Wilcoxon Rank Test Research Articles

Hematological changes in women with cervical cancer before and after cancer treatment: retrospective cohort study.

Hematological changes is one of the most common complications occurred in cancer patients. Therefore, the current study aimed to assess the hematological toxicity of cervical cancer patients before and after the initiation of treatment. The retrospective cohort study was conducted from 2015 to 2022 at the University of Gondar Comprehensive Specialized Hospital. The hematological profile and sociodemographic and clinical data of the cervical cancer patients were collected using data extraction sheets. The Epidata version 3.1 and SPSS version 25 were used for data entry and analysis, respectively. Descriptive statistics were employed to summarize the data. To compare the median differences in hematological parameters before and after treatment, the Wilcoxon rank test was used. In addition, to assess the presence of an independent association between hematological abnormalities and the independent variables, logistic regression models were used. A p value less than 0.05 was considered to indicate statistical significance for all tests. In current study, the median (Interquartile range) of hemoglobin levels, white blood cell counts, and platelet counts, before treatment were 13.2 (12.1, 15) g/dl, 7.5 (5.8, 11.8) *109/L, and 330 (252, 383) *109/L, respectively. However, after treatment the median (Interquartile range) value of hemoglobin levels, white blood cell counts, and platelet counts were significantly lowered. On the other hand, red cell distribution width was significantly greater after treatment. At baseline, the magnitude of leucocytosis, anemia, and thrombocytosis were 27.9%, 24.6%, and 18.7%, respectively. After the treatment, anemia increased to 44.3%, but leucocytosis and thrombocytosis were replaced by leucopenia 18.3% and thrombocytopenia 17.8%, respectively. Hematological abnormalities such as anemia, leucopenia and thrombocytopenia were high after chemo-radiotherapy, and surgery. As the stage of cancer advances, the risk of developing anemia, leucocytosis, and thrombocytosis increased in 7.6, 6.9 and 9 times, respectively. Furthermore, being HIV patients and rural resident increased the risk of developing anemia about twofold. In conclusion hematological abnormalities were observed before and after cervical cancer treatment, with significance increment after chemo-radiotherapy and surgery. As the stage of cancer advances, the risk of developing hematological abnormalities increases. Therefore, routine monitoring of hematological changes before and after treatment and screening for major risk factors are important for improved patients' management.

Life History Traits of Ambassidae Fish, Chanda nama (Hamilton, 1822) From the Old Brahmaputra River of Northeastern Bangladesh

ABSTRACTThe present study provides a comprehensive analysis of the population structure (length–frequency distributions), growth pattern (length–weight relationships [LWRs] and length–length relationships), physiological condition factors (allometric [KA], Fulton's [KF] and relative [KR]), relative weight (WR) and form factor (a3.0) of Chanda nama. A total of 1200 specimens were collected from the Old Brahmaputra River, northeastern Bangladesh, for 12 months by traditional fishing gear, including seine net and cast net. The total length (TL) of several individuals varied from 2.3 to 7.2 cm. The highest percentage contributed to the population's 4.0–4.5‐cm‐sized group. The LWRs indicated a positive allometric growth pattern (b > 3.0). Fulton's condition factor significantly correlated with TL and body weight (p < 0.0001). The calculated WR ranged from 67.38 to 137.64. No significant variations from 100 were found using the Wilcoxon rank test (p = 0.034), suggesting that C. nama might live there in a balanced predator–prey environment. Furthermore, the measured value for the form factor (a3.0) was 0.0105. In addition, fish with a TL of 7–8 cm should be caught since they are in good condition and have enough meat. The study's findings will greatly contribute to the efficient and enduring management of C. nama in the Old Brahmaputra River and its adjacent ecosystems.

Effects of gut microbiota on immune checkpoint inhibitors in multi-cancer and as microbial biomarkers for predicting therapeutic response.

Gut bacteria are related to immune checkpoint inhibitors (ICIs). However, there is inconsistency in ICI-associated species, while the role of non-bacterial microbes in immunotherapy remains elusive. Here, we evaluated the association of trans-kingdom microbes with ICIs by multi-cohort multi-cancer analyses. We retrieved fecal metagenomes from 1,359 ICI recipients with four different cancers (metastatic melanoma [MM], non-small cell lung carcinoma [NSCLC], renal cell cancer [RCC], and hepatocellular carcinoma) from 12 published datasets. Microbiota composition was analyzed using the Wilcoxon rank test. The performance of microbial biomarkers in predicting ICI response was assessed by random forest. Key responder-associated microbes were functionally examined invitro and in mice. Trans-kingdom gut microbiota (bacteria, eukaryotes, viruses, and archaea) was significantly different between ICI responders and non-responders in multi-cancer. Bacteria (Faecalibacterium prausnitzii, Coprococcus comes) and eukaryotes (Nemania serpens, Hyphopichia pseudoburtonii) were consistently enriched in responders of ≥2 cancer types or from ≥3 cohorts, contrasting with the depleted bacterium Hungatella hathewayi. Responder-associated species in each cancer were revealed, such as F.prausnitzii in MM and 6 species in NSCLC. These signature species influenced ICI efficacy by modulating CD8+ Tcell activity invitro and in mice. Moreover, bacterial and eukaryotic biomarkers showed great performance in predicting ICI response in patients from discovery and two validation cohorts (MM: area under the receiver operating characteristic curve [AUROC]= 72.27%-80.19%; NSCLC: AUROC= 72.70%-87.98%; RCC: AUROC= 83.33%-89.58%). This study identified trans-kingdom microbial signatures associated with ICI in multi-cancer and specific cancer types. Trans-kingdom microbial biomarkers are potential predictors of ICI response in patients with cancer. Funding information is shown in the acknowledgments.

Increasing teacher confidence in using universal design for learning to support students’ developmental skills through teacher education at tier 1

ABSTRACT Children’s participation and success within the school environment are dependent on developmental and school readiness skills that extend beyond academic skills, including motor, visual, visual motor integration, social, and self-regulation skills. Students enter kindergarten with a varying range of school readiness skills and developmental needs, while teachers may lack the time, support, or ability to address them. A pre-test/posttest design was used to deliver a Universal Design for Learning approach to teacher education on motor, visual, visual motor integration, social, and self-regulation skill development to 12 kindergarten and first-grade teachers using an occupational therapist-teacher collaborative teaching model. Additionally, this approach facilitated opportunities for teachers to integrate skill development within their classrooms. An author-generated survey was used to capture teachers’ self-reported confidence and knowledge of skill development. Comparing pre- and post-survey scores, using the Wilcoxon Rank Test, indicates that the method used in this study has a statistically significant effect in increasing teachers’ knowledge of developmental skills and confidence in providing classroom interventions to support student participation. These results support Universal Design for Learning’s effectiveness in supporting children’s developmental skills through occupational therapist-teacher education.

Pengaruh Senam Otak terhadap Fungsi Kognitif pada Lansia di Panti Sosial Tresna Werdha Budi Luhur Provinsi Jambi

The aim of the research was to determine the effect of brain exercises on cognitive function in the elderly at the Tresna Werdha Budi Luhur Social Home, Jambi Province. This type of research is quantitative with a quasi-experimental design approach, pretest-posttest control group design. This research was conducted at the Tresna Werdha Budi Luhur Social Home, Jambi Province.The sampling method was purposive sampling of 22 people. 11 respondents in the control group and 11 respondents in the intervention group. Data measurement uses MMSE. Bivariate analysis used the Wilcoxon Rank Test and the Man Whitney test. The research results showed that the age frequency distribution of respondents was mostly elderly, female, and had elementary school education. The cognitive function of the pretest intervention group was mostly mild and severe cognitive function. The pretest and posttest results showed a significant increase, so that there was an influence of brain exercise on cognitive function in the elderly, with a p value = 0.002 (< 0.05). There was a significant effect of increasing cognitive function before and after being given brain exercises at PSTW. It is hoped that PSTW can develop brain exercises to improve the cognitive function of the elderly.

Comparison of Video and Booklet Media to Improve Parents' Knowledge About Childhood Tuberculosis

Tuberculosis (TB) is a disease caused by the bacteria Mycobacterium tuberculosis. Indonesia is the country with the second largest number of TB cases in the world. Tuberculosis in children cases in Indonesia reached 110,881 and West Sumatra is in sixth place with 2,751 cases. Tuberculosis in children cases are often ignored for various reasons such as lack of parental knowledge about preventing TB in children. Health education through audio-visual media and booklets is one of the efforts made to provide health information about preventing TB in children. The purpose of this study was to see changes in parental knowledge before and after intervention with video and booklet media and to compare the effectiveness of each media. This study used the "Pretest-Posttest Two Group Design" design which was conducted in the Pegambiran Health Center Work Area. The sample consisted of 54 people consisting of 2 groups, namely 27 people in the audio-visual media group and 27 people in the booklet media group. Sampling used the Simple Random Sampling technique. Univariate analysis showed frequency distribution and bivariate analysis used the Wilcoxon rank test and the Mann Whitney test. The results of the study with the Wilcoxon test obtained knowledge before and after audio-visual intervention with a p-value of 0.000 <0.05 and booklet media showed a p-value of 0.000 <0.05. The results of the Mann Whitney test with a p-value of 0.284> 0.05. It can be concluded that there is no difference in the effectiveness of using audio-visual media compared to booklet media in increasing parental knowledge about preventing childhood tuberculosis. It is hoped that the Health Center and related agencies will use audio-visual media and booklets in providing health education about preventing TB in children.

Bottleneck Effect Analysis in Indigenous Poonchi Chicken Located Near International Border of India and Pakistan

Background: Poonch is the remotest district of Jammu, India located near to line of control with Pakistan. Poonchi chicken is the first native poultry breed of Jammu region which is being characterized and registered with National Bureau of Animal Genetic Resources. Present study is the first study on genetic bottleneck assessment in Poonchi chicken population using recommended microsatellite markers. This study in Poonchi chicken would be of immense use in tracing evolutionary origin and formulating effective conservation strategies for genetic diversity within breeds. Methods: Blood samples were collected randomly from Poonch and Rajouri districts of Jammu for DNA extraction and analysis. Microsatellite markers selected for the analysis were ADL0268, MCW0206, MCW0081, ADL0278, MCW0069, MCW0248, MCW0111, MCW0222, MCW0016 and LEI0094. To evaluate the Poonchi chicken for mutation drift equilibrium, Bottleneck software was used. Infinite allele model (IAM), two phase model of mutation (TPM) and stepwise mutation model (SMM) tests were done. Mode shift test was also used as another method of qualitative test for allele frequency. Result: Total number of alleles observed were 72, with the total number alleles ranged from 6 to 9. The results of all three models (IAM, TPM, SMM) in Sign test depicted the heterozygosity was more in the expected number of loci in Poonchi chicken as 5.97 (P less than 0.05), 5.93 (P less than 0.05), 5.90 (P less than 0.05) respectively. Whereas for Wilcoxon rank test the IAM, TPM and SMM revealed significant values of (P less than 0.05) deviation indicating that all the loci deviate from mutation-drift equilibrium. Mode shift test graph obtained depicted a slight shift from normal L-shaped curve indicating recent bottleneck effect in Poonchi chicken. This might have resulted in the loss of number of effective alleles which suggests a need of planning and implementing an effective breeding policy in order to preserve and promote this native breed.

Endovascular thrombectomy for childhood stroke (Save ChildS Pro): an international, multicentre, prospective registry study.

Emerging evidence suggests that endovascular thrombectomy is beneficial for treatment of childhood stroke, but the safety and effectiveness of endovascular thrombectomy has not been compared with best medical treatment. We aimed to prospectively analyse functional outcomes of endovascular thrombectomy versus best medical treatment in children with intracranial arterial occlusion stroke. In this prospective registry study, 45 centres in 12 countries across Asia and Australia, Europe, North America, and South America reported functional outcomes for children aged between 28 days and 18 years presenting with arterial ischaemic stroke caused by a large-vessel or medium-vessel occlusion who received either endovascular thrombectomy plus best medical practice or best medical treatment alone. Intravenous thrombolysis was considered part of best medical treatment and therefore permitted in both groups. The primary outcome was the difference in median modified Rankin Scale (mRS) score between baseline (pre-stroke) and 90 days (±10 days) post-stroke, assessed by the Wilcoxon rank test (α=0·05). Efficacy outcomes in the endovascular thrombectomy and best medical treatment groups were compared in sensitivity analyses using propensity score matching. The Save ChildS Pro study is registered at the German Clinical Trials Registry, DRKS00018960. Between Jan 1, 2020, and Aug 31, 2023, of the 241 patients in the Save ChildS Pro registry, 208 were included in the analysis (115 [55%] boys and 93 [45%] girls). 117 patients underwent endovascular thrombectomy (median age 11 years [IQR 6-14]), and 91 patients received best medical treatment (6 years [3-12]; p<0·0001). The median Pediatric National Institutes of Health Stroke Scale (PedNIHSS) score on admission was 14 (IQR 10-19) in the endovascular thrombectomy group and 9 (5-13) in the best medical treatment group (p<0·0001). Both treatment groups had a median pre-stroke mRS score of 0 (IQR 0-0) at baseline. The change in median mRS score between baseline and 90 days was 1 (IQR 0-2) in the endovascular thrombectomy group and 2 (1-3) in the best medical treatment group (p=0·020). One (1%) patient developed a symptomatic intracranial haemorrhage (this patient was in the endovascular thrombectomy group). Six (5%) patients in the endovascular thrombectomy group and four (5%) patients in the best medical treatment group had died by day 90 (p=0·89). After propensity score matching for age, sex, and PedNIHSS score at hospital admission (n=79 from each group), the change in median mRS score between baseline and 90 days was 1 (IQR 0-2) in the endovascular thrombectomy group and 2 (1-3) in the best medical treatment group (p=0·029). Regarding the primary outcome for patients with suspected focal cerebral arteriopathy, endovascular thrombectomy (n=18) and best medical treatment (n=33) showed no difference in 90-day median mRS scores (2 [IQR 1-3] vs 2 [1-4]; p=0·074). Clinical centres tended to select children with more severe strokes (higher PedNIHSS score) for endovascular thrombectomy. Nevertheless, endovascular thrombectomy was associated with improved functional outcomes in paediatric patients with large-vessel or medium-vessel occlusions compared with best medical treatment. Future studies need to investigate whether the positive effect of endovascular thrombectomy is confined to older and more severely affected children. None.

A Quality Improvement Approach to Increasing Access to long-Acting Reversible Contraceptives in a Federally Qualified Health Center.

Long-acting reversible contraceptives (LARCs) are the most effective forms of contraception available and therefore play a critical role in supporting patients to exercise bodily autonomy and achieve reproductive goals. A comprehensive set of quality improvement (QI) interventions were implemented between March and June 2019 to improve LARC access at a federally qualified health center (FQHC) in (US State). An evaluation study was conducted to assess the impact of the QI initiative considering the number of LARCS delivered as a proxy for access. The Wilcoxon-rank test was applied to test for significance, given a non-parametric sample of LARCs delivered by 13 providers (matched to themselves) pre- and post-intervention. Reimbursement for LARC procedures pre- and post-intervention was also examined to determine economic impact and sustainability of incorporating a new device, the Liletta™, in the floor stock. There was a statistically significant increase in LARC delivery between July 2019-March 2020 compared to July 2018-March 2019. Approximately $1,000 per month increased reimbursement for LARC services occurred post-intervention. The evaluation study concluded success of the QI intervention, with need for further study needed to determine equitable delivery of contraceptive services between different subpopulations and by insurance status. The study provides a blueprint for QI initiatives to improve access to LARCs while also increasing revenue for LARC services in an FQHC setting.

A Picture Paints a Thousand Words: Perspectives of the Use of Images and Videos of Physical Findings in Virtual OSCE Teaching Sessions.

The COVID-19 pandemic has resulted in medical students' education being disrupted and a new direction of learning towards the online classroom, with students frequently learning to identify clinical signs via online conferencing platforms. Given this shift in student study techniques in the pandemic and post-pandemic era, we set out to analyse the confidence levels of students recognizing clinical signs in patients and the opinions and patterns of resources students would use to build up the knowledge and confidence for their future clinical practice. OSCEazy, a student-led medical education organisation, delivered an online teaching session and disseminated a questionnaire containing ten-point Likert scales, multiple-choice questions and free text options. The majority (over 75%) of respondents reported using digital resources to learn physical examinations. Most respondents were somewhat confident with recognising clinical signs during physical examinations (Median 7, IQR 6-8). Kruskal-Wallis H-test on students' impression of the quality of current OSCE materials showed a statistically significant difference between cohorts (X2(2) = 14.209, p = 0.014). A large proportion of students (98.41%) agreed that an online resources bank would be beneficial for their learning. Wilcoxon rank test showed a statistically significant preference for learning physical examinations using clinical images rather than videos (p = 0.014). A 29% of respondents mentioned the use of physical textbooks as a resource, while online platforms such as OSCE revision websites, YouTube and Google Images had become the mainstream platforms. The findings reported here suggest that there needs to be a greater emphasis on providing online image-based resources to support medical students in learning clinical signs. A resource containing these clinical signs would prove to be of benefit for students to access high-quality self-directed learning to identify and verify clinical signs.

The Effectiveness of Familiar Auditory Sensory Training (FAST) in Increasing Consciousness Levels among Stroke Patients

Stroke is a leading cause of death worldwide, along with myocardial infarction and cancer. Stroke often results in loss of consciousness and neurological deficits that affect sensory perception. To support recovery, non-pharmacological therapies like auditory sensory stimulation are crucial. Familiar Auditory Sensory Training (FAST) is one such intervention. This study assessed the effectiveness of FAST in improving consciousness levels in stroke patients using a one-group pretest-posttest design. It involved 35 stroke patients aged 35-75, who were selected through purposive sampling and underwent three FAST sessions. Consciousness levels were measured using the Glasgow Coma Scale (GCS) before and after the intervention. Data analysis with the Wilcoxon rank test at α=0.05 revealed a significant increase in consciousness from a mean of 6.77 to 10.83 post-intervention (p=0.001), demonstrating FAST's effectiveness in enhancing consciousness in ICU stroke patients.

Association between bariatric surgery preoperative chemoprophylaxis and postoperative bleeding.

Use of chemoprophylaxis for prevention of venous thromboembolism (VTE) after bariatric surgery is a generally accepted principle; however, the optimal strategy in terms of medication type and pre- and postoperative dosing is uncertain. In our healthcare system, four hospitals performed bariatric surgery and utilized differing protocols for VTE prophylaxis. The analysis sought to evaluate the association of differing prophylaxis strategies on bleeding and VTE occurrence. Adult patients who underwent laparoscopic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) from 2018 to 2021 at four hospitals were studied. Patients were grouped by whether or not they received preoperative chemoprophylaxis. The primary outcome was postoperative bleeding, defined as requiring a blood transfusion or reoperation for bleeding within 30days. Bivariate analyses were performed with Chi-square and Wilcoxon Rank tests where applicable. Multivariate logistic regression was performed for the outcome of postoperative bleeding. A total of 2145 bariatric surgeries were evaluated (33.6% RYGB, 66.4% SG). Among 1712 patients who underwent surgery at Hospitals A, B, and C, 93.1% received preoperative VTE prophylaxis, compared with 1 patient (0.1%) among 433 patients operated on at Hospital D. Postoperative bleeding occurred more frequently in patients who received preoperative VTE prophylaxis versus those who did not (3.7% vs 1.1%; p < 0.01). After multivariable regression analysis, only RYGB (OR 3.59; p < 0.01) and preoperative VTE prophylaxis (OR 3.54; p = 0.02) were significantly associated with postoperative bleeding. Rates of VTE for patients receiving preoperative VTE prophylaxis or no prophylaxis were not significantly different (0.6% vs. 0.2%; p = 0.26). Preoperative VTE prophylaxis prior to bariatric surgery was associated with postoperative bleeding without differences in VTE occurrence. These results call into question the routine use of VTE chemoprophylaxis for all patients undergoing bariatric surgery and favor selective usage.

Peningkatan teknologi bagi agroindustri pliek-u sebagai upaya pelestarian kearifan lokal di Aceh [Technology improvement on pliek-u agroindustry as an effort to maintain a local wisdom in Aceh

Pliek-u is a specialty food product in Aceh with local wisdom values that should be preserved. The Program of Community Service Based Product (PKMBP) aimed to improve the pliek-u agro-industry by adapting simple processing technologies so that it could lighten work, produce quality products, and attract the interest of the younger generation as pliek-u entrepreneurs in future. The method applied consist of surveys, preparation of tools and materials, assembly of a solar tunnel dryer type Hohenheim Aceh and a hydraulic press, training and dissemination of technology through field schools, and evaluation of the program with pre-tests and post-tests. Data analysis was carried out using the Wilcoxon rank test with alpha of 5%. The results of the program were the construction of 1 unit of Hohenheim Aceh tunnel dryer, 1 unit of hydraulic press, and the implementation of training and dissemination activities which have been published in the form of videos on YouTube media and press releases through online media. The results of the Wilcoxon rank test also showed that of the 13 participants whose data were valid, 100% of participants received positive rankings and the pre-test scores were significantly different from the post-test scores. Thus, it can be concluded that the program carried out has contributed to increasing the knowledge, expertise capacity, and interest of participants in pliek-u processing technologies since the profile of conventional agroindustry can be transformed to be better agroindustry by the use of solar tunnel dryer type Hohenheim Aceh and hydraulic press. In addition, the use of technologies will ensure the halal requirement of pliek-u.

Bone marrow edema-like signal after cartilage repair does not affect outcomes in a five-year follow-up.

Bone marrow edema-like signal (BMELS) after cartilage repair is common, but its clinical significance remains uncertain. This study aimed to investigate the clinical and structural significance of BMELS following microfracturing (MFX) and matrix-induced autologous chondrocyte implantation (MACI). In this multicenter study, MRI examinations were performed over a period of 5 years after cartilage repair surgery (MFX n = 17; MACI n = 28) in 45 patients. Morphological assessments, including the MOCART 2.0 (magnetic resonance observation of cartilage repair tissue), quantitative imaging biomarkers (QIB) with T2 mapping of the repair tissue, and, specifically, assessment of the presence and size of BMELS, were conducted along with patient-reported outcome measures, such as the Knee injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee (IKDC). BMELS structural and clinical assessments were obtained after 3 months, 12 months, and 60 months. Statistical analysis included the Mann-Whitney U-test, Wilcoxon rank test, Shapiro-Wilk test, and simulation-based power analysis. BMELS were a common finding 60 months after cartilage repair. The size of BMELS differed significantly only between MACI and MFX patients after 3 months, with larger BMELS occurring in the MFX group. There were no significant differences in patients with or without BMELS regarding the T2 ratio of the treated area, the MOCART 2.0, or clinical scores. BMELS frequently appeared after cartilage repair procedures. We could show that the postoperative size and change in the size of BMELS after MACI and MFX did not affect clinical scores, morphological MRI results, or biochemical properties of the treated area after 60 months. Question What is the clinical significance of bone marrow edema-like signal (BMELS) appearance after matrix-induced autologous chondrocyte implantation (MACI) or microfracture (MFX)? Finding There were no significant differences in patients with or without BMELS regarding the T2 ratio of the treated area, the MOCART 2.0, or clinical scores. Clinical relevance BMELS frequently appeared after cartilage repair, the appearance or the size dynamic after MACI and MFX did not affect clinical scores, morphological MRI results, or biochemical properties after 60 months.

Comparison of complications and degree of correction between the extensile lateral and sinus tarsi approaches in the treatment of calcaneus fractures: a cross-sectional observational retrospective study

Introduction: Calcaneus fractures are a challenge for traumatologists. Their complex anatomy, relative scarcity of surrounding soft tissue, and long learning curve for surgical treatment partly explain the difficulties encountered by surgeons, in addition to contributing to the high rate of complications. Objective: This study aimed to identify the differences in complication rates and degree of correction between extensile lateral access (ELA) and sinus tarsi (STA) approaches by reviewing medical records between 2018 and 2023 of patients who underwent open reduction and internal fixation of calcaneus fractures at a hospital in the interior of São Paulo. Methods: The present study followed a retrospective observational and cross-sectional model (STROBE). The Kolmogorov Smirnov test, Student-t test, Wilcoxon Rank test, Mann-Whitney test, Pearson Chi-Square test, and binary and predictive logistic regression analysis were used, adopting a confidence risk of 0.05. Results and Conclusion: A total of 77 patients were included (52 ELA and 25 STA). It was concluded that no statistical differences were observed after intergroup comparisons (ELA vs. STA). There was also no statistically significant influence of the predictor “age” on the predictors of the responses “Böhler and Gissane angles in degrees” in the final post-procedure phase. In general, STA presented a lower probability of complications with the use of the sinus tarsi route, reaching the same level of joint reduction and control of progression to osteoarthritis. All these results of the present study almost completely confirm the literary findings that appear under discussion.

Antepartum vs postpartum amoxicillin oral challenge in pregnant patients with a reported penicillin allergy: A two-center prospective cohort study.

While 10% of pregnant individuals report a penicillin allergy, there is no established best practice for penicillin allergy delabeling in pregnancy. To better understand options for penicillin delabeling, we aimed to evaluate two penicillin allergy delabeling protocols in pregnancy regarding efficacy, adverse events, and patient satisfaction. From July 2019 to December 2022, we completed a two-center prospective cohort study, where each site recruited pregnant patients over 24 weeks gestational age with a reported penicillin allergy. One center offered antepartum amoxicillin oral challenges, either directly or after negative skin testing (i.e., antepartum oral challenge site). Our other centers completed a two-step approach with antepartum penicillin skin testing only and deferred oral challenges to the postpartum period (i.e., postpartum oral challenge site). Our primary outcome was the rate of penicillin allergy delabeling, defined as tolerating an antibiotic challenge with penicillin or amoxicillin. Univariate analyses were completed using chi-squared, Fisher's exact, and Wilcoxon rank tests. During the study period, 276 pregnant patients were assessed, with 207 in the antepartum oral challenge site and 69 in the postpartum oral challenge site. Among the 204 patients who completed antepartum oral challenges, 201 (98%) passed without reactions. Deferring oral challenges to the postpartum period led to a loss of follow-up for 37/53 (70%) of eligible individuals. Overall, 97% (201/207) of patients at the antepartum oral challenge site were delabeled from their penicillin allergy-compared to 38% (26/69) of patients referred to the postpartum oral challenge site (p < 0.0001). Three antepartum oral challenge reactions were noted, including two mild cutaneous reactions and a case of transient abdominal discomfort. Antepartum amoxicillin oral challenge is a more effective method to delabel pregnant patients from their penicillin allergy. Deferral of oral challenges to the postpartum period introduces a significant barrier for penicillin allergy delabeling.

Influence of occlusal surface reduction on post endodontic pain following instrumentation and obturation: A randomized double blinded clinical study.

The purpose of this randomized clinical study was to investigate the influence of occlusal surface reduction on postendodontic pain. Sixty patients were included with a diagnosis of acute irreversible pulpitis and acute apical periodontitis and divided randomly into two groups. In the intervention group, occlusal surfaces were reduced and left intact in the control group. Postoperative pain was evaluated at the 6th, 12th, 24th, and 48th h after the root canal instrumentation and 6th and 12th h following obturation using visual analog scale. Data were evaluated using the Chi-square test, t-test, Friedman test, Mann-Whitney U-test, and Wilcoxon rank test. Postoperative pain levels in both groups were reduced significantly over the time period evaluated, however, between the two groups, there was no difference evident. Occlusal surface reduction did not influence the pain following root canal instrumentation and obturation.

The Psychological Impact of COVID-19: A Comparative Analysis of Pre-Lockdown and During-Lockdown Periods Among Saudi General Population.

Prior research has revealed substantial psychological impacts of COVID-19 among the general population. However, there is a noticeable gap in studies addressing the enduring anxiety levels before and during lockdown periods of the COVID-19 pandemic. The study assessed and compared the psychological impact of the COVID-19 pandemic before and during lockdown periods among the general population in Saudi Arabia. A validated and reliable General Anxiety Disorder (GAD)-7 instrument was used to quantify stress levels by measuring anxiety. Nonprobability snowball sampling was used to collect data from 516 participants residing in Saudi Arabia. The difference in scores for each of the seven related questions of GAD-7 was determined using a non-parametric Wilcoxon rank test. A mild level of anxiety was consistently observed both before and during the lockdown, as indicated by GAD-7 scores of 6.17 (SD = 5.5) before the lockdown and 6.42 (SD = 5.7) during the lockdown. There were no differences in GAD-7 scores before 6.17 (SD = 5.5) and during 6.42 (SD = 5.7) the lockdown periods. However, levels of moderate anxiety increased by 5% during the lockdown period. Anxiety levels before and during lockdown were significantly associated with gender (χ2 (3, n = 516) =11.23 p = 0.01) and employment status (χ2 (3, n = 516) = 9.41 p = 0.024). Among the GAD-7 questionnaire items, item number 1 ("Feeling nervous, anxious, or on edge") (p= 0.00) and item number 7 ("Feeling afraid as if something awful might happen") (p= 0.025) showed a significant association with anxiety levels before and during the lockdown periods. The enduring prevalence of mild anxiety, persisting both before and during the lockdown periods, underscores the profound impact of COVID-19 on the mental health of the general population in Saudi Arabia.

Response Rates and Nonresponse Bias Among 20 Years of Pediatrician Surveys

ObjectivesOur objectives were to examine the following: physician survey response rates across a 20-year period; the impact of a token incentive on response rates; whether survey nonresponse bias is present and if it is associated with response rate; and the impact of a token incentive on nonresponse bias. MethodsWe utilized data from 68 American Academy of Pediatrics (AAP) pediatrician surveys from 2000 to 2019 and an AAP administrative database, which included information for both respondents and non-respondents (target sample). Linear regression examined response rates over time. To assess nonresponse bias, a t-test or Wilcoxon rank test compared respondents and the target sample by age, gender, and US Census region. Linear regression or Spearman correlation examined the association of response rate and nonresponse bias. Interrupted time series analyses tested the introduction of a $2 token incentive on both response rates and nonresponse bias. ResultsOverall mean survey response rate was 56.2%. Response rates declined across survey years (β = −0.58, P < 0.001). The $2 incentive generated an 8.7% response rate increase (P < 0.001). The respondent groups had more female pediatricians than the target samples (62.5% vs 60.1%, P < 0.001). Age nonresponse bias was associated with lower response rates (β = −0.47, P < 0.001). The $2 incentive was associated with nonresponse bias shifts toward older, away from female, and away from Northeastern respondents. ConclusionsOur study demonstrates an overall decline in pediatrician survey response rates and a meaningful impact of a token incentive on response rates and nonresponse bias, underscoring the importance of measuring nonresponse bias whenever possible.

DIFFERENCES IN FIRM FINANCIAL PERFORMANCE BEFORE AND DURING THE COVID-19: A STUDY ON FNB SECTOR

&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;: Covid-19 has had a major impact on the global economy, including in Indonesia. One of the most notable impacts has been felt by food and beverage firm. Indonesia government gives more attention for this sector due to its importance for public needs. This research is used to obtain the difference ROA ratio before and during Covid -19 period using statistical approach. This approach was chosen for finding is there a significant differences firm performance between before and during Covid-19 period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective&lt;/strong&gt;: This approach was chosen for finding is there a significant differences firm performance between before and during Covid -19 period and analyze the differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research Methodology&lt;/strong&gt;: Paired test approach for this research uses non-parametric Wilcoxon Ranks test by measuring return on assets (ROA). The population in this research were all firm operating in food an beverages sector from 2018-2021 which were listed on Indonesia for four consecutive years by classifying these four years in to before (2018-2019) and during Covid-19 (2020-2021).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research Findings&lt;/strong&gt;: This research gained significantly different firm performance between before and during Covid-19. Wilcoxon Rank test performing this research gained a significant value 0.001&amp;lt;0.05. This difference is because the firm's ROA level tends to decline and suffer losses, the effect of implementing Perlakuan Pembatasan Kegiatan Masyarakat (PPKM) which seeks to reduce transmission through community mobility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Originality/Novelty of Research&lt;/strong&gt;: This research provides a difference in firm financial performance with extended period data over two years before (2018-2019) and two years during Covid-19 (2020-2021).&lt;/p&gt;