Score Range Research Articles

Enterprise risk management and supply chain management: The mediating role of competitive advantage and decision making in improving firms performance

The complexity of risk management and supply chain optimization in the business context, especially in financial institutions such as banking, highlights several factors that require special attention. In the banking sector, where risk and operational smoothness are crucial, risk management and supply chain optimization play pivotal roles in maintaining stability and competitiveness. The objective of this research is to explore the extent to which the implementation of ERM (Enterprise Risk Management) and SCM (Supply Chain Management) can create a competitive advantage, influence decision-making, and ultimately impact company performance. The research methodology employed is quantitative. Data collection was conducted through the distribution of Likert-scale questionnaires with a score range from 1 to 5. The sample selection process utilized random sampling techniques, involving managers and staff working in State-Owned Enterprises (SOE/BUMN) in Indonesia. The study analyzed 263 samples, with data collected from February 2023 to June 2023. Structural Equation Modeling (SEM) with SmartPLS software facilitated data analysis. The results indicate that ERM significantly influences competitive advantage and decision-making, but it does not directly impact company performance. Similarly, SCM has a significant positive impact on competitive advantage and decision-making but does not directly affect company performance. Competitive advantage, in this study, did not prove to enhance firm performance or act as a mediator connecting ERM and SCM to company performance. However, decision-making significantly influences company performance and serves as a significant mediator in the relationship between ERM and SCM concerning company performance.

Arthroscopic Rotator Cuff Repair With Superior Capsule Reconstruction for Irreparable Supraspinatus Tears

Background: Irreparable rotator cuff tears represent approximately 12% of all presenting cuff tears, and multiple surgical techniques have been described for treatment, including allograft/bridge augmentation, debridement, partial repair, subacromial balloon, tendon transfer, and superior capsule reconstruction (SCR). SCR has demonstrated durable improvement in range of motion (ROM) and outcome scores at 2 and 5 years. Indications: Surgical indications for SCR include an irreparable tear of the supraspinatus and/or infraspinatus with a preserved or reparable subscapularis and preserved glenohumeral joint cartilage. Technique Description: Diagnostic arthroscopy is performed to identify and characterize the rotator cuff tear. Thorough debridement of the greater tuberosity is performed. Two all-suture FiberTak anchors are placed in the superior aspect of the glenoid. Two 2.6-mm FiberTak suture anchors are placed in the humeral head at the chondral margin. After measuring, the dermal allograft is cut to size with 15-mm overhang left on the far lateral edge. A 12-mm passport cannula is inserted laterally and the sutures from the glenoid and humeral head anchors are brought out through the cannula maintaining their position and orientation. The sutures are passed through the graft outside the cannula. The graft is introduced into the shoulder via the passport cannula with a back grasper. A cannula-in-cannula technique is used to tie the glenoid anchors first and then the medial row anchors. Two lateral row swivel lock anchors are used to complete a standard double row repair. Margin convergence is performed between the dermal allograft and remaining rotator cuff anterior and posterior. Postoperatively, patients are kept in a sling for 6 weeks, with no shoulder ROM. From weeks 6 to 12, patients discontinue sling and begin passive progression to active ROM. Strengthening is initiated at 12 weeks, and return-to-sport or work is at approximately 6 months. Results: Irreparable rotator cuff tears treated with arthroscopic rotator cuff repair and SCR show durable improvement in patient-reported outcomes at 2 and 5 years. Re-tear rates did not differ between athletes and non-athletes. Discussion/Conclusion: Arthroscopic rotator cuff repair with SCR is a durable and reliable surgical option for patients presenting with preserved glenohumeral joint and irreparable supraspinatus and/or infraspinatus tear. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Improving diabetes disease patients classification using stacking ensemble method with PIMA and local healthcare data

Diabetes mellitus, a chronic metabolic disorder, continues to be a major public health issue around the world. It is estimated that one in every two diabetics is undiagnosed. Early diagnosis and management of diabetes can also prevent or delay the onset of complications. With the help of a variety of machine learning and deep learning models, stacking algorithms, and other techniques, our study's goal is to detect diseases early. In this study, we propose two stacking-based models for diabetes disease classification using a combination of the PIMA Indian diabetes dataset, simulated data, and additional data collected from a local healthcare facility. We use both the classical and deep neural network stacking ensemble methods to combine the predictions of multiple classification models and improve classification accuracy and robustness. In the evaluation protocol, we used both the train-test and cross-validation (CV) techniques to validate our proposed model. The highest accuracy is obtained by stacking ensemble with three NN architectures, resulting in an accuracy of 95.50 %, precision of 94 %, recall of 97 %, and f1-score of 96 % using 5-fold CV on simulation study. The stacked accuracy obtained from ML algorithms for the Pima Indian Diabetes dataset is 75.03 % using the train-test split protocol, while the accuracy obtained from the CV protocol is 77.10 % on the stacked model. The range of performance scores that outperformed the CV protocol 2.23 %–12 %. Our proposed method achieves a high accuracy range from 92 % to 95 %, precision, recall, and F1-score ranges from 88 % to 96 % using classical and deep neural network (NN)-based stacking method on the primary dataset. The proposed dataset and ensemble method could be useful in the early detection and treatment of diabetes, as well as in the advancement of machine learning and data analysis techniques in the healthcare industry.

Genomic analysis of hypoxia and mitophagy related genes with prognosis and characterization of the immune microenvironment in LUAD.

Background: Lung adenocarcinoma (LUAD) stands as a prominent subtype within the realm of non-small cell lung cancer and constitutes a primary contributor to cancer-related mortality on a global scale. Notably, hypoxia, a prevalent attribute within solid tumor environments, and mitophagy, a selective manifestation of autophagy dedicated to the removal of damaged mitochondria, have risen to prominence as pivotal factors influencing the initiation and advancement of tumorigenesis. Methods: This investigation harnessed publicly accessible genomic datasets encompassing LUAD patients to delineate genes linked to hypoxia and mitophagy, termed hereafter as hypoxia and mitophagy-related genes (HMRGs). Large-scale repositories furnished both gene expression profiles and clinical particulars. The expression profiles of HMRGs were meticulously scrutinized across 1,093 LUAD specimens, leveraging resources such as The Cancer Genome Atlas and Gene Expression Omnibus datasets. A methodical exploration of HMRG patterns within LUAD led to the discernment of two distinct molecular subtypes. Moreover, a discernible correlation emerged between the subtypes and their respective clinical attributes. A risk scoring system was formulated to prognosticate overall survival (OS) and therapeutic responsiveness in LUAD patients. Subsequently, the reliability of this scoring system was authenticated, and a nomogram was adopted to refine the clinical utility range of the risk score. The proliferation and migration impacts of KRT8 on LUAD cells were evaluated through cck8 assays, edu assays, and transwell assays, the results were further validated in vivo. Results: Elevated risk scores were indicative of unfavorable OS probabilities. Furthermore, these risk scores exhibited associations with immune checkpoints and chemotherapeutic drug sensitivity. Collectively, our exhaustive analysis of HMRGs in LUAD patients unveiled their conceivable participation in configuring the multifaceted tumor microenvironment, encompassing clinicopathological attributes and prognosis. A sequence of experiments illuminated the pro-proliferative and pro-migratory attributes of KRT8 in vitro and vivo, thus underscoring its carcinogenic potential. Conclusions: In this study, we have unearthed innovative gene signatures tethered to HMRGs, which harbor prognostic implications concerning patient outcomes. These insights hold potential for steering the development of targeted therapeutic modalities tailored for LUAD.

Early Diagnosis of Neonatal Sepsis Using the Leukocyte Alkaline Phosphatase Score: A Cohort Study

Introduction: The clinical features of sepsis in neonates are subtle and non specific, requiring a high index of suspicion for early diagnosis. Blood culture is the gold standard for diagnosis, but it is time consuming. Therefore, there is a need for a costeffective and reliable screening tool. The Leukocyte Alkaline Phosphatase (LAP) activity of neutrophils is known to increase during bacterial infections in adults. Aim: To determine the activity of LAP in Neonatal Sepsis (NS) and compare the results with blood culture. Materials and Methods: This is a prospective cohort study conducted from January 2018 to June 2019 at Mandya Institute of Medical Sciences, Karnataka, India. Total of 200 neonates by their haematological profile were clinically suspected of having sepsis. A peripheral smear was prepared from a drop of blood and stained to assess the LAP activity. In each smear, a total of 100 consecutive segmented neutrophils were examined and were rated from 0 to 4 according to the red granular precipitate intensity within their cytoplasm. The possible range of 0-400. The blood culture report was obtained from the case sheet. The neonates were divided into two groups: Group 1 consisted of culture-proven sepsis cases, and Group 2 consisted of neonates with clinical suspicion of sepsis but negative blood culture results. Descriptive analysis was performed using mean and standard deviation for quantitative variables, and frequency and proportion for categorical variables. Chi-square test was conducted, and a p-value <0.05 was considered statistically significant. Results: Out of the 200 cases studied, 64 neonates showed a positive blood culture. The most common causative organism observed was Klebsiella pneumoniae, which was seen in 56 neonates. The age of the neonates ranged from newborn to 28 days old, with 115 being male. Furthermore, 116 neonates were term neonates, and 146 presented with early onset sepsis. The study revealed a wide range of LAP activity in both groups. In the culture-positive sepsis group, the LAP activity ranged from 36 to 350, while in the clinical sepsis group, it ranged from 10 to 354. Due to the broad range of LAP scores observed, it is concluded that LAP activity is not useful as a screening test. Conclusion: Findings of the present study indicate that LAP activity exhibited a wide range in both the culture-proven and clinical sepsis groups. However, due to this variability, LAP activity does not appear to be a reliable screening test for NS. While LAP activity assessment may still hold diagnostic value, further research is needed to refine its utility and explore its clinical relevance.

Comparison of ensemble‐based data assimilation methods for sparse oceanographic data

AbstractProbabilistic forecasts in oceanographic applications, such as drift trajectory forecasts for search‐and‐rescue operations, face challenges due to high‐dimensional complex models and sparse spatial observations. We discuss localisation strategies for assimilating sparse point observations and compare the implicit equal‐weights particle filter and a localised version of the ensemble‐transform Kalman filter. First, we verify these methods thoroughly against the analytic Kalman filter solution for a linear advection diffusion model. We then use a nonlinear simplified ocean model to do state estimation and drift prediction. The methods are rigorously compared using a wide range of metrics and skill scores. Our findings indicate that both methods succeed in approximating the Kalman filter reference for linear models of moderate dimensions, even for small ensemble sizes. However, in high‐dimensional settings with a nonlinear model, we discover that the outcomes are significantly influenced by the dependence of the ensemble Kalman filter on relaxation and the particle filter's sensitivity to the chosen model error covariance structure. Upon proper relaxation and localisation parametrisation, the ensemble Kalman filter version outperforms the particle filter in our experiments.

Assessment of awareness and knowledge regarding nuclear medicine and appropriate use of Nuclear medicine modalities, among medical students and faculty members in two academic medical institutes in North India: A Cross sectional Study.

Despite significant progress in the field of nuclear medicine, basic nuclear medicine awareness and understanding among clinicians remains unsatisfactory, leading to under utilization of nuclear medicine modalities. To evaluate the awareness and knowledge regarding nuclear medicine and appropriate use of Nuclear medicine modalities, among medical students and faculty members. In this descriptive cross sectional study, a self timer limited objective questionnaire based on Google forms was distributed to the study population and scores obtained by the participants were analyzed. Percent scores range for intern, residency trainees, and senior resident/faculty groups for general awareness were 16-46%, 37-58% and 62-91% and for knowledge and appropriate use were 7-21%, 28-43%, and 35-85% respectively. Overall, 61% of the participants had poor awareness and knowledge regarding nuclear medicine modalities. None of the participants had received nuclear medicine exposure or education during their academics or training. Only 49% of the participants considered utilizing nuclear medicine modalities for their patient management. Undergraduate interns and residency trainees had a poor to fair level of awareness and knowledge regarding nuclear medicine. Hence creating more awareness in early stages of their career by incorporating Nuclear medicine basic education in medical undergraduate curriculum is required. The senior residents/faculty members had a moderate to good level of awareness and knowledge but still improvement in their knowledge would lead to a more appropriate and better utilization of nuclear medicine modalities for optimum patient management in a variety of clinical settings.

Investigation of Cnidium monnieri compounds as phosphodiesterase-5 antagonists in erectile dysfunction via molecular docking and dynamic simulation

This study aimed at evaluating the inhibitory potential of bioactive compounds from C. monnieri and predicting lead compounds for achieving and maintaining penile erection through computational models. A total of 79 compounds were retrieved for the plant through public repositories, phosphodiesterase-5 (PDE-5) was retrieved from the data bank for proteins (PDB). The molecular docking, free binding energy calculation, pharmacophore modeling and molecular dynamic simulation were performed using Schrodinger suite (2017–1). The quantum chemical calculation was also carried out with Spartan 14 computational software. Among the 79 compounds virtually screened against Phosphodiesterase-5 (PDE-5), eight (8) bioactive compounds showed potent antagonist against PDE-5 with varying binding scores comparable to that of Sildenafil (co-crystalized ligand). Monnieriside (−10.625 kcal/mol), Diosmetin (−10.041 kcal/mol and Isogosferol (−10.038 kcal/mol) were observed to have the best docking score comparable with Sildenafil (−11.872 kcal/mol). The fitness score range of 0.982–1.941 confirmed the validation of the docking scores using e-pharmacophore hypothesis. The result of the MD simulation reveals better stability of hit compound-protein complex (Monnieriside A-PDE-5) compared with the Sildenafil-PDE-5 complex. None of the hit compounds violated more than one rule of five and within the reference range for pharmacokinetics parameters. The quantum mechanics estimation revealed the hit molecules possess proton accepting and donating potential therefore, possess antagonistic potential. Based on the results from this study, the three top binding compounds may be predicted as potent inhibitors of PDE-5 and could use as lead compound for discovery of potent drugs for erectile dysfunction.

Persepi Masyarakat terhadap Pemerian Modal Usaha oleh Bumdes Bandem Jagathita dalam Upaya Pengentasan Kemiskinan di Desa Bebandem

This study aims to find out (1) public perception in terms of the perceptual actor dimension, (2) public perception in terms of the perceived object dimension (3) public perception in terms of the context dimension of the perceived situation regarding the provision of business capital by BUMDes Bandem Jagathita in an effort to alleviate poverty in the Bendadem Village. The present study employed a descriptive research design, utilizing a quantitative approach. The study focuses on the population of the village community in Bebandem who have access to business capital. The research sample for this study was determined using a saturated or census sampling technique, consisting of a total of 68 respondents. The employed data collection methodology entails the utilization of a questionnaire. The data analysis technique employed in this study is descriptive analysis. The findings of this research demonstrate that: (1) The public perception, as measured by the dimensions of the perpetrators of perception, achieved a score of 2,821 within the score range of 2,570 – 3,060. This score falls under the category of “strongly agree.” (2) The perception of the general public regarding the dimensions of the object, which is associated with a score of 600, falls within the range of scores 571 to 680, and is classified as “strongly agree.” (3) the public's perception in terms of the situational context dimension obtained a score The score of 1.203 falls within the range of scores from 1.142 to 1.360, and it has been classified as “strongly agree.

PENGEMBANGAN MEDIA PUZZLE GEOMETRI DATAR BERBASIS KEARIFAN LOKAL DI SEKOLAH DASAR

This research aims to determine the validity of puzzle media and the feasibility of mathematical puzzle media based on local wisdom in flat shape material in class IV in elementary schools and to find our student’s responses to the use of local wisdom based mathematical puzzle media in flat shape material in class IV elementary school. This research ures the ADDIE model research method which consists of five development stages, namely: analysis stage, design stage, development stage, impelementation stage and evaluation stage. The field trial was carried out in class IV of SDN 2 Korleko Selatan with 12 students as respondents. The data obtained in the research are qualitative and quantitative data. Data collection instruments include validation sheets and student response questionnaires. The results include: in media expert validation, they obtained a total score of 50, with an average score of 3.66 with good categories/criteria in the score range and 40.8 < 54, with and average score of 4.15 in the good category which is in the score range of 47, 58 58,74 in the good category. Therefore, the resulting learning media is suitable for use to obtain data in field trials. Based on the results of student responses carried out during field trials, the results of student response questionnaire on learning media had a total score of 700, indicating good students responses with an average of 47,58 X 58,7. in the good category.

Basic life support knowledge among nurses at public health center in rural Banten Province, Indonesia

Background: Public Health Center (PHC) is one of the primary healthcare facilities that has an important role in the chain of survival of out-of-hospital cardiac arrest (OHCA) patients, especially in rural areas. Nurses are an important component of health workers in PHC. Basic Life Support (BLS) knowledgeis the basic component of building a qualified resuscitation.Purpose: To analyze the relationship between demographic characteristics of PHC’s nurses in a rural area and their knowledge about BLS.Method: An observational analytical study with a cross-sectional approach involved 32 PHC nurses with total sampling techniques. The data was analyzed with the Spearman Rho and Fisher Exact test.Results: 32 nurses were involved. Most respondents are male (18/56.25%), have a Diploma educational background (23/71.88%), and non-government employees (24/75%). The average age of respondents was 34.75 years, and the average worked for 9.25 years. The level of knowledge of BLS was mostly more than 56% (25/78.1%). The knowledge average was 74.06+ 8.93 with a median of 75 anda score range of 50-85. Gender, educational background, BLS certificate upgrades, and employment status were not related to the level of knowledge of BLS. Age and length of work variables have a significant correlation with knowledge. Calculated rs was -0.043 with a p-value of 0.008 (α 0.05) for age and rs value of -0.353 with a p-value of 0.024 (α 0.05) for length of work.Conclusion: Gender, educational background, BLS certificate upgrades, and employment status were not related to the level of knowledge of BLS.There is a sufficient and significant relationship between the age and length of workwith knowledge of BLS with the opposite direction of the relationship.The older and longer a nurseworks, the lowerthe nurse’s knowledge of BLS. Routine BLS training sessions or emergency drills in PHC both online and offline can be some solution in partnership with emergency organizations and nearby referral hospitals.

Machine Learning Based Weed Detection System

This abstract underscores the importance of weed detection in crop cultivation to prevent plant diseases and minimize crop losses. To address these challenges and promote eco-friendly practices, the authors propose a weed detection program employing K-Nearest Neighbors, Random Forest, Decision Tree algorithms, and the YOLOv5 neural network. The abstract also provides a concise overview of existing research in weed identification using machine learning and deep learning. The authors developed a YOLOv5-based weed detection system and evaluated the performance of the algorithm, showing traditional classifiers achieve accuracies of 83.3%, 87.5%, and 80%, while the neural network scores range from 0.82 to 0.92 for each class. The study demonstrates the effectiveness of this approach in classifying low-resolution weed images.

The Revised Hearing Handicap Inventory and Pure-Tone Average Predict Hearing Aid Use Equally Well.

This study aimed to (a) compare the Revised Hearing Handicap Inventory (RHHI) and pure-tone average (PTA) in their abilities to predict hearing aid use and (b) report the optimal cut-point values on the RHHI and PTA that predict hearing aid use. Participants were from a community-based cohort study. We evaluated the ability of the RHHI and PTA as (a) continuous variables and (b) binary variables characterized by the optimal cut point determined by the Youden Index to predict hearing aid use. RHHI scores range from 0 to 72, and PTA was defined as averaged thresholds at frequencies 0.5, 1.0, 2.0, and 4.0 kHz in the worse ear. We used logistic regression models and receiver operating characteristic curves with corresponding concordance statistics (c-statistics) and 95% confidence intervals (CIs) to determine the predictive ability of models and chi-square tests to determine whether c-statistics were significantly different. This study included 581 participants (Mage = 72.9 [SD = 9.9] years; 59.9% female; 14.3% Minority race). The c-statistics for the RHHI (0.79, 95% CI [0.75, 0.83]) and PTA (0.81, 95% CI [0.78, 0.85]), as continuous variables, were not significantly different (p = .25). The optimal cut points for the RHHI and PTA to predict hearing aid use were 6 points and 32.5 dB HL, respectively. The c-statistics for the RHHI (0.72, 95% CI [0.68, 0.76]) and PTA (0.75, 95% CI [0.71, 0.79]), as binary variables, were not significantly different (p = .27). The RHHI and PTA are similar in their ability to predict hearing aid use.

Development of the Rapid Cough Questionnaire: Key item identification

BackgroundThe Leicester Cough Questionnaire (LCQ) is a reliable tool for measuring the multidimensional impact of cough on patients’ quality of life; however, its scoring algorithm is lengthy and complex for routine clinical use. ObjectiveThe study aimed to develop a simplified version of the LCQ, the Rapid Cough Questionnaire (RCQ), as a substitue in clinical practice and validate the RCQ using an independent cohort. MethodsTo select items for the RCQ score, a correlation network was used to determine the items from each domain that were strongly correlated with the total LCQ score. The final items for the RCQ were selected on the basis of the centrality of the node degree, betweenness, and closeness in the correlation network. ResultsThe RCQ score was derived from 3 items: tiredness (LCQ3) in the physical domain, the feeling of being fed up (LCQ13) in the psychological domain, and annoyance with partner/family/friends (LCQ19) in the social domain. The correlation between the LCQ and RCQ was high, with a coefficient of 0.93 (P < .001). The mean score of the RCQ was 11.2 ± 3.2, with scores ranging from 5.15 to 19.55. The minimal clinically important difference in the RCQ score was calculated to be 1.6 using a distribution-based method. The concurrent validity of the LCQ and the RCQ with cough numeric rating scale was similar. In the validation cohort, the correlation between the LCQ and RCQ scores was consistent regardless of sex and etiology. ConclusionThe RCQ score, which is concise, reliable, and valid, can be a valuable tool for patient assessment, particularly in clinical practice.

The knowledge and attitude on the prevention of pressure ulcers in Chinese nurses: A cross-sectional study in 93 tertiary and secondary hospitals.

Although pressure ulcers are related to substantial health burdens, they may be preventable. Since nurses play a fundamental role in pressure ulcer prevention, their knowledge and attitude are of great importance. This study aims to investigate the current situation and associated factors of nurses' knowledge and attitude on the prevention of pressure ulcers from both tertiary and secondary hospitals. A total of 11 347 nurses were recruited including 7108 nurses (62.6%) from tertiary hospitals and 4239 nurses (37.4%) from secondary hospitals. The median (interquartile range) of the pressure ulcer knowledge score was 51% (38%, 90%) for all the participants with the lowest scores on prevention of pressure ulcers (51.33%). The mean (standard deviation) of attitude towards pressure ulcer prevention was 39.64 (4.65) with the lowest scores on personal competency to prevent pressure ulcers (mean 3.09). The results of multivariate linear regression showed that hospital level, nurses' age, years of work experience, initial education level at work and time of last training significantly associated with nurses' knowledge of pressure ulcer prevention. Meanwhile, hospital level, job title, previous training, time of last training and subjective needs for further training had significant association with nurses' attitude towards pressure ulcer prevention (all p < 0.05). Results showed inadequate knowledge but relative positive attitudes in nurses indicating the importance to deliver continuing education and training regarding pressure ulcer prevention in practice to improve the quality of care.

Systematic Literature Review: Ability of the IBDQ-32 to Detect Meaningful Change in Ulcerative Colitis Health Indicators.

Previous reviews produced weak evidence regarding the responsiveness of the Inflammatory Bowel Disease Questionnaire (IBDQ-32) to changes in ulcerative colitis (UC) health indicators. This systematic review and meta-analysis provide an updated synthesis on IBDQ-32 responsiveness. A systematic literature review identified 11 articles reporting IBDQ-32 responder analyses in randomized control trials, which were included in a random effects meta-analysis, and 15 articles linking IBDQ-32 change to change in UC health indicators, which were summarized narratively. Meta-analysis compared differences between IBDQ-32 responder proportions in efficacious and nonefficacious treatment arms relative to placebo. Linear meta-regression examined the association of treatment efficacy and proportions of IBDQ-32 responders in active treatment compared with placebo. Meta-analysis showed larger differences in IBDQ-32 response proportions between active treatment and placebo for efficacious treatments (pooled OR, 2.19; 95% CI, 1.83-2.63) than nonefficacious treatments (pooled OR, 1.21; 95% CI, 0.84-1.74; Cochran's Q[df = 1] = 8.26, P = .004). Meta-regression showed that the magnitude of treatment efficacy positively predicted IBDQ-32 response in active treatments relative to placebo (β = 0.21, P < .001). Moderate to strong correlations were found between change in IBDQ-32 and change in health indicators (eg, patient-reported measures, disease activity, endoscopic indices; correlations, 0.37-0.64 in absolute values). Patients achieving clinical response or remission showed greater change in IBDQ-32 total scores (range, 22.3-50.1 points) and more frequently met clinically meaningful thresholds on the IBDQ-32 than those not achieving clinical response or remission (all P < .05). The IBDQ-32 is responsive to changes in UC health indicators and disease activity, including in response to efficacious treatment (relative to placebo).

Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials

ObjectivesRobotic knee arthroplasty procedures have emerged as a new trend, garnering attention from orthopedic surgeons globally. It has been hypothesized that the use of robotics enhances the accuracy of prosthesis positioning and alignment restoration. The objective of this study was to provide a high-level, evidence-based comparison between robotic total knee replacements and conventional methods, focusing on radiological and functional outcomes.MethodsWe searched five databases from their inception until June 1, 2022, specifically targeting randomized controlled trials (RCTs) that compared the outcomes of robotic and conventional total knee replacements. We were interested in outcomes such as knee range of motion, clinical and function knee society scores, the Western Ontario and McMaster University score (WOMAC), the Hospital of Special Surgery score, complications, and radiological alignment. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guidelines. We assessed the risk of bias using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2).ResultsOur search returned seven RCTs suitable for our analysis, which included a total of 1942 knees; 974 of these knees were implanted using robotic arms while the remaining 968 utilized jig-based knee systems. Our findings indicated that robotic knees had significantly better post-operative anatomical (OR − 0.82; 95% CI, − 1.027 to − 0.58, p value < 0.00001) and mechanical restoration (OR − 0.95; 95% CI, − 1.49 to − 0.41, p value < 0.0006). While knee range of motion (OR − 2.23; 95% CI − 4.89–0.43, p value 0.1) and femoral prosthesis position (OR − 0.98; 95% CI, − 2.03–0.08, p value 0.07) also favored robotic knees, these differences did not reach statistical significance. Both clinical and functional outcomes, as well as the rate of complications, were found to be statistically similar between the groups undergoing robotic and traditional knee replacement surgeries.ConclusionThis meta-analysis indicates that robotic total knee replacements offer superior post-operative anatomical and mechanical alignment compared to conventional total knee replacements. Despite this, clinical and functional outcomes, as well as complication rates, were similar between the two. These findings should be considered in light of potential confounding factors. More randomized controlled trials with the latest robotic systems are needed to confirm any superior functional and clinical outcomes from robotic-assisted surgeries.Level of evidenceI.

Kualitas hidup terkait kesehatan gigi dan mulut pada anak prasekolah di Batam

Background: The high number of dental and oral health problems in preschool children, such as dental caries, can indirectly interfere with children's development and daily activities. This situation will affect children's Oral-Health Related Quality of Life (OHRQoL) up to his family. Objective: Defines the quality of life related to dental and oral health at Nabilah Kindergarten in Batam City District. Methods: This research is a descriptive observational study with a cross-sectional design to describe the Oral-Health Related Quality of Life at Nabilah Kindergarten in Batam City District. The research was conducted by distributing ECOHIS questionnaire sheets consisting of 13 question items to 79 mothers of Nabilah Kindergarten students in Batam City District. Respondents filled out the informed consent and ECOHIS questionnaire sheets. The assessment of Oral-Health Related Quality of Life in the questionnaire is divided into four categories, namely good, sufficient, bad, and very bad. The score of each respondent's answer is added up and then adjusted based on the score range of the ECOHIS questionnaire. Results: The results showed that Oral-Health Related Quality of Life in the children impact section was in the good category 68.4%, sufficient 29.1%, bad 2.5%. Meanwhile, the family impact section was 58.2% good, 35.4% sufficient, and 6.3% bad. Conclusion: Oral-Health Related Quality of Life at Nabilah Kindergarten in Batam City District tends to be in the good category.

USABILITY TESTING OF THE PACE APP TO SUPPORT FAMILY CAREGIVERS IN MANAGING PAIN FOR PEOPLE WITH DEMENTIA

Abstract Pain is a common symptom in older adults with Alzheimer’s Disease and Related Dementias (ADRD). It is difficult to assess and is often undertreated in people with ADRD. The PACE-app (Pain Control Enhancement application, was developed to enhance self-efficacy of family caregivers when controlling the pain of their care partner. The objective of this study was to test the usability of the PACE-app with family caregivers and clinicians. We evaluated the usability of the PACE-app. Participants (17 family caregivers, 6 clinicians) took part in a mixed-methods study that included a one-time recorded zoom meeting with standardized semi-structured guided review, interview, and a survey specific to their role. The Post-Study System Usability Questionnaire (PSSUQ) was used to measure usability. The overall PSSUQ score we found was 1.9. The range of scores can be between 1 and 7 with the lower numbers meaning favorable usability. The qualitative interviews showed a favorable user experience with 75% of all participants feeling the overall design was effective; 48% felt the tailored pain management strategies were useful; 24% suggested improving the app by having direct coaching information for the family caregiver. This study demonstrated favorable usability with those who tested the PACE-app. Suggestions for improvement were given and using the interview results in conjunction with the PSSUQ scores, we are able to make changes to the app interface to impact the overall design to enhance user experience.

CORRELATES OF PHYSICIAN TRUST: DEMOGRAPHIC FACTORS AND EXPERIENCES OF MEDICAL CARE DISCRIMINATION

Abstract Lack of trust between older adults and their physicians may decrease adherence to medication or limit disclosure of information to healthcare providers. Trust may be shaped in part by demographic factors as well as previous experiences of discrimination in healthcare. We hypothesized that more experiences of discrimination in a medical care setting would be negatively associated with general physician trust. We used cross-sectional data from a follow-up visit (2013-2016) of the national REasons for Geographic and Racial Differences in Stroke (REGARDS) longitudinal cohort study. Our sample included participants who completed an 11-item general physician trust measure (score range=11-55) and a four-point item about discrimination in medical care settings (n=8,235, age 52-98, 31% Black, 45% men). We examined two sequential linear regression models with trust as the outcome, with the first model including demographic factors and the second adding discrimination in a medical setting. Female gender (β=-0.09, p&amp;lt;.05), Black race (β=-0.03, p&amp;lt;.05), and higher level of education (β=-0.8, p&amp;lt;.05) were each related to lower trust. Higher income (β=0.04, p&amp;lt;.05) and older age (β=0.12, p&amp;lt;.05) were associated with higher trust. Perceived discrimination had a negative association with physician trust (β=-0.14, p&amp;lt;.05) and the relationship between Black race and trust reversed direction and was no longer statistically significant (β=0.20, p=.298) with discrimination in the model. The potential impact of previous discrimination experiences in a medical care setting on physician trust should be considered when providing healthcare services to diverse populations of older adults.