and act. In this study, a superior OS, though lacking statistical significance, was seen in the group that started IO &lt;14 days post CRT compared to ≥14 days. Further studies with larger sample size, are needed to validate these findings.

Understanding differences in the rates of BRCA/HRD testing and treatment in 1st line maintenance in patients with ovarian cancer treated by gynecologic oncologists compared to other providers: A quality initiative by Integra Connect (IC) PrecisionQ.

5576 Background: The role of PARPi in the treatment of advanced ovarian cancer (aOC) has expanded in recent years. In this context, South Carolina Oncology Associates (SCOA) partnered with Integra Connect (IC) on a quality initiative (QI) to evaluate the rate of BRCA and HRD testing in newly diagnosed OC patients and the use of maintenance therapy in the 1st line (1L) setting in aOC. Patients with aOC at SCOA are typically managed by gynecologic oncologists. Methods: Using the IC Precision Q real-world database of over 1 million cancer patients across 275 sites of care, we assessed newly diagnosed OC patients evaluated via medical chart curation from 1/1/2020 to 6/30/2022 for BRCA and HRD testing at SCOA (N = 81) and other oncology practices (N = 1,045). We also studied the use of maintenance therapy in patients with stage II-IV OC who completed platinum-based chemotherapy from 1/1/2020 to 6/30/2022 at SCOA (N = 75) and other oncology practices (N =899). SCOA was compared to other oncology practices in terms of provider specialty treating the patient, rates of HRD and BRCA testing, and use of 1L maintenance treatment in patients with or without BRCA or HRD mutations. Descriptive analyses were used. Proportions were compared using a two tailed two sample z-test. Results: Among newly diagnosed patients at SCOA, 95% of patients with OC were primarily managed by a gynecologic oncologist compared to 5% at other practices. The rate of BRCA testing at SCOA was 81% (66 of 81) compared to 75% (788 of 1045) and HRD testing was 60% (49 of 81) compared to 39% (403 of 1045) at other oncology practices in the IC database. The difference in HRD testing was significant (p &lt; 0.01). The use of 1L maintenance regardless of biomarker status was 64% (48 of 75) at SCOA compared to 50% (449 of 899) at other practices. The difference in 1L maintenance use was significant (p&lt;0.05). PARPi were used at SCOA for maintenance therapy in 82% (38 of 46) of patients compared to 74% (314 of 427) at other practices. The use of maintenance in BRCA or HRD positive patients was 84% (21 of 25) at SCOA compared to 75% (151 of 201) for other practices. Conclusions: In this real-world study, treatment by gynecologic oncologists was associated with higher rates of BRCA and HRD testing and higher use of 1L maintenance treatment in patients with aOC compared to other practices. These findings underscore the importance of gynecologic oncologists in the management of aOC to ensure optimal testing and adherence to treatment guidelines.

The Entrepreneurial Self-Efficacy of Micro-Entrepreneurs: A Social Cognitive Perspective

Today, the world is witnessing a massive transformation in all spheres of activity as a result of the outbreak of the COVID-19 pandemic. Recognising opportunities is more crucial than ever. The purpose of this article is to analyse the impact of social capital (SC) on the opportunity recognition (OR) of micro-entrepreneurs through entrepreneurial self-efficacy. The study is in line with the social cognitive theory. Furthermore, the study analyses the influence of gender and type of business on SC, entrepreneurial self-efficacy and OR. Data were collected through a cross-sectional survey among micro-entrepreneurs in Kerala, India. Independent sample Z-test and structural equation modeling were used to analyse the data. The results reveal that entrepreneurial self-efficacy mediates the relationship between SC and OR. Sobel test was used to reaffirm the mediation effect. This study provides suggestions for enhancing entrepreneurial self-efficacy to better identify opportunities in today’s ever-changing global business environment.

The effectivity of problem-based learning assisted by snakes and ladders games on students divergent thinking ability

This study aims to determine the effectiveness of problem-based learning assisted by the game of snakes and ladders on students' divergent thinking skills. The type of research is quasi-experimental, and it was conducted at a public junior high school in Semarang for the 2022/2023 academic year. The sampling technique in this study used purposive sampling, the population in this study was the entire class VIII, and the sample in the study was class VIII F as the experiment class (KF) and class VIII E as the control class (KE). The instrument used was a test result of student learning with five description questions, the hypothesis test used is one sample t-test, independent t-test, and z-test with sig 0.05. Based on the results of the study, it was found that the experimental class learning outcomes were higher than the control class learning outcomes. One sample t-test obtained that t count = 6.045 while t table = 0.683, so that t count &gt; t table, it can be said that KF capability average exceeds 70, independent t-test obtained sig &lt; 0.05 which is 0.001. The average of students with learning model problem-based learning with the help of snakes and ladders game on divergent thinking ability more than the average divergent thinking ability of mathematics. It can be said that 75% of students in the experimental class completed it classically. Learning with problem-based learning assisted by snake and ladder games on the students' divergent thinking skills was effective for the mathematics learning outcomes of class VIII students.

Smartphone Color Vision Testing as an Alternative to the Conventional Ishihara Booklet.

Introduction Color vision testing was first seen as a parameter to be tested in the 1700s. Nowadays, it is a well-known phenomenon with significant quality-of-life implications. Structures involved in color vision include the lens, pupil, retinal cone photopigments, and several photoreceptor processes that translate the incoming spectrum of different light wavelengths into a processed colored image. An initial color vision assessment was made simply by comparing the color perception of the individual to that of the examiner. The most commonly used tools to screen for color vision defects today are color plates, such as the Ishihara color plates. In the modern age, smartphones have evolved to become an essential part of our everyday lives with applications such as Eye Handbook, which allow easier access to color vision testing using color plates displayed on smartphone screens. In this study, we compared color vision testing on Android and iOS devices to the standard Ishihara booklet. Materials and methods A cross-sectional validation study was performed on patients presenting to the Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan for six months. The sample size collected was 162 with a 95% confidence interval. The age range of the sample population was kept at 12-70 years. A patient was selected for participation in the study, and a color vision assessment was performed using the Ishihara color plates and Android and iOS smartphones. The collected data was then entered into IBM SPSS (Statistical Package for the Social Sciences) Statistics 25 for analysis, with the p-value being kept at 0.05. Results The sample size was 162, with the gender distribution being predominantly male (69.14%). The average age of the participants was 35.94 (SD = 12.04). The result of the two-tailed paired sample z-testwas not significant based on a p-value of 0.565, indicating the null hypothesis cannot be rejected. This finding suggests the difference between the mean of Ishihara and the mean of the iPhone was not significantly different from zero. Similar results were found for comparisons between Android smartphones and the Ishihara booklet. Conclusions Previous studies conducted showed nearly 60% of subjects with normal color vision correctly identified all colors on standard Ishihara color plates. The two-tailed paired sample t-test conducted in our study showed no significant difference between either of the smartphone groups (iPhone or Android) and the Ishihara booklet group, indicating that smartphones present a viable alternative to standard Ishihara booklet testing. However, there are certain limitations to our study. Different types of smartphone screens present a challenge in standardization while testing color vision, something that is not a problem when using the Ishihara booklet. However, smartphones are more widely available, more versatile, and present far greater ease of access. Both these factors should be considered when comparing the two in future studies.

Screening PLHIV for depression using PHQs: A RCT comparing non-selective with selective screening strategy within a primary health care facility in Uganda.

BackgroundDepression is rarely screened for among People Living with Human Immunodeficiency Virus (PLHIV) although it is 2 to 3 times more prevalent among PLHIV than in the general population. In instances where depression is screened for using screening tools, it usually follows noticing depression risk factors. This practice of selectively screening for depression could be leaving some cases of depression unattended to. On the other hand, subjecting every client to screening tools (non-selective screening) offers every patient an opportunity to be managed for depression. However, this could require additional resources as compared to selective screening. We present and discuss results on whether non-selective and selective screening strategies differ in depression case detection, and in addition, we also present perceptions of the stake holders on the two screening strategies.MethodsThe study was conducted in Princess Diana Memorial Health Centre IV HIV clinic using a randomized controlled trial with a qualitative component. To determine whether there was a difference in depression case detection, consecutively sampled participants were randomly allocated to either non-selective or selective screening strategy. Participants allocated to selective screening were screened for depression using the patient health questionnaire (s) (PHQs) if they were at “crisis points”. While those allocated to non-selective screening were screened regardless of whether the “crisis points” were noticed or not. The PHQ-2 and PHQ-9 were used in sequence. 326 PLHIV participated in the study. Outcomes of the MINI evaluation were analyzed for those with PHQ-9 scores of 10 or more to confirm major depressive disorder (MDD). Data was analyzed using the two sample Z-test for proportions with Stata 2013 software. To explore the perceptions of the stake holders, key informant interviews were performed with six stakeholders that experienced the study.ResultsCases of depression (PHQ-9 score ≥ 5) were more likely to be detected by the non-selective screening strategy 30.2% (49/162) compared to the selective screening strategy 19.5% (32/164) (difference in proportions 0.107, 95% confidence interval 0.014–0.200, Cohen’s h = 0.25, P = 0.03). The stake holders thought it was important to screen for depression among PLHIV with preference to non-selective screening strategy.ConclusionEvidence from this data suggests that more cases of depression (PHQ-9 score ≥ 5) are likely to be detected with non-selective screening as opposed to selective screening.Trial registrationPACTR201802003141213 (name: comparison of routine versus selective screening for depression strategies among PLHIV attending Princess Diana Memorial Health Centre iv Soroti).

Comparative Analysis of Rice Farming using Combine-Harvester and Thresher in Kenagarian Kambang Barat, Lengayang Sub-District, Pesisir Selatan District

The rice harvesting process has progressed a lot. Farmers used to harvest simply using a sickle and a simple thresher machine, while nowadays, they are using the latest harvest machine, called Combine Harvester. Technological developments should enable farmers to gain more significant benefits, such as higher production, a shorter processing time for harvesting, and lower costs incurred during harvesting. This study aims to describe the characteristics of farmers who use Combine Harvester technology and farmers who use Thresher harvesting technology. This study also compares the costs of rice harvesting and production of both farmers in lowland rice farming in Kenagarian Kambang Barat, Lengayang Sub-District, Pesisir Selatan District. The farmers sampling chose as many as 30 farmers purposively for each of those using a Combine Harvester and Thresher, so the total number of farmers to be interviewed was 60. The data analysis method used in this study is the analysis of the average difference test of the independent sample Z-test model. The research finds that farmers' main reasons for using the Combine Harvester were faster harvesting times and less labor. While the main reason for farmers using the Thresher was that its cost is considered the same if using a Combine Harvester machine. Moreover, the research indicates a significant difference in the cost of harvesting and producing rice using both harvesting machines. The harvesting cost of the Combine Harvester was lower than Thresher, which was Rp. 3,543,149 and Rp. 4,385,543 respectively. The difference in harvesting cost of these two harvesting machines was Rp. 842,394. Furthermore, the rice production using the Combine Harvester is higher than the thresher harvesting machine, which was 5,312 Kg/Ha/MT and 5,089 Kg/Ha/MT, respectively, with a difference of223 kg

Comparative Analysis of Rice Farming using Combine-Harvester and Thresher in Kenagarian Kambang Barat, Lengayang Sub-District, Pesisir Selatan District

The rice harvesting process has progressed a lot. Farmers used to harvest simply using a sickle and a simple thresher machine, while nowadays, they are using the latest harvest machine, called Combine Harvester. Technological developments should enable farmers to gain more significant benefits, such as higher production, a shorter processing time for harvesting, and lower costs incurred during harvesting. This study aims to describe the characteristics of farmers who use Combine Harvester technology and farmers who use Thresher harvesting technology. This study also compares the costs of rice harvesting and production of both farmers in lowland rice farming in Kenagarian Kambang Barat, Lengayang Sub-District, Pesisir Selatan District. The farmers sampling chose as many as 30 farmers purposively for each of those using a Combine Harvester and Thresher, so the total number of farmers to be interviewed was 60. The data analysis method used in this study is the analysis of the average difference test of the independent sample Z-test model. The research finds that farmers' main reasons for using the Combine Harvester were faster harvesting times and less labor. While the main reason for farmers using the Thresher was that its cost is considered the same if using a Combine Harvester machine. Moreover, the research indicates a significant difference in the cost of harvesting and producing rice using both harvesting machines. The harvesting cost of the Combine Harvester was lower than Thresher, which was Rp. 3,543,149 and Rp. 4,385,543 respectively. The difference in harvesting cost of these two harvesting machines was Rp. 842,394. Furthermore, the rice production using the Combine Harvester is higher than the thresher harvesting machine, which was 5,312 Kg/Ha/MT and 5,089 Kg/Ha/MT, respectively, with a difference of223 kg

Intra-Operative Discomfort in Photorefractive Keratectomy

PurposePhotorefractive keratectomy (PRK) remains a viable, safe, and efficacious option for patients wishing to correct refractive errors. One of its most significant drawbacks is pain. While post-operative pain has been well studied with different management options, intra-operative pain has been less well defined. The purpose of this study was to characterize intra-operative pain during PRK in regard to eye operated on, gender, excimer platform used, surgeon, and age.Patients and MethodsA total of 134 patients (264 eyes) were prospectively randomized to undergo bilateral PRK of either the right eye first or the left eye first followed immediately by the fellow eye. In the immediate post-operative period they were surveyed using an 11-point Numeric Rating Scale regarding intra-operative pain or discomfort experienced in each eye. Resultant pain scores were then analyzed via two sample z-test and analysis of variance (ANOVA) to characterize pain overall as well as comparing first versus second eye operated on, right versus left eye, male versus female, excimer platform used, inter-surgeon variability, and age.ResultsOf 264 eyes surveyed the mean pain experienced on a 0–10 pain scale was 1.13 (minimal discomfort). There was no statistically significant difference in pain or discomfort when comparing first versus second eye operated on, right versus left eye, male versus female, excimer platform used, operating surgeon, or age.ConclusionIntra-operative pain or discomfort experienced by patients is minimal. The absence of statistically significant differences in pain scores studied implies that standard of care procedures achieve adequate analgesia in PRK.

OS14.6.A GlioCova: Defining patient safety events for brain tumour patients undergoing neurosurgery

Abstract BACKGROUND Surgery is associated with a risk of adverse events (e.g. venous thrombosis). These have been used to define the OECD Patient Safety Event (PSE) indicators (41 diagnostic codes), but not in the brain tumour population. The GlioCova project uses English linked national cancer data on all 51,775 adult primary brain tumour patients (2013–2018). MATERIAL AND METHODS We identified all glioblastoma patients having surgery for their tumour and noted the 100 most common ICD-10 diagnostic codes within 30 days of surgery, excluding previous medical conditions, brain tumour diagnosis codes and OECD-defined codes. Potential post-surgical complications were reviewed by a group of experienced clinicians. We reviewed these “novel PSE codes” in all brain tumour patients re-admitted after surgery. We looked at the co-occurrence between our novel and OECD codes and combined them to form the final PSE list.Patients readmitted within 30 days were divided into those without codes (“PSE-free”), and those with at least one PSE code during admission or readmission. We examined age, length of stay, in-hospital and 30-day mortality and assessed statistical significance using Welch’s t-test and a two sample Z-test for proportions. RESULTS 29,135 patients underwent neurosurgery, of whom 8,361 (28.7%) were readmitted within 30 days. We identified 32 novel PSE codes. 1,319 (16%) patients had an OECD code, 5,524 (66%) had a novel code, and 2,098 (25%) patients were PSE-free. 83% of patients who had an OECD PSE code also had a novel code. Patients in the PSE group were older (median age = 60 years) than the PSE-free group (57 years). Length of stay was longer in patients who had a PSE after surgery (median = 7 days) and after readmission (5 days) compared with PSE-free after surgery (4 days), at readmission (0 days). More patients died in hospital after readmission in the PSE group (4.7%) compared with no-PSE (2.7%). 30-day mortality after surgery was similar in both groups (2.5% PSE-free, 3.1% PSE group). All differences were highly statistically significant (p&amp;lt;0.0001). CONCLUSION We identified 32 novel patient safety event codes following surgery in the brain tumour population. Patients with these diagnostic codes had an elevated LOS and in-hospital death rate. Using brain tumour specific PSE codes captures many more events than the existing list of OECD codes.

Impact of the new digital competitors on Swiss banking business models

This study examines the impact of new digital-only competitors on the Swiss banking business models and value chain. Despite various studies and articles available in the literature about the impact of new digital competitors on the banking industry, there is little research focusing on the Swiss market. The comprehensive research conducted in this study and the data collected through the survey provides a foundation to gauge the impact of the new digital competitors’ pressure on business models and value chain in the Swiss banking industry. The design of the research instrument employed for collecting the primary data has been achieved through a survey shared with 75 managers and experts working in the Swiss banking industry including Swiss banks, FinTechs, BigTechs, and other financial services and consultancy firms. One sample z-test and descriptive statistics have been applied to the survey results to gain a deeper understanding. The outcome of the analysis suggests that the competitive pressure of BigTechs and FinTechs is expected to have a significant impact on the Swiss banking industry, and mainly BigTechs are anticipated to be significantly dominant with disruptive impact. The obtained results also strongly indicate that the cross-industry ecosystems and close partnerships with the new digital competitors are the potential key strategies to be pursued as the future Swiss banking business models. Besides, the disruptive new market entrants are anticipated to be highly likely to gain significant market share in certain market segments of the banking industry and also to create an “ecosystem” accordingly. The area of Personal and Corporate Banking is found out to be more vulnerable to digital disruption in comparison with the other banking areas.

Intensity of End of Life Care for Hematologic Malignancy Patients in Western Washington, United States and Alberta, Canada

Background: Aggressive care at the end of life (EOL) leads to unnecessary suffering and healthcare costs for patients with cancer. We have previously shown that among patients with solid tumor malignancies, EOL utilization of chemotherapy, intensive care unit (ICU) admissions and &amp;gt;1 emergency department (ED) visits are higher in Washington State vs Alberta (AB). In this study, we use cancer registry and claims data to compare EOL care among patients with hematological malignancies between western Washington (WW) and AB. Methods: Adult patients with hematological malignancies diagnosed between 2007 and 2017 who died before December 31, 2018 were identified from regional population-based cancer registries in WW and AB. Data sources were 1) WW Cancer Surveillance System (a regional SEER registry) with data from 13 counties linked to enrollment files and claims from four regional insurers and 2) Canada National Ambulatory Care Reporting System, Discharge Abstracts Database, and chemotherapy records from AB Health Services. Proportions of patients receiving chemotherapy, ICU admission, or &amp;gt;1 ED visit in the last 30 days of life (DOL) in WW and AB were determined among all patients and those ≥65 years and compared using two sample z-test with two-tailed hypothesis (α=0.006 after Bonferroni correction). Results: 7859 AB and 3767 WW patients met study inclusion criteria. Median age was 76 (IQR 66-83) and 79 (IQR 71-86) for AB and WW, respectively; 78% and 85% were over age 65, 33% and 59% with ≥2 Charlson Comorbidity Score. Cancer distribution was 33% (AB) and 54% (WW) non-Hodgkin lymphoma, 14% (AB) and 20% (WW) myeloma and 27% (AB) and 19% (AB) leukemia. Table 1 shows utilization of chemotherapy, &amp;gt;1 ED visits and ICU admissions in AB and WW for all patients and Table 2 in those ≥65 years. More patients in WW vs AB were treated with chemotherapy (21% WW vs 7% AB) and admitted to ICU (34% WW vs 9% AB) in the last 30 DOL, whereas multiple ED visits were more similar between WW and AB (17% vs 19%, respectively). Similarly, among patients ≥65 years, chemotherapy use and ICU admissions were higher in WW. The same was true for patients in the last 60 and 90 DOL. Conclusions: Similar to what was noted in solid tumor patients, intensity of healthcare use at EOL is greater in WW vs AB for patients with hematological malignancies. However, ≥1 ED visits were similar between populations. Further work is needed to understand drivers of high intensity healthcare use and identify interventions to minimize low value care at EOL. Disclosures Khaki: Merck: Other: share/stockholder; Pfizer: Other: share/stockholder. Ramsey:AstraZeneca: Other: Personal Fees. Cowan:Janssen: Consultancy, Research Funding; Abbvie: Research Funding; Cellectar: Consultancy; Sanofi: Consultancy; Bristol Myers Squibb: Research Funding.

Comorbidity of COVID-19 related Fatalities in Tertiary Care Hospitals of Rawalpindi, Pakistan

Objectives: To assess the COVID-19 associated fatalities with respect to demographics, comorbidity, critical illness, and length of hospital stay in tertiary care hospitals.&#x0D; Subjects &amp; Methods: A retrospective hospital data-based research was done among 216 COVID-19 associated mortalities registered in 4 tertiary care hospitals Holy Family Hospital (HFH), Benazir Bhutto Hospital (BBH), District Head Quarters Hospital (DHQ) and Rawalpindi Institute of Urology &amp; Transplantation (RIU &amp; T) affiliated with Rawalpindi Medical University from 29th March-15th June 2020. The data was gathered by consecutive sampling pertinent to demographics, hospital stay, comorbidity, critical illness, and ventilator or oxygen support. The length of hospital stay among fatalities with and without comorbidity was compared by an independent sample z-test. Data were analyzed by using SPSS version 25.0.&#x0D; Results: Of the total 216 COVID-19 related mortalities, 150(69.4%) were males and 66(30.6%) were females. The mean age of fatalities was 55.66 ± 13.97 years. About 76.7% of dying males were 41-70 years old while 56.1% of females dying of COVID-19 were 41-60 years old. Most (60.8%) of study subjects had hypertension followed by diabetes (53.8%), Ischemic Heart Disease (17.5%), and respiratory disorders (12.3%). About 75% of the critically ill patients needed a ventilator for respiratory support. Length of hospital stay was determined to have a statistically insignificant association (P &gt; 0.10) with the presence or absence of comorbidity among COVID-19 patients. Critical illness had a highly significant association (P &lt; 0.000) with ventilator support among COVID-19 related mortalities.&#x0D; Conclusion: People 41-70 years should preferably adopt stringent precautions for protection against COVID-19. Comorbid states chiefly hypertension, diabetes, cardiac and respiratory diseases need special consideration amid COVID-19 pandemic to abstain from adverse health outcomes.