Standard T-test Research Articles

The Effects of Jigsaw Technique on Learning Achievement and Retention of Science Teacher Students

The cooperative learning Jigsaw technique is one learning management that promotes learning in the 21st century, and it is a learning management that promotes student learning achievement. Therefore, the researcher is interested in studying the learning achievement of science teacher students before and after learning with the Jigsaw technique and exploring the retention of students’ learning using the experimental research. The participant in this research consisted of 32 second-year students in the Department of General Science at Rajabhat University in southern Thailand who enrolled in the course Learning Management 1 in the first semester of the academic year 2022. The research tools consisted of 1) the JIGSAW technique lesson plan and 2) a learning achievement test. The statistics used in data analysis were mean standard deviation and dependent Sample t-test. The result of the learning achievement test of the science teacher students who learned by using the Jigsaw technique found that the mean score of learning achievement after learning was significantly higher than before learning at the .05 level. After the 2-week learning period, it revealed that the student’s learning achievement was not different from after learning at the statistical significance level of .05. The findings suggest that the Jigsaw technique is one learning management that can improve learning achievement and learning retention. So, it can be applied to subjects that focus on cognitive learning.

Double-Estimation-Friendly Inference for High-Dimensional Misspecified Models

All models may be wrong—but that is not necessarily a problem for inference. Consider the standard t-test for the significance of a variable X for predicting response Y while controlling for p other covariates Z in a random design linear model. This yields correct asymptotic type I error control for the null hypothesis that X is conditionally independent of Y given Z under an arbitrary regression model of Y on (X,Z), provided that a linear regression model for X on Z holds. An analogous robustness to misspecification, which we term the “double-estimation-friendly” (DEF) property, also holds for Wald tests in generalised linear models, with some small modifications. In this expository paper, we explore this phenomenon, and propose methodology for high-dimensional regression settings that respects the DEF property. We advocate specifying (sparse) generalised linear regression models for both Y and the covariate of interest X; our framework gives valid inference for the conditional independence null if either of these hold. In the special case where both specifications are linear, our proposal amounts to a small modification of the popular debiased Lasso test. We also investigate constructing confidence intervals for the regression coefficient of X via inverting our tests; these have coverage guarantees even in partially linear models where the contribution of Z to Y can be arbitrary. Numerical experiments demonstrate the effectiveness of the methodology.

Upgraded Analytical Protocols in Bauxite Refining Industry Using Composite Sampling Approach to Minimize Laboratory Analysis Load

The laboratories in the bauxite processing industry are always under a heavy workload of sample collection, analysis, and compilation of the results. After size reduction from grinding mills, the samples of bauxite are collected after intervals of 3 to 4 hours. Large bauxite processing industries producing 1 million tons of pure aluminium can have three grinding mills. Thus, the total number of samples to be tested in one day reaches a figure of 18 to 24. The sample of bauxite ore coming from the grinding mill is tested for its particle size and composition. For testing the composition, the bauxite ore sample is first prepared by fusing it with X-ray flux. Then the sample is sent for X-ray fluorescence analysis. Afterwards, the crucibles are washed in ultrasonic baths to be used for the next testing. The whole procedure takes about 2 - 3 hours. With a large number of samples reaching the laboratory, the chances of error in composition analysis increase. In this study, we have used a composite sampling methodology to reduce the number of samples reaching the laboratory without compromising their validity. The results of the average composition of fifteen samples were measured against composite samples. The mean of difference was calculated. The standard deviation and paired t-test values were evaluated against predetermined critical values obtained using a two-tailed test. It was found from the results that paired test-t values were much lower than the critical values thus validating the composition attained through composite sampling. The composite sampling approach not only reduced the number of samples but also the chemicals used in the laboratory. The objective of improved analytical protocol to reduce the number of samples reaching the laboratory was successfully achieved without compromising the quality of analytical results.

Repositioning Science Teacher Education Through Practical Oriented Application in the Teaching and Learning Process for Global Competitiveness: University Undergraduate’s View

The dynamism in educational development today had change holistically so people in charge too need to be proactive to meet the global challenges that can compete with the global world and to meet the global competitiveness if not our educational system will not be in line with the word educational system. This prompts the researchers to look at repositioning teaching and learning process by laying emphases on practical. Forty (40) respondents were used as the pilot study that comprises of six (6) science education lecturer and thirty-four post graduate student of the same department. Sixty-three undergraduate students were randomly selected as the sample population of the study from science education department. A structure questionnaire was design that consist of ten items for data collection using Linkert scale and the result was analyses using frequency counting, mean and standard deviation and t-test at P>0.05. From the result it was observed that repositioning teaching and learning process using practical process is inevitable and that the teacher should ready to adopt practical as one of the cardinal points to teach some of the recommendation proffer includes giving awareness to the need for repositioning teaching and learning of science through practical oriented process and prompt adequate financing of the practical for better understanding of scientific phenomenon.

111 POST-OPERATIVE OUTCOME OF ADULT PATIENTS WITH PRE-TRICUSPID SHUNT UNDERGOING DEFECT CLOSURE

Abstract Background patients with pulmonary arterial hypertension (PAH) associated with corrected congenital heart disease (CHD) have a worse prognosis than other 3 groups of patients with PAH associated with CHD (Eisenmenger, small defect, prevalent systemic-to-pulmonary shunt). For this reason, in CHD the indication and timing of defect repair should be evaluated carefully. Current recommendations rely essentially on pulmonary vascular resistance (PVR) when deciding about defect closure, but this may be insufficient as PAH may develop even in cases of normal pre-operative PVR. In particular, patients with PVR below 3 WU are usually deemed operable and patients between 3 and 5 WU (gray zone) are deemed operable in case of significant persistence of left-to-right shunt. Detecting preoperative characteristics of patients who developed PAH after pre-tricuspid shunt repair can be helpful when deciding about CHD correction. Methods we enrolled adult patients referred to our centre for the suspicious of PAH after pre-tricuspid shunt correction from 2006 to 2021. We evaluated clinical, echocardiographic and hemodynamic parameters before and after defect repair (a post-correction hemodynamic evaluation was performed only in case of non-invasive signs of PAH) and PAH after defect closure was defined by the concomitant occurrence of a mean pulmonary artery pressure (mPAP) >25 mmHg and PVR >3 WU. Continuous variables were summarized using mean and standard deviation and Student's t-test was used for comparisons. Results sixty patients were included in the final analysis. After shunt repair, 10 patients (16.6%) were diagnosed with PAH during the long-term follow-up, with no differences given by the type of defect or type of correction. As expected, these patients already had an abnormal baseline hemodynamic profile: 7 had a clear PAH diagnosis before the correction [mPAP >25 mmHg with PVR between 3 and 5 WU and with a pulmonary/systemic cardiac output ratio of at least 1.5] while 3 had pulmonary hypertension related to high pulmonary blood flow (mPAP >25 mmHg and PVR <3 WU). At the baseline hemodynamic evaluation, patients with PAH after shunt repair had higher mPAP (39±6 vs 24±10 mmHg, p <0.001) and PVR (3.7±1.2 vs 1.5±0.9, p <0.001) and lower mixed venous oxygen saturation (81±3 vs 87±3, p <0.001). At the baseline echocardiographic evaluation, patients with PAH after shunt repair had a greater right ventricular hypertrophy (RV wall thickness 0.7±0.1 vs 0.5±0.2 cm, p= 0.011), tricuspid regurgitation jet velocity (424±63 vs 319±62 cm/s, p <0.001) and a significant lower RV fractional area change (34±8 vs 43±9%, p= 0.009). Conclusions currently there are no established evidence-based algorithms to predict the development of PAH after defect correction. Our study shows that this condition may persist or develop even when PVR values are lower than 5 WU despite a significant left-to-right shunt before defect closure. Patients with grey zone PVR values require a global clinical, instrumental and hemodynamic assessment that takes into account more than bare calculated PVR that, especially in patients with a high pulmonary blood flow, can be less reliable.

Cognitive Screening in Adults with Sickle Cell Disease: Prospective Validation of the Rowland Universal Dementia Assessment Scale

Background: Adults with sickle cell disease (SCD) are at increased risk of early cognitive decline. The American Society of Hematology recommends surveillance for cognitive impairment. However, optimal screening strategies in this population have not been established. The RUDAS (Rowland Universal Dementia Assessment Scale) is a short screening questionnaire developed for use in culturally diverse patient populations. In adults with SCD, it is less biased by educational attainment than the Montreal Cognitive Assessment (MoCA). Hypothesis: We hypothesized that the RUDAS is a valid tool to predict neurocognitive disorder (NCD) in adults with SCD. Aims: 1. Describe trends in RUDAS scores during long-term cognitive surveillance; 2. Evaluate the ability of RUDAS scores to predict the diagnosis of NCD. Method: A retrospective study was conducted. All patients who had undergone cognitive screening with RUDAS in 2018 and repeat testing as part of routine surveillance in 2021-2022 were identified. Starting in 2021, all adults with SCD are assessed by a multidisciplinary team (neurologist, hematologist, neuropsychologist) for neurocognitive screening and assessment. RUDAS was administered and scored as previously described (Forté et al, JAMA Net Open 2021). A clinical diagnosis of NCD was established by a neurologist and/or neuropsychologist. Repeated measure t-test was performed to compare RUDAS trends over time. Standard t-test was used to compare RUDAS between a priori defined subgroups (with and without NCD). Positive predictive values (PPV) were calculated. Results: From an initial assessment of 92 patients, 28 adult SCD patients met the inclusion criteria. The median age was 39 years [range: 24-65], 16 (57%) were female and the median educational level was 14 years [range: 10-18]. Genotype distribution was 18 (64%) with the SS or Sβ0-thalassemia genotype and 10 (36%) with the SC or Sβ+-thalassemia genotype. None of the patients had an established diagnosis of NCD, and 5 (18%) had a prior history of stroke. The mean (±standard deviation (SD)) RUDAS scores were 26.7±2.0 in 2018 and 27.3±2.7 in 2021-2022. Overall, the scores did not significantly change over time (+0.6±2.8, paired t-test P=0.3). In table 1, we present the results of the subgroup analysis according to NCD diagnosis. In those in whom a diagnosis of NCD was established in 2021-2022, RUDAS score declined by -0.9±2.8 points (P=0.3). In those not meeting the criteria for NCD, the mean change was +1.7±2.4 (P=0.01). RUDAS scores differed significantly in those with and without NCD (25.5±2.8 and 28.6±1.5, P<0.001). RUDAS scores <28 and even more significantly those <23 were highly predictive of a diagnosis of NCD (PPV=86% and 100%, respectively, P<0.001, table 2). Conclusion: The results of our study suggest that lower RUDAS scores are associated with the diagnosis of neurocognitive disorder in adults with SCD. Prospective validation is ongoing with a larger sample size. In addition, patient characteristics will be explored as potential predictors of NCD. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Endoscopic Retrograde Cholangiopancreatography Performed by Trainees Is Not Associated with Increased Immediate Adverse Events or Technical Failure Rates.

Training endoscopists to perform endoscopic retrograde cholangiopancreatography (ERCP) is critical to address the increasing patient population with pancreatobiliary diseases. Concerns remain about ERCP safety and success involving trainees. We compared the technical success and immediate adverse events between ERCP with and without trainee involvement. Retrospective analysis of 28,271 ERCP procedures in a national sample of the United States over 12years. Demographics, procedure and fluoroscopy time, visualization and cannulation of main structures, adverse events, and technical success rates were compared between ERCP with and without trainees. Categorical variables were compared using Pearson's chi-square test and continuous variables using a standard t-test. Univariate and multivariate regressions were performed adjusting for age, gender, ethnicity, US region, ASA class and clinical setting. Approximately 49.5% of ERCPs had a trainee involved. The ampulla was visualized in 97.4% with trainee vs. 97.3% without trainee involvement (P = 0.858). The common bile duct was visualized and cannulated in 90.4% with trainees vs. 91.7% without trainees involved (P < 0.001). The ERCP was incomplete in 5.9% of cases with trainees vs. 6.4% without trainees involved (P = 0.207). Trainee participation added 8.7min to average procedure time (aOR: 1.02, P < 0.001) and 2.0min to fluoroscopy time (aOR: 1.00, P = 0.796). Adverse events (aOR: 0.89, P = 0.704) and technical success (aOR: 0.83, P = 0.571) were similar in both groups. Trainee involvement leads to increased procedure duration but is not associated with increased immediate adverse events, or technical failure. Our study supports ERCP safety and success with trainee participation.

Improved outcomes for borderline resectable adenocarcinoma of the pancreas after neoadjuvant chemotherapy in a community cancer center

BackgroundBorderline resectable adenocarcinoma of the pancreas involves the major vascular structures adjacent to the pancreas and has traditionally led to poor resection rates and survival. Newer chemotherapy regimens have demonstrated improved response and resection rates. We performed a retrospective review of borderline resectable pancreatic cancers who presented to a community cancer program to determine the effect of neoadjuvant chemotherapy to improve resection rates and overall survival. MethodsRecords of all patients diagnosed with adenocarcinoma of the pancreas from January 1, 2015 to December 31, 2019 were reviewed to determine stage at presentation, resectablility status, treatment methods, surgical resection and survival. Borderline resectable status was determined by preoperative imaging in agreement with published criteria from the National Comprehensive Cancer Network (NCCN) Guidelines 2.2021. Data was collected and analyzed by standard t-test. This study was approved by the institution's IRB. ResultsDuring this time period 322 patients were diagnosed with ductal adenocarcinoma of the pancreas of which 151 (47%) were unresectable, 31 (10%) were locally advanced, 70 (22%) were borderline resectable, and 69 (21%) were resectable at the time of presentation. 36 (51%) of the borderline resectable patients underwent neoadjuvant chemotherapy at our institution with either FOLFIRINOX or gemcitibine/nab-Paclitaxel regimens and served as the basis for this analysis. After neoadjuvant chemotherapy 24 (68%) of the borderline-resectable patients were deemed suitable for surgical exploration. At exploration, 15 (64%) were resected with 9 (60%) achieving margin-free resection on final pathology. The overall survival of those that underwent resection was increased by 19.6 months compared to those that did not undergo surgery (35.4 versus 15.8 mos, p < 0.01). Overall morbidity after resection was 46% (33% class 1 or 2, 13% class 3) with 0% mortality at 90 days. ConclusionsUse of neoadjuvant chemotherapy for borderline resectable adenocarcinoma of the pancreas results in improved resection rates and overall survival in resected patients. This management strategy for ductal adenocarcinoma of the pancreas is safe and feasible in a community-based cancer program.

Randomized Controlled Clinical Trial to Examine the Efficacy of Oral Midazolam in Post Operative Pain Reduction in Patients Undergoing Laparoscopic Cholecystectomy

Background: Stressful conditions like surgery and anesthesia trigger neuroendocrine pathway activation, which can have dangerous hemodynamic effects on the patient. One method for minimizing these hemodynamic consequences is maintaining an optimum level of anesthesia. Another option is giving patients a pharmaceutical formulation that modifies how anesthetic agents react. Objective: The current study sought to determine if preoperative oral midazolam could reduce postoperative pain scores and the occurrence of Rescue Analgesia in patients undergoing laparoscopic cholecystectomy. Methods: This is a single-blinded randomized controlled study conducted at the Surgery department of Jinnah Medical College Hospital, Korangi Karachi, on patients undergoing laparoscopic cholecystectomy. Through simple random sampling, participants were divided into two study groups, control (n=32) and 7.5mg receiving preoperative oral midazolam-intervention group. After surgery, the VAS pain score in both group participants was measured at 2, 8, 12, and 24 hours. The frequency of rescue analgesia and duration of hospital stay was also observed. Standard deviation, mean, chi-square test, and T-test was performed to determine the variation in both groups by using SPSS version 26. The P value ≤0.005 was measured significant. Results: No significant difference in the postoperative pain score after oral administration of midazolam in the intervention group compared to the control group at 2, 12, and 24 hrs intervals. Except at 8-hour intervals, a significant change of 0.004 was observed in both study groups. A significant variation of 0.008 was observed in the duration of hospital stay in the intervention group when compared with the control group. Lastly, in the present study, no significant difference in the frequency of rescue analgesics was observed in both study groups. Practical implication: This study will help out to determine the right dosage of oral midazolam which might effectively be used in managing post-operative pain in laparoscopic cholecystectomy patients. Conclusion: Orally administeredmidazolam was not efficient in lowering the pain score in patients undergoing laparoscopic cholecystectomy. Keywords: Midazolam, Post-operative pain, Laparoscopic cholecystectomy, Local anesthetics

Effect of Assessment for Learning (Afol) on Mathemetics Performance Among Senior Secondary School Students in Port Harcourt Metropolis, Nigeria

The study investigated Effect of Assessment for Learning (AfoL) on Mathematics Performance among Senior Secondary School Students in Port Harcourt Metropolis. The study adopted the quasi-experimental research design. The population of the study comprised of 3,234 SS2 students drawn across all public secondary schools in Port Harcourt metropolis. A sample of 60 SS2 students across two schools was drawn for the study using purposive sampling technique. Intact class was used without random assignment. The researcher classified the students into the experimental and the treatment groups using the two schools (School A &amp; B) with school A being the experimental group (AfoL) and B (AoL) the control group. These are the assessment for learning group as school A and the control group. The research instrument used for the study was “Mathematics Performance Test” (MPT) which served as pre-test and a reshuffled version serving as the posttest. Table of specification (ToS) was used to determine content and validity of the instrument while KR20 was used to determine a reliability coefficient of 0.91. Mean and standard deviation, t-test and 2-Way ANOVA were used in the analysis. Results showed that there is a significant difference (p=0.000&lt;0.05) in the effect of AfoL on mathematics performance of senior secondary school students in Port Harcourt metropolis as compared between their pretest and posttest scores. There was also a significance difference (p=.021&lt;.05) in the effect of AfoL on mathematics performance of senior secondary school students in Port Harcourt metropolis as compared between the experimental and control groups. On the other hand, there was no significant difference (p=.80&gt;.05) in the effect of AfoL and AoL on mathematics performance of male and female senior secondary school students in Port Harcourt metropolis. Based on this, recommendation among others was that classroom teachers and evaluators should from time to time assess their students (AfoL) instead of waiting till the end of the term (Summative assessment).

A Large Single Institution Analysis of Disparities in Genomic Testing in Lung Cancer Patients

<h3>Purpose/Objective(s)</h3> There has been an increase in genomic testing in lung cancer patients which has helped guide treatment and improve outcomes. However, there is an underrepresentation of racial and ethnic minority groups in many genomic sequencing studies. The disparate use of genomic testing could contribute to and widen health care disparities, as well as, limit the generalizability of findings. The purpose of this study was to determine the demographic of lung cancer patients that undergo genomic sequencing at our institution across a diverse health system. <h3>Materials/Methods</h3> A retrospective analysis of patients presenting to our institution with a pathology diagnosis of primary lung cancer and demographic date entered into SEMA4 biorepository database between December 2004 and January 2022 was performed. Demographic, clinical presentation, treatment, staging, and genomic testing (e.g., hotspot or targeted panels) were evaluated. Statistical analysis was performed using descriptive statistics, standard t-test, chi-square, Fisher's exact test, univariate and multivariate logistic regression. <h3>Results</h3> In total, 5729 patients met inclusion criteria for this study. Of these patients, 37.2% (2134) had genomic testing and 62.8% (3595) did not have testing. Mean ages of 75.9 in non-tested cohort and 72.7 years in tested cohort (p<0.001). The tested cohort was 55.4% (1182) female versus 51.5% (1851) in the non-tested cohort (p=0.004). In the tested cohort, there was lower proportion of white patients (p=0.001), but higher proportion of Asian (p=0.0001), other (p=0.0001) and unknown race patients (p=0.0001), as well as, non-Hispanic ethnicity (p=0.001). There were 835 (14.6%) patients overall that received radiation therapy (RT), with a higher proportion of tested patients receiving RT (20.0% vs 11.4%, p=0.0001). On multivariate logistic regression, the odds of testing decreased with older age (CI 0.98-0.99, p<0.001) and male sex (CI 0.74-0.93, p=0.001). The odds increased if patients were any race other than white non-Hispanic, including black non-Hispanic (CI 1.88-2.75, p=0.03), black Hispanic (CI 1.12-6.40, p<0.001), Asian (CI 3.01-5.67, p<0.001), and other race (CI 1.50-2.05, p<0.001) patients. The odds of genomic testing did not change if patients were white Hispanic (p=0.94) or Pacific Islander (p=0.30). <h3>Conclusion</h3> In contrast to previously published literature, there was not an underrepresentation of racial and ethnic minorities in patients who underwent genomic testing. In fact, patients who received SEMA4 testing were generally racially and ethnically diverse. Patients that were younger, female sex, and Asian race were significantly more likely to undergo testing. In order to mitigate health care disparities, there needs to be a concerted effort to recruit underserved, diverse populations to identify full range of genetic variation and appropriate targeted therapies.

A Comparison between Eight Formulas for the Estimation of Plasma Low-Density Lipoprotein Cholesterol in the Saudi Arabian Population

CONTEXT: Low-density lipoprotein cholesterol (LDL-C) is the classical target in cardiovascular (CV) disease management and is usually estimated by Friedewald's formula. However, this formula may over- or underestimate LDL-C levels. AIMS: Our aim is to compare eight LDL-C-estimating formulas to the direct LDL-C measurement and validate their use in the Saudi population. SETTINGS AND DESIGN: This was a retrospective study. SUBJECTS AND METHODS: A blood sample of fasting 669 Saudi subjects was tested for lipid profiles in King Abdulaziz University Hospital Laboratory, from which directly measured LDL-C was obtained. LDL-C was then estimated from eight different formulas: Friedewald's, Cordova's, Hata's, Puavilai's, Chen's, Ahmadi's, Hattori's, and Vujovic's, which were all compared to direct LDL-C. STATISTICAL ANALYSIS USED: Mean and standard deviation, paired t-test, and Pearson's correlation were used for statistical analysis. RESULTS: The mean differences between the direct LDL-C and Hattori and Chen's LDL-C were 0.03 and 0.08 mmol/L, respectively; P &lt; 0.001, while the mean difference observed with Hata, Friedewald, Puavilai, and Vujovic's formulas were higher in comparison: 0.15, 0.24, 0.29, and 0.33 mmol/L, respectively, P &lt; 0.001. Ahmadi and Cordova's LDL-C were estimated to be 0.60 and 0.64 mmol/L more than direct LDL-C levels, respectively, which showed the highest discordance with direct LDL-C, P &lt; 0.001. At a triglyceride (TG) level of &lt;4.5 mmol/L, Hattori also had the best agreement with direct LDL-C, with a mean difference of 0.04 mmol/L, and with TG &gt;4.5 mmol/L, their mean difference was 0.21 mmol/L. All estimated LDL-C strongly correlated with direct LDL-C, except for Ahmadi's. CONCLUSIONS: Hattori's LDL-C had the best agreement with the direct LDL-C, and across all TG levels. However, we recommend directly measuring LDL-C in those with high CV risk.

PERCEIVED CHALLENGES AND SATISFACTION OF EDUCATION STUDENTS IN ONLINE DISTANCE LEARNING

The study aimed to determine the perceived challenges and satisfaction levels of Bachelor of Elementary Education in online distance learning. The descriptive-correlational design was used in this study. The investigations were conducted at Notre Dame of Midsayap College on fifty (50) BEED students who are enrolled in online distance learning for School Year 2021-2022 and the majority of them were female students. A researcher-modified survey questionnaire was used in data gathering, Frequency and percentage distribution, mean and standard deviation, t-test and ANOVA, and Pearson-r correlation were used in treating the data. The study revealed that the students have challenges in online distance learning. The study found out that the highest challenges encountered by the students in online distance learning are slow internet connection due to their location and facing many interruptions when learning at home such as household chores and other errands. The students are highly satisfied with how teachers showed interest in helping students to learn and the teacher’s accessibility and availability. Moreover, the respondents are least satisfied with how timely teachers give feedback on their performance. The study also revealed that there was a significant difference in the satisfaction level of the students in terms of their sex.&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0369/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Effects of Long-Duration Wearing of Personal Protective Equipment with N95 Masks on Blood Oxygen Concentration and Pulse Rate Among Dental Professionals

Background: The importance of personal protective equipment (PPE) for health-care professionals working in an infective environment has been highlighted again in this COVID pandemic. CDC recommends the use of PPE with FFp2/N95 wear in dental health professionals. There are studies revealing the varied physiological as well as psychological impact of long-duration wear of PPE in health professionals. This study aims to evaluate the effects of wearing PPE with N95 mask before donning and after doffing (for 4 h) on the oxygen saturation levels and pulse rate. Materials and Methods: Forty dental surgeons of both sexes with informed consent working at a government dental college, in Kerala, were studied by a standard pulse oximetry test for oxygen saturation and pulse rate before donning and after doffing of PPE with FFP2/N95 respirator over 4 h duration. They were ensured to be hemodynamically stable, breathing room air under standard room temperature, and humidity. Data were entered and evaluated using a standard paired t-test using SPSS version 20. Results: The mean age group of the dental surgeons was 39 ± 9 years, and 60% were male. The mean values of oxygen saturation before donning and after doffing were 97.6 (1.1) and 96.7 (1.2), respectively, and the difference was significant (P &lt; 0.01). The pulse rate before donning and after doffing was found to be 79.7 (6.7) and 81.2 (6.7), respectively, with significance (P &lt; 0.01). However, the difference was not significant according to gender or age groups. Conclusion: The decrease in oxygen saturation and an increase in heart rate among dental surgeons were found to be significant after 4 h wear of PPE with FFP2 respirator. Nevertheless, these data of physiological impact of PPE cannot overshadow the risk-benefit ratio of PPE wear. The cautious use of PPE with improved technology can mitigate the risks involved in its use.

Sedative and analgesic effects of propofol–ketamine versus propofol–fentanyl for emergency department procedures

Background:To manage and reduce painful procedures in the emergency wards, procedural sedation as well as analgesia can be used. Propofol combinations are the most common short‐acting intravenous sedative drugs in the field of emergency medicine.Objectives:This research aimed to compare the effectiveness, safety, and complications of intravenous infusion of ketofol with fentofol in painful emergency procedures.Methods:This study was a randomized, double‐blind clinical trial. Sampling was simple and used random assignment; 196 participants were randomly assigned to two groups of 98 patients each. In each group, injection was done with fentanyl–propofol or ketamine–propofol. For data gathering, pre‐procedure, and procedure, modified Aldrete's scoring checklist was used. In order to determine the levels of sedation, we used the Ramsay Sedation Scale. Data analysis was performed via SPSS Version 20 using statistical tests such as mean ± standard division, t‐test, chi‐square test, and analysis of variance.Results:Among the participants in this study, shoulder procedure was performed more than other procedures (56.6%). The mean of recovery time was significantly different in the two groups (ketofol: 5.65 ± 0.35 vs fentofol: 9.33 ± 0.78); the recovery time in group B (fentofol) was longer than that in group A (ketofol) (p = 0.001). Drug complications were statistically significant in the two groups, and complications by ketofol were less than those by fentofol (p = 0.001). “Hypotension and bradycardia” were observed with fentofol and “tachycardia” was observed with ketofol. The performance of these two drugs was not the same when subject to various procedures.Conclusion:Results of this study revealed that ketofol provided better analgesia and sedation, faster recovery time, lesser complications and adverse events, and reduced bradycardia and hypotension.

Management of Isolation Precautions in Ambulatory Care Settings

<h3>Background</h3> Failure to discontinue transmission-based precautions (TBP) for eligible ambulatory patients may decrease stakeholder buy-in, adherence, and experience. Successful removal is hindered by unclear criteria and inadequate resources. We sought to create a pre-visit review process to identify TBP removal opportunities to support stakeholders without exhausting resources. <h3>Methods</h3> Study period was 11/02/2020 – 11/30/2021. We generated an electronic medical record (EMR) report of ambulatory encounters in the coming week with a TBP flag. Interventions tested included: A spreadsheet macro to filter and format the EMR report (implemented 01/29/21); Standardized IP chart review and notification; Clinical stakeholder engagement to define and evaluate process expectations. We used a standard t-test for weekly encounter and percent no-change review comparisons. <h3>Results</h3> During 11/02/2020-01/28/21, 3,111 encounters were reviewed for TBP removal. Of those, 310(9.96%) had TBP status updated, 1,134(36.45%) required email communication to determine status, and 1,667(53.58%) had no change. These no-change encounters included cystic fibrosis patients (remain in life-long TBP) and ineligible long term TBP. We built the macro to remove no-change encounters to focus on encounters needing review. During 1/29/21-11/27/21, 6,060 encounters were reviewed, with 1,818(30.00%) updated, 1,646(27.16%) requiring email, and 2,596(42.84%) no-change. Macro implementation reduced average reviewed encounters weekly (246 to 142, p<.0001) and the proportion of no-change encounters (56.36% to 47.39%, p=0.0224). Subjectively, reviews took less time (approximately 15 hours to 5 hours per week). Process standardization and stakeholder engagement were well-received. <h3>Conclusions</h3> Macro utilization increased review efficiency by removing no-change encounters. Despite a reduction in pre- and post-implementation proportions of no-change encounters, there is still opportunity to further reduce time wasted on no-change encounters. Standardizing our process allowed for cross training of IPs, alleviating burden on others. Stakeholder engagement improved relationships between IPs and ambulatory staff.

Influence of an Interventional Health Education in Enhancing the Perceived Learning Needs of Patients with Myocardial Infarction

Background: Myocardial infarction is the leading cause of coronary heart disease and death. Because post-MI patients are more likely to have another attack, it is vital that they have enough knowledge about their health and the appropriate self-care. post-MI patients, it is critical for post-MI patients to have adequate health information and self-care, especially if they have risk factors such as smoking, hypertension, hyperlipidemia, obesity, and a lack of exercise. Objectives: To evaluate influence of an interventional health education in enhancing the perceived learning needs of patients with myocardial infarction. Methods: A quasi-experimental design was used with the application of pre and post-test approach for both studied and controlled groups. This study was conducted at cardiac advisory department on purposive sample was selected to obtain representative and accurate data consisting of (90) patients at Missan Center for Cardiac Diseases and Surgery, (10) patients were excluded for the pilot study. Data were analyzed using descriptive statistical data analysis approach of frequency, percentage, mean, mean of scores, a total of scores, range and standard deviation and inferential statistical data analysis approach T-test, and analysis of variance (ANOVA). Results: highly significant difference between pre and posttests responses at (P value &lt; .05) in the study group related to all domains of the study. Conclusions: Less than one-quarter of patients in the study group were institute graduate level, and more than one-quarter of patients in the control group were secondary level graduate, one quarter of patients in the study group were within employee level; and more than one quarters in control group were within the retired level. more than half of patients in the study group and more than two-thirds of patients in the control group were married. In pretest and posttest, there is a significant influence of an interventional health education in enhancing the perceived learning needs of patients with myocardial infarction. Recommendations: The study recommend that it is critical to update patient learning needs by encouraging and inspiring patients to participate in particular interventional health education on the perceived learning needs of patients with Myocardial Infarction. Patients should have access to continued education and resources that enhance patient's learning needs during their hospitalization. Keyword: Myocardial Infarction, Influence, Interventional, Enhance.

Salivary Microbiota is Associated with Cannabis Use in Adolescents

PurposeCannabis is now the second most commonly used substance during adolescence, with 35.7% of 18‐year‐olds reporting use in the past year and 6.4% reporting daily use. Accumulating evidence suggests that cannabis use affects the microbiome, however, this is still underexplored. Given that adolescence is a vital period of neural and microbial development, it is essential to investigate if cannabis use is associated with differences in microbiota as perturbations to microbial systems during this period of development may influence brain development.MethodsSaliva biospecimens were collected from adolescent (15‐19 years old) cannabis users (N=8) and control participants (N=9) in an ongoing clinical trial (K23 AA025399) at the Medical University of South Carolina. Bacterial quantification was performed by real‐time quantitative PCR (qPCR) using primers for representative oral phyla (Bacteroidetes, Firmicutes, Proteobacteria, and Actinobacteria) and related species (Staphylococcus, Clostridium coccoides, Clostridium leptum, Lactobacillus, Escherichia coli, Bacteroides, and Prevotella). Standard t‐test was used to compare the relative abundances between the cannabis using group and control group. Correlations between levels of oral phyla and related species with cannabis use days reported on the Timeline Follow back (TLFB) and Cannabis Use Disorder Identification Test (CUDIT) scores were completed.ResultsAll saliva samples contained significant levels of bacterial gDNA (mean concentration: 96.9 ng/μl; ~10 ng/μl is sufficient). We observed significantly lower levels of Proteobacteria (p=0.031) and Bacteroides (p= 0.006) in the cannabis‐using group compared to the non‐cannabis‐using control group. Additionally, the number of cannabis use days reported on the TLFB and CUDIT scores were inversely correlated with Bacteroides levels (p= &lt;0.001, p=0.011 respectively).ConclusionThese preliminary data suggest that cannabis use during adolescence may be associated with changes in the oral microbiota, specifically in Proteobacteria and Bacteroides. The lower abundance of Bacteroides in the cannabis using group is further strengthened by the inverse correlations between cannabis use days and CUDIT scores. Interestingly, Bacteroidesactively expresses GABA‐producing pathways, a type of inhibitory neurotransmitter pathway that studies have shown is inhibited by THC. In addition, ratios of Bacteroides from stool microbiota analyses have also been reported to be decreased in cannabis users. Therefore, saliva microbiota collection may serve as a favorable alternative to classic stool collection. Inclusion of more participants in future studies will allow for more power to detect microbial differences within adolescents who use cannabis.

Influencing factors on prenatal depression in unmarried pregnant women

The results of this study is show that the higher the self-control and the lower the anxiety, the higher the self-control and the lower the anxiety level, the higher the level of prenatal depression is assessed and Based on this, the there is a need to develop and apply nursing interventions for unmarried pregnant women. Data were analyzed using IBM SPSS 24.O through mean and standard deviation, t-test, ANOVA, Pearson correlation, and stepwise regression analysis. The results showed that self-control had a negative correlation. In addition, the factors affecting prenatal depression in unmarried pregnant women were self-control and anxiety, and the explanatory power was 24.7%. Based on the results of this study, it is necessary to develop a nursing intervention program to effectively manage the prenatal depression and postpartum depression clusters of unmarried pregnant women.

Factors influencing premenstrual syndrome in nursing students

The purpose of this study is to examine the menstrual attitude, resilience, and premenstrual syndrome (PMS) of nursing students, and to identify predictors of PMS in nursing students. A descriptive survey design was used in this study and 154 nursing college students enrolled in the nursing departments of universities located in D and K cities became the study participants. Data were collected through survey questionnaires and were analyzed using IBM SPSS 20.0 through mean and standard deviation, t-test, ANOVA, Pearson correlation, and stepwise regression analysis. The results showed that menstrual attitude has a negative correlation with PMS, and resilience has a positive correlation with PMS The participants’ PMS showed a positive correlation with menstrual attitude (r=.114, p=.004) and a negative correlation with resilience. In addition, factors affecting PMS in nursing students were menstrual attitude and resilience, with an explanatory power of 20.5%. In particular, resilience was identified as the key factor for predicting PMS among nursing students. Therefore, based on the study results, a nursing intervention program must be developed to effectively manage the premenstrual and postmenstrual clusters of nursing students.