SPSS Statistical Software Research Articles

Significance of Selected Posturographic Methods in Diagnosis of Balance Disorders in Patients with Early-Stage Gonarthrosis.

Degenerative joint disease is a dynamic pathological process characterised by a destabilisation of the degradation and synthesis processes of articular cartilage and subchondral bone layer. Studies suggest that individuals with gonarthrosis experience deficits in proprioception, in addition to changes within their joints, which directly affects their ability to maintain posture and increases their risk of falling. Objectives: The aim of this study was to assess the functional status of patients with gonarthrosis through a posturographic examination conducted on a stabilometric platform (force plate) and a functional clinical examination. Methods: Participants were divided into two groups-a control group (n = 125) and a study group (n = 125). During the qualification process, subjective and objective examinations were conducted, including a functional assessment by means of such tests as the "Up and Go" Test, Functional Reach Test, Five Time Sit to Stand Test, and the Step Test. Subsequently, an assessment was conducted on the force plate by means of a posturographic test-the Romberg test performed with open and closed eyes in a standing position-and balance was evaluated using the Berg Balance Scale. The obtained data were analysed with the use of the IBM SPSS Statistics software version 27.0, by means of the Mann-Whitney test, and correlations were determined by means of Spearman's test. A significance level of p = 0.05 was adopted. Results: Statistically significant differences were observed among the assessed groups as a result of both functional and posturographic examinations, along with positive correlations for disease duration, age, and BMI index. Conclusions: Patients with gonarthrosis exhibited disturbances in balance, functionality, and posture compared to healthy individuals in the control group.

Factors Influencing the Adoption of Technology in Pharmaceutical Service Delivery in Tertiary Hospitals in Southwestern Nigeria

The aim of this paper is to identify those factors determining the adoption of technology in pharmaceutical service delivery in selected tertiary hospitals in Southwestern Nigeria. The study was a cross-sectional survey of 132 pharmacists who were randomly selected from a pool of 186 pharmacists in eight of the sixteen tertiary hospitals in Southwestern Nigeria. Primary data were collected using a pre-tested structured questionnaire with items on a 5-point Likert scale of importance and weighting scores of 1-5. The data were analysed with the aid of SPSS statistical package version 21 using descriptive statistics including relative significance indexes (RSI) as well as ANOVA inferential statistics at p<0.05. The results show that the respondents’ knowledge (RSI = 0.96), skill in the application of technology (RSI = 0.94), quality of output of the technology (RSI = 0.91) and relative advantage over current technology (RSI = 0.91), were the key adoption influencing factors (F = 14.062, p<0.05). The chapter concludes that the main factors determining the adoption of technology in pharmaceutical service delivery in tertiary hospitals were pharmacists’ knowledge of technology and skill in the application the technology, among others.

Critical Thinking and Teaching Mathematics: An Analysis from Education

This paper analyzes the critical thinking and teaching of mathematics from the perspective of education. Its purpose is to determine the link between the variables and their consequent analysis. Methodologically, it takes a mixed approach. It uses a correlational design and systematic review in the Scielo and Scopus databases over the past five years. The sample consisted of 103 professors and 36 articles. The technique was the survey. Inferential statistics were used using the SPSS statistical package. The results indicate that Spearman's Rho is 0.579, showing a moderate positive correlation. In conclusion, there is a moderate correlation between teachers' critical thinking and their way of teaching mathematics, showing that 48.5% of them reach a high level in their teaching method. At the same time, the systematic review shows that the studies are focused on two components; Social Development and Educational Praxis.

KHRONOS Project: Is time to surgery really important in the treatment of early breast cancer?

e12598 Background: Recent studies suggest that delaying surgery in early breast cancer (BC) longer than 8 weeks(w) has a worse overall survival compared to those who undergo surgery between 0-4 w. Because BC has developmental heterogeneity over time, the aim of our study is to demonstrate that time from diagnosis to primary surgery is not the most important factor and focus on the value of biology in BC development. Methods: Descriptive, observational and retrospective study in our centre with patients (pts) diagnosed with early stage BC from 2015-2022 without radiological lymph node involvement, whose first therapeutic strategy was surgery. We used chi-square test to analyse the association between categorical variables using SPSS statistical software. Results: 927 pts were included, of which 75.3% (696) maintained pre-surgical staging (N0), while 24.7% (228) changed from N0 to N+ after surgery, with 157 cases having exclusive sentinel lymph node involvement. 98 pts (11.1%) underwent axillary emptying. The histological characteristics were 789 cases (84.9%) ductal while 126 cases (13.6%) were lobular carcinoma. Tumor grades were distributed as follows: G1 (296 cases), G2 (419 cases), and G3 (205 cases). Hormone receptor expression was ER+ (51 cases), ++ (45), +++ (755), and PR + (77), ++ (134), +++ (537). HER2 expression in 516 cases were negative, HER2+ (195), ++ (151), +++ or FISH+ (56). Regarding surgery, 71.8% underwent breast conservative surgery while 28.2% underwent mastectomy. 583 pts were operated below 8w (62.9%), and in 344 (37.1%) time to surgery were > 8w. 583 pts were operated <8w (62.9%), 134 transitioned from N0 to N+ post-surgery, while 448 maintained negative nodal after surgery. In 344 (37.1%) time to surgery were > 8w, 94 pts went from radiologically N0 to nodal involvement after surgery; however, 248 maintained negative nodal status. Although there was a tendency for pts who underwent surgery beyond 8 w to have a greater change in nodal involvement, the differences were not statistically significant (p=0.129). When we performed a stratified analysis by subgroups, in terms of tumour grade, we observed that among pts with G3 tumours operated on >8w, 37.8% had gone from N0 to N+ vs. 23.8% of the group operated <8w, with statistically significant differences, p=0.034. No statistically significant differences were found stratifying by hormone receptors, HER2 or Ki67. Conclusions: In our study we do not find that delay from diagnosis to surgery in BC ≥ 8w worsens lymph node staging. However, we observe that changes in nodal staging occur (transitioning from N0 to N+ in early BC) in poorly differentiated tumors (G3). Therefore, due to BC developmental heterogeneity over time, we believe tumour biology is more important than time to surgery, this may be useful for prioritising pts with these characteristics on the surgical waiting list. Further studies including other biological factors are needed to confirm it.

The correlation between Ki 67 and Oncotype Dx on HR+, HER2- early breast cancer management: Insights of molecular testing.

e12546 Background: Elevated Ki-67 expression serves as an indicator of tumoral proliferation in breast cancer (BC) and is used in Ecuador for survival estimation, recurrence risk assessment, and guiding chemotherapy decisions. The Oncotype DX Breast Recurrence Score (ODX RS) is a validated 21-gene assay for hormone receptor-positive, HER2-negative invasive BC. It predicts chemotherapy benefits and the risk of distant recurrence over 10 years and is a mortality indicator. ODX RS has the potential to reduce the need for chemotherapy, alleviate financial burdens, and enhance clinical outcomes. Despite conflicting evidence on the significance of Ki-67 in the ODX RS, there is a lack of exploration within Latin populations. This study aims to compare the correlation of immunohistochemical (IHC) measured Ki-67 to the ODX RS in the Ecuadorian population. Methods: A retrospective analysis included women with early BC who underwent ODX RS testing in Ecuador from May 2020 to January 2023. Inclusion criteria: early BC (T1-T3/N0-N1a); IHC estrogen receptor (ER) positive; HER2 negative; and availability of tumor size, grade, lymph node status, and Ki67 proliferation index data. Exclusion criteria: patients with recurrent BC, incomplete pathology, or lacking IHC data. Patients were categorized into low (≤5%), intermediate (6%–29%), and high Ki67 expression groups (≥30%). Using the statistical software SPSS, the correlation between ODX scores and Ki-67 expression was analyzed using Pearson’s correlation coefficient. For risk stratification groups, Spearman's correlation was employed. Results: Among 77 patients undergoing Oncotype DX testing, 64 (with a mean age of 55) met the inclusion criteria. Eighty-six percent of cases were invasive ductal carcinomas (IDC). Seventeen percent exhibited low Ki-67 expression, 61% intermediate, and 20% high. No statistically significant correlation was found between IHC Ki-67 expression and ODX RS (r=0.051; p=0.69), neither when stratified by categories (r=0.086; p=0.50). A subanalysis based on risk categories showed 82% correspondence in the low Ki-67 group, 18% in the intermediate group, and 31% in the high Ki-67 group. No significant correlation was observed when stratified by histological types (invasive ductal carcinoma and invasive lobular carcinoma), nor by sample origin (core biopsy, excisional biopsy). Conclusions: There was no correlation between IHC Ki-67 expression and ODX risk scores in this study involving Ecuadorian patients. Our findings emphasize that IHC Ki-67 expression should not be the sole determinant for guiding therapeutic decisions and predicting recurrence in early breast cancer.[Table: see text]

Inclusion and Diversity in Healthcare Organizations’ Teams

Abstract Inclusion and diversity (D&I) are an integral part of an organization’s success in today’s world due to the impact they can have on employees and managers in all fields of activity. Teams and organizations are shaped and changed in ways that were not considered years ago. The review of the literature showed what D&I are, the differences between the two, and the impact on organizations worldwide, as well as in Romanian organizations. The research goal is the analysis of the differences in perception of manager and team members regarding D&I in healthcare/clinical research organizations, since one of the values of the organization analyzed is inclusion. The research method used for this study is quantitative research using a self-administered questionnaire, with structured questions. The 53 responses received were processed with Mann-Whitney nonparametric test in IBM SPSS Statistics software. The results showed that managers put greater emphasis on D&I than team members. Considering the global structure of the organization, the aspects of D&I have a great importance within management teams, their effects being able to influence team performance, the motivation of their members, and especially employees’ retention. The findings underscore the managerial implications, particularly those within the healthcare sector, in prioritizing and actively cultivating diversity and inclusive environments. In addition, research contributes to the theoretical background by providing empirical evidence that substantiates and enriches existing theoretical frameworks related to organizational inclusivity.

An Online Home Energy Management System using Q-Learning and Deep Q-Learning

The users of home energy management systems schedule their real-time energy consumption thanks to advancements in communication technology and smart metering infrastructures. In this paper, a data-driven strategy is proposed, which is an Online Home Energy Management System (ON-HEM) that uses reinforcement learning algorithms (Q-Learning and Deep Q-Learning) to control the optimal energy consumption of a smart home system. The proposed system comprises power resources (grid, photovoltaic), communication networks, and appliances with their agents classified into four groups: deferrable, non-deferrable, power level controllable, and electric vehicle. The system reduces electricity costs and high peak demands while considering the cost of user dissatisfaction with real-life data. Simulations are performed on the proposed ON-HEM considering different pricing approaches (Real Time Pricing and Time of Use Pricing) with Q-Learning and Deep Q-Learning (DQL) algorithms using PyCharm Professional Edition software. The findings demonstrate both the superiority of DQL over Q-Learning and the efficiency of the proposed ON-HEM in decreasing high peak demand, electricity costs, and customer dissatisfaction costs. The efficiency and dependability of the proposed system were verified by utilizing simulation-based findings with real-life data using IBM SPSS Statistics software.

Exploring health professionals' knowledge, practices and attitudes regarding gestational diabetes: A cross-sectional Irish national survey.

Gestational diabetes confers short- and long-term risk of mother and offspring health complications. Healthcare professionals such as endocrinologists, diabetes nurses, dietitians, midwives and general practitioners provide gestational diabetes care. We sought to explore healthcare professionals' perspectives on gestational diabetes care during pregnancy and postpartum. Healthcare professionals in the Republic of Ireland, whose role included gestational diabetes care were invited to complete an online 20-item survey between June and September 2022. Social media, professional organisations and personal networks were used for recruitment. Questions included guideline use, postpartum diabetes screening and advice practices. Analyses were performed using SPSS statistical software and free text was coded using NVivo. Seventeen healthcare professions across primary and secondary care settings participated (n = 127). No differences were noted between groups (medical, nursing/midwifery, allied health/other); therefore, findings were reported as a single group. Healthcare professionals reported using multiple different guidelines to support gestational diabetes management (n = 14). The most cited were 'Health Service Executive guidelines' (24.5%), 'local guidelines' (13.2%) and National Institute for Clinical Excellence guidelines (11.3%); 12.3% cited uncertainty, and 27.5% reported not to follow any named guidelines. For postpartum follow-up, 39% felt clear guidelines were available to support practice, 37% felt appropriate systems were in place and 29% reported effective communication between primary and secondary care services. Qualitative findings emphasised a desire for improved communication between systems, participants and providers, clear interdisciplinary guidelines, and adequate resourcing for gestational diabetes management and postpartum diabetes prevention, including comprehensive support and follow-up. System-level challenges and ineffective communication across settings are barriers to optimum postpartum care. Nationally agreed guidelines for best practice gestational diabetes management including postpartum diabetes prevention are needed.

Diffusion tensor imaging from past to present: A bibliometric analysis with trending topics and global productivity during 1980–2022

AbstractDiffusion tensor imaging (DTI) provides increasing opportunities for clinicians. As bibliometric studies define trends of novel modality applications, this study on DTI analyzed global productivity, most prolific institutions, and research areas. Articles obtained from the Web of Science (WoS) database were analyzed with the VOSviewer program, biblioshiny library in the R studio software bibliometrix package, exponential smoothing estimator, and with the SPSS (Version: 22.0) statistical software. In descending order, the United States, China, and Germany were the top 3 countries publishing DTI research. In descending order, the top 3 most productive institutions were California, Harvard and Johns Hopkins University. Trend topics include traumatic brain injury, tract‐based spatial statistics, fractional anisotropy, prognosis, machine learning, autism, white matter integrity and microstructure and Parkinson's disease. According to the estimations, 345 DTI articles will be published in 2025 (95% CI: 254–437). This study indicates the ever‐growing employment of DTI in clinical and basic sciences.

Genetic association of Interleukin-17A polymorphism in Bangladeshi patients with breast and cervical cancer: a case-control study with functional analysis

BackgroundBreast and cervical cancer are the two leading cancers in terms of incidence and mortality. Previous studies reported different interleukins, including interleukin-17A (IL-17A) to be responsible for the development and progression of these malignancies. Therefore, we speculated that the variants in this gene might be associated with these cancer developments in Bangladeshi population. For evaluating the hypothesis, we investigated the association of IL-17A rs3748067 polymorphism with the susceptibility of both breast and cervical cancer. MethodsThis case-control study was performed on 156 breast cancer patients, 156 cervical cancer patients, and 156 controls using the tetra-primer amplification refractory mutation system-polymerase chain reaction. The statistical software package SPSS (version 25.0) was applied for analyses. The genetic association was measured by the odds ratio (OR) and 95% confidence intervals (CIs). A statistically significant association was considered when p-value ≤ 0.05. Functional analysis was performed using GEPIA and UALCAN databases.ResultsFrom the calculation of the association of IL-17A rs3748067 with breast cancer, it is found that no genotype or allele showed a statistically significant association (p>0.05). On the other hand, the analysis of IL-17A rs3748067 with cervical cancer demonstrated that CT genotype showed a significant association (CT vs. CC: OR=1.79, p=0.021). In the overdominant model, CT genotype also revealed a statistically significant association with cervical cancer, which is found to be statistically significant (OR=1.84, p=0.015).ConclusionOur study summarizes that rs3748067 polymorphism in the IL-17A gene may be associated with cervical cancer but not breast cancer in Bangladeshi patients. However, we suggest studies in the future with a larger sample size.

Screening of essential oils against oxacillin-resistant Staphylococcus aureus strains isolated from bovine mastitis

Bovine mastitis is a disease with far-reaching consequences for the dairy industry. Staphylococcus aureus is a pathogen that is especially resistant to antibiotics. The objective of this study was to evaluate the antimicrobial activity of the essential oils Lippia citriodora (Lam.), Thymus vulgaris (L), and a mixture of the essential oils Lippia citriodora and Thymus vulgaris (50/50 v/v), against isolates of oxacillin-resistant Staphylococcus aureus (n=15) of positive cases of bovine mastitis. For the statistical analysis, the IBM SPSS statistical package was used. The mixture of essential oils (Lippia citriodora and Thymus vulgaris (50/50 v/v)) obtained the most significant antimicrobial activity in relation to pure essential oils. It is therefore concluded that the mixture of these oils boosts their antimicrobial activity (p<0.05). The minimum inhibitory and bactericidal concentration of this mixture for the total isolations was 12 μL/L and 25 μL/mL, respectively.

ANALYSING THE IMPACT OF TAX INCENTIVES ON SAVINGS AND INVESTMENTS

Tax incentives have a significant impact on how people save and invest. The goal of this study is to look into the impact of tax incentives on saving and investing. This study tries to provide insights into how tax incentives influence behavior. The study aims to examine the effects of tax incentives on savings and investment habits among respondents. The study also sets up some hypothesis about the impact of tax incentives. The study primarily uses primary data, i.e., a questionnaire. The data will be tested by chi-square tests, regression, and frequency using the statistical software SPSS. The study received approximately 110 responses. The study addressed the debated effects of tax incentives on individuals' behavior, the effectiveness of incentive structures, and overall economic outcomes. The study found that tax incentives significantly impact savings habits, investment portfolio checks, and awareness among respondents. The study also found that the hypothesis being tested was that tax incentives have an impact on savings and investments.

Influence of Supplier Responsiveness on Procurement Performance of Parastatals in Mombasa County, Kenya

The purpose of this study was to establish how supplier responsiveness influences procurement performance within Mombasa County. The study adopted descriptive research study design. The research was grounded on the Kaizen Theory. The target population comprised of 308 procurement staff members, including both managerial and non-managerial roles, across parastatals in Mombasa County. A sample size of 174 was determined using the Yamane method and respondent were selected using Stratified random sampling technique to ensure equitable representation and eliminate bias. Data analysis was conducted utilizing the statistical software SPSS version 28. Regression analysis was used to ascertain the predictive relationship between dependent and independent variables, with results being presented in tabular form alongside percentages. The findings showed that there was a strong positive correlation between supplier responsiveness and procurement performance(B1=0.307, t=2.354 & p=0.022<0.05), highlighting the critical role of suppliers' ability to swiftly adapt to changing environments and efficiently address challenges in determining overall procurement outcomes. The small standard deviation among participants underscores the consensus on the importance of supplier responsiveness in expediting the procurement process. Notably, the research indicates a significant boost in procurement performance with each unit increase in supplier responsiveness, emphasizing the pivotal role of supplier sensitivity in enhancing procurement success within Mombasa County's state corporations. The study recommends that managers of parastatals should prioritize fostering strong and collaborative relationships with suppliers to enhance responsiveness. Additionally, adoption of electronic procurement solutions can expedite the procurement process and enable quicker responses to market changes.

Phenotypic and Genotypic Antibiotic Resistance Patterns of Clinical Shigella Isolates from Tehran, Iran

Background: The emergence of multidrug-resistant (MDR) Shigella is a health concern in both developed and developing countries. The indiscriminate use of antibiotics without considering resistance patterns has led to the emergence of resistant strains. Objectives: This study aimed to investigate the phenotypic and genotypic patterns of antibiotic resistance and virulence gene distribution in Shigella isolates from patients in Tehran, Iran. Methods: In this cross-sectional study, 60 Shigella isolates were collected from patients referred to Milad Hospital and Pasargad Laboratory in Tehran. The isolates were gathered over four months, from February 2023 to June 2023. After biochemical and genetic confirmation of the isolates, the disk diffusion method was employed to determine antibiotic resistance patterns. The distribution of beta-lactamase genes (blaCTX-M1, blaCTX-M2, blaCTX-M8, blaSHV, blaTEM, and blaOXA) and virulence genes (ial, virF, invE, sigA, and pic) was investigated in Shigella isolates using the multiplex PCR method. SPSS statistical software version 22 was used for data analysis. Results: Thirty-six percent of isolates were found to be MDR. The highest rate of resistance was against tetracycline (90%) and ampicillin (80%). The lowest resistance rate was against azithromycin (1.9%) and amikacin (7.1%). The blaCTX-M1 and blaCTX-M8 genes were more prevalent, detected in 38.3% and 50% of the isolates, respectively. However, the blaSHV and blaCTX-M2 genes were not detected in any of the isolates. Additionally, 32% of the MDR isolates harbored both the blaCTX-M1 and blaCTX-M8 genes simultaneously. The distribution of virulence genes ial, virF, invE, sigA, and pic in the studied isolates was 28.3%, 85%, 68.3%, 81.7%, and 15%, respectively. Conclusions: The present study emphasizes the increasing trend of MDR Shigella isolates. Therefore, serious measures are needed to prevent the spread of resistant genes. Furthermore, the detection of virulence factors could help in controlling shigellosis, which is a significant global health issue.

Apoptotic efficiency of Dicoma anomala biosynthesized silver nanoparticles against A549 lung cancer cells

Lung cancer is one of the common forms of cancer that affects both men and women and is regarded as the leading cause of cancer related deaths. It is characterized by unregulated cell division of altered cells within the lung tissues. Green nanotechnology is a promising therapeutic option that is adopted in cancer research. Dicoma anomala (D. anomala) is one of the commonly used African medicinal plant in the treatment of different medical conditions including cancer. In the present study, silver nanoparticles (AgNPs) were synthesized using D. anomala MeOH root extract. We evaluated the anticancer efficacy of the synthesized AgNPs as an individual treatment as well as in combination with pheophorbide a (PPBa) mediated photodynamic therapy (PDT) in vitro. UV–VIS spectroscopy, high-resolution transmission electron microscopy (HR-TEM), Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) was used to confirm the formation of D.A AgNPs. Post 24 h treatment, A549 cells were evaluated for ATP proliferation, morphological changes supported by LIVE/DEAD assay, and caspase activities. All experiments were repeated four times (n=4), with findings being analysed using SPSS statistical software version 27 set at 0.95 confidence interval. The results from the present study revealed a dose-dependent decrease in cell proliferation in both individual and combination therapy of PPBa mediated PDT and D.A AgNPs on A549 lung cancer cells with significant morphological changes. Additionally, LIVE/DEAD assay displayed a significant increase in the number of dead cell population in individual treatments (i.e., IC50’s treated A549 cells) as well as in combination therapy. In conclusion, the findings from this study demonstrated the anticancer efficacy of green synthesized AgNPs as a mono-therapeutic drug as well as in combination with a chlorophyll derivative PPBa in PDT. Taken together, the findings highlight the therapeutic potential of green nanotechnology in medicine.

Impact of Eight Weeks of Supplementation with Vitamins C and E on the Expression of CP Protein and the HSP70 Gene in the Brain Tissue of Rats with Alzheimer’s Disease

Introduction: Impact of antioxidant supplements on the health of patients with Alzheimer’s disease has not yet been clearly defined. Given that no study has been conducted so far to evaluate the effectiveness of vitamins C and E on the expression of Carbonyl Protein (CP) and Heat Shock 70 (HSP70) genes in rats with Alzheimer’s, this study aims to investigate the effect of an eight-week supplementation of vitamins C and E on the expression of CP and HSP70 in the brain tissue of rats with Alzheimer’s disease. Methods: In this experimental study, 28 rats with Alzheimer disease were injected with 10 mg/kg of trimethyltin and divided into four groups: patient control, sham (soluble vitamin E), Vitamin C, and Vitamin E (VE). Seven healthy rats were included in the control group to investigate the effects of disease induction on the variables under study. They were administered a daily supplement of 4 mg/kg of vitamin C and 30 mg/kg of vitamin E for eight weeks. After supplementation period, the groups were compared in terms of CP values and HSP70 gene expression. Data were analyzed by SPSS16 statistical software. Shapiro-Wilk test was used to check normality of the finding distributions. Effect of vitamin E and vitamin C supplementation was evaluated using one-way analysis of variance. Tukey's post hoc test was used to check the type of variable effects. A significant level of 0.05 was considered for all analyses. Results: Levels of carbonyl protein in both the vitamin C and vitamin E groups were significantly lower than those in the patient control group (P < 0.05). HSP70 levels in the vitamin C and E groups were significantly higher than those in the patient control group (P < 0.05). No significant difference was observed between vitamin C and E supplement groups (P > 0.05). Conclusion: Findings of this study suggest that both vitamin C and E exhibit similar antioxidant and cellular protective effects in the brain tissue of mice with Alzheimer’s disease. Given the impact of vitamins C and E on reducing carbonyl protein levels and increasing HSP70 levels in the hippocampal tissue of rats, it is recommended to explore the effects of these vitamins on other neurodegenerative disorders in future studies.

Analysis of the factors influencing of sleep quality in intensive care unit awake patients based on a structural equation model: A cross-sectional study.

The objective of this study was to construct and validate a structural equation model (SEM) to identify factors associated with sleep quality in awake patients in the intensive care unit (ICU) and to assist in the development of clinical intervention strategies. In this cross-sectional study, 200 awake patients who were cared for in the ICU of a tertiary hospital in China were surveyed via several self-report questionnaires and wearable actigraphy sleep monitoring devices. Based on the collected data, structural equation modelling analysis was performed using SPSS and AMOS statistical analysis software. The study is reported using the STROBE checklist. The fit indices of the SEM were acceptable: χ2/df = 1.676 (p < .001) and RMSEA = .058 (p < 0.080). Anxiety/depression had a direct negative effect on the sleep quality of awake patients cared for in the ICU (β = -.440, p < .001). In addition, disease-freeness progress had an indirect negative effect on the sleep quality of awake patients cared for in the ICU (β = -.142, p < .001). Analgesics had an indirect negative effect on the sleep quality of awake patients cared for in the ICU through pain and sedatives (β = -.082, p < .001). Sedation had a direct positive effect on the sleep quality of conscious patients cared for in the ICU (β = .493; p < .001). The results of the SEM showed that the sleep quality of awake patients cared for in the ICU is mainly affected by psychological and disease-related factors, especially anxiety, depression and pain, so we can improve the sleep quality of patients through psychological intervention and drug intervention.

Metagenomic analysis reveals ecological and functional signatures of oral phageome associated with severe early childhood caries

ObjectivesSevere early childhood caries (S-ECC) is highly prevalent, affecting children's oral health. S-ECC development is closely associated with the complex oral microbial microbiome and its microorganism interactions, such as the imbalance of bacteriophages and bacteria. Till now, little is known about oral phageome on S-ECC. Therefore, this study aimed to investigate the potential role of the oral phageome in the pathogenesis of S-ECC. MethodsUnstimulated saliva (2 mL) was collected from 20 children with and without S-ECC for metagenomics analysis. Metagenomics sequencing and bioinformatic analysis were performed to determine the two groups’ phageome diversity, taxonomic and functional annotations. Statistical analysis and visualization were performed with R and SPSS Statistics software. Results85.7 % of the extracted viral sequences were predicted from phages, in which most phages were classified into Myoviridae, Siphoviridae, and Podoviridae. Alpha diversity decreased, and Beta diversity increased in the S-ECC phageome compared to the healthy group. The abundance of Podoviridae phages increased, and the abundance of Inoviridae, Herelleviridae, and Streptococcus phages decreased in the S-ECC group. Functional annotation revealed increased annotation on glycoside hydrolases and nucleotide metabolism, decreased glycosyl transferases, carbohydrate-binding modules, and biogenic metabolism in the S-ECC phageome. ConclusionsMetagenomic analysis revealed reduced Streptococcus phages and significant changes in functional annotations within the S-ECC phageome. These findings suggest a potential weakening of the regulatory influence of oral bacteria, which may indicate the development of innovative prevention and treatment strategies for S-ECC. These implications deserve further investigation and hold promise for advancing our understanding and management of S-ECC. Clinical significanceThe findings of this study indicate that oral phageomes are associated with bacterial genomes and metabolic processes, affecting the development of S-ECC. The reduced modulatory effect of the oral phageome in counteracting S-ECC's cariogenic activity suggests a new avenue for the prevention and treatment of S-ECC.

Converting an interprofessional opioid use disorder simulation from high-fidelity to an online branching pathway scenario

The Covid-19 pandemic caused a disruption in teaching for institutions across the country, particularly for those using simulation-based education. Our team converted a live high-fidelity simulation (HFS) into an online virtual simulation using a storyline and branching pathway approach. The team collaborated with multimedia specialists in video production to create a branching path simulation (BPS), taking interprofessional teams of online students through several decision-making points of a patient's experience in the emergency department (ED). Video vignettes of simulation decision points are incorporated throughout the simulation, with a final outcome eventually emerging. The TeamSTEPPS® Teamwork Attitudes Questionnaire (T-TAQ) was administered before and after the online simulation and descriptive data analysis (paired sample t-test) was conducted using SPSS statistical software. A post simulation satisfaction survey was similarly analyzed.

KECURANGAN AKUNTANSI: PENGENDALIAN INTERNAL, KOMITMEN ORGANISASI, DAN ASIMETRI INFORMASI

This study aims to influence the effectiveness of internal control, organizational commitment, and information asymmetry on accounting fraud in Banda Aceh City with the census method so that the entire population is sampled. The data in this study were collected using a survey distributing questionnaires. Respondents in this study were structural officials involved in the preparation and implementation of the budget consisting of heads of agencies, heads of finance, and treasurers in 46 SKPK of Banda Aceh City. Data analysis in this study used multiple linear regression analysis with the help of statistical software SPSS version 26. The results showed that (1) the effectiveness of internal controls, organizational commitment, and information asymmetry have a simultaneous effect on accounting fraud, (2) the effectiveness of internal controls affects accounting fraud, (3) organizational commitment affects accounting fraud, and (4) information asymmetry affects accounting fraud.