Standard Score Research Articles

Impact of Drying Methods on Phenolic Composition and Bioactivity of Celery, Parsley, and Turmeric—Chemometric Approach

Drying is one of the most commonly used methods for food preservation, and in spice processing, it has a significant impact on quality. In this paper, the influences of drying at room temperature, 60 °C, and 90 °C and freeze-drying on celery and parsley roots and turmeric rhizomes were examined. The highest content of total phenolics was found in celery dried at 60 °C (C60), parsley at room temperature (PRT), and freeze-dried turmeric (TFD) (1.44, 1.58, and 44.92 mg GAE/gdm, respectively). Celery dried at room temperature (CRT), PRT, and TFD showed the highest antioxidant activity regarding the DPPH and ABTS radicals and FRAP. The analysis of color parameters revealed that celery dried at 90 °C (C90); PFD and TFD showed the most similar values to control samples. The drying process was optimized using a combination of standard score (SS) and artificial neural network (ANN) methods. The ANN model effectively evaluated the significance of drying parameters, demonstrating high predictive accuracy for total phenolics, total flavonoids, total flavonols, total flavan-3-ols, IC50ABTS, and FRAP. TFD showed the strongest α-glucosidase inhibitory potential. Also, TFD extract showed good antibacterial activity against Staphylococcus aureus but not against Escherichia coli. C90 and PFD extracts did not show antibacterial activity against the tested microorganisms.

Phenolic compounds' stability in reduced-calorie plum spread fortified with freeze-dried plum pomace: Effects of processing techniques and pasteurization

Fortified reduced-calorie plum spreads (∼40°Brix), containing 10 % (w/w) freeze-dried plum pomace (FD-PP), were analyzed for phenolic compounds (spectrophotometrically and chromatographically determined) and antioxidant activity to evaluate the effects of processing and pasteurization during the transition from laboratory (LS-S) to industrial scale (IS-S) spread manufacturing. Additionaly, a control sample at an industrial scale (IS-CS) was prepared to estimate FD-PP's functional contribution. The physicochemical properties of spreads and plum materials used (FD-PP and plum purée, PP), were also investigated. IS-S exhibited increased levels of total phenols, total flavonoids, total anthocyanins, catechin, chlorogenic acid, caffeic acid, rutin, quercetin, cyanidin 3-O-glucoside, and cyanidin 3-O-rutinoside, alongside higher antioxidant activity compared to IS-CS. LS-S retained more phenolics than IS-S, possibly due to the pasteurization step (85 °C, 1 h) introduced in IS-S processing. Although characterised by reduced phenolic and anthocyanins content upon pasteurization, appealing colour of the IS-S spread was retained. Significant correlations (p<0.05) were observed across most individual phenolic compounds and antioxidant activity. Standard score (SS) analysis showed that phenolic retention and antioxidant activity were highest in LS-S (SS=0.754), followed by IS-S (SS=0.490) and IS-CS (SS=0.163). Pasteurization and the use of FD-PP contributed to the microbiologically stable spread after 21 days of storage.

Measuring Happiness and Life Satisfaction amongst Swedish Citizens: an Inquiry into Semantic Equivalence in Comparative Survey Research

A consistent empirical finding is that Scandinavian countries by international standards score steadily high in terms of subjectively reported levels of happiness and life satisfaction. Intrigued by previous findings in Denmark (Lolle and Goul Anderson in Metode Og Forskningsdesign 1:95–119, 2013, in Journal of Happiness Studies 6:1–14)), this paper confirms that this is partly due to language effects. In this paper, Sweden serves as a case study that, similar to the Danish study, seeks to determine whether it is possible to establish semantic equivalence between translated survey items. By using randomized experiments on a representative sample of Swedish citizens with fluent skills in English, we test the effects of different designs in question wordings and response scale labels implemented by international surveys. The results reveal significant differences in answers on happiness. While the mean differences are very small, the distribution of answers is substantial enough to confirm a strong semantic threshold between the English term happy the Swedish term lycklig. Hence, it requires something more to be “very happy” in Swedish than in English. Notably, language appears to have a lesser impact on the distribution of responses across language groups when using a numbered response scale with endpoint labels, indicating that a particular question design either mitigates or intensifies translational effects. Happiness, it is concluded, is not easily translated and survey practitioners should bear this caveat in mind when operationalizing the concept across countries and cultures.

Associations of maternal sedentary behavior and physical activity levels in early to mid-pregnancy with infant outcomes: A cohort study.

Physical activity during pregnancy is beneficial for the woman and the fetus. However, non-objective methods are often used to measure physical activity levels during pregnancy. This study aimed to evaluate objectively measured maternal early to mid-pregnancy sedentary behavior and physical activity in relation to infant well-being. This cohort study included 1153 pregnant women and was performed at Uppsala University Hospital, Uppsala, Sweden, between 2016 and 2023. Sedentary behavior and physical activity levels were measured by accelerometers during 4-7 days in early to mid-pregnancy. Outcome measures were infant birthweight standard deviation score, small-for-gestational-age, large-for-gestational-age, preterm birth (<37 weeks' gestation), spontaneous preterm birth, iatrogenic preterm birth, Apgar <7 at 5 min of age, umbilical artery pH ≤7.05, and admission to the neonatal intensive care unit (NICU). There were no associations of sedentary behavior and physical activity levels with infant birthweight standard deviation score, small-for-gestational-age, or large-for-gestational-age. After adjustment for BMI, age, smoking, parity, maternal country of birth, and a composite of pre-pregnancy disease, the most sedentary women had higher odds of preterm birth (adjusted odds ratio (AOR) 2.47, 95% confidence interval (CI) 1.17-5.24, p = 0.018), and NICU admission (AOR 1.93, CI 1.11-3.37, p = 0.021) than the least sedentary women. The most physically active women had lower adjusted odds for NICU admission (AOR 0.45, CI 0.26-0.80, p = 0.006) than the least physically active women. Objectively measured levels of sedentary behavior and physical activity in early to mid-pregnancy were not associated with standardized infant birth size. Sedentary behavior was associated with an increased likelihood of preterm birth and NICU admission, while high level of physical activity was associated with a decreased likelihood of admission to NICU.

Biomarkers of endothelial dysfunction and cognition: A two-step IPD meta-analysis.

This study assessed the association of plasma biomarkers of endothelial dysfunction with cognitive performance and decline. Data from 9414 individuals from eight Dutch cohorts were included (Ø age-range: 57-93 years). Plasma biomarkers of endothelial dysfunction (soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble E-selectin) were combined into a standardized composite score. Cognitive outcomes included executive function, processing speed, immediate and delayed memory, attention, and language. Linear regressions and linear mixed models were run in the individual cohorts and standardized coefficients were subsequently pooled using random-effects meta-analyses. A higher endothelial dysfunction composite score was cross-sectionally associated with worse performance on executive function, processing speed, delayed memory, and attention, but not immediate memory or language (pooled β-range: -0.04, -0.02). We found no association with change in cognition over time. This comprehensive two-step, individual participant data (IPD) meta-analysis showed a small, consistent cross-sectional association between endothelial dysfunction and worse cognitive performance across multiple domains but no support for a longitudinal association. Prior evidence on endothelial dysfunction (ED) biomarkers and cognition is conflicting. This two-step, individual participant data (IPD) meta-analysis used data from eight Dutch cohorts. ED was consistently associated with concurrent cognition. ED was not associated with a change in cognition over time. The association of ED with current cognition may be generic.

Assessment of validity, reliability, and feasibility of OMERACT ultrasound knee osteoarthritis scores in Egyptian patients with primary knee osteoarthritis.

Ultrasound (US) can evaluate all joint components affected by knee osteoarthritis (KOA); however, standardized scoring of US-detected pathology is needed to improve its diagnostic and monitoring capabilities. To examine the validity, reliability, and feasibility of the Outcome Measures in Rheumatology (OMERACT) ultrasound scoring for KOA, comparing with clinical and radiography measures, using predefined cutoff values. This cross-sectional study included 75 Egyptian patients with primary KOA. All patients had Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, bilateral knee radiography, and ultrasonography. Inter-observer reliability of ultrasound was evaluated in 30 knees by another newly trained operator. Most of the OMERACT-US KOA scores showed significant associations with WOMAC clinical scores, except for femoral cartilage damage and effusion. The synovitis score was significantly associated with WOMAC-pain score (p-value 0.046), while medial meniscus extrusion (MME) and medial osteophytes were significantly associated with WOMAC-stiffness score (p-value 0.009 and 0.023, respectively). MME and synovitis were significantly associated with WOMAC-physical score (p-value 0.035 and 0.020, respectively). The ultrasound scores also showed a strong correlation with radiographic scoring. Inter-observer reliability ranged from moderate to excellent agreement (k = 0.58 to k = 0.83); it was highest for lateral osteophytes (k = 0.83), good agreement for synovitis (k = 0.72), any osteophytes (k = 0.71), damage of femoral cartilage (k = 0.70), and moderate agreement for medial osteophytes (k = 0.58) and MME (k = 0.59). OMERACT-US scoring system for KOA demonstrated validity, reliability, and feasibility for evaluating both structural and inflammatory components. Using cutoff values improved the scoring reliability for osteophytes and MME. Key Points • OMERACT-US scores provide a valid assessment of inflammatory and structural components of knee osteoarthritis. • The following changes may improve the performance of the OMERACT-US scores. a. The binary score for effusion and synovial hypertrophy can be omitted, as they have no added value. b. A semi-quantitative grading for effusion may capture the impact of effusion on clinical outcomes. c. Added cutoff values to score medial meniscal extrusion, osteophytes, and pathological effusion improved the respective scores' reliability. d. Applying the updated OMERACT definition of synovitis. • OMERACT-US scores are reliable to be used with a newly trained operator, particularly when cutoff values are included, and proper training time is provided. • The OMERACT-US score is feasible to be used in clinical practice, as the time taken to perform was short, even for a newly trained operator.

Associations between physical activity and development in preschool-aged children born

ObjectiveTo investigate the effect of physical activity (PA) on development (motor, cognitive, social-emotional) in children 4–5 years old born <30 weeks’ gestation, and to describe subgroups of children at risk...

Comparison of central precocious puberty frequency before and during COVID-19: a systematic review and meta-analysis

ObjectiveThe current systematic review and meta-analysis assessed the prevalence of central precocious puberty (CPP) throughout the novel coronavirus disease 2019 (COVID-19) pandemic.DesignA systematic review and meta-analysis were carried out following the principles outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA, 2020).Data sourcesPubMed, Embase, Web of Science, and WANFANG databases were searched from January 1, 2019, to March 30, 2023.Eligibility criteria for selecting studies(1) children and adolescents ≤ 15 years; (2) studies with the outcome of frequency of central precocious puberty, measured prior to and throughout the COVID-19 pandemic; (3) a novel CPP diagnosis was created depending on all of the following criteria: girls with a chronological age < 8 years and boys with a chronological age < 9 years at the onset of symptoms, basal luteinizing hormone (LH) levels > 0.3 UI/L, and/or GnRH-stimulated peak LH levels > 5 IU/L.Data extraction and synthesisThe process of extracting data and evaluating the likelihood of bias was carried out by two independent reviewers. The data were pooled employing the generic inverse-variance method and presented as mean differences (MDs) with 95% CIs. The evaluation of heterogeneity was conducted employing the Cochran Q statistic, and the degree of heterogeneity was measured employing the I2 statistic.ResultsThis meta-analysis included 17 studies. In contrast to the same period prior to the COVID-19 pandemic, the occurrence of CPP elevated (OR = 2.57; 95% CI, 1.85–3.56). Moreover, body mass index standard deviation score (BMI SDS) differences between CPP patients prior to COVID-19 and throughout the pandemic follow-up was 0.12 (95% CI − 0.01 to 0.25 P = 0.06).ConclusionOverall, CPP frequency significantly elevated throughout the COVID-19 pandemic. Given the restricted number of cohort investigations in this meta-analysis, additional research may be conducted on larger groups of children in order to establish a correlation between the observed rise in precocious puberty and specific pathogenic factors.

Acceptability, validity and responsiveness of inertial measurement units for assessing motor recovery after gene therapy in infants with early onset spinal muscular atrophy: a prospective cohort study

BackgroundOnasemnogene abeparvovec gene replacement therapy (GT) has changed the prognosis of patients with spinal muscular atrophy (SMA) with variable outcome regarding motor development in symptomatic patients. This pilot study evaluates acceptability, validity and clinical relevance of Inertial Measurement Units (IMU) to monitor spontaneous movement recovery in early onset SMA patients after GT.MethodsClinical assessments including CHOPINTEND score (the gold standard motor score for infants with SMA) and IMU measurements were performed before (M0) and repeatedly after GT. Inertial data was recorded during a 25-min spontaneous movement task, the child lying on the back, without (10 min) and with a playset (15 min) wearing IMUs. Two commonly used parameters, norm acceleration 95th centile (||A||_95) and counts per minute (||A||_CPM) were computed for each wrist, elbow and foot sensors.Results23 SMA-patients were included (mean age at diagnosis 8 months [min 2, max 20], 19 SMA type 1, three type 2 and one presymptomatic) and 104 IMU-measurements were performed, all well accepted by families and 84/104 with a good child participation (evaluated with Brazelton scale). ||A||_95 and ||A||_CPM showed high internal consistency (without versus with a playset) with interclass correlation coefficient for the wrist sensors of 0.88 and 0.85 respectively and for the foot sensors of 0.93 and 0.91 respectively. ||A||_95 and ||A||_CPM were strongly correlated with CHOPINTEND (r for wrist sensors 0.74 and 0.67 respectively and for foot sensors 0.61 and 0.68 respectively, p-values < 0.001). ||A||_95 for the foot, the wrist, the elbow sensors and ||A||_CPM for the foot, the wrist, the elbow sensors increased significantly between baseline and the 12 months follow-up visit (respective p-values: 0.004, < 0.001, < 0.001, 0.006, < 0.001, < 0.001).ConclusionIMUs were well accepted, consistent, concurrently valid, responsive and associated with unaided sitting acquisition especially for the elbow sensors. This study is the first reporting a large set of inertial sensor derived data after GT in SMA patients and paves the way for IMU-based follow-up of SMA patients after treatment.

How do employees feel their health is valued? a descriptive case study

PurposeA descriptive case study approach was adopted to examine employees' perceptions of the prevalence and usefulness of wellness programs. Relying on Centers for Disease Control and Prevention Health ScoreCard (CDC HSC), this study aims to assess the prevalence of worksite wellness programs, policies and benefits in general and incorporated employee perspectives to contextualize the CDC HSC wellness assessments.Design/methodology/approachThe authors first compared the CDC HSC assessments to evaluate the effectiveness of wellness programs in 20 select organizations. Follow-up employee interviews (n = 25) were conducted to contextualize the CDC HSC assessments.FindingsA variety of wellness programs are likely to increase employee engagement and participation when organizations adopt a bundling approach to combine wellness policies, incentives and an array of wellness programming opportunities that encourage and incentivize employees’ health promotion behaviors.Research limitations/implicationsFuture researchers might examine health metrics, in terms of dollars, doctor visits or biometrics before and after the implementation of a wellness program or paid wellness coordinator. Because this study interviewed employees and not members of executive leadership or finance and accounting, financial metrics were not available or the focus of this study. The inclusion of leaders and directors of wellness initiatives would offer additional ways for examining the impact of wellness initiatives on employee behaviors on organizational outcomes.Practical implicationsNutrition, weight management and chronic disease management were identified as major challenges impacting the health of employees. Even when organizations reported robust scores in their CDC HSC assessments, employers identified these three areas as critical for sustaining the health and well-being of their employees. Finally, the issue of employee safety was a top priority for all organizations regardless of how they scored on their CDC HSC assessments.Social implicationsThe authors suggest that when high-impact wellness practices are linked to organizational supports in the workplace, these efforts are likely to have more positive effects on both employee outcomes and organizational outcomes. A regular routine of checking on wellness issues can help keep potential problems from going unnoticed. An example of this is a reminder to stretch at a morning meeting or during work hours as a reminder to stay focused on health and well-being.Originality/valueThe authors aggregated the organizational assessments for different wellness interventions and compared the scores (falling above or below) with standardized CDC wellness scores. The incorporation of the CDC scorecard ensured a standardized and evidence-based evaluation of workplace wellness programs. This additional step informed the interview guide and follow-up with employees who offered recommendations for how organizations could enhance their wellness programs and policies.

Developmental Profile of Children with Autism Spectrum Disorder Versus Social Communication Disorder: A Pilot Study.

Social Communication Disorder (SCD), introduced in the DSM-5, is distinguished from Autism Spectrum Disorder (ASD) by the absence of restricted and repetitive behaviors or interests (RRBIs). To compare the adaptive, sensory, communication, and cognitive profiles of children with ASD and SCD. The assessments of nine children with SCD and ten with ASD were compared with either Fisher's Exact Test or the Mann-Whitney Test. Assessments included the Vineland Adaptive Behavior Scales, the Autism Diagnostic Observation Schedule (ADOS), the Short Sensory Profile, Bishop's Children's Communication Checklist, a pragmatics evaluation, and the Wechsler Intelligence Scale for Children IV. The total ADOS score and the second subtotal "Restricted and Repetitive Behaviors" were significantly higher (p = 0.022) in the ASD group than in the SCD group. The Vineland standard score for the "Socialization" domain was significantly lower (p = 0.037) in the ASD group (mean: 51 +/- 19) than in the SCD group (mean: 80 +/- 28). The working memory index score was also significantly lower (p = 0.013) in the ASD group compared to the SCD group. While ASD and SCD share similarities in communication and pragmatic difficulties, some distinctions have been identified, e.g. in executive functioning and the impact on socialization, which may be linked to the absence of RRBIs in SCD. These findings highlight the challenges posed by this nosographic separation during diagnostic evaluations due to the scarcity of discriminative tools.

Identifying and Addressing Errors in Anatomical Pathology: A Survey Analysis

Abstract Introduction/Objective To get an update on potential sources of pre-analytical, analytical, post-analytical and other sources of errors in anatomic pathology and strategies to mitigate such errors. Methods/Case Report The authors designed a 5-question survey in Google software and shared it widely on social media platforms. Results (if a Case Study enter NA) The survey, which garnered 43 responses from staff across various areas of the anatomic pathology laboratory, revealed significant insights. Labeling and fixation/preservation errors emerged as the most prevalent pre-analytical errors, while discrepancies between gross and microscopic examinations were common analytical errors. Specimen handling, inadequate clinical information, and transportation were the most frequently perceived other potential sources of errors. The implications of these findings are clear: robust protocols with multiple identifiers, staff training, and barcode labeling can significantly reduce patient identification errors. Similarly, standardized collection instructions, pre-labeled containers, and meticulous verification processes can effectively minimize such errors. Validated tests, standardized scoring systems, and proper investigation of quality control discrepancies are key to reducing analytical errors. Documented procedures, staff training, regular equipment calibration, and reagent testing are also crucial. Conclusion This study contributes to the literature on the current state of potential sources of errors in anatomic pathology. The study findings and recommendations on strategies to address such errors would improve the performance of the anatomic pathology laboratory and eventually improve patient care.

Item response theory-based continuous test norming.

In norm-referenced psychological testing, an individual's performance is expressed in relation to a reference population using a standardized score, like an intelligence quotient score. The reference population can depend on a continuous variable, like age. Current continuous norming methods transform the raw score into an age-dependent standardized score. Such methods have the shortcoming to solely rely on the raw test scores, ignoring valuable information from individual item responses. Instead of modeling the raw test scores, we propose modeling the item scores with a Bayesian two-parameter logistic (2PL) item response theory model with age-dependent mean and variance of the latent trait distribution, 2PL-norm for short. Norms are then derived using the estimated latent trait score and the age-dependent distribution parameters. Simulations show that 2PL-norms are overall more accurate than those from the most popular raw score-based norming methods cNORM and generalized additive models for location, scale, and shape (GAMLSS). Furthermore, the credible intervals of 2PL-norm exhibit clearly superior coverage over the confidence intervals of the raw score-based methods. The only issue of 2PL-norm is its slightly lower performance at the tails of the norms. Among the raw score-based norming methods, GAMLSS outperforms cNORM. For empirical practice this suggests the use of 2PL-norm, if the model assumptions hold. If not, or the interest is solely in the point estimates of the extreme trait positions, GAMLSS-based norming is a better alternative. The use of the 2PL-norm is illustrated and compared with GAMLSS and cNORM using empirical data, and code is provided, so that users can readily apply 2PL-norm to their normative data. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Biomarker Profiles and Clinicopathological Features in Head and Neck Squamous Cell Carcinoma Patients.

Background and Objectives: Head and neck squamous cell carcinomas (HNSCCs) vary significantly in terms of invasiveness, growth rate, and metastatic potential. This study aimed to investigate the expression of several prognostic biomarkers (Ki67, p53, EGFR, COX-2, Cx43, and p16) in HNSCC from various anatomical regions and to correlate these expressions with clinicopathological parameters. Materials and Methods: We performed immunohistochemistry on 91 histologically verified HNSCC cases from the County Emergency Hospital, Targu Mures. Biomarker expression for Ki67, COX-2, and Cx43 was assessed using a standard immunoexpression scoring system: S1: 0-10%, S2: 11-25%, S3: 26-50%, S4 > 50%; EGFR was scored based on membrane staining intensity: 0, 1+, 2+, 3+; we classified p16 as positive or negative; p53 was grouped into mutant and wild-type; and we compared these across histopathological types, tumor grades, anatomical locations, gender, and different age groups. We performed a comparative analysis of Cx43 expression levels in relation to the expression of the rest of the markers. Statistical analysis was conducted using GraphPad InStat 3 software, version 3.06 (GraphPad Software Inc., San Diego, USA). Results: The majority of tumors were in males (95.6%) aged 51-60 years. Mutant p53 expression was prevalent in most cases. Elevated Ki67 and EGFR expression were associated with more aggressive tumors. COX-2 levels varied, with a higher proportion of moderate and high immunoexpression (S3 + S4) observed in patients under 70 years old. Cx43 expression was generally low, especially in extralaryngeal tumors. Conclusions: HNSCC primarily affects older males, with the larynx being the most common site. High levels of Ki-67 and EGFR suggest more aggressive tumors, while low COX-2 levels reflect varying prognoses. Women may develop more aggressive tumors, and extralaryngeal tumors often present with more challenging prognoses. Low Cx43 expression may be more likely to coincide with higher Ki67 and COX-2 levels, possibly indicating a link with more aggressive tumor behavior.

The Manifestations and Complications of X-linked Hypophosphatemia in Saudi Arabia: A Retrospective Study

Background: X-linked hypophosphatemia (XLH) is a genetic disease of phosphate metabolism in which inactivating mutations of the phosphate regulating endopeptidase homolog, X-linked (PHEX) gene lead to local and systemic effects. In our pediatric clinics, XLH was observed to be associated with multiple complications despite conventional treatment. There is a need for novel treatment modalities to prevent disease progression and aid in the resolution of symptoms. Methods: This retrospective cross-sectional study aimed to understand the manifestations and complications of XLH in patients followed up at the endocrinology clinics in King Faisal Specialist Hospital and Research Center in Saudi Arabia. The study was conducted by reviewing the medical files of all XLH patients at the King Faisal Specialist Hospital and Research Center. Results: All the patients (N=24) who were included in this study had PHEX gene mutations. The mean age was 18.7 13.6 years and 68% were females. The mean height standard deviation score (HSDS) was ‑2.96 (-5.25 to -0.97) and 12 patients reached their final height (mean final HSDS, -3.28 [-1.39 to ‑5.39]). Skeletal deformities (mainly genu varum) were observed in 68% of the patients and 29% had craniosynostosis; 54% had undergone corrective osteotomy. Hyperparathyroidism was observed in 54% of the patients and 45% of the patients had nephrocalcinosis (grades 2/3). Conclusions: In our study, a majority of the XLH patients suffered from complications arising from the use of conventional therapy, thus indicating the need for novel treatment modalities for these patients. Additionally, no correlation between genotype and phenotype was found.

Evaluating Students' Academic Progress in the Role of Fuzzy Logic

This paper explores the role of fuzzy logic in the assessment of student performance in local high school, Badr, Libya, positing that it offers a more flexible and accurate alternative to traditional categorization methods of academic achievement. Conventional assessment tools, such as standardized test scores and GPAs, often yield a distorted and overly simplistic view of student performance. Utilizing a mixed-methods research design, this study compares the performance, attendance, and self-reported satisfaction of students assessed through fuzzy logic with those evaluated by traditional methods. The results demonstrate that students assessed using fuzzy logic achieved higher average scores and expressed greater satisfaction with the assessment process. Additionally, educators employing fuzzy logic provided more detailed and constructive feedback, enriching the learning experience. Thus, this research indicates that fuzzy logic can effectively mitigate the shortcomings of traditional assessment methods, enhancing the recognition of diverse student abilities. The findings advocate for the integration of fuzzy logic in educational assessment practices to promote inclusivity and improved learning outcomes.

Stress and Coping Behavior Exhibited by Family Members Toward Long-Term Care Facility Residents While Hospitalized.

With the increase in the elderly population, institution-based care has become another option for elderly people. In Changhua, Taiwan, the number of long-term institutions has doubled in the past decade, and more families are choosing to send their elders to institutions for care. However, there is stress induced by having to care for these elders when they come back to their family members when hospitalized. Therefore, this study aimed to understand the stress and coping behaviors of family members in regard to hospitalized long-term care facility residents and identify relevant factors that affect and predict the stress and coping behaviors exhibited by these family members. In this study, a quantitative and cross-sectional survey was conducted using the convenience-sampling method; family members of long-term care facility residents hospitalized in a regional hospital in central Taiwan were selected as the research participants and a total of 162 family members were admitted. The data were collected in the form of questionnaires including basic information and data on the stress and coping behaviors of the family members. The data were collected and coded by using SPSS 22.0 to perform descriptive and inferential statistical analysis. The standard average score of total stress for family members was 57.03 points, which corresponds to a moderate level. The four perceptions of stress by family members were, in order, physiological, life, psychological, and economic. Furthermore, family income, work status, and the relationship between residents of the family members and physiological, psychological, and economic factors had predictive power for their problem-oriented coping behaviors, with an explanatory power of 59.6%. Life aspects, gender, marital status, and the number of hospitalizations in half a year had significant predictive power for the family members' emotion-oriented coping behaviors, with an explanatory power of 19.0%. The family members had high levels of stress, especially physical stress, and the total scores of stress perception were higher for those who were younger than 39 years old and had no rotating family members. Additionally, the coping behavior of the main caregiver was mainly problem-oriented. The results of this study may serve as a reference that can help nursing staff in clinical or long-term care facilities to provide or develop effective and individualized services for family members of facility residents.

Improvement of Bone Metabolism in Prepubertal Girls with Turner Syndrome Following Long-term Pegylated Growth Hormone Treatment.

The study aims to assess the improvement in bone metabolism in prepubertal girls with Turner Syndrome (TS) after long-term polyethylene glycol recombinant human Growth Hormone (PEG-rhGH) treatment. A 12-month longitudinal prospective study was conducted with 28 prepubertal girls diagnosed with TS. Participants were divided into two groups: 18 received PEG-rhGH therapy (0.1-0.25 mg/kg/week) and 10 did not. Anthropometric measurements, bone turnover markers (BTMs), and serum levels of IGF-1, calcium, and phosphate were collected at baseline and after 12 months. BTMs included bone alkaline phosphatase (BAP), Type I collagen propeptide (CICP), Type I collagen telopeptide (CTX), and fibroblast growth factor 23 (FGF23). After 12 months of PEG-rhGH therapy, the treatment group showed significant increases in growth velocity (GV) and height standard deviation scores (HtSDS). Serum IGF-1 levels increased rapidly within one month and remained elevated. BTMs indicated enhanced bone formation, significantly increasing BAP and CICP, while CTX levels remained low. FGF23 levels initially rose slightly but declined below baseline by 12 months. Elevated blood phosphate levels were observed. PEG-rhGH therapy in children with TS significantly improves linear growth and enhances bone formation markers, benefiting bone metabolism.

How much does an MRI change over a period of up to 2years in patients with chronic low back pain? Is a repeated MRI really necessary in the follow-up of patients with chronic low back pain?

Clinical practices vary between healthcare providers when it comes to asking for a Magnetic Resonance Imaging (MRI) during follow-up for chronic low-back pain (LBP). The association between progressive changes on the MRI and the clinical relevance of these findings is not clearly defined. The objective of our study is to investigate to what extent do MRI findings change during a period less than or equal to two years in patients with chronic LBP. We question the efficacy of its routinary use as a tool for follow-up and we also study the correlation between new changes on MRI and modifications in therapeutic attitude. Data was collected from 468 lumbar spine MRIs from 209 patients undergoing two or more MRIs between January 2015 and December 2019 with a mean of 2.24 MRIs per patient. The evaluated data included diagnosis, reason for request, MRI findings and treatment offered post-MRI. MRIs were assessed according to a standardized scoring system from 0 to 14 points according to the severity in findings (modified Babinska Score). Radiological changes were defined as increased severity of findings in the most affected segment. 51.06% of MRI requests had no documented reason to be asked for. The average score of the findings on the first MRI was 5,733 (SD 2,462) and 6,131 (SD 2,376) on the second, not reaching a statistically significant difference (p = 0.062). There was no difference on the findings between the first and the second MRI in 40, 15% (n = 104) and up to 89, 96% with only mild changes (-1/ + 2 points over 14 possibles). After repeating the MRI, no modification to the treatment plan was made in 44, 79% of patients (n = 116) and only in 11.58% (n = 30) was surgical treatment indicated. The rate of lumbar MRI has risen to an alarming pace without evidence of consequent improvements in patient outcomes. A significant number of repeated MRIs did not show radiological changes, nor did they give rise to further surgical treatment after obtaining these images. This study should help to review the real applications of clinical guides on the appropriate use for image tests.

Mapping the Embarkation Haji dormitory model equivalent to a star rating hotel to empower local communities and improve the national economy

The aim of this research is to map a model for utilizing Hajj dormitories in terms of products, services, management and relevant policies, towards utilizing Hajj dormitories equivalent to star hotels through Hajj dormitory accommodation services to empower local communities and improve the national economy. Specific objective: To realize the management of Hajj dormitories equivalent to star hotels in Indonesia. Research stages: in 2024 research will be carried out on the Medan Hajj embarkation dormitory. Method: This research was carried out descriptively, qualitatively, quantitatively, with a star hotel study approach, as well as community base tourism, as a model for using Hajj dormitories on a par with star hotels. The data was analyzed using the theory of hotel and tourism quality standards, and relevant theories according to the data found at the research site. The research results show a significant value, and equivalently the star hotel rating according to the Ministry of Tourism and Creative Economy no. 53/2013 shows the results, namely: 1). Product with a score of 429, out of 118 elements assessed, 2). Service with a score of 83 out of 31 elements assessed. , 3). Management with a score of 79 out of 20 elements assessed. Fulfillment just needs to improve 9 elements of the standard target score of 600 according to the business requirements for star hotel ratings. The suggestions are: fulfillment of the annual budget needs to be increased to improve product standards, services, training, competency tests, and direct employee involvement, as well as local community empowerment needs to be maximized.