Average Score Research Articles

The Effect of Lavender Oil Use on Pain and Comfort Level in Intramuscular Injection Administration: A Single Blind Randomized Controlled Study

ContextThe fact that the concept of quality in health care services has come to the fore and that evidence-based practices have become widespread made such concepts as patient satisfaction and comfort important and priority parameters in determining the quality of health services. ObjectivesThe aim of the study is to determine the effects of using lavender oil in intramuscular injection on injection pain, comfort level, blood pressure, pulse rate and respiratory rate. MethodsThe study was designed as a prospective, single-blind randomized controlled trial. The research was conducted in accordance with the CONSORT Checklist guide. In our study, a total of 160 individuals were included in the sample, 80 of whom were control and 80 were intervention. Structured Information Form, Visual Analog Scale and Comfort Scale were used to collect the data of the research. Mann Whitney U, Kruskal Wallis test and Wilcoxon test were used to evaluate the data. ResultsIt was determined that the mean pain scores of the individuals who received intramuscular injection by applying lavender oil were statistically significantly lower than the individuals in the control group. Again, the comfort score averages of the individuals who were applied lavender oil were found to be statistically significantly higher than the control group. It was determined that the blood pressure, pulse rate and respiratory rate before the injection of the individuals in the control group increased statistically significantly according to the post-injection measurements, while the blood pressure, pulse rate and respiratory rate in the lavender oil group decreased significantly after the injection and remained within their normal values. ConclusionAs a result, it was determined that the application of lavender oil in intramuscular injection had a positive and significant effect on the blood pressure, pulse rate and respiratory rate of the individuals on the injection pain and comfort level.

CALL TO ECLS-Acronym for Reporting Patients for Extracorporeal Cardiopulmonary Resuscitation Procedure from Prehospital Setting to Destination Centers.

The acronym CALL TO ECLS has been proposed as a potential tool to support decision-making in critical communication moments when qualifying a patient for the ECPR procedure. The aim of this study is to assess the accuracy of the acronym and validate its content. Validation is crucial to ensure that the acronym is theoretically correct and includes the necessary information that must be conveyed by EMS during the qualification of a patient with out-of-hospital cardiac arrest for ECMO. A survey was conducted using the LimeSurvey platform through the Survey Research System of the Jagiellonian University Medical College over a 6-month period (from December 2022 to May 2023). Usefulness, importance, clarity, and unambiguity were rated on a 4-point Likert scale, from 1 (not useful, not important, unclear, ambiguous) to 4 (useful, important, clear, unambiguous). On the 4-point scale, the Content Validity Index (I-CVI) was calculated as the percentage of subject matter experts who rated the criterion as having a level of importance/clarity/validity/uniqueness of 3 or 4. The Scale-level Content Validity Index (S-CVI) based on the average method was computed as the average of I-CVI scores (S-CVI-AVE) for all considered criteria (protocol). The number of fully completed surveys by experts was 35, and partial completion was obtained in 63 cases. All criteria were deemed significant/useful, with I-CVI coefficients ranging from 0.87 to 0.97. Similarly, the importance of all criteria was confirmed, as all I-CVI coefficients were greater than 0.78 (ranging from 0.83 to 0.97). The average I-CVI score for the ten considered criteria in terms of usefulness/significance and importance exceeded 0.9, indicating high validity of the tool/protocol/acronym. Based on the survey results and analysis of responses provided by experts, a second version was created, incorporating additional explanations. In Criterion 10, an explanation was added-"Signs of life"-during conventional cardiopulmonary resuscitation (ROSC, motor response during CPR). It has been shown that the acronym CALL TO ECLS, according to experts, is accurate and contains the necessary content, and can serve as a system to facilitate communication between the pre-hospital environment and specialized units responsible for qualifying patients for the ECPR.

Normative values of neck extensor endurance test in young adults

BackgroundNeck extensor muscles frequently exhibit poor performance in individuals with neck pain. The Deep Neck Extensor Endurance Test (NEET) is commonly used to assess the isometric holding time of the neck extensor muscles. Establishing normative values for this test may assist clinicians in the development of rehabilitation programs. ObjectivesTo identify the average holding time of the NEET in healthy young adults without neck pain. DesignNormative research. Methods440 young adults (172 males and 268 females; age: 18–28 yrs) satisfied eligibility criteria were recruited for participation in this study. The average of hold-time scores for 2 attempts was recorded and used for data analysis. ResultsThe data were not normally distributed; therefore, descriptive data were expressed in terms of median and interquartile range. Demographic data including age, gender, height, weight, Body Mass Index, International Physical Activity Questionnaire expressed as the mean with 95% confidence interval (CI) and range. The average holding time of healthy young adults for NEET was 43.1 (95% CI 38.8 to 46.6), men produced an average hold time of 47.1 (95% CI 46.1 to 51.9) and women produced 40.7 (95% CI 39.9 to 44.0). ConclusionThe holding time of NEET for healthy young adults was 43 seconds. Forty-seven seconds was average hold time for males and for females, it was 40 seconds.

Evaluating online patient education materials for liver cirrhosis.

Liver cirrhosis affects 4.5 million adults in the United States (US). As more patients educate themselves online, we evaluated the accessibility, quality, understandability, accuracy, readability, and comprehensiveness (AQUA-RC) of online patient education materials for cirrhosis. Cross-sectional analysis using Google® and YouTube® on a cleared internet browser from 12 cities across the US. The authors independently reviewed the top 25 search results from each platform using search terms "liver cirrhosis" and "cirrhosis". Accessibility was evaluated from twelve cities in six regions across the US. We evaluated resource quality using the DISCERN score, understandability using the PEMAT score, readability using the Flesch-Kinkaid score, and accuracy/comprehensiveness using a list of author-generated criteria. AQUA-RC was compared between 1) academic websites (AW) vs. non-academic websites (NAW), and 2) websites vs. YouTube® videos. 28 websites and 25 videos were included. Accessibility was equal across all regions. Websites had higher average quality scores than videos, although this was not statistically significant (p = 0.84). Websites were more understandable than videos (p < 0.00001). Both websites and videos were 100% accurate. Readability for websites was higher than recommended standards. Websites were more comprehensive than videos (p = 0.02). Online patient education materials for cirrhosis in the US are equally accessible, but readability and understandability are too complex. Websites are of greater quality, accuracy, and comprehensiveness than YouTube videos, which are often narrowly focused and targeted at the medical community rather than patients. Further efforts should be made to improve online patient education and expand content across platforms.

A pilot initiative to enhance quality improvement teaching with simulation.

Quality Improvement and Patient Safety (QIPS) is a recognised competency across residency programmes. Although a variety of teaching modalities exist, many do not represent the multifaceted clinical environment that trainees work in. Residents have reported challenges in linking QIPS classroom-based learning with their clinical duties. High-fidelity simulation has been used to bridge this gap within clinical skills teaching and therefore has potential to address this issue in QIPS learning. We developed and piloted four high-fidelity simulation scenarios with 15 surgical residents (Orthopaedics, General Surgery, Gynaecology and Neurosurgery). Each scenario contained elements of both latent and active safety errors. Residents were provided with a short pre-reading from an open-access resource on basic QIPS methodology and underwent a debriefing by a trained QIPS faculty. Residents were then tasked to apply their learning to their scenario to develop a QIPS-focused solution. Objective knowledge acquisition was assessed with the Quality Improvement Knowledge Assessment Tool-Revised (QIKAT-R) in conjunction with a survey based upon the Kirkpatrick Model of Learning. Overall, residents agreed that the simulation was helpful in learning QIPS methodology and agreed that they could perform fundamental QIPS tasks. The average QIKAT-R score demonstrated a trend towards improvement. High-fidelity simulation is a potential means to provide residents with hands-on experience in QIPS knowledge acquisition and application. Future directions should aim to compare the efficacy of simulation with other teaching modalities and evaluate the long-term impact of QIPS teaching on resident behaviours and motivation to take part in QIPS initiatives.

Application of Improved Class of Weighted Averaging Operators in Intuitionistic Fuzzy Ann Guided MAGDM E-Commerce Problems

Objectives: To propose a novel and improvised Artificial Neural Network (ANN) technique to solve Multiple Attribute Group Decision Making (MAGDM) problems and an improved class of Aggregation operators for combining Intuitionistic Fuzzy Set (IFS) matrices for the ANN algorithm. Methods: A novel class of improved aggregation operators namely the Improved Intuitionistic Fuzzy Weighted Arithmetic Averaging (IM-IFWAA) operator and the Improved Intuitionistic Fuzzy Ordered Weighted Averaging (IM-IFOWA) operator are proposed in this work. The proposed improved class of aggregation operators will aggregate the IFS matrix data sets appearing in the form of matrices and then the revised input vectors which is then fed into the ANN algorithm following Delta, Perceptron, and Hebb Learning Rule for the next phase. Findings: Aggregating the Intuitionistic Fuzzy set information or data in today’s digital world is a tedious task in the field of MAGDM problem-solving. In this work, two new classes of operators for aggregating the data sets are proposed namely the IM-IFWAA operator and the IM-IFOWA operator which will improve the performance of the ANN. Necessary theorems for the proposed operators are proved to provide consistency of the same. The input created using the aforementioned operators is then fed into the novel ANN algorithm for further computations. Varieties of learning rules are then engaged for ranking of the best alternative for the decision problem. The developed theory is supported by a numerical example which is computed using all the proposed techniques. Novelty: Most of the research done on Intuitionistic Fuzzy Artificial Neural Network models are based on learning rules or using some other calculations. The proposed methods of using novel and improvised aggregation operators for ANN are used to find the inputs for ANN where varieties of learning rules for ANN are employed for effective decision analysis. Keywords: ANN, Learning Rules, MAGDM, Intuitionistic Fuzzy Sets, Weighted Aggregation Operator

Comparative Study among Term Frequency-Inverse Document Frequency and Count Vectorizer towards K Nearest Neighbor and Decision Tree Classifiers for Text Dataset

Background: Text classification techniques are increasingly important with the exponential growth of textual data on the internet. Term Frequency-Inverse Document Frequency (TF-IDF) and Count Vectorizer(CV) are commonly used methods for feature extraction. TF-IDF assigning weights to terms based on their frequency. CV simply counts the occurrences of terms. The performance of CV as well as TF-IDF are evaluated and compared with KNN and DT classifiers across text datasets. Methodology: The investigation begins with preprocessing. The feature vectors are created using both TF-IDF and CV. Feature vectors are passed into the KNN and DT classifiers at in training stage. Experiments are executed the usage of Kaggle's public database Ukraine 10K tweets sentiment_analysis dataset and the Womens ecommerce clothing reviews dataset. Findings: The average of precision, recall, f1 score and accuracy of KNN with TF-IDF were 84.5%, 87%, 83%, 87% respectively and KNN with CV were 83.5%, 87%, 83.5%, 87% respectively. Similarly, average of precision, recall, f1 score and accuracy of DT with TF-IDF were 89%, 89%, 89%, 89% respectively and DT with CV were 89%, 89.5%, 89.5%, 89.5% respectively. The results obtained in this research is consistent with previous similar research result. Conclusions: The performance of TF-IDF is almost similar as CV for a particular dataset and a particular classifier in this study. Novelty: The experiment performed using these classifiers and feature extraction methods on the datasets is a novelty and contribution of this research.

Analysis of numerical simulations and semi-empirical models on distribution characteristics of wind-driven rain on low-rise building facades

Wind-driven rain (WDR) is a significant contributor to indoor moisture in buildings, directly impacting the thermal and moisture performance of facades. Previous research on WDR in China focused on a limited number of low-rise pilot buildings, whose materials, shapes, and environmental settings are not entirely representative of typical applications. Aim to improve the accuracy of WDR predictions on low-rise building facades, there is a need for assessing different WDR calculation methods under various rain events. The paper presented high-resolution WDR measurements from a low-rise concrete building in Chongqing to investigate the distribution of WDR on building facades under local meteorological conditions. The study compared the performance of numerical simulations and two semi-empirical models with different meteorological data averaging techniques. The results indicated that Computational Fluid Dynamics (CFD) simulations using the Eulerian multiphase (EM) model more closely matched the actual catch ratio across various locations and the WDR amount across the facade, with errors ranging between 10%-25 % and 2%–23 %, respectively. Furthermore, the ISO model with weighted averaging (WA) technique outperformed others in estimating catch ratios at various locations and the WDR amount across the facade, particularly when estimating the midline catch ratio. When considering both cumuliform and stratiform rainfall, the arithmetic averaging (AA) technique was a viable method for the ASHRAE model to forecast WDR. The ISO model's predictions corresponded to 54%–81 % of the field measurements, while the ASHRAE model's estimates varied more widely, ranging from 33 % to 229 % of the measured values.

Ethical values held by nursing students. Comparative study in two country

IntroductionEthical values are a guideline for behavior in certain situations. They take on particular importance in patient care. Ethical values depend on many factors including culture. The aim of this study is to compare the ethical values of nursing students.MethodsA cross-sectional study design was used. A total of 463 students participated in the survey, including 191 from Poland and 272 from Turkiye. The study was conducted from April to June 2022. For the purposes of this study was used Ethical Values Scale (IEVS). The criteria for excluding participants from the study were nursing student status and consent to participate in the study.ResultsThe IEVE total score for all respondents was 68.20 and the median was 68. In the individual subscales: Love-Respect 34.76 (median 35), Justice-Honesty 21.29 (median 21) and Cooperation 12.14 (median 12). Polish students’ total IEVS score average was 70.48 ± 6.81 and Turkish students’ IEVS total score average was 66.61 ± 9.65. There is a statistically significant difference between the total score average on the IEVS of students from the two countries (p < 0.001).ConclusionStudents in both countries generally demonstrate high ethical standards. There are noticeable differences between the responses of students from Poland and Turkiye.

Study of Multimodality Imaging Features of Brown Tumor or Osteitis Fibrosa Cystica

Introduction Brown tumor, also known as osteitis fibrosa cystica, is a rare but significant manifestation of hyperparathyroidism characterized by focal bone lesions resulting from excessive osteoclastic activity. Despite its rarity, Brown tumor poses diagnostic challenges due to its varied clinical presentations and radiographic features, often mimicking other bone lesions such as giant cell tumors or metastatic disease. Material and Methods In this study, we present a retrospective analysis of 6 cases of Brown tumor diagnosed and managed at our institution over a 12 months period from April 2022 to April 2023. Our objectives are to delineate the diverse clinical manifestations of Brown tumor, discuss diagnostic modalities utilized, treatment strategies employed, and evaluate patient outcomes. Results Five out of our six patients were females. Also 5 out of our 6 patients were under the age of 25. 2 patients presented to us with multiple lytic lesions and other 4 patients had solitary lesions. 1 patient out of 6 presented to us with pathological fracture. Only 2 out of the 6 patients had a positive sestamibi scan but Ultrasonography (USG) of the neck and MRI of the neck showed the presence of parathyroid adenoma in all the cases. Preoperative average of VAS score in this patients was 67 which was decreased to as low as 24. We performed paired t-tests on the blood investigation values and Visual Analog Scale (VAS) scores for all patients. The results were statistically significant, with values returning to normal three months post-surgery. Conclusion When radiographic evidence of a lytic lesion and hypercalcemia are present, Brown tumor should always be considered in the differential diagnosis. Brown tumor has a distinctive imaging appearance, with solid components displaying intermediate to low intensity on T1- and T2-weighted images, while the cystic components appear hyperintense on T2-weighted images and exhibit fluid-fluid levels. MRI of the neck corroborates the ultrasound findings and detects parathyroid adenomas as hyperintense nodes on T2-weighted images. Parathyroidectomy yields excellent results, enabling conservative management of lytic lesions.

Comparison of the postoperative effects of the erector spinae plane block and local infiltration analgesia in patients operated with lumbotomy surgery incision: Randomized clinical study.

Our aim was to observe the effects of local infiltration analgesia (LIA) or erector spinae plane block (ESPB) methods, which we applied preemptively in patients who were scheduled for surgery with a lumbotomy surgical incision and on intraoperative remifentanil consumption, and to compare the postoperative numerical rating scale (NRS), morphine demand, consumption, and pain degrees. Sixty American Society of Anesthesiologists I to III patients aged 18 to 75 years who were due to be operated on with a lumbotomy surgical incision were included in the study. The present study was conducted via prospective, randomized controlled, double-blind trials. After the induction of standard anesthesia, LIA was applied to 30 patients and ESPB was applied to 30 patients preemptively. The dose of remifentanil consumed in the intraoperative period was measured, and the hemodynamic parameters were measured every 5 minutes. Morphine bolus treatment with the postoperative patient-controlled analgesia and rescue analgesia with paracetamol were planned for the patients. Postoperative morphine and additional analgesia consumption, NRS, hemodynamic parameters, and complications were recorded for 48 hours. There was no difference between the groups in terms of demographic and hemodynamic data. The mean consumption of remifentanil was measured as 455 ± 165.23 µg in the intraoperative ESPB group and 296.67 ± 110.59 µg in the LIA group, and a statistical difference was observed (P = .001). In the postoperative follow-ups, the ESPB group drug consumption and NRS score averages were significantly lower at all times (P = .01; patient-controlled analgesia-morphine, 41.93 ± 14.47 mg vs 57.23 ± 15.5 mg and additional analgesic-paracetamol: 2.1 ± 1.06 vs 4.27 ± 1.14 g). The mean duration of additional analgesic intake of the groups was 10.6 ± 8.1 in the LIA group, while it was 19.33 ± 8.87 in the ESPB group, a significant difference. The patient satisfaction questionnaire was also significantly in favor of ESPB (P = .05). In conclusion, it has been shown that the intraoperative LIA method is more effective in terms of remifentanil consumption and in controlling pain in operations performed with a flank incision, but the ESPB method provides longer and more effective pain control in postoperative follow-ups.

Effects of telephone nursing education and counselling on discharge satisfaction level and self-care strength of patients after coronary artery bypass grafting.

The aim of this study was to determine the effects of nursing education and counselling provided by telephone to individuals undergoing coronary artery bypass graft surgery on their discharge satisfaction levels and self-care power levels. The study was conducted using a randomized controlled experimental research model with a pre-test-post-test control group (30 individuals in the experiment group and 30 individuals in the control group). Routine nursing care was applied to the patients in the control group throughout their attendance, and no training or intervention was made after discharge. By contrast, in addition to routine nursing care, the for 4 weeks in the experimental group received nursing education and counselling services by phone in the post-discharge period. A 'Personal Information Form,' 'Discharge Training Satisfaction Scale,' and 'Self-Care Strength Scale,' which were prepared by the researchers and included the personal information of the patients, were used to collect the data. The difference between the pre-test self-care power scale and discharge education satisfaction scale sub-dimensions of the groups and the mean score of the total score was not statistically significant. The post-test self-care power scale and discharge education satisfaction scale sub-dimensions and total score averages of the patients in the experimental group were higher than in the control group, and the difference between them was statistically significant (P <0.05). The nursing education and counselling services given to the patients on the phone increased their self-care skill levels and discharge satisfaction levels.

The Effect of Self-Acupressure on Sleep Quality and Fatigue in Nurses: A Sham-Controlled Study.

This study was conducted to determine the effects of self-acupressure on sleep quality and fatigue in nurses working in medical clinics. A total of 64 nurses (n=32 acupressure, n =32 sham acupressure) participated in this prospective, 2-arm (1:1) study with an experimental design. In the study, both groups used the pressure points they were taught while performing self-acupressure 3 times per week for 4weeks. After the intervention, the total mean score average of the acupressure group on the Pittsburg Sleep Quality Index and Fatigue Severity Scale was significantly lower than that of the sham acupressure group (P <.05). Self-acupressure is a noninvasive, easy-to-use, safe, and efficient complementary and integrated technique that nurses can use to improve their sleep quality and manage fatigue.

Stability and genetic parameters for cassava yield attributes in the tropical humid region of Brazil

The performance differences in cassava genotypes arising from genotype vs. environment interactions (G × E) often lead to responses that are significantly lower than expected for selection. The objective of this study was to evaluate different stability methods, both parametric and non-parametric, such as additive main-effects and multiplicative interaction (AMMI), main effect of genotypes plus G × E (GGE), and weighted average of absolute scores (WAASB), in order to quantify the G × E in multi-environmental trials. A total of 12 genotypes were assessed across 12 environments using a completely randomized block design, with three replicates for traits such as fresh root yield (FRY) and dry matter content in the roots (DMC). The data were subjected to analysis of variance and the Scott Knott test (p < 0.05). The sum of squares (SQ) of genotypes, environment, and G × E effects were equally distributed for FRY, whereas for DMC, these effects accounted for 64.1%, 21.9%, and 13.8% of the SQ, respectively, indicating a lower environmental effect on this characteristic. Using the AMMI, GGE, and WAASB methods, genotypes with high agronomic performance and stability for FRY (BR11-34–41 and BR11-34–69) (> 32 t ha−1) and DMC (BRS Novo Horizonte, BR12-107–002, and BR11-24–156) (> 37%) were identified. The broad-sense heritability (h2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${h}^{2}$$\\end{document}) for FRY and DMC was estimated to be 0.45 and 0.75, respectively. Approximately 72% of the methods identified BRS Novo Horizonte as the genotype with the highest stability and performance for DMC, while 47% identified genotypes BR11-34–41 and BR11-34–69 for FRY and intermediate DMC. Genotype BR11-24–156 exhibited high static stability according to 50% of the methods. Significant correlations were observed between stability and agronomic performance across the different methods, enabling the formation of groups based on stability concepts. Additionally, it was found that two mega-environments existed for FRY, whereas DMC displayed a single mega-environment with similar patterns, indicating an absence of G × E. We identified superior genotypes that could be promoted to national performance trials to develop stable cultivars with better yield attributes in cassava.

Health literacy as a predictor of cardiovascular disease risk factor knowledge level among women in Turkey: A community-based cross-sectional study.

While more common in men globally, heart diseases also rank as the leading cause of death among women. This study aimed to examine the relationship between Turkish women's level of knowledge about cardiovascular disease (CVD) risk factors and their health literacy. Data for this descriptive and cross-sectional study were collected online by using Health Literacy Scale and CVD risk factor knowledge level scale from October 2022, to May 2023. The study sample consisted of 409 women. It was found that the total score average of the women on the CVD risk factor knowledge level was 20.65 ± 4.72 and the Health Literacy Scale was 107.06 ± 16.01. There was a moderate, significantly positive correlation between CVD knowledge levels and health literacy (r = .548, P = .000). It was found that women with high health literacy also had increased knowledge levels. Furthermore, all health literacy dimensions of access to information (P < .001), understanding information (P < .001), appraisal/evaluation (P < .001), and implementation (P < .001) were detected as the predictors of CVD risk factor knowledge levels. Factors such as educational level and economic status significantly influenced scores on both scales (P < .05). The study's findings highlight the challenges encountered by women with low socioeconomic status in accessing accurate information. It may be recommended that nurses provide health education and consultancy services to these women on the prevention and management of cardiovascular diseases. Also, public education programs should consider socioeconomic and educational levels, focusing on women who encounter difficulties accessing information.

Evaluating effectiveness of clonal plant selection of alfalfa (Medicago sativa L.) and sainfoin (Onobrychis viciifolia Scop.) in mixtures: Mean performance and stability in a multi‐environment trial

AbstractAlfalfa (Medicago sativa L.) ‐ grass or alfalfa ‐ sainfoin (Onobrychis viciifolia Scop.) mixtures are commonly used for pastures in western Canada because of their high forage quality and their low risk of causing frothy bloat in grazing animals. However, the proportion of these two legumes declines in mixed forage stands over time. The objective of this study was to evaluate the effectiveness of selecting superior genotypes from clonally propagated alfalfa or sainfoin under plant competition in different growth environments. For this study, around 100 genotypes of each legume were cloned and transplanted into meadow bromegrass (Bromus riparius Relm.) or alfalfa swards at Saskatoon, SK and Lethbridge, AB, Canada in 2017. Genotype‐environment (G x E) interactions of alfalfa and sainfoin genotypes were analysed by an additive main‐effects and multiplicative interaction (AMMI) model. Significant variations in plant height, spring vigour and total dry matter yield (TDM) were observed for both species. Among the measured traits, plant height was a more highly heritable trait (H2 = .16 for alfalfa and H2 = .18 for sainfoin), while TDM was the least heritable (H2 = .08 for alfalfa and H2 = .04 for sainfoin). In the AMMI Analysis of variance for TDM, the genotype explained &lt;12% of the variation for both species, suggesting a direct selection of yield would result in a low genetic gain. The biplot mean performance (Y) x weighted average of absolute scores from the singular value decomposition of the matrix of BLUPs stability index (WAASB) identified several promising genotypes with superior performance and stability across different environments that were selected for producing synthetic lines. However, the synthetic lines of both alfalfa and sainfoin did not consistently exhibit superior performance in mixtures compared to their respective check cultivars.

Factors Affecting Speech Discrimination After Vestibular Schwannoma Resection.

Investigate the relationship between word recognition score (WRS) and pure tone average (PTA) after hearing preservation surgery for vestibular schwannomas (VS) as well as evaluate the consistency of hearing classification systems. A retrospective chart review was performed. This study included patients from a single academic tertiary referral hospital. Patients with VS and serviceable hearing who underwent hearing preservation surgery 2014-2023. Patients excluded for neurofibromatosis 2 and lacking pre/postop audiograms. All patients underwent resection of vestibular schwannoma. Pre/postop WRS, PTA, and AAO-HNS, Gardner-Robertson (GR), and WRS Class (WRSC) hearing classifications. Seventy-five patients were included. Average preop and postop PTA and WRS were 26 ± 12 dB, 79 ± 39 dB, 92 ± 12%, and 33 ± 43%, respectively. Postop PTAs were distributed along the complete testable decibel range, while the postop WRS displayed a bimodal distribution, with WRS >50% or <20%. Worsening intraop ABR changes were significantly associated with poorer hearing outcomes (p = 0.005). With increasing Koos grades, intraop ABRs were significantly more likely to exhibit changes (p = 0.005). AAO-HNS and GR classified patients nearly identically, while the WRSC resulted in more class I and fewer class II. The cutoff of serviceable hearing was comparable across all classification systems. Effects on the brainstem component of Koos 3-4 tumors may particularly disturb speech processing. This effect seems amplified by surgical dissection. AAO-HNS, GR, and WRSC hearing classifications are comparable in describing serviceable hearing in vestibular schwannoma patients.

The effect of cognitive behavioral therapy-based psychoeducation on substance abuse proclivity in adolescent smokers

ABSTRACT Aim The aim of this study is to determine how CBT-based psychoeducation affects substance abuse proclivity in adolescent smokers. Materials and Methods The study is an experimental study model with pretest–posttest control group. As a result of the power analysis carried out for the sample of the study, the sample size was calculated to be 110 adolescent smokers at a significance level of 0.05, confidence interval of 95%, an effect size of 0.7, and power of population representation of 0.95. A Descriptive Characteristics Form and SAPS were used to collect the data. The experimental group received eight sessions of cognitive-behavioral therapy-based psychoeducation. No educational program was applied to the control group. The data were analyzed using number, percentage, mean, standard deviation, chi-square, dependent samples t-test and independent samples t-test. Results Substance abuse proclivity was determined in adolescents who smoked cigarettes in the experimental and control groups. The SAPS total score average of the individuals in the experimental group decreased after psychoeducation compared to before psychoeducation. The difference between the posttest SAPS total mean scores of the control and experimental groups was statistically significant. Conclusion CBT-based psychoeducation was found to be effective in reducing substance use proclivities in adolescent smokers.

Decomposing the effective radiative forcing of anthropogenic aerosols based on CMIP6 Earth system models

Abstract. Anthropogenic aerosols play a major role in the Earth–atmosphere system by influencing the Earth's radiative budget and precipitation and consequently the climate. The perturbation induced by changes in anthropogenic aerosols on the Earth's energy balance is quantified in terms of the effective radiative forcing (ERF). In this work, the present-day shortwave (SW), longwave (LW), and total (i.e., SW plus LW) ERF of anthropogenic aerosols is quantified using two different sets of experiments with prescribed sea surface temperatures (SSTs) from Earth system models (ESMs) participating in the Coupled Model Intercomparison Project Phase 6 (CMIP6): (a) time-slice pre-industrial perturbation simulations with fixed SSTs (piClim) and (b) transient historical simulations with time-evolving SSTs (histSST) over the historical period (1850–2014). ERF is decomposed into three components for both piClim and histSST experiments: (a) ERFARI, representing aerosol–radiation interactions; (b) ERFACI, accounting for aerosol–cloud interactions (including the semi-direct effect); and (c) ERFALB, which is due to temperature, humidity, and surface albedo changes caused by anthropogenic aerosols. We present spatial patterns at the top-of-atmosphere (TOA) and global weighted field means along with inter-model variability (1 standard deviation) for all SW, LW, and total ERF components (ERFARI, ERFACI, and ERFALB) and for every experiment used in this study. Moreover, the inter-model agreement and the robustness of our results are assessed using a comprehensive method as utilized in the IPCC Sixth Assessment Report. Based on piClim experiments, the total present-day (2014) ERF from anthropogenic aerosol and precursor emissions is estimated to be −1.11 ± 0.26 W m−2, mostly due to the large contribution of ERFACI to the global mean and to the inter-model variability. Based on the histSST experiments for the present-day period (1995–2014), similar results are derived, with a global mean total aerosol ERF of −1.28 ± 0.37 W m−2 and dominating contributions from ERFACI. The spatial patterns for total ERF and its components are similar in both the piClim and histSST experiments. Furthermore, implementing a novel approach to determine geographically the driving factor of ERF, we show that ERFACI dominates over the largest part of the Earth and that ERFALB dominates mainly over the poles, while ERFARI dominates over certain reflective surfaces. Analysis of the inter-model variability in total aerosol ERF shows that SW ERFACI is the main source of uncertainty predominantly over land regions with significant changes in aerosol optical depth (AOD), with eastern Asia contributing mostly to the inter-model spread of both ERFARI and ERFACI. The global spatial patterns of total ERF and its components from individual aerosol species, such as sulfates, organic carbon (OC), and black carbon (BC), are also calculated based on piClim experiments. The total ERF caused by sulfates (piClim-SO2) is estimated at −1.11 ± 0.31 W m−2, and the OC ERF (piClim-OC) is −0.35 ± 0.21 W m−2, while the ERF due to BC (piClim-BC) is 0.19 ± 0.18 W m−2. For sulfates and OC perturbation experiments, ERFACI dominates over the globe, whereas for BC perturbation experiments ERFARI dominates over land in the Northern Hemisphere and especially in the Arctic. Generally, sulfates dominate ERF spatial patterns, exerting a strongly negative ERF especially over industrialized regions of the Northern Hemisphere (NH), such as North America, Europe, and eastern and southern Asia. Our analysis of the temporal evolution of ERF over the historical period (1850–2014) reveals that ERFACI clearly dominates over ERFARI and ERFALB for driving the total ERF temporal evolution. Moreover, since the mid-1980s, total ERF has become less negative over eastern North America and western and central Europe, while over eastern and southern Asia there is a steady increase in ERF magnitude towards more negative values until 2014.

Characteristics of Flakes from Kepok Banana Flour and Black Rice Flour with Variation of Steaming Time

This research has the objective to determine the effect of flour rasio kepok banana and black rice Black rice flour with variations in steaming time on physicochemical characteristics of flakes. This research used a randomized design Complete (RAL) factorial pattern with two factors and two replications. The first factor is thr proportion of kepok banana flour: black rice flour (30%: 70%, 40% : 60% and 50%:50%) and the second factor is the length of steaming time (10 minutes, 15 minutes, 20 mintes minutes). The data obtained was analyzed using ANOVA and followed by Duncan Multiple Range Te. Multiple Range Test (DMRT) at the 5% level. The results of the research showed that there There was interaction. There was a significant difference between the treatments of kepok banana flour: black rice flour on moisture content, starch content and water absorption. The best treatment is Banana flour : black rice flour on moisture content, starch content and water absorption. The best treatment is flakes with a proportion of 50% kepok banana flour and 50% black rice flour and a steaming time of 10 minutes produced flakes with characteristics of the value value of water content 4.77%, ash content 2.12%, fat content 8.35%, content protein 5. 5 5,56% starch content 78.01% water absorption 24.96%, hardness 414.57N and dietary Fiber content of 5.22 %, calcium content of 169.89mg/100g and the average of favorability favorability scores for taste (3.83), color (4.80), aroma (4.20) and textire (3.37)