Whitney Test Research Articles

2146 Evaluation of pulmonary hypertension by echocardiogram in geriatrics patients with SARSCOV2 from a Latin American cohort

Abstract Introduction Pulmonary hypertension evaluated by echocardiography and ROX index in older patients with COVID-19 could be linked to worse outcomes. Methods We conducted a retrospective cohort of adult patients with COVID-19. The main objective was to evaluate pulmonary hypertension as an echocardiographic finding and its association with hard outcomes in patients with COVID-19 infection. In the inferential statistical analysis, the OR with confidence intervals greater than 95% was used as a measure of association. Qualitative variables were evaluated using the Chi square test or Fisher’s exact test. In quantitative variables, the Student’s T test, or Mann–Whitney test, was used. Results 306 individuals with COVID-19 infection were included; the majority of these were men (78% vs. 22% women). Patients who died had lower ROX values at 2 hours compared to survivors (4,5 with a SD of 3,6–5,6, vs. 5,8 with a SD of 4,7–6,1, respectively). This trend was maintained at 12 hours (4,9 with a SD of 3,8–6,0 for deceased patients vs. 7,8 with a SD of 5,2–8,7 for survivors). For the ROX index at 2 hours, an OR adjusted for age and gender of 8,5 with a CI of 2,0–91,4 was found, and at 12 hours, an OR of 17,6 with a CI of 2,8–93,6 was found. Low values of the ROX index were associated with pulmonary hypertension (p = 0.048) and higher mortality (p = 0.037). Conclusions In patients with COVID-19, the presence of pulmonary hypertension estimated by ecocardiography and the ROX index is associated with worse outcomes, including a higher rate of comorbidities and mortality in patients over 70 years of age. Prospective studies with a more representative population sample are required to validate the results found here.

Is Declined Cognitive Function Predictive for Fatal Accidents Involving Aging Pilots?

Background. Civil aviation comprises airlines/charters and general aviation (GA). Currently, airlines are experiencing a pilot shortage, partly reflecting scheduled retirements mandatory for airline (but not GA) pilots aged 65 years, fueling a debate as to whether the retirement age should be increased. Herein, using 16–40 years-of-age aviators as a reference, we determined whether GA pilots aged 60+ years (i) incurred an elevated accident rate, employing, for the first time, age-tiered flight time as a measure of risk exposure and (ii) carried an excess risk for cognitive deficiency-related fatal accidents. Methods. Airplane accidents (2002–2016) involving Class 3 medical certificated pilots were per the National Transportation Safety Board (NTSB) databases. Age-tiered pilot risk exposure represented a summation of flight hours per Class 3 medical applications. Cognitive decline measures were per NTSB field codes. Statistical analyses employed Chi-Square, Mann–Whitney, logistic regression, and binomial tests. Results. Using flight hours as the denominator, the fatal accident rate for older pilots (41–80 years) was unchanged compared with aviators aged 16–40 years. In the logistic regression, no cognitive deficiency measure was predictive (p = 0.11, p = 0.15) for pilots aged 61+ years who were involved in fatal accidents. Conclusion. These findings question the necessity of an automatic disqualification of air transport pilots at 65 years of age.

The association between the history of supplement use (vitamin or mineral) and COVID-19 disease in the persian cohort population

The aim of the study was to examine the association between vitamin and mineral supplement consumption and the possibility of contracting COVID-19 disease in the Persian cohort population in 2020. This retrospective cohort study was conducted on 4241 people who were registered in the Cohort Registration System. A logistic regression was performed to ascertain the multivariate association between demographic, health variables, and supplement use and the likelihood that participants were infected with COVID-19. The software used was IBM SPSS 24.0, and a significance level of 0.05 was considered. Analyze the quantitative variables, if the variable was normal, the independent t-test was used, and if the variable was not normal, the Mann–Whitney test was used. To compare the distribution of qualitative variables in the groups, a chi-square test or, if necessary, a Fisher’s exact test was used. The number of participants in this cohort study was 4241. The average age of the participants in the study was 49.22±8.77. The OR value of age variable 0.989 (95% CI: 0.927–1.056); sex variable (95% CI: 0.238–2.743, OR = 0.808); BMI variable (95% CI: 0.927–1.056, OR = 0.953); vitamin D variable (95% CI: 0.333–6.769, OR = 1.502); omega3 variable (95% CI: 0.410–7.688, OR = 1.776); calcium variable (95% CI: 0.041–3.738, OR = 0.391); calcium variable (95% CI: 0.041–3.738, OR = 391); multiVIT variable (95% CI: 0.211–5.645, OR = 1.090); VitC variable (95% CI: 0.000–0.000, OR = 0.000); vitE variable (95% CI: 0.000–0.000, OR = 0.000); were the interval includes. There were no statistically significant multivariate associations (P 0.05) between the explanatory variables infected with COVID-19. There was only a statistically significant correlation between the use of iron tablets and contracting COVID-19 (P = 0.025). Controlling the variables or identifying causal correlations is not feasible due to the observational nature of the study. The results cannot be safely extrapolated to other regions of the world because the cohort sample was limited to inhabitants of Iran.

Determinants of possible inflammatory myocardial damage in acute intestinal infections in children

BACKGROUND: Non-coronary cardiomyopathies, including inflammatory cardiomyopathies, are one of the leading causes of disability and mortality in children and adults. Inflammatory cardiomyopathy in most cases is an outcome of myocarditis as a result of direct agent-dependent myocardial damage or autoimmune reactions in the absence of genetic predisposition. AIM: On the basis of clinical assessment of cardiovascular system changes, to develop a discriminant model to predict the possibility of myocardial damage of inflammatory genesis in acute intestinal infections (AII) in children. MATERIALS AND METHODS: In the Intestinal Infections Department of the Children’s Research and Clinical Center for Infectious Diseases of FMBA of Russia in the period 2020-2022, 33 children aged from 1 month to 13 years with AII of different etiology were consecutively observed, in whom, according to clinical, laboratory and instrumental examination data, for the first time in their lives, changes in cardiovascular system were detected. The sample was formed using an algorithm for diagnosing inflammatory myocardial lesions in points, the sum of which concluded that there were no or presence of such, which allowed us to identify group 1 (n = 24) and group 2 (n = 9), respectively. Etiological diagnosis of acute intestinal infections was performed in all children, clinical and laboratory data, results of a 12-channel electrocardiogram (ECG), transthoracic echocardiography (EchoCG) were evaluated. The differences in the groups were revealed using the Pearson chi-squared test and the Mann–Whitney test, which were considered reliable at p 0.05. The method of discriminant analysis was used. RESULTS: Functional systolic noise and increased cardiospecific enzymes were observed less frequently in group 1 than in group 2 (4.2%; 22.2% and 67%; 100%). Of the pathological ECG changes, violations of the repolarization process were observed (16.7%; 33.3%). No significant changes in the Echo-KG were detected. The viral etiology of acute intestinal infections dominated (79.2%; 88.9%). Changes in the hemogram were characterized by a high frequency of leukocytosis in group 1 (29.2%; 0%) and leukopenia in group 2 (4.2%; 22.2%). In group 1, there was a higher frequency of neutrophilosis (79.2%; 44.4%), rod-shaped shift (62.5%; 22.2%), thrombocytosis (29.2%; 0%), lymphocytopenia (95.8%; 55.6%; p 0.05), monocytosis (8.3%; 0%); increased C-reactive protein (41.7%; 33.3%), ALT (29.2%; 11.1%), urea (29.2%; 11.1%), leukocyturia (16.7%; 0%). CONCLUSIONS: Clinical evaluation of cardiovascular system changes in children with acute intestinal infections using a discriminant model allows to exclude myocardial damage of inflammatory genesis with high probability (95.7%), which is of practical importance.

A scale development study on the perception of the sustainable urban environment

AbstractIn order to assess sustainability, it is necessary to monitor social conditions on environmental, global, national and urban scales. Therefore, the objective of this study is to develop a scale to determine PSUE. In addition, it is also examined whether there is a significant difference between the components that determine the perception of sustainable urban environment according to the characteristics of the participants. For this purpose, Exploratory Factor Analysis, Spearman–Brown correlation test, Cronbach alpha test, Mann–Whitney test and Kruskal–Wallis test are implemented. According to the findings acquired, it has been detected that the components that determine PSUE are “spatial strategies related to sustainable environment and transportation”, “spatial strategies related to ecological sustainability and solid waste management” and “spatial strategies related to social and economic sustainability” respectively. In this study, differences have been identified in the perspectives on social and economic sustainability strategies according to gender. However, participant’s viewpoints regarding strategies related to sustainable environment and transportation, as well as ecological sustainability and solid waste management, are similar. Additionally, significant differences exist in social and economic sustainability strategies based on the age of the participants. The urban or rural character of the settlement where the students families live or grew up influences their perspectives on strategies based on social sustainability and economic relations.

Reverse Shoulder Arthroplasty in the Treatment of Cuff Tear Arthropathy: Systematic Review

Purpose: In our study, we aimed to examine the results and complications of reverse shoulder prosthesis (RSA) applied after rotator cuff tear arthropathy (CTA) in the light of the current literature. Methods: The literature search was conducted simultaneously on 1 April 2024 in the Medline, Cochrane, EMBASE, Google Scholar and Ovid databases using the ''reverse total shoulder arthroplasty'', ''reverse total shoulder prosthesis'', ''cuff tear arthropathy'', ''outcomes'' and ''complications'' keywords. Only clinical review published in English in peer-reviewed journals was evaluated. The comparison between preoperative and postoperative clinical scores, as well as range of motion (ROM), was performed using the Wilcoxon–Mann–Whitney test. P values lower than 0.05 were considered statistically significant. Results: 12 articles were included in our study. When comparing the results of the pre- and postoperative examinations, a statistically significant improvement in the range of motion and the functional score was found. It was found that various complications occurred in 21.1% of patients. The most common complication is scapular notching, which occurred in 13.8% of patients. Revision surgery was required in 1.57% of patients. The most common cause of revision was a periprosthetic joint infection. Conclusion: In CTA patients, RSA can achieve both freedom from pain in the shoulder joint and an increase in function. Despite positive results, complications of varying degrees of severity can occur in around one fifth of patients. The lack of Level I studies limits a true understanding of the possibilities and limitations of RSA in the treatment of CTA patients.

Childhood obesity is associated with a high degree of metabolic disturbance in children from Brazilian semi-arid region

Projected to impact 310 million children by the next decade, childhood obesity is linked to serious health issues like metabolic disturbance and cardiovascular diseases. This study introduces a novel approach for the integrated assessment of inflammatory, glycemic and lipid disorders in obese children in resources-limited settings and also identifies key factors contributing to these changes. Conducting a cross-sectional analysis of 231 children aged 5–12 years from public schools in Brazil's semi-arid region, the research involved collecting medical history, anthropometric measurements, and blood samples to analyze glycemic and lipid profiles, along with C-reactive protein levels. We used an adapted the Molecular Degree of Perturbation model to analyze deviations in metabolic markers from a healthy control group. Statistical analyses included Mann–Whitney and Fisher exact tests, backward logistic regression, and hierarchical cluster analysis. The study identified a direct and independent association between elevated Metabolic Disturbance Degree and both overweight and obesity in children, with significant differences in CRP, Triglycerides, and HDL levels noted between obese and healthy-weight groups. The findings highlight the critical need for early detection and comprehensive understanding of obesity-related changes to mitigate the severe health risks associated with childhood obesity.

Adaptive rank-based tests for high dimensional mean problems

The Wilcoxon signed-rank test and the Wilcoxon–Mann–Whitney test are commonly employed in one sample and two sample mean tests for one-dimensional hypothesis problems. For high-dimensional mean test problems, we calculate the asymptotic distribution of the maximum of rank statistics for each variable and suggest a max-type test. This max-type test is then merged with a sum-type test, based on their asymptotic independence offered by stationary and strong mixing assumptions. Our numerical studies reveal that this combined test demonstrates robustness and superiority over other methods, especially for heavy-tailed distributions.

Emotion dysregulation in participants with substance use disorders: A metacognitive perspective

BackgroundUsing the metacognitive model of emotion dysregulation as a basis, this study explored whether, among participants with substance use disorders (SUDs), metacognitive beliefs and repetitive negative thinking were associated with emotion dysregulation. Methods127 participants with SUDs and 127 controls without SUDs were recruited. Emotion dysregulation, metacognitive beliefs, rumination, worry, anxiety, and depression were assessed. t-tests, Mann–Whitney tests, logistic regression, correlation, and hierarchal regression analyses were run. ResultsParticipants with SUDs reported significantly higher levels of emotion dysregulation, positive beliefs about worry, beliefs about the need to control thoughts, rumination, and worry, compared to controls without SUDs. Among participants with SUDs negative beliefs about thoughts concerning uncontrollability and danger, cognitive confidence, beliefs about the need to control thoughts, rumination, and worry were significantly associated with an increase of emotion dysregulation. LimitationsThe cross-sectional design. ConclusionEmotion dysregulation, metacognitive beliefs, and repetitive negative thinking may contribute to increase the risk of substance use. Among participants with SUDs emotion dysregulation is associated with the tendency to endorse dysfunctional metacognitive beliefs and report repetitive negative thinking. Metacognitive beliefs and repetitive negative thinking could be a suitable therapeutic target to reduce emotion dysregulation among participants with SUDs.

SARS-CoV-2 vaccine hesitancy and its relationship with health-related quality of life in patients with heart failure - pilot cross-sectional study

Abstract Introduction Heart failure (HF) is a complex disease which influences various aspects of life. The latest COVID-19 outbreak exposed that HF patients were at higher risk of severe outcomes and mortality after being infected with SARS-CoV-2. Therefore, vaccination against SARS-CoV-2 is particularly recommended in that group. However, vaccine hesitancy is a growing problem, and it also affects vulnerable HF patients. Health-related quality of life (HRQoL) may be related to the resignation from vaccination against SARS-CoV-2. Purpose The study aims to assess the relationship between avoiding vaccinations against SARS-CoV-2 and HRQoL using the World Health Organisation Quality of Life Brief questionnaire of Life Brief (WHOQOL-BREF) in patients with heart failure. Methods To evaluate the HRQoL, the WHOQOL-BREF questionnaire was used. 117 patients hospitalized with a diagnosis of HF in 2022 irrespectively of left ventricle ejection fraction (LVEF) at the cardiology department were interviewed. Additionally, a detailed medical history was collected. Until the beginning of 2022, all patients could receive the vaccine. Patients were divided into two groups - vaccinated against SARS-CoV-2 and unvaccinated. HRQoL domain scores and total HRQoL were compared between the mentioned groups using the U-Mann Whitney test. Results The mean age of enrolled patients was 55.3±17.4 years, 21.4% were women, and the mean LVEF was 30.3±14.4%. 13 (11.1%) patients were not vaccinated against SARS-CoV-2 at the time of the interview. There was no difference in total HRQoL (p=0.437) and individual domains scores: somatic (p=0.787), psychological (p=0.171), social (p=0.261) and environmental (p=0.834) between both study groups. Patients avoiding vaccination against SARS-CoV-2 compared to vaccinated patients were younger (39.7±13.8 years vs. 57.3±6.9 years, p<0.001) and had lower LVEF (23.8±14.0% vs. 31.3±14.3%; p=0.04). In the unvaccinated group of patients, the duration of HF was three times shorter (mean 4.3 vs.12.4 years, p=0.002). Conclusions The study revealed no differences in domains of the WHOQoL-BREF questionnaire and overall HRQoL between patients who decided to vaccinate and those with the opposite decision. Almost 90% of the patients with HF were vaccinated against SARS-CoV-2. Younger HF patients are more hesitant to vaccinate against SARS-CoV-2, which is consistent with the trend observed in HF patients [1] and the general population [2]. Further studies could better characterize the patients with heart failure who are vaccine-hesitant. Eventually, it could help develop more specific care to convince them to vaccinate.

Is all that glitters gold? Exploring sustainability and business ethics education in ethics-friendly environments

Purpose This study aims to identify students’ perceptions of the importance and objectives of sustainability and business ethics education, considering contextual factors (ethics-friendly environments) and including the social desirability (SD) bias to strengthen data robustness and assess response truthfulness. Design/methodology/approach A survey was administered to 170 business students at an Icelandic university to measure their attitudes and perceptions toward sustainability and business ethics courses. Descriptive statistics, Mann–Whitney tests, χ2 tests and multivariate regression were used for the analysis. Findings The results show no significant differences among participants, depending on individual and organizational factors. The authors did not find significant differences in gender, age or exposure to sustainability and business ethics courses concerning social desirability bias. Contextual solid factors can explain these results. Originality/value This study expands on previous research by examining students’ perceptions of sustainability and business ethics education in an “ethics-friendly environment” like Iceland, a new and fertile territory for business ethics education research. These elements are crucial for further research on students’ attitudes toward sustainability and business ethics and the role of this subject in university curricula.

A 12-month randomized controlled trial to assess the efficacy of revitalization of retreated mature incisors with periapical radiolucency in adolescents

The use of regenrative endodontics is restoring the health status of the root canals of retreated mature teeth is a novel approach. Therefore, the current trial aimed to compare the effectiveness of regenerative endodontic procedures (REPs) to non-surgical root canal retreatment (NS-RCR) in reducing periapical radiolucency over one year for the retreatment of mature incisors with periapical periodontitis. The secondary purpose was to assess clinical success and regain pulp sensibility. A parallel randomized controlled trial, 66 mature incisors with periapical radiolucencies were randomly divided into two equal groups and retreated with either REPs or NS-RCR. At baseline and after 6 and 12 months, teeth were assessed clinically and radiographically using a periapical index (PAI). The Mann–Whitney test was used to analyze nonparametric PAI scores. The Electric pulp test readings were analyzed using the repeated measure analysis of variance (ANOVA). Over the follow-up intervals, there was no significant intergroup difference in the PAI medians, the majority of the teeth displayed a reduction in periapical radiolucency. At the end of the follow-up period, the clinical successes for the REP and NS-RCR groups were 93.9% and 97%, respectively (p = 0.555). Positive pulp sensibility was recorded in 54.54% of cases in the REPs after 12 months. Both approaches showed a comparable diminishing of periapical radiolucencies and equivalent clinical results. A conventional, non-surgical endodontic retreatment may not always be necessary.

Exploring the effects of post operative hyperoxic intermittent stimuli on reticulocyte levels in cancer patients: a randomized controlled study

BackgroundAnemia is common among hospitalized critically ill and surgical oncological patients. The rising incidence of cancer and aggressive treatments has increased the demand for blood products, further strained by a dwindling donor pool. The normobaric oxygen paradox (NOP) has emerged as a potential avenue to increase EPO levels. While some studies support its efficacy, research remains limited in clinical settings. This study aims to assess the effectiveness of a NOP protocol in stimulating erythropoiesis, as measured by changes in reticulocyte counts, in cancer patients undergoing abdominal surgeries.MethodsThis is a post hoc analysis of a prospective, single-center, controlled, randomized study. A total of 49 patients undergoing abdominal surgery were analyzed at the Institut Jules Bordet. Adult patients admitted to the intensive care unit (ICU) for at least 24 h were enrolled, excluding those with severe renal insufficiency or who received transfusions during the study period. Participants were randomized into two groups: a normobaric oxygen paradox (OXY) group who received 60% oxygen for 2 h on days 1, 3, and 5 post-surgery and a control (CTR) group who received standard care. Data on baseline characteristics, surgical details, and laboratory parameters were collected. Statistical analysis included descriptive statistics, chi-square tests, t-tests, Mann–Whitney tests, and linear and logistic regression.ResultsThe final analysis included 33 patients (median age 62 [IQR 58–66], 28 (84.8%) males, with no withdrawals or deaths during the study period. No significant differences were observed in baseline surgical characteristics or perioperative outcomes between the two groups. In the OXY group (n = 16), there was a significant rise (p = 0.0237) in the percentage of reticulocyte levels in comparison to the CTR group (n = 17), with median values of 36.1% (IQR 20.3–57.8) versus − 5.3% (IQR − 19.2–57.8), respectively. The increases in hemoglobin and hematocrit levels did not significantly differ between the groups when compared to their baselines’ values.ConclusionsThis study provides preliminary evidence supporting the potential of normobaric oxygen therapy in stimulating erythropoiesis in cancer patients undergoing abdominal surgeries. While the OXY group resulted in increased reticulocyte counts, further research with larger sample sizes and multi-center trials is warranted to confirm these findings.Trial registrationThe study was retrospectively registered under NCT number 06321874 on The 10th of April 2024.

Pharmacotherapy with alpha-1 adrenergic blockers and lipid spectrum correction in patients with urinary disorders

The study was based on treatment outcomes in a group of 130 patients aged 18–81 years. Subgroups were formed according to gender and age criteria, which included 56 men and 74 women, and were also divided into subgroups under 65 years of age and after 65. Treatment lasting continuously from 11 to 18 months was carried out in the form of combination therapy with the prescription of α1‑blockers (terazosin, doxazosin) in combination with vitamin-like drugs (levocarnitine, alpha-lipoic acid) in dosages according to the official instructions for the drug. The work involved systems for tabular assessment of the clinical symptoms of urinary disorders, as well as instrumental, laboratory, and statistical methods (Mann — Whitney test, Spearman's rank correlation coefficient).Results. Against the background of the prescribed treatment, HDL levels significantly changed from 1.3 to 1.38 mmol/L, as well as VLDL from 0.88 to 0.72 mmol/L in the general observation group. In some indicators, particularly total cholesterol, low-density lipoprotein, and triglycerides, no dynamics were noted. In the men subgroup, the indicators of both HDL and VLDL changed significantly and reliably from 1.2 to 1.29 mmol/L and, accordingly, from 0.79 to 0.65 mmol/L. In the 65-yearold subgroup, VLDL levels significantly decreased from 0.88 to 0.76 mmol/L and triglyceride levels from 1.9 to 1.65 mmol/L, respectively. In the subgroup of patients aged >65 years, there was a significant increase in HDL from 1.29 to 1.46 mmol/L.Conclusion. Long-term combination therapy over 11 months, including alpha1 inhibitors in combination with vitamin-like drugs, significantly changed the lipid spectrum. The best outcomes of pharmacotherapy were observed in the male subgroup and in patients aged >65 years.

Retrospective study investigating the performance of the SQA-vision analyser compared with manual semen analysis

The objective of this study was to compare the results of semen analysis using the manual method and the SQA-Vision sperm analyser after four years of practice and with a large cohort of patients. This was a comparative study of 1130 cases collected for semen analysis between October 2019 and October 2023, which were analysed simultaneously and independently by different operators using the manual microscopic method and an SQA-V automated analyser. For each sample, sperm concentration, progressive motility, motility, normal morphology, and round cells count were performed. There was no significant difference between the SQA-V method and manual assessment for all sperm parameters (Mann–Whitney test p > 0.05). According to the parameter studied, there was a strong correlation (rho = 0.81) and a very high correlation (rho = 0.98) between manual assessment and the SQA-V method. In the analysis of sperm concentration, the sensitivity and specificity were 0.90 and 0.99, respectively. The sensitivity and specificity for the analysis of sperm progressive motility were 0.98 and 0.99, respectively, while the sensitivity and specificity for the analysis of sperm motility were 0.87 and 0.99, respectively. The sensitivity and specificity for the analysis of normal morphology were 0.88 and 0.99, respectively. Regarding the analysis of round cells, the sensitivity and specificity were 0.98 and 0.99, respectively. The results of this retrospective study indicate that the SQA-V system offers satisfactory performance for routine sperm analysis.

Spatiotemporal Dynamics of Carbon and Nitrogen in Subtropical Urban Streams (Santo André, SP, Brazil)

Urban sprawl poses a significant threat to urban stream water quality due to impermeabilization, reduced vegetation cover, and the release of diffuse pollutants. This study evaluates water quality in seven catchments in Santo André, SP, considering seasonality. Nutrient concentrations and in situ measurements were taken during both dry and rainy seasons. Comparisons were made using Kruskal–Wallis and Mann–Whitney tests. Streams showed significant differences in relation to water quality parameters. The Carapetuba, Jundiaí, and Apiaí streams were most adversely affected, underscoring the need for urgent water quality intervention (water conductivity above 500 μS/cm, dissolved oxygen below 2 mg/L, total dissolved carbon above 50 mg/L, and total dissolved nitrogen above 25 mg/L). Significant differences were observed across seasons. The dry season showed elevated temperatures (above 25 °C) and increased total dissolved carbon (above 50 mg/L) and nitrogen concentrations (above 30 mg/L), indicating reduced dilution effects from rainfall and heightened organic contamination. Conversely, the wet season demonstrated lower nutrient concentrations, emphasizing seasonal dynamics. Sustained, long-term monitoring of urban streams in Santo André and the implementation of sewage collection and treatment in irregular settlements are recommended. These measures are essential to mitigate the adverse impacts of urban expansion on water quality.

Application of The Tri Core Breastfeeding Model Using Audiovisual-Based E-Modules to Increase The Motivation Of Working Mothers in Exclusive Breastfeeding in The Working Area of The Wonoayu Sidoarjo Health Center

The tri core breastfeeding model is a health education model for breastfeeding mothers that includes three main aspects: lactation education, self-efficacy or increased confidence in breastfeeding mothers, and support from the surrounding environment. The importance of increasing self-confidence when breastfeeding, especially in working mothers, is something that needs to be considered. The government's efforts to increase exclusive breastfeeding coverage are contained in Government Regulation No.33/2012 on breastfeeding. This study aims to analyze the application of tri core breastfeeding models using audiovisual-based e-modules to increase the motivation of working mothers in exclusive breastfeeding. This study used a quasy experiment method with a non-equivalent control group design. The intervention group (18 people) used e-modules, while the control group used e-leaflets (18 people). The results of this study obtained ρvalue 0.000 < α = 0.05. It can be concluded that there is a significant difference between the use of audiovisual-based e-module media and e-leaflets on increasing motivation for exclusive breastfeeding in working mothers. Data analysis in this study used marginal homogeneity test and mann whitney test. The application of tri core breastfeeding models using audiovisual-based e-modules is expected to be able to increase exclusive breastfeeding coverage in working mothers.

Comparison of Changes in the Neutrophil-lymphocyte Ratio (NLR) and Post-surgery Outcomes in Child Patients with COVID-19 and Non-COVID-19

Background Pediatric patients with COVID-19 who undergo surgery have two actual problems, both the presence of a viral inflammatory response and an inflammatory response to surgery, which can affect the outcome of surgery and therapy. NLR is considered a fairly accurate predictor of surgery and COVID-19 infection. Objective This study aims to investigate the effect of changes in neutrophil-lymphocyte (NLR) on post-surgery outcomes in pediatric patients with COVID-19 infection. Methods It is a retrospective cohort study with an observational analysis. This research is a multi-center study on COVID-19 patients using a data bank of pediatric patients with COVID-19 and control patients non COVID-19 children undergoing surgery in three hospitals. Data recorded were age, gender, nutritional status, anesthetic status before surgery, length of stay, repeat surgery, sepsis, septic shock, and mortality. Statistical analysis was performed by the U-mann Whitney test. Results The study sample consisted of 87 total samples consisting of 2 groups, namely the group of pediatric patients with 29 samples with COVID-19 and 58 non-COVID-19 samples. Gender, nutritional status, length of stay, the incidence of reoperation, sepsis, septic shock, and mortality were not significantly different between the two groups with a p<0.05. Risk analysis by looking at the incidence of sepsis and septic shock obtained an intersection point of 2.175 and 2.225, respectively. Analysis of changes in the NLR (delta-NLR) in the mortality events of the COVID-19 group and non-COVID-19 found that the NLR of the COVID-19 group was two times greater than the cut-off NLR of 2,175. Conclusion There is no difference in the outcome of surgery for children with COVID-19 and non-COVID-19 based on the NLR change analysis.

Comparative study between dexmedetomidine and midazolam as pre-medication for the prevention of etomidate-induced myoclonus and attenuation of stress response at endotracheal intubation in laparoscopic cholecystectomies

Background: Myoclonus is a common issue in etomidate anesthesia induction, and various drugs have been used to reduce its incidence, highlighting the ongoing search for better alternatives in anesthesiology. Aims and Objectives: The study analyzed the impact of dexmedetomidine (DEX) and midazolam pre-treatment on etomidate-induced myoclonus incidence, stress response at laryngoscopy, and intubation during etomidate induction. Materials and Methods: A prospective randomized controlled intervention study (superiority trial) was done involving 42 patients of age 20–60 years, randomly allocated in two equal groups (Group D: Inj. DEX was given as infusion (0.5 μg/kg) in 10 mL 0.9% normal saline over 10 min and 5 min before induction. Group M: Inj. Midazolam was given 0.02 mg/kg, prepared in 10 mL 0.9% normal saline, to be infused over 10 min and 5 min before induction). Myoclonus was graded after intravenous administration of etomidate (0.3 mg/kg) and hemodynamic response to laryngoscopy and intubation were observed at various time intervals. Statistical analysis was done using SPSS version 27.0. Independent t-test/Mann–Whitney test (for non-parametric data) and Chi-square test/Fisher’s exact test were used to compare variables. A P<0.05 was considered statistically significant. Results: The study found that DEX effectively suppressed stress response due to intubation compared to midazolam, with mean myoclonus gradation (Mean±SD) in Group-D and Group-M being 0.6190±0.7400 and 1.6667±0.8563, respectively, indicating a significant distribution with group. Conclusion: DEX was found to be more effective than midazolam in preventing etomidate-induced myoclonus and attenuating stress response compared to midazolam.

Analisis Komparatif Kualitas Pelayanan pada Nasabah Pengguna Aplikasi Pegadaian Syariah Digital dan Manual: Studi Kasus Pegadaian Syariah Cabang Kusumanegara

The background of the problem of this research is a comparison of the quality of service received by customers using the Pegadaian Syariah Digital application and manually at Pegadaian Syariah Kusumanegara Branch Yogyakarta. Customers predominantly use the manual system rather than using the Pegadaian Syariah Digital application, because the system often errors and transaction failures occur. The Pegadaian Syariah Digital application is expected to help customers make smartphone transactions without having to make transactions manually. With this Digital Sharia Pegadaian application, it can meet the needs of customers when transacting without directly attending the Sharia Pegadaian and this application has various features that will be selected when transacting. The formulation of the problem of this study is whether there are differences in service quality for customers using digital and manual sharia pawnshop applications. This research is quantitative research, this type of research is also comparative analysis research, the data source used is primary data. The data collection technique used is a questionnaire with a total sample size of 100 samples which are divided into 50 samples for digital sharia pawnshops and 50 samples for manual ones. The analysis techniques used are validity test, reliability test, mann whitney test, and homogeneity test. The results obtained in this study indicate that there is no significant difference between digital and manual pawnshops.