Significant Difference In Terms Research Articles

Surgical experience in adults with Ebstein's anomaly: Long-term results.

The aim of this study was to review late results of the surgical treatment of Ebstein's anomaly with reconstruction and replacement in adults. Medical records of 28 consecutive patients operated on between 1991 and 2014 were reviewed retrospectively. Surgical repair was performed in 19 (67.9%) patients (Hardy: two, Danielson: three, modified Danielson: six, Carpentier: three, Kay annuloplasty reinforced with ring: two), whereas tricuspid valve replacement was performed in nine patients (32.1%). Primary long-term outcomes consisted of right ventricular function, survival and freedom from re-operation. We evaluated the additional impacts of residual tricuspid insufficiency and type of surgery on survival. In-hospital mortality rate was 7.1% (n = 2) due to low cardiac output status and sepsis. Patients showed a significant postoperative decrease in tricuspid regurgitation (p < 0.001), right atrial size (p < 0.001) and pulmonary hypertension (p = 0.002). The mean follow-up time was 140 ± 71.4 months, with a median of 126 months (105 - 192). Late mortality occurred in two patients and there was no significant difference in terms of survival based on residual tricuspid insufficiency (p = 0.57) and type of surgery (p = 0.094). Overall survival rates were 89.3, 85.4, 85.4 and 68.3% at five, 10, 15 and 20 years, respectively. Although complex leaflet reconstruction techniques have evolved to achieve a more physiological and durable repair, both approaches can be performed safely on specific patients and can be alternated, with acceptable rates of survival and re-operation.

Kumar Oynama Eğilimi Üzerine Bir Araştırma

Bu araştırma Yalova Üniversitesi Spor Bilimleri Fakültesi’nde eğitim-öğretimine devam eden öğrencilerin kumar oynamaya yönelik tutumlarını belirlemek, kumar aşerme düzeylerini ölçmek ve farklı değişkenler açısından incelemek amacıyla gerçekleştirilmiştir. Araştırma grubu, 85 kadın ve 143 erkek olmak üzere toplam 228 gönüllü katılımcıdan oluşmaktadır. Araştırmada veri toplama aracı olarak kişisel bilgi formunun yanı sıra Buran, Çakıcı, Çakır ve Yılmaz (2019) tarafından Türk kültürüne uygun güvenirlik ve geçerlilik çalışması yapılan, tek faktör ve 7’li likert tipindeki “Kumar Aşerme Ölçeği” (KAÖ) kullanılmıştır. Ölçeğin mevcut örneklem grubu için güvenirlilik düzeyini belirlemek için Cronbach Alpha iç tutarlılık katsayısı hesaplanmıştır. Güvenilir olduğu tespit edilen ölçeğin normal dağılıma uymadığı belirlenmiş ve testlerin sınanmasında non-parametrik test teknikleri kullanılmıştır. Elde edilen bulgular sonucunda örneklem grubunun serbest zamanı sıklıkla değerlendirme durumu değişkeni açısından KAÖ ortalama puanının anlamlı farklılık gösterdiği tespit edilmiştir. Bulgular, cinsiyet, haftalık serbest zaman süresi, aktif olarak spor yapma durumu ve yaş değişkeni açısından incelendiğinde ise anlamlı farklılık olmadığı görülmüştür. Sonuç olarak Spor Bilimleri Fakültesi’ndeki öğrencilerin düşük düzeyde kumar bağımlılığına yönelik tutum içerisinde olduğu tespit edilmiştir. Ayrıca serbest zamanı pasif olarak değerlendiren bireylerin kumar bağımlılığına yönelik tutumlarının daha yüksek seviyede olduğu görülmüştür.

Clay and organic compost as quality conditioners of a sandy soil in the brazilian semiarid

Due to natural and anthropic pressures of semiarid regions, like sandy texture, organic matter (OM) deficiency, water scarcity and inadequate management, we carried out an experiment under greenhouse conditions, to evaluate the effects of clay and OM addition on the quality of a sandy soil of the Brazilian semiarid. The experiment lasted 75 days, testing four clay contents (10 and 31% natural soils, 15% by clay addition to a sandy soil and 26% by mixing clay subsoil to a sandy topsoil) in the absence and presence of organic compost (7.5g.kg-1). For biological parameters, sorghum plants were used for biometric and mineral composition analysis, in addition to assessing microbial activity (BSR, MBC, and qCO2). The results showed significant differences in soil microporosity and total porosity; the field capacity and permanent wilting point correlated linearly with clay content and OM addition; potencial and exchangeable soil acidity decreased significantly in the presence of compost. Sorghum plants showed higher values of biometric attributes and lower levels of nutrients in the presence of compost. The microbial activity did not show significant differences in terms of clay content or compost addition. The cluster analysis correlated the mixed soils (26%) to the lowest clay content soil (10%), and the clay addition (15%) to the highest clay content soil (31%), showing potential as soil conditioner in association with compost, as it might promote changes in the soil quality properties of semiarid regions.

Treatments related to temporomandibular disorders among patients with prevalent types of Ehlers-Danlos syndrome in Sweden

ABSTRACT The aim of this study was to assess the received TMD treatment modalities and the perceived outcome among the frequent types of EDS. A digital questionnaire was sent to the member of the National Swedish EDS Association during January-March 2022. The subsamples of hypermobile and classical EDS were constructed. Almost 90% reported TMD symptoms. Bite splint therapy, counselling, jaw training and occlusal adjustment were reported as the most common treatments with no statistically significant difference in terms of good effect between the two subsamples. Hypermobile and classical EDS might consider as an entity with regards to TMD.

Comparison of non-COVID-19 critically ill patients between pre-pandemic and pandemic period admitted from emergency department to internal medicine intensive care unit

Aim: During the COVID-19 pandemic, a large number of intensive care unit beds have been organized for critically ill COVID-19 patients. However, the need for intensive care for non-COVID-19 critical patients continues. In our study, we aimed to compare non-COVID-19 critically ill patients admitted to the internal medicine intensive care unit from the emergency department before and during the pandemic period.&#x0D; Materials and Methods: Patients who were admitted to the internal medicine intensive care unit from the emergency department were grouped as pre-pandemic (March 2018-March 2020) and during the pandemic (March 2020-March 2022) and compared retrospectively in terms of the number of hospitalisations, demographic characteristics, length of intensive care unit stay and mortality.&#x0D; Results: The number of emergency department patient admissions other than surgical reasons was 579.657 during the study period. 63.33 % of these patients were admitted before the pandemic and 36.67% during the pandemic period. The number of patients included in our study was 493 before the pandemic and 460 during the pandemic period. Median age was 61 (30) in the pre-pandemic period and 64 (26.8) in the pandemic period, p=0.022. There was no significant difference in terms of comorbidities. The main reason for hospitalisation was similar and sepsis was the leading reason for hospitalisation. The frequency of acute renal failure in intensive care unit was significantly higher during the pandemic period. Mortality was 25.2% before the pandemic and 24.3% during the pandemic period, p=0.760.&#x0D; Conclusion: Although emergency department admissions decreased, the number of non-COVID-19 internal medicine intensive care unit hospitalisations did not decrease. This situation reveals the importance of organising intensive care beds for hospitalisation for non-COVID-19 reasons in order not to disrupt health services during the pandemic period.

Multivariable predictive models for the estimation of power consumption (kW) of a Semi-autogenous mill applying Machine Learning algorithms [Modelos predictivos multivariables para la estimación de consumo de potencia (kW) de un molino Semi - autógeno aplicando algoritmos de Machine Learning

This research aimed to develop machine learning (ML) models to estimate power consumption (Kw) in a Semi-autogenous mill in the mining industry. Using Machine Learning algorithms considering various operating variables for the different models such as Multiple Linear Regression (RLM), Decision Tree Regression (RAD), Random Forest Regression (RBA) and Regression Artificial Neural Networks (ANN). The methodology adopted was applied, with an experimental design with a descriptive and transversal approach. The results of the application of these models revealed significant differences in terms of predictive efficiency. The RLM and RRNA stood out with coefficients of determination (R²) of 0.922 and 0.939, respectively, indicating a substantial capacity to explain the variability in power consumption. In contrast, the tree-based models (RAD and RBA) showed inferior performance, with R² of 0.762 and 0.471. When analyzing key metrics such as Mean Absolute Error (MAE), Mean Square Error (MSE) and Root Root Mean Square Error (RMSE), it was confirmed that both RLM and RRNA outperformed the tree-based models. These results support the choice of RLM and RRNA as preferred models for estimating power consumption in a Semi-autogenous mill.

Postoperative morbidity and mortality of patients with COVID-19 undergoing cardiovascular surgery: an inverse propensity-weighted study

BackgroundTo evaluate the postoperative morbidity and mortality of patients undergoing cardiovascular surgery during the 2022 nationwide Omicron variant infection wave in China.MethodsThis retrospective cohort study included 403 patients who underwent cardiovascular surgery for the first time during the 2022 wave of the pandemic within 1 month. Among them, 328 patients were preoperatively diagnosed with COVID-19 Omicron variant infection during the pandemic, and 75 patients were negative. The association between Omicron variant exposure and postoperative prognosis was explored by comparing patients with and without COVID-19 exposure. The primary outcome was in-hospital death after cardiovascular surgery. The secondary outcomes were major postoperative morbidity, including myocardial infarction (MI), acute kidney injury (AKI), postoperative mechanical ventilation hours, ICU stay hours, and postoperative length of stay. The data were analyzed using inverse probability of treatment weighting (IPTW) to minimize bias.ResultsWe identified 403 patients who underwent cardiovascular surgery, 328 (81.39%) had Omicron variant infections. In total, 10 patients died in the hospital. Omicron variant infection was associated with a much greater risk of death during cardiovascular surgery after adjustment for IPTW (2.8% vs. 1.3%, adjusted OR 2.185, 95%CI = 1.193 to 10.251, P = 0.041). For major postoperative morbidity, there were no significant differences in terms of myocardial infarction between the two groups (adjusted OR = 0.861, 95%CI = 0.444 to 1.657, P = 0.653), acute kidney injury (adjusted OR = 1.157, 95%CI = 0.287 to 5.155, P = 0.820), postoperative mechanical ventilation hours (B -0.375, 95%CI=-8.438 to 7.808, P = 0.939), ICU stay hours (B 2.452, 95%CI=-13.269 to 8.419, P = 0.660) or postoperative stay (B -1.118, 95%CI=-2.237 to 1.154, P = 0.259) between the two groups.ConclusionPerioperative COVID-19 infection was associated with an increased risk of in-hospital death among patients who underwent cardiovascular surgery during the Omicron variant wave of the pandemic.

Evaluation of vitamin D status in adult patients with newly diagnosed immune thrombocytopenia.

It has been shown that 25-OH vitamin D not only preserves calcium and bone homeostasis but also has immunomodulatory effects. The purpose of this study was to assess the association between adult patients with recently diagnosed immune thrombocytopenia (ITP) and vitamin D levels. Retrospective technique was employed in this study. The associations between 25(OH)D value and platelet count, as well as the clinical symptoms of ITP upon diagnosis and 25(OH)D value, were our main findings. A total of 60 patients diagnosed and followed up in our clinic were included in the study. Forty-one patients (68.3%) were female and 19 (31.7%) were male. The median age of the patients was 52.5 (19-88). The median vitamin D level of all patients at diagnosis of ITP was 11.5 (3-86). There was no statistically significant difference between the patients divided into three groups according to their vitamin D levels, in terms of laboratory parameters. There was no statistically significant difference in clinical findings according to vitamin D status in ITP patients. There was no statistically significant difference in terms of relapse-free survival in all three groups (p = 0.71). In conclusion, in our study, no correlation was found between laboratory and clinical findings at diagnosis and vitamin D levels in adult ITP patients. Additional investigations, particularly randomized controlled trials, are required to examine the relationship between 25(OH)D and the incidence and severity of ITP.

Impact of Dexmedetomidine on Postoperative Nausea and Vomiting in Opiate-Addicted Patients Undergoing Elective Laparoscopic Cholecystectomy: A Randomized, Placebo-Controlled Clinical Trial

Background: Postoperative Nausea and Vomiting (PONV) is one of the most common complications of general anesthesia, moreover opioid addiction increases the risk of PONV. Hence, this study evaluates the effect of administering dexmedetomidine infusion as an intraoperative analgesic on PONV in opium-addicted patients who underwent elective laparoscopic cholecystectomy. Methods: In a randomized clinical trial, 100 opium-addicted patients who were candidates for elective laparoscopic cholecystectomy surgery under general anesthesia were studied in two groups of 50 participants. The intervention group received dexmedetomidine infusion 10 min after induction of anesthesia until the end of surgery. The placebo group received normal saline at the same time. The rate of PONV was compared between the two groups. Results: Both groups had no significant difference in terms of hemodynamic parameters during surgery, including pulse rate, systolic and diastolic blood pressure, and duration of anesthesia. In the dexmedetomidine group, patients had less PONV than the control group, and this difference was significant (p=0.0164). Conclusion: Dexmedetomidine administration during laparoscopic surgery can reduce PONV, especially in patients addicted to opium.

Can prolonged P-R interval predict clinical outcomes in non-ST elevation acute coronary syndrome patients?

BackgroundThe present study aimed to respond to clinical question, can prolonged P-R interval predict clinical outcomes in non-ST elevation acute coronary syndrome patients?MethodsThis descriptive-analytical study was conducted on cardiac patients. All of the non-ST elevation acute coronary syndrome (NSTEACS) including non-ST elevation myocardial infarction (NSTEMI) and unstable angina patients included in the study. Then they divided into two groups: prolonged P-R interval and normal P-R interval. The patients who had a history of digoxin and calcium channel blocker use, using antiarrhythmic drugs, known valvular or congenital heart disease and connective tissue, unreadable P-R interval and cardiac block were excluded. Data were collected using the questionnaire consisted demographic data and clinical outcomes and a follow-up part was completed by one of the researchers.ResultsFinally, 248 patients completed the study. The results showed both of the two groups had significant differences in terms of the history of myocardial infarction (MI) (p = 0.018), the level of high-density lipoprotein (HDL) (p = 0.004), heart rate (p = 0.042), inverted T wave (p = 0.017), anterior ST- segment depression (p = 0.008), normal report of coronary angiography (CAG) (p = 0.003), three vessels disease (p = 0.043), left main lesion (p = 0.045) and SYNTAX score (p = 0.032) based on the CAG report. The results of six-month follow-up showed although, the frequency of ischemic stroke, coronary artery disease (CAD) and cardiovascular death were higher in prolonged P-R interval groups. The chi-square test showed this difference was statistically non-significant (p > 0.05). The multivariate logistic regression model revealed non-significant relationships between prolonged P-R interval and SYNTAX score, significant CAD, three-vessel disease, inverted T wave, anterior ST depression, heart rate and HDL.ConclusionsBased on the results of our study the six-month follow-up showed non-significant outcomes. Further studies are recommended to assess the long-term outcomes.

Examining the Effects of Project and Resource-Based Teaching Methods on Social Intelligence, Metacognitive Thinking and Academic Achievement

This study aimed to reveal the effects of project- and resource-based teaching methods on student teachers' social intelligence, metacognitive thinking skills, and academic achievements. A pretest-posttest control group design, a quasi-experimental method, was used in the study. The study used the purposeful sampling method to determine the study group. The study group consists of four different groups. The study analyzed the collected data by MANOVA and paired samples t-test. The findings obtained from the study showed that there was a significant difference in terms of metacognitive thinking skills and academic achievement between the groups to which different teaching methods were applied. In the study, it was understood that the group to which PBTM was applied was more successful than the other groups in terms of metacognitive thinking skills and academic achievements. It was observed that there was a significant difference between the pre-test and post-test scores regarding the metacognitive thinking skills and academic achievement of the group to which PBTM was applied. On the other hand, it was determined that there was no significant difference in terms of the scores regarding social intelligence levels between the groups to which different teaching methods were applied in the study. It was observed that there was no significant difference between the social intelligence variable pre-test and post-test scores of the groups. In conclusion, the study revealed that different teaching methods used in lessons affected students' social intelligence, metacognitive thinking and academic achievement at different levels.

Impact of COVID-19 Pandemic on Otolaryngologic Surgeries in Iranian Pediatrics

Background: There is no study about the evaluation of incidence rates of tonsillectomy, adenoidectomy, and ear surgeries before and during the coronavirus disease 2019 (COVID-19) pandemic and the impact of pandemic peaks on the incidence rates of these operations in the world, particularly in Iran. Objectives: This study aimed to evaluate the impact of the COVID-19 pandemic on the number of most common otolaryngologic operations in the Iranian pediatric population. Methods: This retrospective study was performed in a referral hospital. The data of target patients over the period of March 21, 2018, to November 22, 2021, were collected. The number of surgeries at the period of any peak plus before and during the COVID-19 pandemic was compared. Results: A total of 6 290 patients from the Health Information System of Amir A’lam hospital, Tehran, Iran, were enrolled. In this study, 52.9% and 46.5% of the patients were male and female, respectively. There were 3 main types of surgeries, such as adenoidectomy, tonsillectomy, and ear surgeries, with mean ± standard deviation (SD) age of 10.20 ± 9.4, 11.45 ± 10.8, and 44.19 ± 14.6 years, respectively. There was a significant difference in terms of the total number of operations between before (n = 5070) and during the COVID-19 pandemic (n = 1220) (P &lt; 0.001). The amount of this difference was much greater in tonsillectomy (n = 3736 vs. n = 546) and adenoidectomy (n = 134 vs. n = 21) than in ear surgeries (n = 1200 vs. n = 653). Conclusions: The COVID-19 pandemic significantly reduced the number of most common otolaryngologic surgeries in the Iranian pediatric population. The reason is that the restrictions during the pandemic might have a potential effect on reducing the transmission of tonsil-adenoid gland infection.

Primary implantation of an artificial urinary sphincter using the perineal and penoscrotal approaches: Functional results and assessment of reoperative procedures

IntroductionArtificial urinary sphincter (AUS) is the standard treatment for severe stress urinary incontinence in men. While the perineal access is considered the gold standard, some authors have proposed penoscrotal AUS in order to facilitate the procedure. The main objective of our study was to evaluate the duration of survival without revision surgery (SSRC) according to the surgical approach for primary implantation. Material and methodsData from 1179 patients implanted in France between 1991 and 2020 with an AMS 800 AUS were retrospectively analyzed. A total of 762 men were implanted perineally (VP) and 417 penoscrotally (VPS). ResultsMedian follow-up was 20 vs. 25months respectively. The groups were equivalent overall, apart from the use of anticoagulants (11% VP vs. 6.3% VPS P=0.014). In our population, 54% patients were considered as “dry” in the case of VPS vs. 42% for VP. There was no significant difference in terms of survival time without reoperation, revision, replacement or explantation. In univariate and multivariate analysis, age over 70years was predictive of more reinterventions, whereas the use of a 4.5cm cuff was protective, with hazard ratios of 1.42 (P=0.001) and 0.78 (P=0.04), respectively. ConclusionThe penoscrotal approach does not appear to be associated with more complications, has good functional results and no significant difference in reoperation-free survival. A prospective multicenter non-inferiority study could be of interest to confirm our findings. Level of evidence4.

Characterisation of experimental flowable composites containing fluoride-doped calcium phosphates as promising remineralising materials

ObjectiveRemineralising composites with antibacterial properties may seal the cavity and prevent secondary caries. This study aimed at developing experimental flowable composites containing different concentrations of fluoride-doped calcium phosphate fillers and evaluating their remineralising and antibacterial properties. MethodsExperimental resin-based composites containing different concentrations (0–20 %) of fluoride-doped calcium phosphate fillers (VS10/VS20) were formulated. The release of calcium (Ca), phosphate (PO) and fluoride (F) ions was assessed for 30 days. Remineralisation properties were evaluated through ATR-FTIR and SEM/EDX after storage in simulated body fluid (SBF). The metabolic activity and viability of Streptococcus gordonii was also evaluated through ATP, CFU and live/dead confocal microscopy. The evaluation of specific monomer elution from the experimental composites was conducted using high-performance liquid chromatography (HPLC). ResultsThe composites containing VS10 showed the highest release of Ca, those containing VS20 released more F over time (p < 0.05), while there was no significant difference in terms of PO ions release between the groups (p > 0.05). A quick 7-day mineral precipitation was observed in the tested composites containing VS10 or VS20 at 10 %; these materials also showed the greatest antibacterial activity (p < 0.05). Moreover, the tested composites containing VS10 presented the lowest elution of monomers (p < 0.05). ConclusionsInnovative composites were developed with low monomers elution, evident antibacterial activity against S. gordonii and important remineralisation properties due to specific ions release. Clinical significanceNovel composites containing fluoride-doped calcium phosphates may be promising to modulate bacteria growth, promote remineralisation and reduce the risk of cytotoxicity related to monomers’ elution.

Analysis of pre-service teachers' flow experience in educational drama practices and the effect of practices on attitudes toward creative drama courses

Aim: The analysis of the flow experience of pre-service teachers in educational drama practices and the effect of the practices on the attitude towards creative drama lessons reveal the purpose of the study. It is of great importance for physical education teachers to use creative drama practices as an effective teaching method in physical education and sports lessons, both in terms of their personal development and professional development. Method: The study was designed with a pre-test-post-test control group experimental design, one of the true experimental designs, and one of the quantitative research methods. In addition to the demographic information form, the "Flow Experience Scale" and "Attitude Scale towards Creative Drama Lessons" were applied to the participants as measurement tools. The distribution of the participant's demographic information was analyzed by frequency analysis. T-test independent groups analyzed the participants' pre-test and post-test scale scores, and the change in the pre-test and post-test scores of the scales according to demographic information was analyzed by t-test in independent groups and one-way analysis of variance. A regression model was tested to determine the effect of reason on anxiety. Analyses were performed with SPSS 20.0 software at a 95% confidence level. Findings and Conclusions: As a result, there was no significant difference between the attitude scale scores towards flow experience and creative drama course of the students participating in the research according to their age, gender, income level, place of residence, and activity type, and between the pre-tests and post-tests of the scales. However, a significant difference was detected between the pre-test and post-test scores of the flow experience scale anxiety sub-dimension and the flow sub-dimension of the academic achievement variable. In addition, although there was no significant difference in terms of the variables mentioned, it was noted that the flow experience flow and anxiety subscale scores were low. In contrast, the attitude scores towards the creative drama course were high.

Quasi‐static and high‐rate in‐plane shear tests on aramid and carbon fiber woven composites featuring a nanoparticle‐enriched high‐density polyethylene matrix

AbstractNanoparticles are known to enable the modification of the properties of the material they are integrated into. In the context of ballistic protection, previous works have demonstrated that graphene and Montmorillonite (MMT) particles included in high‐density polyethylene (HD‐PE) and used as a matrix enable an increase in the ballistic performance, of consolidated woven aramid fabrics. Furthermore, the ballistic performance has been reported to be influenced by the in‐plane shear properties of the impacted materials. In this context, quasi‐static and high‐rate in‐plane shear tests have been conducted on two types of reinforcements, aramid, and carbon woven fabrics, consolidated by a high‐density polyethylene matrix enriched by graphene, MMT and a mix of graphene and MMT nanoparticles. The conducted investigations provide for the first time in the literature the results of high‐rate in‐plane shear tests on aramid woven reinforcement consolidated with nanoparticle‐enriched and not enriched high‐density polyethylene composites. Despite the use of the same reinforcement and enriched matrix material as in previous works of literature, no significant differences in terms of in‐plane shear behavior have been observed for any of the different types of nanoparticles integrated into the matrix. Nevertheless, the obtained results demonstrate a clear strain rate sensitivity of the tested materials.Highlights Aramid and carbon fabrics were consolidated with nanoparticle‐enriched HD‐PE Quasi‐static and high‐rate in‐plane shear tests were conducted No influence of the nanoparticles could be identified A clear strain‐rate sensitivity could be identified for both composites

Frequency of Asthma Exacerbations and Upper Respiratory Tract Infections Among Adults With Asthma According to Vaccination Status: Does the annual influenza vaccine have a protective effect?

Annual influenza vaccinations are recommended for asthma patients to prevent seasonal influenza and influenza-triggered asthma exacerbations. However, data on the beneficial effect of this vaccine on the frequency of asthma exacerbations are conflicting. Therefore, this study aimed to assess the effectiveness of the influenza vaccine in terms of reducing the frequency of asthma-related exacerbations and upper respiratory tract infections among adult patients with asthma. This retrospective cohort study was performed from January to December 2018 in Muscat Governorate, Oman. A total of 466 patients attending 9 randomly selected primary health centres in Muscat Governorate were enrolled in the study and followed up for one year post vaccination. Most of the patients were female (70.6%) and had moderate persistent asthma (42.9%). There were 203 patients (43.6%) in the vaccinated group and 263 patients (56.4%) in the non-vaccinated group. A proportion of patients in each group had allergic rhinitis (28.6% and 25.5%, respectively). The frequency of upper respiratory tract infections over the one-year follow-up period was significantly lower in the vaccinated group than in the non-vaccinated group (37.9% versus 73%; relative risk [RR]: 2.299; 95% confidence interval [CI]: 1.834-2.882; P <0.001); however, there was no significant difference in terms of the frequency of asthma exacerbations (41.9% versus 45.2%; RR: 0.925; 95% CI: 0.750-1.141; P >0.050). The influenza vaccine significantly reduces the frequency of upper respiratory tract infections over the following year. However, it does not significantly reduce the frequency of asthma exacerbations among Omani adults with asthma. Further studies are recommended to support the protective effect of the vaccine in this regard.

Organizational Justice as Construct to Teachers’ Motivation at the District of Placer, Surigao del Norte

In any organization, unfair treatment among employees sometimes exists. It is, therefore, a worthwhile endeavour of the researcher to conduct a study about organizational justice in the Department of Education sector where this researcher is working as a teacher. This study aims to determine the organizational justice practiced by the secondary school heads/administrators in the district of Placer, Surigao Del Norte, in construct to teachers' motivation. There were 110 teacher respondents from all secondary public schools in the district of Placer Surigao Del Norte therefore universal sampling technique was employed in distributing the survey questionnaires and quantitative research design was used by the researcher. Results show that organizational justice is highly practiced by the school heads/administrators. It was found out that the teacher respondents have high intrinsic and extrinsic motivation. The study revealed that the demographic profile of the teacher respondents has no significant difference in terms of their perception on the organizational justice and their motivation. However, it was found out that there is a significant degree of relationship between the organizational justice and teachers’ motivation. This study suggests that School Administrators must consistently practice Organizational Justice in order to build greater trust and commitment to improve motivation, job performance, and work ethics and diminish organizational conflicts.

Technique and Study Results of Laparoscopic Gastrectomy for Gastric Cancer

The aim of this paper was to describe the technique of laparoscopic gastrectomy for gastric carcinoma and to present a review of current international studies on this topic.The first part describes and documents a standard laparoscopic gastrectomy for carcinoma. In the second part, after an EMBASE and PubMed search, a total of 123 quality-relevant randomised (RCT) and non-randomised (non-RCT) studies on laparoscopic gastrectomy are identified from a primary total of 3,042 hits by systematic narrowing. The study results are then summarised conclusively for the target criteria of feasibility, outcome, oncological quality, morbidity and mortality.Both, laparoscopic subtotal resection for distal gastric carcinomas and laparoscopic gastrectomy can now be performed safely and with few complications. In a recent literature review of a total of 15 RCTs with 5,576 patients (laparoscopic 2,793 vs. open 2,756), there were no significant differences in terms of feasibility, intraoperative outcome and oncological quality (R0 and lymph node harvest). Surgical morbidity and mortality were comparable. Patients after laparoscopic surgery showed a significantly faster early postoperative recovery with a lower overall morbidity. In contrast, the operating time was significantly longer - by a mean of 45min - compared to the open technique. The advantages of the laparoscopic technique were equally evident in studies on early gastric carcinoma and advanced carcinomas (>T2).Laparoscopic gastrectomy for gastric carcinoma is safe to perform and shows better early postoperative recovery. Complication rates, morbidity and mortality as well as long-term oncological results are comparable with open surgery.

The association between the triglyceride-glucose index and prognosis in postoperative renal cell carcinoma patients: a retrospective cohort study.

Insulin resistance has been proven to be associated with renal cell carcinoma (RCC). However, the prognostic value of the triglyceride-glucose (TyG) index, as a marker for insulin resistance (IR), is still unclear. Therefore, we conducted research to explore the prognostic value and the predictive performance of the TyG index in postoperative RCC patients. A total of 651 postoperative RCC patients from January 2016 to June 2018 were enrolled in the final study. Their clinical and laboratory parameters were collected from medical records and through follow-up by phone. The triglyceride-glucose (TyG) index was calculated as follows: TyG = Ln[TG (mg/dl) × FBG (mg/dL)/2]. The overall survival (OS) and disease-free survival (DFS) were identified as the main outcomes. The TyG index is an independent prognostic factor for OS (HR = 2.340, 95% CI = 1.506 to 3.64, P < 0.001) and DFS (HR = 2.027, 95% CI = 1.347 to 3.051, P < 0.001) in postoperative RCC patients. Kaplan-Meier survival curves of the different TyG index levels showed statistically significant differences in terms of OS and DFS (log-rank test, P < 0.0001). Furthermore, the TyG index was significantly associated with RCC risk factors. The TyG index is significantly associated with RCC survival. The mechanisms responsible for these results may contribute toward the improvement of RCC prognosis and immunotherapy efficacy and the development of new immunotherapeutic targets.