Significant Differences In Scores Research Articles

Fluorescein-guided surgery in high-grade gliomas: focusing on the eloquent and deep-seated areas

PurposeThe vital function of eloquent and deep brain areas necessitates precise treatment for tumors located in these regions. Fluorescein-guided surgery (FGS) has been widely used for high-grade gliomas (HGGs) resection. Nevertheless, the safety and efficacy of utilizing this technique for resecting brain tumors located in eloquent and deep-seated areas remain uncertain. This study aims to assess the safety and extent of resection of HGGs in these challenging tumors with fluorescein and explore its impact on patient survival.MethodsA retrospective analysis was conducted on the clinical and radiological data of 67 consecutive patients with eloquent or deep-seated HGGs who underwent surgery between January 2020 and June 2023. Lacroix functional location grade was used to determine the eloquence of the tumors. The comparison between the fluorescence-guided surgery group (FGS, n = 32) and the conventional white-light microscopic surgery group (non-FGS, n = 35) included assessments of extent of resection (EOR), rates of gross total resection (GTR, 100%) and near-total resection (NTR, 99 to 98%), postoperative Neurologic Assessment in Neuro-Oncology (NANO) scores, overall survival (OS), and progression-free survival (PFS), to evaluate the safety and efficacy of fluorescein-guided technology in tumor resection at these specific locations.ResultsBaseline of demographics, lesion location, and pathology showed no significant difference between the two groups. GTR of the FGS group was higher than the non-FGS group (84.4% vs. 60.0%, OR 3.60, 95% CI 1.18–10.28, p < 0.05). The FGS group also showed higher GTR + NTR (EOR ≥ 98%) than the non-FGS group (93.8% vs. 65.7%, OR 7.83, 95% CI 1.86–36.85, p < 0.01). 87.0% of eloquent tumors (Lacroix grade III) in the FGS group achieved GTR + NTR, compared to 52.2% of control group (OR 6.11, 95% CI 1.50–22.78, p < 0.05). For deep-seated tumors, the rate of GTR + NTR in the two groups were 91.7% and 53.3%, respectively (OR 9.62, 95% CI 1.05–116.50, p < 0.05). No significant difference of the preoperative NANO score of the two groups was found. The postoperative NANO score of the FGS group was significantly lower than the non-FGS group (2.56 ± 1.29 vs. 3.43 ± 1.63, p < 0.05). Median OS of the FGS group was 4.2 months longer than the non-FGS group despite no statistical difference (18.2 months vs. 14.0 months, HR 0.63, 95% CI 0.36–1.11, p = 0.112), while PSF was found significantly longer in FGS patients than those of the non-FGS group (11.2 months vs. 7.7 months, HR 0.59, 95% CI 0.35–0.99, p < 0.05).ConclusionSodium fluorescein-guided surgery for high-grade gliomas in eloquent and deep-seated brain regions enables more extensive resection while preserving neurologic function and improve patient survival.

A cross-sectional study of Hispanic and Latina/o/x/e individuals’ acute coronary syndrome symptom knowledge, attitudes, and beliefs

BackgroundLittle attention has been placed on language proficiency as a potential variable affecting ACS symptom knowledge, attitudes, and beliefs. ObjectivesTo compare the ACS symptom knowledge, attitudes, and beliefs of Hispanic and Latina/o/x/e individuals proficient in English and in those only proficient in Spanish. Secondary aims were to determine if there were differences in ACS symptom knowledge, attitudes, or beliefs based on participants’ previous exposure to ACS symptom information and to evaluate instrument characteristics of the new Spanish version of the ACS Response Index. MethodsThis cross-sectional, comparative study included participants (N = 99) from a community-based clinic in Illinois. Knowledge, attitudes, and beliefs related to ACS symptoms were measured using the ACS Response Index. ResultsThe average participant was 39.8 (SD 15.6) years of age, female (n = 56, 56.6 %), and had a high school education or less (n = 61, 61.6 %). Participants correctly classified a mean 57.5 % (SD 12.8) of symptoms and had mean attitude and belief scores of 12.1 (SD 3.3) and 17.5 (SD 2.9), respectively. There were no significant differences in knowledge, attitudes, and beliefs based on language proficiency. However, there were some statistically significant differences for knowledge and attitude scores based on exposure to ACS symptom information. The ACS Response Index (Spanish Version) also demonstrated favorable internal consistency. ConclusionsOverall knowledge, attitude, and belief scores were modest in this sample. Higher knowledge and attitude scores were observed for some types of ACS information exposure, supporting the importance of future educational efforts in this population.

Different doses of hyaluronic acid injections in patients with knee osteoarthritis: A multicenter, randomized, prospective, single-blind, clinical study.

Many formulations and dosing regimens are available for hyaluronic acid (HA). To compare different doses of linear, high-molecular weight (HMW) HA injections among patients with knee osteoarthritis (OA). Hundred patients were included in this randomized, single-blinded trial and randomly divided into three HA injection groups. The first group received five weekly 20mg HA injections, the second group received three weekly 32mg HA injections, and the third group received a single 48mg HA injection. Patients were evaluated at baseline, 1, 3, and 6months after the last injection for pain, stiffness, and function using the visual analog scale (VAS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire. Quality of life, patient's global assessment, and Timed Up and Go (TUG) test scores were also evaluated. There was significant improvement in the WOMAC, VAS-pain, quality of life, patient's global assessment, and TUG test mean scores at all follow-up time points (p< 0.001). However, the groups showed no significant differences in WOMAC, VAS-activity pain, and patient global scores at any follow-up point. Intra-articular injections of different doses of linear HMW HA can improve pain, stiffness, function, and quality of life in patients suffering from knee OA over a six-month period.

Evaluating Effectiveness of Group Intervention Working on Executive Function for Children with Attention Deficit Hyperactivity Disorder: A Prospective Observational Cohort Study

Introduction: The objective of this study is to evaluate the effectiveness of Simon says program (SSP), a strategy-based group intervention program working on executive function (EF) for children with attention deficit hyperactivity disorder (ADHD). Methods: A prospective observational cohort study was conducted from December 2021 to July 2022 recruiting 21 SSP participants, either they were on stimulant or not on stimulants, and 12 other ADHD patients who are on stimulant medication only without prior participation in SSP, using convenience sampling method, from Child Development Clinic Hospital Sultan Ismail. NICHQ Vanderbilt Assessment Follow Up Scales (VAS) were used to measure its effectiveness and the significance of score differences before and after SSP were assessed using paired sample t-test of Statistical Package for Social Science (SPSS) version 28.0 software. Results: Total of 33 children participated in the study. From our study, only those participants on behavioural therapy alone showed statistically significant reduction in inattentive score, hyperactivity score and total symptoms score at the third month and sixth month after joining SSP from parents-rated VAS. There were no statistically significant differences in the average VAS performance score for both groups. Conclusion: SSP could be an effective behavioral intervention for children with ADHD children. Limitations included lacking clear generalizability due to the convenience sampling method and potential inter-rater variability.

784 Effects of Optimal Versus Suboptimal Median Household Income on the Operative Traumatic Brain Injury Population: A Propensity Score-matched Analysis

INTRODUCTION: Median household income is a useful metric for healthcare disparity assessment. New England holds a highly diverse, densely populated metropolitan area with one of the highest living wages in the US. To our knowledge, there is no published data on the effects of optimal vs. suboptimal median household income on the operative traumatic brain injury (TBI) patients. METHODS: Demographic, clinical and outcome data of operative TBI patients between 2015 and 2021 were collected and stratified based on optimal (80 000$ or more) and suboptimal (less than 80 000$) median residential household income. 1:1 tight caliper (0.01) propensity score matching was performed to balance the groups for comparative analysis. RESULTS: From the initial 91 patients in the optimal and 102 patients in the suboptimal income groups, 62 patients were included in each group after propensity matching. There were significantly more ethnic minority patients in the suboptimal as compared to the optimal income group (66.1% and 35.7%, respectively; p=0.002). Optimal income group patients presented as transfers from other hospitals significantly more frequently than the suboptimal group (52.5% and 30.7%, respectively; p = 0.02). There were no significant differences in post-operative Glasgow coma scale scores (p = 0.15), modified Rankin scale scores at discharge (p = 0.92) and upon follow-up (p = 0.1), mortality (p &gt; 0.999) or disposition destination distribution (p = 0.3). CONCLUSIONS: While the suboptimal income group is significantly more ethnically diverse, optimal versus suboptimal median household income does not seem to affect TBI outcomes and disposition. Optimal income group patients are more frequently presenting as transfers from other facilities indicating fair high-level care at a specialized high safety-net burden trauma center adapted to an ethnically diverse population.

Juvenile Myasthenia Gravis in North Texas: Clinical Features, Treatment Response, and Outcomes

BackgroundJuvenile myasthenia gravis (JMG) is a rare autoimmune disease that causes fatigable muscle weakness in children aged <18 years. There is currently no curative treatment or internationally accepted standard of care for JMG. The objective is to investigate relationships between clinical presentation, antibody status, severity of disease onset, electrodiagnostic evaluation, and response to therapy in JMG. MethodsThis study was a retrospective chart review. Congenital myasthenic syndromes were excluded. Data on demographics, treatments, and outcomes were collected. Disease severity was evaluated using Myasthenia Gravis Foundation of America (MGFA) clinical classifications. ResultsWe identified 84 patients with JMG at Children's Medical Center Dallas between January 2014 and February 2022. It was found that 52% of patients presented with ocular JMG (median onset age 4.5 years) and 48% with generalized JMG (median onset age 11.5 years); 81% tested positive for acetylcholine receptor antibodies. Patients were 17% non-Hispanic white, 29% Hispanic, 39% black, and 12% Asian. There was a significant difference in average MGFA scores between ethnicities (P = 0.047) and age groups (P = 0.004), with postpubertal patients having higher average MGFA scores than prepubertal patients. Seventy-one percent of patients who underwent thymectomy experienced a decrease in MGFA scores postprocedure. ConclusionsOur study showed that there were significant differences in disease severity between ethnicities and age groups and that most patients who underwent thymectomy showed clinical improvement. These outcomes highlight the need for additional therapies in the treatment of JMG and the importance of extending clinical trials to the pediatric population.

A Study to Assess the Effectiveness of Video Assisted Teaching on Knowledge and Attitude of Adolecsent Regarding Healthy Food Habits in Selected School of D&amp;NH

Background: The world health organization (WHO) defines an adolescent as any person between ages 10–19. During adolescent various physiological changes occurs as a result, nutritional requirement of the body increase tremendously, therefore important to consume a balance diet at this stage. In adolescent various health problem occur such as reproductive health problems, nutritional health problem, psychosocial problem etc., but due to poor intake and availability of diet major health problem is under nutrition or over nutrition. Adolescent especially school going children are most vulnerable towards the problem like undernutrition or obesity and when they grow in age this adverse health tendency continues to persist and impairs the health and wellbeing of adolescent population and increase the risk of type 2 diabetes, cardiovascular disease, non-alcoholic fatty liver disease and some cancer. Aim: The aim of the study was to assess the effectiveness of video assisted teaching on healthy food habits among adolescents. Methodology: In this study, pre-experimental research design was used. For total 100 adolescents who met the sampling criteria were selected with Simple random sampling technique from the selected school of D&amp;NH. The data were collected using structure knowledge questionnaire and attitude scale. Results: The result revealed that a significant difference in the mean pre-test knowledge score (9.13) and the mean post-test knowledge score (17.08) of adolescent after administering of video assisted teaching as measured by ‘t’ test (27.248) which was highly significant at 0.001 level of significance. It shows that there was significant difference in mean attitude pre-test score (42.87) and post-test attitude score (49.17) of adolescents, the ‘t’ test measured (11.815) which shows highly significance at 0.001 level of significance. There is no association between pre-test knowledge and attitude with selected demographic variable. Only gender shows that Significant association with selected demographic variable.

Abstract P200: Mediterranean Diet and Metabolic Syndrome in Adolescents: An Analysis From the National Health and Nutrition Examination Survey 2015-2020

Background: The Mediterranean Diet (MD) is an evidence-based dietary approach emphasizing fruits, vegetables, whole grains, seafood, and olive oil. While it’s demonstrated efficacy in enhancing cardiometabolic health in adults, it’s received minimal evaluation in adolescents with metabolic syndrome (MetS). Hypothesis: We hypothesized that higher consumption of MD foods was associated with better metabolic health in a nationally representative sample of U.S. adolescents. Methods: A secondary analysis was conducted using data from the National Health and Nutrition Examination Surveys 2015-2020 (pre-COVID) in adolescents (12-19 years) with ≥ 2 valid 24-hour dietary recalls, complete fasting data for all components of the International Diabetes Foundations definition of MetS risk factors, and no known diabetes. Consumption of MD foods was evaluated using the validated, literature-based MD intake score (Medi-Lite, 0-16 score, excluding alcohol). MetS was evaluated using a continuous MetS score (cMetS) and separated into quartiles [Q1, metabolically unhealthy (cMetS score 1.83 ± 1.64) vs. Q4, metabolically healthy (cMetS score -4.16 ± 0.89)]. Correlation of Medi-Lite scores with cMetS scores and quartile groups controlled for energy intake, age, sex, and BMI were assessed via Pearson correlation and odds ratios, respectively. Results: The primary analyses included 886 adolescents (~15 years, 49% female, 70% non-Hispanic, body mass index ~25 kg/m 2 ) with a mean cMetS score of -1.40 ± 2.39. In the total sample, overall consumption of the MD was low (mean score 6.95 ± 1.83) and cMetS scores were not associated with Medi-Lite scores (r = -0.05, p = 0.21). There was a significant between-group difference for Medi-Lite scores between quartiles (F = 1.69, p = 0.05). In the metabolically healthy group, there was a positive trend towards between cMetS score and Medi-Lite score (r = 0.15, p = 0.06). No correlation was found between cMetS and Medi-Lite scores in the metabolically unhealthy group (r = -0.04, p = 0.59). Metabolically healthy adolescents had higher odds of consuming the MD compared to metabolically unhealthy adolescents (OR 2.012, 95% CI 1.44 to 2.81, p &lt; 0.001). Conclusion: In conclusion, U.S. adolescents had an overall low consumption of MD foods. Metabolically healthy adolescents consumed more MD foods compared to metabolically unhealthy adolescents. Future research should evaluate a MD lifestyle intervention as a treatment option for adolescents with MetS.

No significant difference in thick versus thin osteochondral flap trochleoplasty in the treatment of trochlear dysplasia: A systematic review.

Trochleoplasty has become increasingly utilised to address patellar instability in the setting of severe trochlear dysplasia. There remains a paucity of literature on the outcomes of 'thick'- versus 'thin'-osteochondral flap trochleoplasty. The purpose of this study is to compare clinical and radiographic outcomes between patients with patellar instability with symptomatic trochlear dysplasia treated using a 'thick' versus 'thin' osteochondral flap trochleoplasty. A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using a PRISMA checklist. Quality assessment of final articles was conducted by two blinded reviewers. Articles were separated based on the use of a 'thick' versus 'thin' flap trochleoplasty. Data collection consisted of recording the following variables: patient demographics, indications for trochleoplasty, mean follow-up time, additional procedures performed during trochleoplasty, patient-reported outcome measures (PROMs), radiographic outcomes (tibial tubercle-trochlear groove [TT-TG] distance, Caton-Deschamps Index [CDI] and sulcus angle [SA])and the incidence of any postoperative complications and patellar redislocation rates. A total of 24 studies, consisting of 927 patients, were identified as meeting inclusion criteria. A total of five papers described a 'thick' flap technique, while 19 papers described the use of a 'thin' flap technique. No significant difference in the mean improvement of Kujala scores was appreciated when comparing 'thick' versus 'thin' techniques (p > 0.05). Improvements in mean radiographic outcomes based on TT-TG, CDI and SA were observed in both 'thick' and 'thin' flap trochleoplasty groups. The overall redislocation rate was 0.35%. No significant difference in Kujala scores was observedin patients undergoing trochleoplasty utilising 'thick' versus 'thin' technique, while improvements in mean TT-TG, CDIand SA were noted in both technique groups, with an overall redislocation rate of 0.35%. Level IV.

Evaluating the efficacy of OralDETECT training: Face-to-face versus online delivery in dental education.

This study evaluated the effectiveness of face-to-face (F2F) and online OralDETECT training programme in enhancing early detection skills for oral cancer. A total of 328 final-year dental students were trained across six cohorts. Three cohorts (175 students) received F2F training from the academic years 2016/2017 to 2018/2019, and the remaining three (153 students) underwent online training during the Covid-19 pandemic from 2019/2020 to 2021/2022. Participant scores were analysed using the Wilcoxon signed rank test, the Mann-Whitney test, Cohen's d effect size, and multiple linear regression. Both F2F and online training showed increases in mean scores from pre-test to post-test 3: from 67.66 ± 11.81 to 92.06 ± 5.27 and 75.89 ± 11.03 to 90.95 ± 5.22, respectively. Comparison between F2F and online methods revealed significant differences in mean scores with large effect sizes at the pre-test stage (p < 0.001), while significant differences with small effect sizes were noted for post-test 1 (p = 0.002) and post-test 3 (p = 0.041). Regression analysis indicated that the delivery method is associated with the participants' final scores. F2F and online versions of the OralDETECT training programme significantly enhance participants' knowledge and skills in oral cancer detection. Although F2F appeared to be more effective, the difference was not substantial enough to be considered educationally meaningful.

A clinical study on cognitive dysfunction in depressed patients

ABSTRACT Background: Major depression is a commonly occuring, seriously impairing, and often recurrent mental disorder. Depression and cognitive impairement have enormous implications for public health. Cognitive symptoms represent one of the core features of depression and have an impact on many functional outcomes. Different cognitive domains such as attention and concentration, psychomotor speed, executive functioning, and memory have been found to be implicated. Aim: This study aimed at assessing the cognitive domains affected and severity of cognitive dysfunction in first-episode patients of the unipolar depressive episode without psychosis and to assess the correlation of association of severity of cognitive deficit with severity of depression. Materials and Methods: A total of 40 patients with depression diagnosed according to International Classification of Diseases Research Diagnostic Criteria and 40 healthy controls were included. PGI Battery of Brain Dysfunction, Frontal Assessement Battery, and Hamilton Depression Rating scale (HAM–D) were adminstered, and analysis was done using Chi-square test, unpaired t-test, and Pearson’s correlation. Results: The study revealed significant differences in the dysfunction scores between the study and control populations. In the study group, more than 80% of patients had cognitive dysfunction and a positive correlation was found between dysfunction and HAM–D scores. Conclusion: Depression is associated with significant disturbance in cognitive functioning, and the cognitive dysfunction increases with an increase in the severity of depression.

An investigation into the correlation between visual performance in simulated complex environments and academic attainment among primary school students

Traditional vision screenings in schools are limited to simple visual tasks, yet students in their daily learning face more complex visual environments. Binocular rivalry tasks can partially simulate the visual challenges of real visual environments and activate advanced visual processing mechanisms that simple visual tasks cannot. Therefore, by superimposing binocular rivalry-state tasks onto simple visual tasks, we have developed an innovative vision screening program to rapidly and extensively assess students’ visual performance in complex environments. This is a cross-sectional study in which we investigated the performance of 1126 grade 1–6 students from a primary school in Wuxi, China, in rivalry-state stereoscopic vision tasks. The correlation between the screening results of 1044 students and their academic achievements was also statistically analyzed. The study results revealed pass rates of 53.5–60.5% across various visual tests. Specifically, for first-grade students, there was a statistically significant difference in standardized Chinese scores between the group that failed and the group that passed the rivalry-state stereoscopic vision test (− 0.49 ± 3.42 vs. 0.22 ± 0.58, t = − 2.081, P = 0.04). This result underscores the importance of focusing on the visual adaptability of first graders in complex environments.Trail registration: Ethics Committee of Affiliated Children’s Hospital of Jiangnan University-Certificate number: WXCH2022-04-027

Caliper-verified unrestricted kinematically aligned total knee arthroplasty in Asian patients showed efficacious mid- to long-term results regardless of postoperative alignment categories.

There have been insufficient data regarding the long-term results of unrestricted kinematically aligned total knee arthroplasty (unKATKA) in Asian patients. We investigated mid- to long-term clinical and radiological follow-up data of Korean patients after caliper-verified unKATKA of minimum 7.4-10 years includingcategorised data of postoperative tibial component, limb and knee alignment. Additionally, we analysed the preoperative distribution and postoperative restoration of coronal plane alignment of knee (CPAK) phenotypes. This study is a retrospective analysis of 63 patients:96 osteoarthritic underwent consecutive caliper-verified unKATKA between October 2013 and May 2016 by a single surgeon. Implant survivorship was investigated for revision for any reason. Each knee was categorised into an in-range or outlier group by three postoperative alignment parameters: tibial component, knee and limb alignment. Statistical analyses were done for any significant differences in clinical scores and implant survival rates between groups. Finally, all knees were classified into CPAK classification postoperatively and postoperatively. The CPAK restoration rate was calculated. Among 85 knees in the clinically confirmed group, implant survival was 98.8%. There was one case of revision due to periprosthetic fracture. The percentage postoperatively aligned in the varus (valgus) outlier range was 100% (0%) for tibial component, 16.7% (24.8%) for the knee alignmentand 51% (0%) for the limb alignment. All three categories did not affect implant survival or clinical scores. Eighty one out of 96 knees (84.4%) were restored to their CPAK phenotype postoperatively. With the limitation of a case series having a small number of patients and gender deviation, our study suggests that caliper-verified unKATKA could be a good option regardless of geographical variation of constitutional alignment in patients with osteoarthritis (OA). Level IV, therapeutic study.

Use of Android-Based Flipbook Educational Media to Increase Knowledge, Beliefs, Attitudes, and Intentions of Prospective Brides in Stunting Prevention in Semarang City

Background: The prevalence of stunting in Semarang City is still relatively high. Low public knowledge about stunting prevention can increase the incidence of stunting. Stunting can be prevented before pregnancy. Prospective brides are strategic targets in stunting prevention so that they can prepare for a healthy pregnancy. Increasing the knowledge of the prospective brides can be done by providing education using media that follows the characteristics of the prospective brides, namely using Android-based flipbook media. Aims: The study aims to analyze the effect of education using Android-based flipbook media on increasing knowledge, beliefs, attitudes, and intentions of prospective brides in stunting prevention in Semarang City. Method: This study used a quasi-experimental research design with a nonequivalent control group design. The sample of the research was prospective brides totaling 94 people, consisting of treatment and control groups of 47 people. Data collection used pre-test and post-test questionnaires to measure prospective brides’ knowledge, beliefs, attitudes, and intentions in stunting prevention. Results: The results showed that there were significant differences in the average knowledge score (p = 0.001), beliefs (p = 0.016), attitude (p = 0.001), and intention (p = 0.001) of prospective brides in stunting prevention. Conclusion: So it can be concluded that education about stunting prevention using Android-based flipbook media influences increasing knowledge, beliefs, attitudes, and intentions of prospective brides in stunting prevention. The greatest influence is shown on the knowledge variable, which is equal to 29,7%.

Variations in choroidal thickness between emmetropic and myopic eyes after caffeine intake.

To investigate the variations in choroidal thinning between emmetropic and myopic subjects after caffeine intake. Forty-five healthy participants (age mean ± standard deviation [SD]: 20.75 ± 1.6 years) recruited in a prospective cross-sectional study. They were divided into three groups, based on refractive error status, emmetropes (spherical equivalent [SE] -0.25 to +0.25D), myopes (SE ≥-0.50D to ˂-6.00D), and high myopes (SE ≥-6.00D). The participants underwent choroidal thickness [ChT] measurements using optical coherence tomography [OCT] (Topcon 3D OCT-1 Maestro System) at baseline, 20, 40, and 60 minutes after consuming 200 mg of caffeine. The measurements of ChT were taken from five different areas horizontally. Compared to baseline measurement, the ChT significantly decreased after 200 mg caffeine intake in all conditions ( P < 0.001). There was a statistically significant difference in ChT at baseline between the refractive groups ( χ2 (2)=6.548, P = 0.038) as the high myope group showed lesser horizontal ChT within Nasal at (1 mm) area compared to the myope group ( P = 0.032), however, no other significant differences in mean scores of horizontal ChT at baseline were found. The thinning in ChT in the high myope group was lesser compared to both emmetrope and myope groups; however, it was not statistically significant ( P > 0.05). The results of this study suggest that the reduction in ChT due to caffeine consumption is not significantly affected by the refractive status of the eye. Thus, it is safe to hypothesize that the vascular part of the choroid behaves identically to vasoconstrictive in both emmetropic and myopic eyes. The choroidal thinning found in myopic and high myopic eyes and/or the reduced choroidal vascularity index were not apparent in this study. Therefore, further longitudinal studies recruiting greater numbers of participants, including myopes and high myopes, and measuring both vascular and stromal layers to investigate such variations are warranted.

ĐỘNG LỰC BÊN TRONG CỦA HỌC SINH SỬ DỤNG CÁC HOẠT ĐỘNG DỰA TRÊN TRÒ CHƠI

This study sought to determine the effects of game-based activities (GBAs) on students’ intrinsic motivation. The study employed a sequential explanatory mixed-methods approach using quantitative and then qualitative data to explore the impact of GBAs on intrinsic motivation. It also utilized lessons integrating GBAs into an ecosystem curriculum developed and adapted by the researcher for the study. Sixty-nine Grade 7 students from two sections of a public secondary school in Sorsogon, Philippines, participated in this study. One section with 34 students was assigned to an experimental group and exposed to GBAs developed for ecosystem lessons. The 35 students in the other section were assigned to a control group and taught with games using traditional teaching methods. Respondents completed a survey on the intrinsic motivation inventory (IMI) after the intervention. The survey results revealed a significant difference in the IMI scores of respondents (u = 327, N = 69, p = 0.05), and the integration of GBAs in ecosystem lessons for Grade 7 significantly improved students’ intrinsic motivation. Qualitative data analysis also revealed that GBAs specifically addressed students’ psychological needs in terms of interest or enjoyment, perceived competence, effort or importance, value or usefulness, and relatedness, which ultimately improved students’ intrinsic motivation. Integration of GBA into ecosystem lessons can improve students’ intrinsic motivation when GBAs align with learning goals and include interactive and engaging game elements. This study emphasized the effects of GBAs on intrinsic motivation and delved deeper into the specific context of science education in Grade 7, providing insights on how to harness GBAs effectively in specific educational settings. This study recommends the integration of GBAs into science education to enhance students’ motivation and improve their learning experiences and outcomes. A more comprehensive study of the effect of GBAs on students’ learning experiences is also recommended.

Effects of Travel Distance on Complications and Outcomes in Total Ankle Arthroplasty.

Owing to the last decade's increase in the number of total ankle arthroplasty (TAA) procedures performed annually, there is a concern that the disproportionate distribution of orthopaedic surgeons who regularly perform TAA may impact complications and/or patient satisfaction. This study examines patient-reported outcomes and complications in TAA patients who had to travel for surgery compared to those treated locally. This is a single-center retrospective review of 160 patients undergoing primary TAA between January 2016 and December 2018, with mean age 65 (range: 59-71) years, mean body mass index (BMI) 28.7 kg/m2, 69 (43.1%) females, and mean 1.5 (SD = 0.51) years follow-up. Patients were grouped by distance traveled (<50 miles [n = 89] versus >50 miles traveled [n = 71]). There were no significant differences in rate or type of postoperative complications between the <50 mile group (16.9%) and the >50 mile group (22.5%) (P = .277). Similarly, there were no significant difference in postoperative PROMIS scores between the groups (P = .858). Given uneven distribution of high-volume surgeons performing TAA, this is important for patients who are deciding where to have their TAA surgery and for surgeons on how to counsel patients regarding risks when traveling longer distances for TAA care.Levels of Evidence: Level III: Retrospective Cohort Study.

Variations in anxiety and emotional support among first-year college students across different learning modes (distance and face-to-face) during COVID-19.

College students with more emotional support experience lower levels of anxiety and other psychosocial and behavioral problems. During the COVID-19 pandemic, the emotional well-being of college students was additionally challenged by an abrupt shift to distance learning followed by a return to face-to-face classes. In this exploratory study, we compared the levels of perceived emotional support and anxiety among incoming first-year undergraduate students, prior to starting classes, which included different learning modes in five semesters of instruction from 2021-2023 (three distance semesters and two face-to-face semesters). Data from 8659 undergraduate students were extracted from a Mexican state university database, corresponding to students' responses collected during new student orientation week. Participants were students in the arts and humanities (9.7%), social and legal sciences (38%), life and health sciences (28.9%), and engineering and architecture (23.4%). Anxiety levels were measured with the GAD-7 scale, and emotional support was measured using a subscale of the PERACT-R (To go through with resilience) inventory. Comparisons of emotional support and anxiety scores among semesters revealed highly significant differences with small effect sizes. Anxiety levels increased significantly with mean average of 6.65 SD(5.52) during the baseline measure to the highest in 2022-2 to 7.53 SD(5.3) and Emotional Support decreased systematically each semester from baseline mean = 8.03 SD(2.0) to the lowest 7.52 SD(1.8) in 2022-2. The results show that a return to face-to-face classes was associated with increased anxiety levels, whereas levels of emotional support systematically decreased across the five semesters. MANOVA analysis revealed significant differences in anxiety and emotional support scores between semesters, with peaks during the learning mode semester that students returned to face-to-face classes after distance learning even after adjusting for gender. Given that the effect of emotional support on anxiety may be related to success in future educational and professional activities, it is important to develop interventions to restore and increase college students' emotional support levels and develop anxiety management strategies.

Functional alignment maximises advantages of robotic arm-assisted total knee arthroplasty with better patient-reported outcomes compared to mechanical alignment.

Robotic arm-assisted total knee arthroplasty (RTKA) enables adjustment of implant position to achieve the surgeon's preferred alignment. However, the alignment concept that most effectively enhances patient satisfaction remains unclear. This study compares the clinical outcomes of patients who underwent functionally aligned RTKA (FA-RTKA), mechanically aligned conventional TKA (MA-CTKA) and mechanically aligned RTKA (MA-RTKA). A prospectively collected database was retrospectively reviewed for patients who underwent primary TKA for knee osteoarthritis. One hundred and forty-seven knees were performed with MA-CTKA, followed by 72 consecutive knees performed with MA-RTKA, and subsequently, 70 consecutive knees performed with FA-RTKA were enrolled. After 1:1 propensity score matching of patient demographics, 70 knees were finally included in each group. The extent of additional soft tissue release during surgery was identified, and the Coronal Plane Alignment of the Knee classification was utilised to categorise the alignment. At the 1-year follow-up, patient-reported outcomes, including the pain Visual Analogue Scale, Knee Society Score, Western Ontario and McMaster Universities Arthritis Index and Forgotten Joint Score-12, were also compared among the groups. The FA-RTKA group showed significantly less additional soft tissue release than the MA-CTKA and MA-RTKA groups (15.7%, 38.6% and 35.7%, respectively; p = 0.006). Statistically significant differences in functional scores were observed in the postoperative 1-year clinical outcomes in favour of the FA-RTKA group, which had a significantly larger percentage of knees that maintained constitutional alignment and joint line obliquity than those of the other groups. Functionally aligned TKA showed superior 1-year postoperative patient-reported outcomes compared with those of conventional and robotic arm-assisted mechanically aligned TKA. Therefore, the advantage of RTKA is maximised when the implant positioning is based on functional alignment. The application of RTKA with mechanical alignment has been proven ineffective in improving the clinical outcomes of patients. Level III.

Dyslipidemia may impact initial recovery following arthroscopic rotator cuff repair: a retrospective study

BackgroundThe current literature shows that dyslipidemia can lead to a higher incidence of rotator cuff tears (RCTs) and an increased retear rate after repair. We aimed to evaluate the influence of preoperative dyslipidemia on postoperative pain, patient-reported outcomes (PROs), active range of motion (ROM), and structural integrity.MethodsA cohort of 111 patients who underwent arthroscopic RCT repair between January 2021 and July 2022, and whose complete preoperative serum lipid data were available within one week prior to surgery was retrospectively reviewed. Dyslipidemia was defined as the presence of an increase or decrease in at least one blood lipid profile (triglycerides, total cholesterol, low-density lipoprotein, high-density lipoprotein, or non-high-density lipoprotein). There were 43 patients in the dyslipidemia group and 68 in the ortholiposis group. Patient evaluations, including pain score, PROs, and ROMs, were conducted preoperatively; at 3 and 6 months postoperatively; and at the last follow-up. Structural integrity was assessed by magnetic resonance imaging (MRI) 6 months after surgery if possible, and Sugaya type 4 or 5 was considered a retear. Propensity score matching (PSM) was used to reduce bias.ResultsThe RCT size, surgical technique, preoperative pain status, PROs, and active ROM were comparable between patients with dyslipidemia and those with ortholiposis. Three months after surgery, patients in the dyslipidemia group had worse average PROs (Constant score: P = 0.001; ASES score: P = 0.012; UCLA score: P = 0.015), forward flexion (P = 0.012), and internal rotation (P = 0.001) than patients in the ortholiposis group did. The difference between the two groups persisted after PSM but disappeared at the sixth month after surgery. No significant differences in pain score, PROs, or active ROMs were detected between the dyslipidemia and ortholiposis groups after a mean follow-up of 24 months. Of the 72 patients who underwent MRI, 4 retears (5.6%) were found, and all were in the ortholiposis group. There was no difference in the rate of retears between the two groups (P = 0.291) or with (P = 0.495) PSM.ConclusionsIn conclusion, we found that perioperative dyslipidemia may impact initial recovery within the first 3 months following arthroscopic rotator cuff repair but may have no effect on pain, PROs, or active ROMs at a mean 2-year follow-up or rotator cuff integrity at 6 months postoperatively.Trail registration Retrospectively registered.