Signed Rank Test Research Articles

Evaluating image quality on post-mortem cardiac CT using an anthropomorphic phantom.

Evaluating image quality on post-mortem cardiac CT using an anthropomorphic phantom.

Evaluation of Software-Optimized Protocols for Acoustic Noise Reduction During Brain MRI at 7 Tesla.

MR-generated acoustic noise may be particularly concerning at 7-Tesla (T) systems. Noise levels can be reduced by altering gradient output using software optimization. However, such alterations might influence image quality or prolong scan times, and these optimizations have not been well characterized. To evaluate image quality, sound pressure levels (SPLs), and perceived noise levels when using the acoustic noise reduction technique SofTone for T2-weighted fast spin echo (T2W FSE) and three-dimensional T1-weighted turbo field echo (3D T1W TFE), and to compare with conventional imaging during 7-T brain MRI. Prospective. Twenty-eight volunteers underwent brain MRI, with n = 26 for image quality evaluations. Conventional and SofTone versions of T2W FSE and 3D T1W TFE at 7 T. Peak SPLs (A-weighted decibels, dBA), participant-perceived noise levels (Borg CR10-scale), qualitative image assessments by three neuroradiologists (four-graded ordinal scales), interrater reliability, and percentage agreement. Paired t-test, Wilcoxon's Signed-Rank Test, and Krippendorff's alpha; p < 0.05 were considered statistically significant. SofTone significantly reduced peak SPLs: from 116.3 to 97.0 dBA on T2W FSE, and from 123.7 to 101.5 dBA on 3D T1W TFE. SofTone was perceived as significantly quieter than conventional scanning. T2W FSE showed no significant differences in image quality assessments (p = 0.21-1.00), except one radiologist noting significantly less artifact interference with SofTone. General image quality remained acceptable for 3D T1W TFE, though one radiologist scored it significantly lower with SofTone (mean scores: 3.08 vs. 3.65), and two radiologists observed significantly worse white and gray matter differentiation with SofTone (mean scores: 3.19 vs. 3.54; 2.27 vs. 2.81). SofTone can significantly reduce sound intensity and perceived noise levels while maintaining acceptable image quality with T2W FSE and 3D T1W TFE in brain MRI. It appears to be an effective tool for providing a safer, quieter 7-T scan environment. 4 Technical Efficacy: Stage 5.

A Pilot Double-Blind Randomised Sham-Controlled Trial of Paraesthesia-Free Burst Waveform Spinal Cord Stimulation in a Small Case Series of Patients with Chronic Spinal or Limb Pain

The aim of this study was to identify methodological issues that might influence comparison of burst versus sham spinal cord stimulation for treating chronic pain. Six patients with an implanted BurstDR spinal cord stimulator were assessed double-blind during eight 3-to-4-day ON or OFF cycles over a 28-day period. The stimulator was switched off during two randomly selected cycles. Pain intensity was the primary outcome, and secondary outcomes included analgesic consumption, activity estimation and sleep quality. To minimise stimulation wash-in and wash-out effects, ratings during the first two days of each cycle, or where rescue medication was taken, were discarded. Mean ratings during ON versus OFF cycles were compared using Wilcoxon’s signed-ranks test. Pain ratings averaged 4.1 ± 2.0 during OFF cycles and 3.9 ± 2.5 during ON cycles (difference not significant). However, ratings were one or more points higher during OFF than ON cycles in two patients with recent stimulator implants who correctly identified the stimulator status during most cycles. Patients were more refreshed on waking during ON than OFF cycles but burst stimulation did not influence ratings of pain interference, mood, sensitivity to mechanical stimulation or consumption of rescue medication. The findings in our case series point to the importance of investigating individual differences in response to burst spinal cord stimulation. To establish whether this treatment is effective for managing chronic pain, selecting patients with short wash-in and wash-out times, or including lengthy periods of wash-in and wash-out in the study protocol, is crucial. Selection criteria should also include pain ratings at entry of 3 or less on a 0-10 scale; stable physical and psychological functioning with little disability; minimal rescue medication; and patients who take less than 50 morphine equivalents per day.

Designing, Implementing, and Evaluating the Social Emotional Learning Professional Development Program

In this study, a Social Emotional Learning Professional Development Program (SEL-PDP) was designed for teachers. The program was structured as a 40-hour training process, incorporating practice-based workshops and an in-class application sharing day. Implemented in the 2023-2024 academic year, the program involved 12 primary and preschool teachers working in Istanbul, Türkiye. A nested mixed-methods design was employed, and qualitative and quantitative data were analyzed to evaluate the program. A pre-test and post-test design was utilized to assess cognitive gains, with data analyzed via the Wilcoxon Signed Ranks Test, revealing a significant difference between pre-test and post-test scores (Z = -3.059, p &lt; 0.01). Additionally, an average increase of 66% was recorded in participants' total percentage success scores. The findings indicated that the methods teachers intended to implement in their classrooms were related to the practices conducted in the workshops. During the sharing day, it was observed that the methods applied by teachers in their classrooms bore similarities to those presented during the workshops. Descriptive analysis of the 18-item SEL-PDP Evaluation Form demonstrated that the average item scores fell within the highest range of 4.21–5.00 ("Strongly Agree"). These results suggest that SEL-PDP was evaluated by participant teachers as an effective, practice-based, and goal-oriented professional development program.

Comparative analysis of suture choice in open bilateral carpal tunnel surgery: a randomized controlled trial.

This randomized controlled trial (RCT) compared outcomes of absorbable and non-absorbable sutures for skin closure in open carpal tunnel decompression. Patients diagnosed with bilateral carpal tunnel syndrome proceeding to staged open carpal decompression were invited to participate in the trial. Patients elected left or right hand for the first operation and were randomized to receive Prolene (non-absorbable) or Vicryl Rapide (absorbable) first, and the alternative suture to the contralateral side. Recorded pre-operative data included the Boston Carpal Tunnel Questionnaire (BCTQ) for each hand. At 2 weeks post-operatively the BCTQ, a Visual Analogue Score (VAS) for pain and Asepsis Wound Score were recorded. At 6 weeks, the BCTQ and VAS were repeated and a Patient and Observer Scar Assessment Scale (POSAS) was performed. Patients were asked preference for left or right suture. Statistical analysis using a linear mixed model assessed improvements in the BCTQ, as well as wound scores between sutures. The individual scales were compared using non-parametric Wilcoxon signed rank test. Specific patient factors including age, comorbidities, and previous steroid injections were evaluated for their impact on outcome. There was no significant difference between the two suture types in any of the overall recorded assessments, complications or patient preferences. BCTQ scores improved significantly post-operatively, P = 0.001. Previous steroid injection, diabetes and age over 65 did not affect outcomes. Patients can be advised there is no difference in the outcome following open carpal tunnel decompression from using either absorbable or no-absorbable suture material for skin closure.

Assessing legibility of Thai universal design typeface and Roman-like Thai typefaces across different viewing distances

This study compared the legibility of the Thai Universal Design typeface (FT Manifest UD) with that of two Roman-like Thai typefaces (DB Ozone and Sukhumvit Tadmai) across multiple viewing distances. Using a distance threshold methodology, thirty-one Thai participants of diverse ages and visual acuities identified 36 Thai consonants at 15 distinct viewing distances. Statistical analysis using the Wilcoxon Signed Ranks Test revealed that FT Manifest UD significantly outperformed other typefaces in overall legibility (p &lt; 0.05), with 24 of 36 letterforms showing superior legibility.

Energy Utilization in Premature Neonates Undergoing Screening for Retinopathy of Prematurity

Background/Objectives: Premature neonates are at risk for retinopathy of prematurity (ROP) and routinely undergo screening exams that involve substantial physical manipulation, often causing significant signs of pain, despite pain-relieving interventions. It remains unclear whether these exams affect energy utilization, cellular hypoxia, and clinically significant events, and whether receiving supplemental oxygen affects these relationships. This work examines the effects of ROP screening on (1) urinary uric acid-to-creatinine concentration ratios ([UA]/[Cr]), a known marker of ATP degradation, hypoxia, and oxidative stress; and (2) clinically significant events (apnea, bradycardia, gastric residuals, and oxygen desaturations) in premature neonates on room air or oxygen support. Methods: This prospective pilot study included premature neonates requiring ROP screening examinations at Loma Linda University’s NICU. Urinary [UA]/[Cr], measured by high-performance liquid chromatography, and clinical events, documented by prospective medical chart review, were analyzed pre- and post-exam in subjects on room air (n = 18) or on oxygen support (n = 20). Statistical analyses included a generalized linear mixed model for urinary [UA]/[Cr] and Wilcoxon signed rank tests for clinical events. Results: A significant time effect (p = 0.010) was observed for urinary [UA]/[Cr], with higher levels at 0–12 (p = 0.023) and 12–24 (p = 0.023) hours post-exam. Subjects receiving oxygen support had more total (p = 0.028) and more severe (p = 0.026) oxygen desaturations. Conclusions: ROP examinations may increase energy utilization in premature neonates, with those receiving oxygen support being particularly susceptible to oxygen desaturations post-exam. Further research is needed to clarify the full impact of the procedure and to identify strategies to minimize stress associated with these screening examinations.

Impact of Stock Split on Stock Liquidity of the Companies Listed on NSE and BSE

The aim of study is to find out difference in levels of stock liquidity before and after stock split. The study aims to analyse all the companies that have carried out stock split in Indian stock markets- BSE and NSE between the period 1st April 2019- 31st March 2022. Purposive sampling method is used to get required data. Out of all the companies which performed stock split between the mentioned period (166 companies), all the companies carrying out forward stock split (119 companies) were chosen to carry out the research. With the use of Wilcoxon signed rank test results are obtained to find out difference in stock liquidity data before and after split within the time frame of 30 days. Since the value of p obtained is less than the conventional significance level of 0.05 (indicated as "&lt;.001"), we reject the test null hypothesis which states that there is no difference between the paired observations and accept the alternate hypothesis which concludes that there is significant impact of stock split on stock liquidity.

Financial Performance Analysis and Z-Score Assessment of Pharmaceutical Industry During and After Economic Crisis In 2020

This study discusses the analysis of financial performance and potential bankruptcy of all publicly listed pharmaceutical companies in Indonesia during and after the COVID-19 pandemic. This study uses financial ratio analysis such as Liquidity, Solvency, Profitability, and Activity Ratio as well as bankruptcy potential assessment with the Altman Z-Score Model. This research aims to evaluate the financial conditions of companies and identify the financial risks faced by the pharmaceutical industry in Indonesia. Statistical approach Kolmogorov-Smirnov, Paired T-Test, and Wilcoxon Signed Rank Test, to asses significant change in financial performance during and after pandemic. The results of this study indicate that PT Kimia Farma (KAEF), PT Indonesia Farma (INAF), PT Pharos (PEHA), and PT Pyridam Farma (PYFA) have poor financial conditions based on the results of all poor financial ratios, Moreover, these companies showed significant bankruptcy potential, with Altman Z-Score values below 1.89. and for SOHO it also has a poor profitability ratio especially in Gross Profit Margin categorizing them in the "Distress Zone.", And Soho Global Health (SOHO) is not so safe from the potential remains in the "Gray Zone," with Z-Score values ranging from 1.89 to 2.99, indicating moderate bankruptcy risk. In conclusion, this research highlights the urgent need for pharmaceutical companies in Indonesia to enhance their financial resilience in the post-pandemic era.

An Evaluation of the Balance Error Scoring System in Female Soccer Players Following Soccer Heading: A Pilot Study.

Soccer is a contact sport during which participants risk injury, including due to concussion. Interestingly, the task most frequently associated with concussions is the act of heading the ball. This study seeks to answer the following research question: Does an acute playing of purposeful soccer heading in female football players lead to changes in BESS normative outcomes and balance? Additionally, we aim to explore the relationship between a gold-standard BESS Test and a Balance Test performed on a force plate. This project involved twenty-eight female soccer players (age = 19.6 + 2.96 years, mass = 60.4+ 5.3 kg, and height = 163.6 + 6.4 cm). pre and post the heading condition and the results of the Wilcoxon Signed Ranks Test. The participants were healthy and underwent BESS monitoring on a force plate before and after heading and footing training. Standard 450 g soccer balls were utilized. Participants performed ten headers for the header condition and ten footers for the footer condition. Resultant sway velocity and BESS error outcomes were calculated before and after heading and footing training. I need a brief description of the statistical approach here. Statistically significant increases after the heading condition were found for Single Leg Stance (COP PATH) score (Z = -3.986, p = 0.000), BESS score on foam surface (Z = -2.511, p = 0.012), BESS score on firm surface (Z = -2.353, p = 0.019). A statistically significant increase after the footer condition was found for the Tandem Stance (mm2) score (Z = -2.900, p = 0.004). A statistically significant difference between the group conditions was found in the post-BESS score foam difference (U = 268.500, p = 0.042). BESS score foam mean increase was 1.93 after the heading condition and 0.21 after the footer condition. This pilot study not only tests the feasibility of using force plates to measure BESS outcomes after heading in female soccer but also underscores the effectiveness of using BESS parameters to evaluate changes in balance function following heading compared to a control footer condition. The findings of this study provide valuable insights into the potential effects of soccer on balance in female players, contributing to the body of knowledge in sports medicine and physical education. 3.

A novel fuzzy three-valued logic computational framework in machine learning for medicine dataset.

A novel fuzzy three-valued logic computational framework in machine learning for medicine dataset.

Supportive-educative nursing on knowledge, self-efficacy and medication compliance in pulmonary TB patients

&lt;p&gt;Tuberculosis (TB) cases are very developed in Indonesia and are ranked second largest in the world with 8.5% of global cases. We aim to analyze the effect of supportive-educational nursing interventions on self-efficacy, medication adherence and knowledge of TB patients. The research design used is a quasi-experimental with control group design. The treatment group was given supportive educational nursing using pocket books and teaching aids, while the control group was given education by health workers using leaflets. This research was conducted in the Bima city area by randomly selecting pulmonary TB sufferers in seven community health centers. The sample size is calculated use the Slovin formula and get the sample size was 64 people. Wilcoxon sign rank test and mann whittney was used in this research. The Finding show that there were differences in knowledge, self-efficacy, and treatment adherence in the intervention group regarding pulmonary TB with p-values=0.000, 0.000, 0.001 respectively. Findings show that in the control and treatment post-test groups, there were differences in the variables of self-efficacy, treatment compliance and knowledge with p-values=0.001, 0.000, 0.000, respectively. The conclusion was the intervention given to the treatment group had an impact on increasing self-efficacy, pathophysiology and knowledge compared to the control group in TB patients.&lt;/p&gt;

Medical treatment for pelvic congestion syndrome with flavonoid: Apilot study.

Medical treatment for pelvic congestion syndrome with flavonoid: Apilot study.

Impact of virtual reality with or without hypnosis before oocyte retrieval: a randomised study.

Impact of virtual reality with or without hypnosis before oocyte retrieval: a randomised study.

Exploring Trends between Dance Experience, Athletic Participation, and Injury History.

Dancers sustain substantial injury rates ranging from 0.62-5.6 injuries per 1000 dance exposure hours with 72% of these injuries attributed to overuse mechanisms. Highly technical activities like dance often require high training volumes incorporating deliberate practice from a young age which may contribute to these high percentages of overuse injuries. The purpose of this study was to determine trends between dance participation, athletic participation, and injury history. Cross-sectional survey. Dancers over 18 years old with at least one year of dance experience were recruited from across the United States to complete a survey via Qualtrics. The survey included five sections addressing basic demographic information, dance experience, athletic activity history, and injury history. Relationships between variables were analyzed using the Mann-Whitney U test or the Wilcoxon Signed Rank test. Factorial ANOVAs were also used to observe relationships between three or more groups. Of 424 total responses, 339 were deemed complete for analysis. Nearly 75% of respondents reported experiencing at least one injury that inhibited their dance ability. Greater total injuries were reported by participants who had more years of dance experience, those who practiced ballet, and individuals who began dance before age 12. Approximately one-third of participants exclusively participated in dance with no involvement with other athletic activities. Respondents starting dance prior to age 12 reported participation in fewer athletic activities. However, no difference in the number of injuries was observed between individuals involved in athletic activity compared to those practicing dance alone. Increased dance exposure and associated high training volumes and repetitive movements may represent a greater risk for overuse injuries than sport specialization in dancers. 3B.

Effectiveness of Academic Supervision Models in Improving Teacher Performance in Kindergarten Schools

Introduction. Global education initiatives championed by organizations such as UNESCO, the Council of Europe, and the International Association of Universities (IAU) emphasize continuous professional development for educators as the cornerstone of quality education. In line with these initiatives, implementing academic supervision models in early childhood education settings, such as kindergartens, is important in improving teacher performance. Academic supervision is a key mechanism for improving teaching practices, ensuring educators can meet the demands of an increasingly complex educational environment. This study aims to evaluate the effectiveness of an academic supervision model in improving kindergarten teachers' performance, focusing on the changes observed before and after the implementation of this model. As such, this study contributes to the ongoing global discourse on improving the quality of education through targeted professional development strategies. Study participants and methods. The study involved six kindergarten teachers selected through purposive sampling. Data was collected using pretest and posttest evaluations, measuring teacher performance before and after implementing the academic supervision model. Descriptive statistics, t-tests, and Wilcoxon Signed Rank tests were used for data analysis. The normality of the data was assessed using the Shapiro-Wilk test. N-Gain scores were calculated to determine the relative improvement in performance. KEYWORDS Results. The essence of the pedagogical model used in this study is to improve teacher performance through academic supervision focused on continuous professional development. Improved performance was seen through a comparison of pretest and post-test mean scores; scores increased from 16.33 to 28.33 with a higher variance value (0.667) on the pretest, meaning that pretest scores had a greater spread, indicating that teachers' performance levels were initially highly variable. After implementing the model, the lower variance (0.267) in the posttest indicates that teacher performance scores became more uniform and concentrated at higher scores. This indicates that the academic supervision model effectively improved teacher performance through a t-test with a significance value of 0.000 (p &lt; 0.05), indicating a significant difference between the pretest and post-test scores. The t-test and Wilcoxon signed rank test confirmed that the difference between pretest and posttest scores was statistically significant, further validating the effectiveness of the supervision model. N-Gain analysis, with an average score of 0.8772, highlighted significant and measurable improvements in teacher performance after implementing the academic supervision model. Conclusion. This study confirms the effectiveness of the academic supervision model in enhancing teacher performance. The model improved individual teacher competencies and ensured a uniform teaching quality across the board. These findings suggest that implementing academic supervision consistently could serve as a strategic approach for professional development in educational settings.

An Innovative Osteopathic Curriculum for Allopathic and Osteopathic Family Medicine Residents

Abstract Background: How does a family medicine program meet the osteopathic education needs of its residents with 1 osteopathic faculty member before recruiting additional faculty and applying for osteopathic recognition? Methods: A prospective quality improvement study of an 18-month curriculum developed for a family medicine program with only 1 osteopathic faculty was conducted utilizing pre- and post-curriculum digital surveys. The curriculum consisted of a 3-module self-study introductory element created using Google Forms, monthly lectures with a brief hands-on laboratory experience, and OMM encounters during the resident family medicine continuity clinic. The objective was to assess the curriculum's impact on resident perceptions and confidence regarding osteopathic concepts, referral for OMT, and use of OMT. Summary statistics were generated and the χ2 test and Wilcoxon signed rank tests were used to compare responses. Results: Eleven residents responded to the initial survey and 10 to the follow-up survey. The residents showed statistically-significant increases in confidence concerning knowledge of osteopathic principles (pre-curriculum mean, 2.27 vs. post-curriculum mean, 3.40; p=0.016), and the indications for OMT (pre-curriculum mean, 2.45 vs. post-curriculum mean, 3.80; p=0.011). Confidence related to the diagnosis of somatic dysfunction approached statistical significance (pre-curriculum mean, 2.55 vs. post-curriculum mean, 3.20; p=0.053). There was no statistically significant effect on satisfaction with options for treating low back pain (pre-curriculum mean, 2.91 vs. post-curriculum mean, 3.70; p=0.059), or knowing how to treat using OMT (pre-curriculum mean, 2.55 vs. post-curriculum mean, 2.80; p=0.334). The results suggest the participants increased their familiarity with the mechanisms of each of the assessed OMT modalities, with the largest increase with Still technique (pre-curriculum mean, 2.18 vs. post-curriculum mean, 3.60; p=0.011). There was no statistically-significant change in patient referrals for OMT or treating patients with OMT. Conclusion: These results support the notion that programs not meeting the criteria for osteopathic recognition may disseminate relevant osteopathic knowledge.

Evaluating the uptake of a Global Initiative for Asthma guideline update in a commercially insured, value-based care population.

Asthma is one of the most common chronic respiratory disease states in the United States and poses a large economic burden. The Global Initiative for Asthma updated its clinical guidelines to recommend low-dose inhaled corticosteroids (ICSs)-formoterol as the preferred reliever option in the treatment of asthma. Randomized controlled trials show lower exacerbation rates in patients using an ICS-formoterol inhaler as a reliever compared with patients using a short-acting β2-agonist-based reliever. There are minimal real-world data examining how this update impacts clinical outcomes and costs. To evaluate real-world asthma-specific outcomes and costs before and after members adopt a preferred treatment plan aligning with the updated Global Initiative for Asthma guideline recommendations and evidence. This retrospective, observational cohort study was performed using claims data for commercially insured members initiating an ICS-formoterol inhaler for asthma. The population included members aged 6-65years with an asthma diagnosis, 2 or more pharmacy claims for an albuterol inhaler, and 1 or more pharmacy claims for an ICS-formoterol inhaler. The index date was the first pharmacy claim for an ICS-formoterol inhaler. All members were continuously enrolled during the 24-month study period, consisting of a 12-month preperiod and postperiod based on the index date. The primary clinical outcome was mean annual asthma exacerbations. The primary cost outcomes include the difference among mean annual asthma-specific pharmacy, medical, and total costs per member with asthma. A paired Wilcoxon signed rank test was used for statistical analysis. Claims for 590 members were included in the analysis. The population consisted of 55.9% women with a mean age of 39years. The mean annual asthma exacerbations decreased 25.6% from the preperiod to the postperiod (0.347 vs 0.258; P = 0.028). Mean asthma-specific pharmacy and total asthma costs significantly increased from the preperiod to the postperiod $474 vs $1,796 (P < 0.001) and $1,505 vs $2,567 (P < 0.001), respectively. The mean asthma-specific medical costs significantly decreased in the postperiod compared with the preperiod ($1,031 vs $771; P = 0.031). In this descriptive study, initiators of ICS-formoterol experienced a decrease in asthma exacerbations and an increase in professional visits. Initiators also had higher mean asthma-specific pharmacy and total costs, but lower mean asthma-specific medical costs. Health plans can take additional steps to promote implementation of updated guidelines. Pursuing clinical programs to further reduce asthma exacerbations would benefit members, providers, and the health plan.

만 5세 유아의 그림책 만들기 활동이 유아의 창의성과 놀이성에 미치는 영향

Objectives This research investigates the effects of picture book creation activities on the creativity and playfulness of 5-year-old children. Methods The subjects of this study were 13 five-year-old children from H Kindergarten in K City, Gyeongsangbuk-do, and 13 five-year-old children from D Kindergarten in D City, selected as the experimental group and the control group, respectively. The experimental intervention involved conducting picture book creation activities and storytelling sessions from November 8, 2023, to January 17, 2024. The test results were analyzed using SPSS 28.0 for Windows. Specific methods included frequency analysis, independent/dependent t-tests, non-parametric statistics such as the Mann-Whitney U test, the Signed Ranks Test, and correlation analysis. The findings of this research are as follows. Results First, picture book creation activities were found to positively impact the enhancement of children's creativity. Specifically, the sub-factors of creativity, including flexibility, fluency, imagination, and originality, were positively influenced. Second, picture book creation activities were found to positively affect children’s playfulness. All sub-factors of playfulness, including physical spontaneity, social spontaneity, cognitive spontaneity, expression of enjoyment, and sense of humor, showed positive developmental effects. Conclusions These findings suggest that picture book creation activities are influential variables in enhancing the creativity and playfulness of 5-year-old children. Therefore, the results of this study indicate that picture book creation activities can help promote the creativity and playfulness of young children.

Evaluation of the Clear Fear Smartphone App for Young People Experiencing Anxiety: Uncontrolled Pre- and Post-Follow-Up Study.

Mobile health apps are proving to be an important tool for increasing access to psychological therapies early on, particularly with rising rates of anxiety and depression in young people. We aimed to assess the usability, acceptability, safety, and effectiveness of a new app, Clear Fear, developed to help young people manage symptoms of anxiety using the principles of cognitive behavioral therapy. The Clear Fear app was developed to provide cognitive behavioral strategies to suit anxiety disorders. An uncontrolled pre- and post-follow-up design over a 9-week period was used to assess the app and its effects. This study comprised 3 phases: baseline (stage 1), post-app familiarization phase (stage 2), and follow-up (stage 3). Eligible participants were aged between 16 and 25 years with mild to moderate anxiety but not currently receiving treatment or in contact with specialist mental health services or using other interventions or apps to help monitor or manage their mental health. A community sample was recruited via advertisements, relevant websites, and social media networks. Eligible participants completed standardized self-report tools and questionnaires at each study stage. These measured probable symptoms of anxiety (7-item Generalized Anxiety Disorder scale) and depression (Mood and Feelings Questionnaire); emotional and behavioral difficulties (Strengths and Difficulties Questionnaire); and feedback on the usability, accessibility, and safety of the app. Mean scores at baseline and follow-up were compared using paired 2-tailed t tests or Wilcoxon signed rank tests. Qualitative data derived from open-ended questions were coded and entered into NVivo (version 10) for analysis. A total of 48 young people entered the study at baseline, with 37 (77%) completing all outcome measures at follow-up. The sample was mostly female (37/48, 77%). The mean age was 20.1 (SD 2.1) years. In total, 48% (23/48) of the participants reached the threshold for probable anxiety disorder, 56% (27/48) had positive scores for probable depression, and 75% (36/48) obtained a total score of "very high" on the Strengths and Difficulties Questionnaire for emotional and behavioral difficulties. The app was well received, offering reassurance, practical and immediate help to manage symptoms, and encouragement to seek help, and was generally found easy to use. A small minority (3/48, 6%) found the app difficult to navigate. The Clear Fear app resulted in statistically significant reductions in probable symptoms of anxiety (t36=2.6, 95% CI 0.41-3.53; P=.01) and depression (z=2.3; P=.02) and behavioral and emotional difficulties (t47=4.5, 95% CI 3.67-9.65; P<.001), representing mostly medium to large standardized effect sizes. The Clear Fear app was found to be usable, acceptable, safe, and effective in helping manage symptoms of anxiety and depression and emotional and behavioral difficulties.