Shapiro-Wilk Research Articles

Towards sustainable development in the European Union: a critical raw materials perspective

Sustainability is a key goal of the European Union, which is seen as a global leader of change in tackling climate change, as well as building green economic sustainability, leading to greater social prosperity. A milestone of sustainable development to support the European Union in achieving climate neutrality is the European Green Deal. Its initiatives aim to build a competitive and innovative EU economy while respecting and protecting the environment. According to current priorities, the European Union aims to become the first climate-neutral continent by 2050, thanks to critical raw materials. The purpose of this article is to analyse and assess the impact of critical raw materials on the sustainability of the European Union. The study uses a scoping review methodology and statistical analysis based on the Shapiro-Wilk test and Spearman correlation coefficient. The results show that critical raw materials are important for achieving sustainable development and implementing the EU economy towards climate neutrality. This paper contributes to the literature on sustainability. It can also provide important information for policymakers to understand how to shape green policies in the context of the strategic importance of critical raw materials in the transformation of an eco-innovative economy.

Effect of various surface coating methods on surface roughness, micromorphological analysis and fluoride release from contemporary glass ionomer restorations.

To evaluate the effect of various surface coating methods on surface roughness, micromorphological analysis and fluoride release from contemporary resin-modified and conventional glass ionomer restorations. A total of 72 permanent human molars were used in this study. The teeth were randomly assigned into 2 groups according to type of restorative materials used; resin modified glass ionomer cement and conventional glass ionomer (SDI Limited. Bayswater Victoria, Australia). Each group was subdivided into 3 subgroups according to the application of coat material; Sub-group1: without application of coat; Sub-group2: manufacturer recommended coat was applied and sub-group3: customized (vaseline) coat was applied. Each group was then subdivided into two divisions according to the time of testing; immediate (after 24h) and delayed (after 6 months of storage). Three specimens from each sub-group were selected for surface roughness test (AFM) and another 3 specimens for the micromorphological analysis using scanning electron microscope (SEM). For the fluoride release test, a total of 60 cylindrical discs were used (n = 60). The discs were randomly split into 2 groups according to type of restorative materials used (n = 30); resin modified glass ionomer cement and conventional glass ionomer. Each group was subdivided into 3 subgroups (n = 10) according to the application of the coat material; Sub-group1: without application of coat; Sub-group2: with the manufacturer recommended coat and sub-group3: with application of customized (vaseline) coat. Data for each test was then collected, tabulated, were collected, tabulated, and tested for the normality with Shapiro-Wilk test. Based on the outcome of normality test, the significant effects of variables were assessed using appropriate statistical analysis testing methods. Regarding the data obtained from surface roughness test, Shapiro-Wilk test showed normal distribution pattern of all values (p > 0.05). Accordingly, Two-way ANOVA outcome showed that the 'type of restoration' or 'test time' had statistically significant effect on the AFM test (p < 0.05). Regarding Fluoride specific ion electrode test 2-way ANOVA followed by Least Significant Difference (LSD) Post-hoc test revealed significant difference among the groups (p < 0.05). It showed that SDI GIC group after 14 days of measurement had the highest mean of fluoride release (36.38 ± 3.16 PPM) and SDI RMGIC after 30 days of measurement had the second highest mean of fluoride release (43.28 ± 1.89 PPM). Finally, regarding the micromorphological analysis using SEM, a slight difference was observed between the studied groups. Based on the results of this study, various coatings enhance surface roughness in the initial 24h of restoration insertion. Different coat types seems that have no influence on fluoride release and the micromorphological features of the restoration/dentin interface.

Evaluation and comparison of the effects of a new paste containing 8% L-Arginine and CaCO3 plus KNO3 on dentinal tubules occlusion and dental sensitivity: a randomized, triple blinded clinical trial study

BackgroundDentin hypersensitivity, often occurring after dental treatments or from erosive lesions, is a prevalent patient complaint. This study introduces a paste combining 8% L-arginine, calcium carbonate, and potassium nitrate to evaluate its impact on dentinal tubules occlusion, dentin permeability, and tooth sensitivity.MethodsDentin surfaces from 24 third molars (thickness: 2 mm) were divided into two groups of 12. One received the experimental paste, while the other received a placebo without desensitizer. Permeability and sealing ability were assessed through scanning electron microscopy (SEM) and dentin permeability measurement. The pastes’ effects on hypersensitivity were then examined in a triple-blind, randomized parallel-armed clinical trial with 16 eligible patients. Sensitivity to cold, touch, and spontaneous stimuli was recorded using the VAS scale at various intervals post-treatment. Statistical analysis was conducted using Shapiro-Wilk, Mann-Whitney U, Friedman, and Wilcoxon tests (α = 0.05).ResultsThe permeability test demonstrated a significant reduction in dentin permeability in the experimental group (P = 0.002) compared to the control (P = 0.178). SEM images revealed most dentinal tubules in the intervention samples to be occluded. Clinically, both groups showed a significant decrease in the three types of evaluated sensitivity throughout the study. However, no significant difference in sensitivities between the two groups was observed, with the exception of cold sensitivity at three months post-treatment (P = 0.054).ConclusionThe innovative desensitizing paste featuring 8% L-arginine, calcium carbonate, and potassium nitrate effectively occluded dentinal tubules and reduced dentin permeability. It mitigated immediate and prolonged dentin hypersensitivity to various stimuli, supporting its potential role in managing dentin hypersensitivity.Trial registrationhttp://irct.ir: IRCT20220829055822N1, September 9th, 2022.

3D Printer-Assisted Layered Fabrication of a Novel Appliance for Oral Myofunctional Therapy and Functional Evaluation of Its Effects on Orofacial Muscles During Wear.

Aim Balanced function of the orofacial muscles is important for normal occlusion and dentition; however, patients with malocclusion often present with myofunctional disorder (MFD). Myofunctional therapy (MFT) has received much attention as a method for reducing MFD. Moreover, prefabricated functional appliances (PFAs) have been developed as a method to eliminate abnormal muscle pressure and guide the tongue into the correct position. However, PFAs have disadvantages, such as poor intraoral retention, limited usage time due to discomfort and poor patient compliance, and changes in the axis of the mandibular anterior teeth.Therefore, this study aimed to develop a new custom-made splint-type orthodontic appliance with CAD/CAM technology. Moreover, we evaluated the characteristics of the appliance and conducted functional tests to determine the effects of the appliance on the orofacial muscles and the discomfort associated with its use. Materials and methods Twenty-five volunteers (nine females and 16 males; mean age 28.4 ± 3.4 years) with normal swallowing function were included in the study. Lip-closing strength (LCS), electromyogramduring swallowing, oxygen saturation, and pulse rate were measured and compared when the appliance was not worn and when it was worn. In addition, tongue habits were evaluated, and the maximum tongue pressure was measured when the appliance was not worn. The subjects were asked to answer a questionnaire using a numerical rating scale (NRS) regarding discomfort when wearing the appliance. The evaluation items were swallowing difficulty, speaking difficulty, and breathlessness, which were rated on an 11-point scale ranging from 0 to 10. Statistical tests were conducted using IBM SPSS version 28.0.1 (IBM, Armonk, NY, USA) with the Shapiro-Wilk and Levene's test, followed by the Wilcoxon signed rank sum test. The significance level was set at α = 0.05. The measurement error for each measurement item was evaluated using an intraclass correlation coefficient. Results A new custom-made splint-type orthodontic appliance was fabricated for each subject. The fit and retention of the appliance in the mouth were good when fitted, and a comparison of the functional test measurements of 25 subjects with and without the appliance showed that the LCS decreased significantly (p<0.05) before and after wearing the appliance. However, no statistically significant differences were found for the other items. The Mann-Whitney U test regarding the effects of sex, previous orthodontic treatment, or MFT, and oral habits did not statistically significantly influence the effects of wearing the device. In the NRS results, "difficulty swallowing" was observed in half of the subjects, "difficulty breathing" was rarely observed, and "difficulty speaking" was observed in all subjects. Conclusions A novel custom-made splint-type orthodontic appliance was designed and fabricated using digital workflow and 3D printing technology. This appliance was designed to correct oral habits and was made from a new material classified as a class II medical appliance according to the international harmonized classification.

Evaluation of bond strength between zirconia milled ceramic material and veneered dental porcelain.

This study aimed at examining the bond strength between zirconia and ceramic veneer, following the ISO 9693 guidelines. A total of fifty specimens of zirconia/ceramic-veneer system were produced using two commercial zirconias (VITA YZ-HTWhite and Zolid HT+ White, referred to as Group A and Group B, respectively) and a ceramic-veneering material (Zirkonia 750). The microstructure (via x-ray diffraction analysis, XRD and Secondary Electron mode, SEM) and the mechanical properties (via 3-point bending tests) of the two groups were assessed. Then, experiments were conducted according to the ISO 9693 and conventional protocols applied for producing zirconia/ceramic-veneer restorations. Bond strength values, measured by 3-point bending tests, were 34.42±7.60MPa for Group A and 31.92±6.95MPa for Group B. SEM observations of the cohesively fractured surfaces (on the porcelain side) and the examination for normality using the Shapiro-Wilk test suggested the use of Weibull statistical analysis. Median strength (σ50%) for Group A and Group B was 34.76 and 32.22MPa, while the characteristic strength (σ63.2%) was 35.78 and 33.14MPa, respectively. The Weibull modulus disparity between groups (12.69 and 13.07) was not significant. Bond strength exceeded the ISO 9693 minimum of 20MPa, suggesting satisfactory strength for clinical use.

Bleaching versus color change resistant adhesive in the discoloration of bracket-bonded tooth surfaces: an in vitro study

ObjectivesThe aim of this study was to compare the effect of office bleaching of teeth bonded with Transbond XTTM (3M Unitek, Monrovia, CA, USA) (TRXT) and the use of color change resistant Orthocem (FGM, Joinville, Brazil) in bracket bonding on coffee-induced enamel discoloration.Materials and methodsEighty premolars were distributed in equal numbers (n = 20) to group 1 (TRXT + distilled water), group 2 (TRXT + coffee solution), group 3 (TRXT + coffee solution + bleaching), and group 4 (Orthocem + coffee solution). Color was measured using a SpectroShade Micro (MHT, International, Verona, Italy) device at the beginning (T0), after coloring (T1), after bleaching (T1B), and after debonding (T2). ΔE color change values were calculated as T1-T0, T1B-T0 and T2-T0 differences. The conformity of the data to the normal distribution was examined with the Shapiro–Wilk test. Multiple comparisons were made with Tamhane’s T2 test and Tukey’s HSD test using one-way analysis of variance in the comparison of normally distributed data, and multiple comparisons were made with Dunn’s test using the Kruskal–Wallis H test for comparison of non-normally distributed data. The significance level was set at p < 0.050.ResultsA statistically significant (p < 0.001) difference was found between the T1-T0 and T2-T0 stages for group 1–4 ΔE values. A statistically significant (p < 0.001) difference was also found when the T1B-T0 ΔE values of group 3 were compared with the T1-T0 ΔE values of groups 1, 2, and 4.ConclusionsAfter coffee-induced enamel discoloration, bleaching of teeth bonded with TRXT produced acceptable color difference of the incisal, middle, and gingival regions of the crown. In teeth bonded with Orthocem, acceptable color difference was seen only in the middle of the crown.Clinical relevanceThe presented study will guide the clinician on how enamel discoloration side effect of fixed orthodontic appliance can reduce.

PENGARUH PENERAPAN METODE TIME GAMES TOURNAMENT (TGT) TERHADAP PENINGKATAN HASIL BELAJAR PESERTA DIDIK PADA MATERI INFAK DAN SEDEKAH DI KELAS V SD IT ULUL ALBAB JATI AGUNG LAMPUNG SELATAN

The purpose of this research is to investigate the influence of the Time Games Tournament (TGT) method on improving students' learning outcomes and their response towards the TGT method. The methodology employed in this study is a quantitative true experimental design, utilizing data collection techniques such as pre-tests and post-tests, as well as a student response questionnaire. Sample selection was conducted using random sampling techniques, with data analysis including Shapiro-Wilk normality tests, hypothesis testing using paired t-tests, and N-Gain analysis. The results of the study indicate that the TGT method significantly enhances students' learning outcomes, as evidenced by the normal distribution of the data. The paired sample t-test yielded a significance value of 0.000 &lt; 0.05, indicating a substantial impact of the TGT method on students' learning outcomes. Additionally, the N-Gain results showed a mean value of 57.6%, suggesting a satisfactory level of effectiveness for instructional purposes. Regarding students' responses to the TGT method, 83% expressed their interest, stating they are "Interested" in using the TGT method for learning purposes. This indicates a positive reception of the method among the student population involved in the study.

Effect of Eight Weeks of Intense Interval Training and Self-Obesity on Serum Lipid Peroxidation Status and Adiponectin Gene Expression in Obese Male Wistar Rats

Introduction: A high-fat diet and increased calorie intake increase the prevalence of obesity،,which itself causes many diseases. The studies carried out in the field of investigating the mechanisms related to obesity and its related diseases have introduced the increase of fat mass and as a result the disruption of cytokines as one of the most important influencing factors. Therefore, the aim of the current research was the effect of eight weeks of intense interval training on serum lipid peroxidation indices and adiponectin gene expression in obese mice. Methods: The current research was experimental with a control group. 24 male rats were randomly divided into three control groups, self-obesity group and self-obesity group with high intensity interval training (HIIT). The normal distribution of the data was evaluated using the Shapiro-Wilk test. Then، in order to compare data between groups، one-way analysis of variance was used, and if it became significant، the data were compared using Tukey's post hoc test at a significance level of P &lt; 0.05. Results: The findings of this research showed that in the exercise group, there was a significant increase in the state of superoxide dismutase (SOD) compared to the self-obesity group. However,, there was no significant change in the level of malondialdehyde (MDA) and the level of adiponectin gene expression in the liver of self-obesity group and interval training group. Conclusion: Obesity causes an imbalance in the oxidative status and a disturbance in the production and secretion of adiponectin in the liver tissue of obese mice، and intense intermittent exercise improves the oxidative status, but it does not have a significant effect on the expression of the adiponectin gene.

Fracture characteristics and translucency of multilayer monolithic zirconia crowns of various thicknesses

ObjectivesMultilayer monolithic zirconia (M-Zr) crowns can be engineered to achieve gradational translucency and color intensity. However, this modification may compromise the mechanical strength, raising concerns regarding the ability of M-Zr crowns to withstand occlusal stresses. The effects of M-Zr crown thickness on translucency and ability to endure occlusal forces were investigated at different tooth positions (incisors, premolars, and molars). The objective was to determine the minimal thickness of M-Zr crowns used in tooth preparation to meet aesthetic and functional demands. MethodsM-Zr samples (Vita A1) with four thicknesses (0.5, 1.0, 1.5, and 2.0 mm) were prepared and subjected to translucency testing using a digital colorimeter by 3-third and 9-square division methods. Crown-shaped M-Zr samples with three thicknesses (1.0, 1.5, and 2.0 mm) and three tooth positions (incisor, premolar, and molar) were digitally designed, and 2.0 mm metal abutments were fabricated. The samples were bonded to the abutments; their fracture characteristics were evaluated using a universal testing machine, and their fracture surfaces examined using an optical microscope. Statistical analyses included the Shapiro-Wilk test, Pearson correlation, and one-way and two-way ANOVA with a post hoc Tukey HSD test (α = 0.05). ResultsColor analysis results revealed a significant negative correlation between thickness and translucency (r < −0.96, P < 0.01), with the highest values in the incisal region. Cross-sectional profiles confirmed the uniform thickness and morphology of the digitally designed M-Zr crowns. The results of fracture strength analysis showed position-dependent variability, a strong positive correlation with thickness (r > 0.96, P < 0.01), and fracture strengths consistently exceeding 1200 N across all tooth positions. Fracture patterns indicated that thinner crowns at the incisors and molars were more prone to cracking, whereas those at the premolars demonstrated significantly higher strength (4872.51 N, P < 0.05), only with crack or even no fracture occurring at 2.0 mm. ConclusionsThickness significantly influenced both the translucency and fracture strength of M-Zr, with the tooth position playing an additional role, albeit to a lesser extent. Although thinner crowns exhibited lower strength at each tooth position, even at a thickness of 1.0 mm, fracture strength exceeding 1200 N was maintained, surpassing the typical occlusal forces. Thus, it can be asserted that M-Zr crowns with a minimum thickness of 1.0 mm can meet both aesthetic and functional requirements.

“Seeing inside out”: revealing the effectiveness of otoscopy training in virtual reality enhanced practical exams - a randomized controlled trial

BackgroundThe study aimed to assess the impact of different training modalities on otoscopy performance during a practical exam using a high-fidelity simulator and to determine if objective evaluation of otoscopy is feasible using a simulator that records insertion depth and tympanic membrane coverage.MethodsParticipants were assigned to one of four groups: control and three intervention groups with varying training approaches. Participants received otoscopy training and then were assessed through a practical exam on a high-fidelity simulator that uses virtual reality to visualize the ear canal and middle ear. Performance was evaluated using a modified Objective Structured Assessment of Technical Skills checklist and Integrated Procedural Performance Instrument checklist. Insertion depth, tympanic membrane coverage, and correct diagnosis were recorded. Data were tested for normal distribution using the Shapiro-Wilk test. One-way ANOVA and, for non-normally distributed data, Kruskal-Wallis test combined with Dunn’s test for multiple comparisons were used. Interrater reliability was assessed using Cohen’s κ and Intraclass correlation coefficient.ResultsAll groups rated their training sessions positively. Performance on the OSATS checklist was similar among groups. IPPI scores indicated comparable patient handling skills. The feedback group examined larger tympanic membrane areas and had higher rates of correct diagnosis. The correct insertion depth was rarely achieved by all participants. Interrater reliability for OSATS was strong. IPPI reliability showed good correlation.ConclusionRegardless of training modality, participants perceived learning improvement and skill acquisition. Feedback improved examination performance, indicating simulator-guided training enhances skills. High-fidelity simulator usage in exams provides an objective assessment of performance.

Bichectomy Surgery and EMG Masticatory Muscles Function in Adult Women: A Longitudinal Study

Bichectomy Surgery and EMG Masticatory Muscles Function in Adult Women: A Longitudinal Study

CAN DARK CHOCOLATE ACUTE SUPPLEMENTATION IMPROVE CYCLOERGOMETER PERFORMANCE TEST?

Prevalence studies of dark chocolate may produce results similar to those observed after resistance exercise. The results examining the effects of dark chocolate ingestion on aerobic exercise performance are controversial. In addition, there is a choice in experiments with chronically consumed chocolate components (40 to 80 g) and large amounts of dark chocolate in studies to improve athletic performance. Therefore, the purpose of this study to verify the effect of acute supplementation of 80 g dark chocolate (70% cocoa) on performance on cycle ergometer test. Eleven healthy, physically active, but untrained men participated in the study. Two incremental cycle ergometer tests were performed to determine the peak power output (Ppeak) without chocolate supplementation (control condition, C) and with supplementation of 80 g of dark chocolate 70% cocoa (C70%) ingested orally two hours before the test. Variables such as heart rate (HR), blood glucose concentration [GLI], blood pressure (SBP/DBP), and rating of perceived exertion (RPE) were monitored. Data normality was verified by the Shapiro-Wilk test, and the results are presented as mean ± standard deviation (SD). The performance data of the tests and physiological variables were compared using Student's t-test for paired samples, adopting a significance level of P &lt; 0.05. No statistical differences were found for Ppeak (238.0 ± 35.1 vs 250.9 ± 42.7 W) between conditions (C and C70%, respectively), as well as in the other variables. Therefore, we concluded that although the ingestion of 80 g of dark chocolate (70% cocoa) 2 hours prior the cycle ergometer test did not modify the peak power output, physiological and psychophysiological variables analyzed when presenting the average results, individual analysis demonstrated that this supplementation could be used to enhance peak power, which support individual as opposed to group analysis to evaluate performance responses to supplementation protocols.

Evaluation of peritoneal l-lactate concentration in horses in the early post-partum period.

Peritoneal fluid lactate concentration is an important diagnostic tool in horses with abdominal pain. Information on peritoneal lactate concentrations is lacking following parturition in the mare. To compare blood and peritoneal lactate concentrations in a population of mares within 36h post-partum, report a normal reference range and identify any impact of retained foetal membranes (RFMs). This is a retrospective study evaluating healthy mares from which blood and peritoneal samples had been obtained within 36h of parturition. Exclusion criteria included signs of abdominal pain within this period. Data was interrogated for normality using a Shapiro-Wilk test. Wilcoxon signed-rank test and Bland-Altman analysis were used to compare blood and peritoneal lactate concentrations. Linear regression was used to compare age and breed data with peritoneal lactate concentrations. Significance was defined as p<0.05. Forty mares met the inclusion criteria. Mean age was 12.6±4.1 years, and most mares were multiparous (65%). Peritoneal lactate ((1.2 (IQR=0.9-1.6)mmol/L) was increased compared to blood lactate concentration (0.7 (IQR=0-1.1)mmol/L; p<0.001). Plasma total protein (TP) concentrations were 68 (IQR=64-74)g/L and peritoneal protein concentrations 8 (IQR=4-9.7)g/L. Six mares developed RFM. The median fold-increase in peritoneal lactate concentration compared to blood lactate concentration was 0.9 (IQR: 0.01-1.7; range: 0-2.5). The reference range for peritoneal fluid lactate concentration was 0-2.5mmol/L. Peritoneal lactate concentrations in healthy post-partum mares remained within the normal reference range and were not influenced by RFM or parturition. Increased peritoneal lactate in this group warrants further investigation.

Impact of yoga on the central and peripheral vascular function among desk-based workers: A single-centred trial study

Background The aim of this study was to observe and analyze vascular function in ‘prolonged sitting’, followed by a yoga routine and pranayama intervention. Participants in this study include those who work from desks in offices. The study required the participants to attend on three separate days at random, and they had to finish a computerized test on each day. On the first day, participants were required to complete a computer test while sitting still for four hours (with the exception of washroom breaks). The next day, they underwent a computerized test along with a pranayama intervention. Finally, on the last day, they underwent a computerized test along with a yoga intervention. At the start of the study and after two and four hours, we measured the diameter and velocity of the common carotid artery (CCA) and superficial femoral artery (SFA). Methods The study was a within-subjects prospective single-center trial conducted in the Department of Radio-Diagnosis and Imaging, Kasturba Medical Hospital, Manipal, India, between September 2022 and January 2023. Participants were asked to do one of the following ‘activities’ over successive weeks: Week 1 – Prolonged sitting; Week 2 – Pranayama intervention; and Week 3 – Yoga intervention during prolonged sitting. The baseline and follow-up variables of pulse velocity, endothelial thickness, and shear rate were assessed for normality through a Shapiro-Wilk Test. Results Our sample included 11 participants with moderate physical activity, five with high physical activity and one with low physical activity. Yoga intervention comprised participants sitting continuously for four hours, with a yoga session intervention being provided every hour, lasting for 10 minutes. Conclusions Yoga improves vascular functions in prolonged sitting conditions. This routine can promote the concept of interrupted sitting and ways to reduce it with efficient yoga practice without changing the work culture and provide better physical relief. Trial registration Clinical Trials Registry – India ( CTRI/2022/09/045628), date of registration: 19/09/2022(CTRI/2022/9/045628)https://ctri.nic.in/Clinicaltrials/main1.php?EncHid=16349.27799,

Assessing the quality and reliability of YouTube videos as a source of information on inflammatory back pain.

Inflammatory back pain is a chronic condition with localized pain, particularly in the axial spine and sacroiliac joints, that is associated with morning stiffness and improves with exercise. YouTube is the second most frequently used social media platform for accessing health information. This study sought to investigate the quality and reliability of YouTube videos on inflammatory back pain (IBP). The study design was planned as cross-sectional. A search was conducted using the term "inflammatory back pain," and the first 100 videos that met the inclusion criteria were selected on October 19, 2023. The data of the videos selected according to the inclusion and exclusion criteria in the study settings were examined. Videos with English language, with audiovisual content , had a duration >30 s, non-duplicated and primary content related to IBP were included in the study. A number of video parameters such as the number of likes, number of views, duration, and content categories were assessed. The videos were assessed for reliability using the Journal of the American Medical Association (JAMA) Benchmark criteria and the DISCERN tool. Quality was assessed using the Global Quality Score (GQS). Continuous variables were checked for normality of distribution using Shapiro-Wilk test and Kolmogorov-Smirnov test. Kruskal-Wallis test and Mann-Whitney U test were used to analyze the continuous data depending on the number of groups. Categorical data were analyzed using Pearson's chi-square test. Reliability assessment based on JAMA scores showed 21% of the videos to have high reliability. Quality assessment based on GQS results showed 19% of the videos to have high quality. JAMA, DISCERN, and GQS scores differed significantly by source of video (p<0.001, < 0.001, and = 0.002, respectively). Video duration had a moderate positive correlation with scores from the GQS (r=0.418, p<0.001), JAMA (r=0.484, p<0.001), and modified DISCERN (r=0.418, p<0.001). The results of the present study showed that YouTube offers videos of low reliability and low quality on inflammatory back pain. Health authorities have a responsibility to protect public health and should take proactive steps regarding health information shared on social media platforms.

Impact of the COVID-19 pandemic on acute ischemic stroke medical care: a prospective study

INTRODUCTION: Acute ischemic stroke (AIS) is not uncommon in patients with novel coronavirus infection. During the COVID-19 pandemic, an increase of the frequency of adverse clinical and functional outcomes of AIS was noted.OBJECTIVE: The recent study was to evaluate the impact of the COVID-19 pandemic on the clinical and diagnostic characteristics of patients with AIS, as well as on the results of various types of treatment.MATERIALS AND METHODS: The prospective study included 460 patients with AIS after systemic or selective thrombolysis, thromboextraction and combination of thromboextraction with thrombolysis and stenting, hospitalized in 2019–2022: 55 patients in 2019, and in 2020–2022 — 405 patients. All patients were clinically evaluated using NIHSS and Rankin scales. Instrumental data included: assessment of computed tomography (CT) lesion size, extracranial and transcranial Duplex ultrasound (DUS) and computed angiography. Patients who received invasive treatment (thromboextraction, including in combination with thrombolysis or stenting) underwent cerebral angiography (CA). The characteristics of cerebral hemodynamics before and after the use of various types of treatment, clinical and functional outcomes were subject for comparison.Statistics: The statistical software Statistica 12.0, SPSS Statistics 17.0 were used. Normality of distribution was assessed using the Shapiro–Wilks test. Comparison of groups based on quantitative parameters was carried out using the Mann–Whitney U test. When testing statistical hypotheses, the acceptable level of error of the first type was considered to be a value not exceeding 0.05. To assess the correlation between parameters, the Spearman method was used.RESULTS: During the pandemic of COVID-19, patients with AIS were younger, had lower percentage of comorbidities and a higher NIHSS score. A significantly lower rate of favorable clinical and functional outcomes was obtained during the pandemic compared to the period before the pandemic, including after the use of invasive treatment methods: only 47% of patients had clinical improvement during the pandemic, while in 2019 the proportion of favorable outcomes was 64% (p=0.003). There was an increase in the share of pulmonary embolism and pneumonia in the structure of mortality from AIS during the pandemic (25% in the period before the pandemic vs 38% during the pandemic). Duplex ultrasound of cerebral arteries demonstrated high comparability with angiography data (correlation coefficient with invasive methods 0.84).DISCUSSION: According to the literature data, strokes are not uncommon in patients with COVID-19, especially in those with severe disease and risk factors. The authors consider thrombosis and/or thromboembolism of cerebral arteries to be possible ways of cerebral ischemia. According to Russian scientists, from the beginning of the pandemic, a significant increase in the incidence of ischemic stroke of varying severity was noted. The statistical pattern we identified confirms the data from literature sources that when infected with the SARS-CoV-2 virus, the brain and cerebral arteries are target organs. It is significant for clinical practice that we have evaluated the clinical and instrumental characteristics of these lesions in relatively homogeneous gender, age and clinical groups.CONCLUSION: The incidence of favorable clinical and functional outcomes during the pandemic was significantly lower compared to the pre-pandemic period. Complete and partial restoration of blood flow, as well as a decrease in the ischemic focus, were significantly more common before the pandemic. The effectiveness of invasive methods of cerebral revascularization during the pandemic were also lower. Duplex ultrasound serves as a reliable method not only for primary diagnosis, but also for dynamic monitoring. Initial changes in hemodynamics in patients with AIS before and during the pandemic did not differ significantly and were represented by hypoperfusion with a decrease in peripheral resistance. In 2020–2022 after treatment, hypoperfusion was observed significantly more often, which can be considered as one of the reasons for the less favorable clinical and functional outcomes obtained during the pandemic.

Determination of the Institutional Image of the University According to the Opinions of Students Receiving Sports Education

This research was conducted to determine the institutional image of the university they study according to the opinions of the students receiving sports education and to determine whether the institutional image of the university they study differs according to demographic variables. The normality of the data obtained in the study was tested with Kolmogorov-Smirnov and Shapiro-Wilk tests; since the data did not show normal as a result of the test, Mann-Whitney U Test was used for pairwise comparisons and Kruskal-Wallis Analysis of Variance was used for multiple comparisons. In cases where a significant difference was found as a result of Kruskal-Wallis Analysis of Variance in multiple comparisons, Mann-Whitney U Test was applied to determine between which groups this difference originated. In all statistical calculations, the basic significance level was accepted as 0.05. As a result of the research; it was determined that the perceptions of the students receiving sports education towards the image of the universities they study are high / positive. It was determined that students' perceptions of the corporate image of their universities in all dimensions (employees, management quality, social responsibility, working environment, product and service quality, communication activities) differed significantly according to gender, age and the department they studied. Again, it was determined that students' perceptions of their universities' corporate image dimensions of employees, management quality, social responsibility, product and service quality, communication activities differed significantly according to the class variable, and their perceptions of product and service quality and communication activities corporate image dimensions differed significantly according to the sport branch variable. It was determined that the perceptions of the students towards the corporate image dimension of the working environment of the universities they studied according to the class variable; the perceptions of the students towards the dimensions of employees, management quality, social responsibility, working environment corporate image did not differ significantly according to the sport branch variableKeywords: Education, Institutional image, Student, University

Targeting transitioning lung monocytes/macrophages as treatment strategies in lung disease related to environmental exposures

BackgroundEnvironmental/occupational exposures cause significant lung diseases. Agricultural organic dust extracts (ODE) and bacterial component lipopolysaccharide (LPS) induce recruited, transitioning murine lung monocytes/macrophages, yet their cellular role remains unclear.MethodsCCR2 RFP+ mice were intratracheally instilled with high concentration ODE (25%), LPS (10 μg), or gram-positive peptidoglycan (PGN, 100 μg) for monocyte/macrophage cell-trafficking studies. CCR2 knockout (KO) mice and administration of intravenous clodronate liposomes strategies were employed to reduce circulating monocytes available for lung recruitment following LPS exposure. Lung tissues and bronchoalveolar lavage fluid (BALF) were collected. Pro-inflammatory and/or pro-fibrotic cytokines, chemokines, and lung extracellular matrix mediators were quantitated by ELISA. Infiltrating lung cells including monocyte/macrophage subpopulations, neutrophils, and lymphocytes were characterized by flow cytometry. Lung histopathology, collagen content, vimentin, and post-translational protein citrullination and malondialdehyde acetaldehyde (MAA) modification were quantitated. Parametric statistical tests (one-way ANOVA, Tukey’smultiple comparison) and nonparametric statistical (Kruskal–Wallis, Dunn’s multiple comparison) tests were used following Shapiro–Wilk testing for normality.ResultsIntratracheal instillation of ODE, LPS, or PGN robustly induced the recruitment of inflammatory CCR2+ CD11cintCD11bhi monocytes/macrophages and both CCR2+ and CCR2− CD11c−CD11bhi monocytes at 48 h. There were also increases in CCR2+ CD4+ and CD8+ T cells and NK cells. Despite reductions in LPS-induced lung infiltrating CD11cintCD11bhi cells (54% reduction), CCR2 knockout (KO) mice were not protected against LPS-induced inflammatory and pro-fibrotic consequences. Instead, compensatory increases in lung neutrophils and CCL2 and CCL7 release occurred. In contrast, the depletion of circulating monocytes through the administration of intravenous clodronate (vs. vehicle) liposomes 24 h prior to LPS exposure reduced LPS-induced infiltrating CD11cintCD11bhi monocyte-macrophage subpopulation by 59% without compensatory changes in other cell populations. Clodronate liposome pre-treatment significantly reduced LPS-induced IL-6 (66% reduction), matrix metalloproteinases (MMP)-3 (36%), MMP-8 (57%), tissue inhibitor of metalloproteinases (61%), fibronectin (38%), collagen content (22%), and vimentin (40%). LPS-induced lung protein citrullination and MAA modification, post-translational modifications implicated in lung disease, were reduced (39% and 48%) with clodronate vs. vehicle liposome.ConclusionHighly concentrated environmental/occupational exposures induced the recruitment of CCR2+ and CCR2− transitioning monocyte-macrophage and monocyte subpopulations and targeting peripheral monocytes may reduce the adverse lung consequences resulting from exposures to LPS-enriched inhalants.

Exploring critical success factors for digital transformation in construction industry–based on TOE framework

PurposeThis study aims to investigate the critical success factors of digital transformation in the construction industry and identify whether the respondents' profiles influence their perceptions of critical success factors for digital transformation.Design/methodology/approachTo achieve the objectives, a literature review was first conducted based on technology-organization-environment (TOE) framework. Then a questionnaire survey was carried out. A total of 86 people were surveyed in this study, mainly from the construction industry. At the level of data processing, SPSS was used for analysis. Among the main tests used were the Shapiro–Wilk test, reliability analysis, mean rank analysis, Kruskal–Wallis test and Mann–Whitney U test.FindingsThe study identified 15 critical success factors of digital transformation and found the three most important factors of digital transformation. Furthermore, respondents with different years of experience, enterprises with different sizes and different years made no difference in the perception of factors. Respondents' different occupations and types of enterprises created a bias in the perception of factors for digital transformation.Research limitations/implicationsFirstly, the small sample size of the questionnaire limits the reference value of data analysis for certain groups. In addition, this study focuses broadly on construction enterprises without specifically examining different types of enterprises, thus lacking depth in its findings.Practical implicationsThis study establishes a connection between TOE theory and the construction industry through an extensive literature review, identifying relevant factors and providing a reference for future research.Originality/valueThe study's results would enrich the research on digital transformation in the construction industry and provide a reference for the digital transformation of construction enterprises.

Impact assessment of integrated-pathy on cancer-related fatigue in cancer patients: an observational study.

Integrated-pathy aims to integrate modern medicine with traditional systems via applying the holistic approach of Ayurveda, Yoga, and natural medicine. This is important for addressing the challenges surrounding the delivery of long-term palliative care for chronic ailments including cancer. The prime intent of this study was to substantiate the underlying hypothesis behind the differential and integrative approach having a positive impact on Quality of Life of cancer patients. Cross-sectional Observational study. A standardized questionnaire was developed and used, after obtaining written informed consent from patients to assess the impact of Integrated-pathy on patients (n = 103) diagnosed with cancer receiving care at Patanjali Yoggram. The research was carried out over 8 months. All participants received a uniform treatment protocol as prescribed by Patanjali. For the sample size determination and validation, α and 1-β was calculated and for the significance of the pre- and post-treatment QoL ratings, Shapiro wilk test and other descriptive statistics techniques were explored. A total of 103 patients seeking cancer special-healthcare were interviewed, out of which 39 (37.86%) remained finally based on the inclusion/exclusion criteria with age (25-65years), types of cancers (Carcinoma and Sarcoma), chemotherapy/radiotherapy received or not, before opting Integrated-pathy. Follow-ups revealed a significant increase in the QoL (17.91%) after receiving the integrated therapy over a course of at least 1 month. Further, a significant reduction in cancer-related pain followed by an increase in QoL index was reported in the patients. Shapiro-wilk test revealed significant pairing (p < 0.001) with validation of the model using test. To bolster evidence-based backing for Integrated-pathy, there is a need for clearly delineated clinical indicators that are measurable and trackable over time. Clinical investigators are encouraged to incorporate Integrated-pathy into their proposed interventions and conduct analogous studies to yield sustained advantages in the long run.