Wilcoxon Signed Rank Sum Test Research Articles

Bonding performance of universal adhesives to eroded dentine: A 6-year evaluation

ObjectivesTo evaluate the microtensile bond strength (µTBS) and nanoleakage (NL) of several universal adhesives to eroded dentine (ED) using etch-and-rinse (ER) and self-etch (SE) strategies, immediately and after 6 years of water storage. Material and methodsFour hundred and eighty human molars were distributed into 60 groups according to dentine substrate (sound dentine [SD], eroded with soft drink, or eroded with citric acid), application method of the adhesive (SE or ER), and the adhesives used: 1. All-Bond Universal, 2. Ambar Universal, 3. Clearfil Universal, 4. Futurabond U, 5. One Coat 7 Universal, 6. Peak Universal Bond, 7. Prime&Bond Elect, 8. Scotchbond Universal, 9. Tetric n-bond Universal, and 10. Xeno Select. The restoration was then performed with a composite resin, and the specimens were sectioned into resin-dentine bonded sticks. The sticks were tested (immediately or after 6 years of storage) for µTBS (0.5 mm/min) or used to assess NL. The eroded dentine surfaces were also examined using FE-SEM to evaluate the NL. Data for µTBS were analyzed by four-way ANOVA and Tukey's post-hoc test (a = 0.05), and the NL was analyzed by Kruskal–Wallis and the Wilcoxon Signed Rank Sum test (a = 0.05). ResultsIn ED, there was no difference in μTBS and NL between ER and SE strategies (p > 0.05). Most μTBS and NL values obtained for ED were lower and higher, respectively, than those for SD (p < 0.005). Additionally, the worst results (μTBS and NL) were observed for erosion with citric acid groups in comparison with erosion with soft-drink groups (p < 0.007). After 6y, μTBS was generally lower and NL higher for all substrates, adhesives, and strategies (p < 0.05), except for AMB, SBU, and TEU in dentine eroded with citric acid. The lowest μTBS and highest NL values were observed for ABU, FBU, OCU, PUB, PBE, and XEN in both types of eroded dentine and evaluation times (p < 0.002). Conclusion: The use of MDP-containing adhesives seems to be essential to maintain adhesion to eroded dentine. However, other factors such as acidity should be considered. Clinical significanceThe bonding of eroded dentine is a challenge. However, the use of MDP-containing universal adhesives showed less degradation after long-term evaluation.

Adherence to preventive measures after SARS-CoV-2 vaccination and after awareness of antibody response in kidney transplant recipients in the Netherlands: a nationwide questionnaire study

Kidney transplant recipients (KTRs) were advised to tightly adhere to government recommendations to curb the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) because of a high risk of morbidity and mortality and decreased immunogenicity after vaccination. The aim of this study was to analyse the change in adherence to preventive measures after vaccination and awareness of antibody response, and to evaluate its effectiveness. In this large-scale, national questionnaire study, questionnaires were sent to 3531 KTRs enrolled in the Dutch RECOVAC studies, retrospectively asking for adherence to nine preventive measures on a 5-point Likert scale before and after SARS-CoV-2 vaccination and after awareness of antibody response. Blood samples were collected 28 days after the second vaccination. Antibody response was categorised as non-responder (≤50 BAU/mL), low-responder (>50≤300 BAU/mL) or high-responder (>300 BAU/mL), and shared with participants as a correlate of protection. Participants of whom demographics on sex and age, blood samples and completed questionnaires were available, were included. Our study took place between February 2021 and January 2022. The primary outcome of adherence before and after vaccination was assessed between August and October 2021 and compared via the Wilcoxon signed rank sum test. Logistic regression analysis was performed to estimate the association between antibody response and non-adherence, and adherence on acquiring SARS-CoV-2 infection. This study is registered at ClinicalTrials.gov (NCT04841785). In 2939 KTRs (83%) who completed the first questionnaire on adherence to preventive measures, adherence was higher before than after vaccination (4.56, IQR 4.11-4.78 and 4.22, IQR 3.67-4.67, p<0.001). Adherence after awareness of antibody response was analysed in 2399 KTRs (82%) of whom also blood samples were available, containing 949 non-responders, 500 low-responders and 950 high-responders. Compared to non-responders, low- and high-responders reported higher non-adherence. Higher adherence was associated with lower infection rates before and after vaccination (OR 0.67 [0.51-0.91], p=0.008 and OR 0.48 [0.28-0.86], p=0.010). Adherence decreased after SARS-CoV-2 vaccination and in KTRs who were aware of a subsequent antibody response compared with those without. Preventive measures in this vulnerable group seem to be effective, regardless of vaccination status. This study starts a debate on sharing antibody results with the patient and future studies should elucidate whether decreased adherence in antibody responders is justified, also in view of future pandemics. The Netherlands Organization for Health Research and Development and the Dutch Kidney Foundation.

Functional improvements of patients admitted to an inpatient rehabilitation facility after bilateral lung transplant due to severe COVID-19 pulmonary disease.

Coronavirus disease (COVID-19) has introduced a new subset of patients with acute end-stage lung damage for which lung transplantation has been successfully performed. To describe the inpatient rehabilitation course of patients who underwent bilateral lung transplant due to severe COVID-19 pulmonary disease. Retrospective chart review. Free-standing, academic, urban inpatient rehabilitation hospital. Seventeen patients aged 28-67 years old (mean 53.9 ± 10.7) who developed COVID-19 respiratory failure and underwent bilateral lung transplant. Patients participated in a comprehensive inpatient rehabilitation program including physical, occupational, and speech therapy tailored to the unique functional needs of each individual. Primary outcome measures of functional improvements, include mobility and self-care scores on section GG of the Functional Abilities and Goals of the Improving Post-Acute Care Transformation Act, as defined as quality measures by the Centers for Medicare and Medicaid Services. Other functional measures included 6 minute walk test, Berg balance scale, Mann Assessment of Swallowing Ability (MASA), and Cognition and Memory Functional Independence Measure (FIM) scores. Wilcoxon signed rank sum test was used to evaluate statistical significance of change between admission and discharge scores. Fourteen patients completed inpatient rehabilitation. Self-care (GG0130) mean score improved from 20.9 to 36.1. Mobility (GG0170) mean score improved from 30.7 to 70.7. Mean 6-minute walk distance improved from 174.1 to 467.6 feet. Mean Berg balance scores improved from 18.6/56 to 36.3/56. MASA scores improved from 171.3 to 182.3. All functional measures demonstrated statistically significant improvements with p value ≤ .008, except for cognition and memory FIM scores, which did not show a statistically significant difference. A majority (76%) of patients discharged home. This new and unique patient population can successfully participate in a comprehensive inpatient rehabilitation program and achieve functional improvements despite medical complications.

#3738 KIDNEY TRANSPLANT RECIPIENTS BECOME LESS ADHERENT TO PREVENTIVE MEASURES AFTER SARS‑COV‑2 VACCINATION AND AFTER AWARENESS OF ANTIBODY RESPONSE

Abstract Background and Aims Kidney transplant recipients (KTRs) were advised to tightly adhere to government recommendations to curb the spread of SARS-CoV-2 because of a high risk of morbidity and mortality and decreased immunogenicity after vaccination. The aim of this study was to analyze the change in adherence to preventive measures after vaccination and awareness of antibody response, and to evaluate the effectiveness of these measures. Method Questionnaires were sent to 3531 KTRs enrolled in the Dutch RECOVAC studies, retrospectively asking for adherence to nine preventive measures on a 5-point Likert scale before and after SARS-CoV-2 vaccination and after awareness of antibody response. Blood samples were collected 28 days after the second vaccination. Antibody response was categorized as non-responder (≤50 BAU/mL), low-responder (&amp;gt;50 ≤300 BAU/mL) or high-responder (&amp;gt;300 BAU/mL), and shared with participants as a correlate of protection. Adherence before and after vaccination were compared by the Wilcoxon signed rank sum test. Logistic regression analysis was performed to estimate the association between antibody response and adherence, and adherence on acquiring SARS-CoV-2 infection. Results In 2939 KTRs (83%) who completed the first questionnaire on adherence to preventive measures, adherence was higher before than after SARS-CoV-2 vaccination (4.56, IQR 4.11-4.78 and 4.22, IQR 3.67-4.67, p &amp;lt; .001) (Figure 1). Adherence after awareness of antibody response was analyzed in 2399 KTRs (82%) of whom also blood samples were available, containing 949 non-responders, 500 low-responders and 950 high-responders. Compared to non-responders, low- and high-responders reported lower adherence (Figure 2). Higher adherence was associated with lower infection rates before and after vaccination (OR 0.67 [0.51-0.91], p = 0.008 and OR 0.48 [0.28–0.86], p = 0.010). Conclusion To the best of our knowledge, we are the first to show that KTRs became less adherent to social isolation and other preventive measures after vaccination against COVID-19. Adherence decreased in KTRs who were aware of a subsequent antibody response compared to those without. Moreover, preventive measures in this vulnerable group are effective, regardless of vaccination status.

Clinician satisfaction and preference for central venous catheter systems promoting patient safety, ease-of-use and reduced clinician error

ABSTRACT Objectives Central venous catheters (CVC) are frequently utilized with limited data on user preferences. A simulation/survey-based study was conducted among anesthesia providers to evaluate attitudes toward general CVC system attributes, and satisfaction with elements of the most-commonly used and a novel CVC system. Methods Forty providers completed a simulation using both CVC systems and a 29-item questionnaire, including multiple-choice, free-text, ranking, and Likert-like questions. Ranking scores were reported using a scale of 0 (least important/satisfactory) to 100 (most important/satisfactory). Statistical significances were evaluated via Wilcoxon signed-rank sum test. Results Participants chose (mean±SD) patient safety (83.9 ± 25.3), ease-of-use (64.6 ± 26.1), and reduced risk for error (61.1 ± 26.7) as the most important attributes when considering a CVC system. Satisfaction levels were significantly higher for the novel system: overall (p < 0.001), its ease-of-use (p < 0.001), tray layout/design (p < 0.001), and safety (p = 0.012). Mean satisfaction scores were significantly higher for the novel system’s potential to reduce 5 of 7 common issues, including clinician error (p < 0.001), and contamination/infection (p < 0.001). Conclusion Anesthesia providers preferred CVC systems promoting patient safety, ease-of-use and reduce clinician error. Significantly higher (p < 0.05) satisfaction scores were awarded to a novel system featuring a sequentially organized tray, enhanced labeling, and a guidewire funnel.

Differences in Center of Pressure Displacement and Lower Limb Muscle Activity During Relevé Descending Phase Comparing Flat Shoes and Pointe Shoes.

In classical ballet, dancers may wear flat shoes and pointe shoes. To consider the kinematic changes between flat shoes and pointe shoes to prevent injuries, it is essential to focus on the fundamental ballet movement of standing on pointe. This study aimed to clarify the differences in the center of pressure (COP) displacement and lower limb muscle activity during the descending phase of a relevé when wearing pointe shoes versus flat shoes. Ten amateur ballet dancers volunteered for this study and performed a reléve wearing flat shoes and pointe shoes. We measured the COP displacement by using a footplate and electromyographies of the tibialis anterior, soleus, lateral gastrocnemius, and peroneus longus muscles during the relevé descending phase. These data were compared using a paired t-test or Wilcoxon signed-rank sum test. The COP significantly shifted to the lateral side when dancers were wearing pointe shoes compared to wearing flat shoes (p<0.05). The muscle activity of the tibialis anterior and soleus muscles was significantly higher by 5.7% and 5.3%, respectively, when ballet dancers were wearing pointe shoes compared to flat shoes (p<0.05). However, there were no differences in both lateral gastrocnemius and peroneus longus. Greater muscle activities in the tibialis anterior and soleus muscles when wearing pointe shoes than when wearing flat shoes were associated with a larger lateral displacement of the COP. To control the COP displacement during the descending phase of a relevé, the muscle activity of the peroneus longus, which is antagonist of tibialis anterior muscle, and soleus muscles should be increased.

Effects of Deciduous Forests on Adolescent Emotional Health in Urban Areas: An Example from the Autumn Ginkgo Forest in Chengdu

Many studies have shown that urban green spaces can promote emotional health. Deciduous forest is an important landscape and ecological resource of the city. However, the emotional impact of different behavior patterns in this kind of natural space with obvious seasonal changes are rarely discussed. This study explores the emotional feedback of two typical behavior patterns within an urban landscape forest in autumn: sitting and walking. We recruited 80 volunteers and divided them into a sitting viewing group (group S) and a walking viewing group (group W). On the premise of gender balance, they were randomly assigned to a natural path under a Ginkgo biloba forest in autumn for 15 min of viewing. Physiological and psychological indicators were used for monitoring. Blood pressure, heart rate and electroencephalography (EEG) were used for physiological indicators, and a POMS questionnaire was used for psychological indicators. A paired t-test and one-way ANOVA were used to analyze the physiological parameters of the two experimental groups, and a paired Wilcoxon signed-rank sum test was used to analyze the differences in psychological indexes between the two behavior groups. The results showed that the diastolic blood pressure and pulse of the sitting group decreased significantly under the seasonal deciduous forest, and the walking group attained higher “Engagement”, “Excitement”, and “Relaxation”. In the absolute α and β waves, there were significant differences in the parietal P8 channels between the sitting and walking groups, and significant differences in the RAB indicators of the AF3, F7, P7, FC5, FC6, F3 and T7 channels. The two behavior patterns can effectively reduce negative mood, and the “Vigor” mood in the walking group was significantly increased, which was significantly better than that of the sitting group in reducing negative mood. These results enrich research on the influence on emotional health in the field of seasonal green-space restoration. The differences of different behavior patterns can provide guidance for planning urban landscape forest construction and activity facilities.

Analysis of verification results of protective effects of hearing protectors in different industries

Objective: To get insight into the current practice of noise reduction effect of workers as they wore hearing protectors in different domestic enterprises and the possible affected factors. Methods: From October 2020 to April 2021, using a random sampling method, 1197 workers exposed to noise in petrochemical factories, textile factories, and parts manufacturing factories were selected as the study subjects. The noise reduction effect of hearing protectors worn by workers in daily use was tested using a hearing protector suitability testing system. The personal sound attenuation level (PAR) was compared among workers in three enterprises, Targeted intervention and repetitive testing were conducted for workers who did not meet the noise reduction effect required by the enterprise, and the changes in PAR of workers before and after the intervention were compared. The comparison of baseline PARs between two or more groups was performed using the Mann Whitney test, the comparison of baseline PARs with post intervention PARs was performed using the Wilcoxon signed rank sum test, and the comparison of qualitative data between two or more groups was performed using the Chi square test. Results: The median baseline PAR for all workers was 15 dB. Men, age<30 years old, education level at or above college level, working experience of 5 to 15 years, and those who used hearing protectors for 5 to 15 years had higher PARs, with statistically significant differences (P<0.05). The median difference in baseline PAR among workers from three enterprises was statistically significant (H=175.06, P<0.01). The median PAR of subjects who did not pass the baseline increased from 3 dB to 21 dB after intervention (Z=-27.92, P<0.01) . Conclusion: Some workers wearing hearing protectors do not meet the required PAR, and low PARs may be related to incorrect wearing methods and incorrect selection of hearing protectors. As a tool for testing, training, and assisting in selection, the hearing protector suitability testing system is of great significance for worker hearing protection.

Functional and oncological outcomes of robot-assisted radical prostatectomy in obese men: a matched-pair analysis.

Robot-assisted radical prostatectomy (RARP) in men with body mass index (BMI) ≥ 35kg/m2 is considered technically challenging. We conducted a retrospective matched-pair analysis to compare the oncological and functional outcomes of RARP in men with BMI ≥ 35kg/m2. We interrogated our prospectively maintained RARP database and identified 1273 men who underwent RARP from January 2018 till June 2021. Among them, 43 had BMI ≥ 35kg/m2, and 1230 had BMI < 35kg/m2. A 1:1 genetic matching was performed between these two groups for PSA, Gleason grades, clinical stage, D'Amico risk stratification, and nerve-spare extent. Continence rates and biochemical rates on 1-year follow-up were analysed. We performed statistical analysis using SPSS, and Paired tests were done using Wilcoxon sign rank-sum test. p < 0.05 was considered statistically significant. The two groups were comparable in almost all parameters except for age. Console time (p = 0.20) and estimated blood loss (p > 0.90) were not significantly different. There was no blood transfusion, open conversion or (Clavien-Dindo grade ≥ 3) intra/postoperative complication in either of the two groups. The two groups did not have any difference in biochemical recurrence rates (BCR) on 1-year follow-up (p > 0.90). Men with BMI ≥ 35 achieved continence rates equivalent to men with BMI < 35 within 1 year. On logistic regression analysis, age (p < 0.001) and extent of nerve sparing (p = 0.026) emerged as significant factors influencing continence recovery. RARP is safe in men with BMI ≥ 35kg/m2. The 1-year continence and oncological outcomes are similar to matched men with BMI < 35kg/m2 undergoing RARP.

Severity of Menstrual Pain Is Associated with Nutritional Intake and Lifestyle Habits.

Recently, the employment rate of women in Japan has steadily increased. Approximately 80% of women experience menstrual pain and premenstrual syndrome (PMS). These symptoms decrease a woman's quality of life and her work productivity, leading to an economic loss. This cross-sectional study of 321 healthy Japanese women aged 20-39 years aimed to clarify the lifestyle-related factors or nutrient intake that might cause menstrual pain. The participants underwent body composition measurements and completed meal survey sheets and lifestyle questionnaires, including menstrual status, exercise, sleep and breakfast consumption. Based on the questionnaire results, participants were divided into two groups according to the severity of menstrual pain, namely, heavy and light. Chi-square and Wilcoxon signed-rank sum tests were used to compare the severity of menstrual pain in the two groups. In the heavy group, the intake of animal proteins, including fish, vitamin D and vitamin B12, was significantly lower (p < 0.05), as was the frequency of breakfast consumption and bathing (p < 0.05). The rate of PMS symptoms was significantly higher in the heavy group (p < 0.05). This study suggests that a lack of animal protein, the accompanying vitamins and fatty acids, and the frequency of breakfast or bathing are associated with the severity of menstrual pain.

The Impact of a Job Crafting Intervention on Wellbeing in Health Care Leaders.

Job Crafting is a strategy undertaken by highly motivated individuals to modify their own work. Educating individuals about the benefits of this approach has recently been explored in other professions as a wellbeing intervention. We aimed to demonstrate that a Job Crafting intervention for health care leaders would result in improved wellbeing, lower burnout, and enhanced job resources. Fourteen health care leaders across 6 departments at one academic medical center participated in a two-part workshop on Job Crafting between January 1, 2019 and December 31, 2020. Participants completed electronic surveys before and 4-6weeks after the sessions. Pre- and post-intervention scores were compared using Wilcoxon signed rank sum tests. Eighty-six percent of participants stated the sessions were useful and applicable to their jobs, with 93% stating they were a valuable use of time and would recommend sessions to others. Participant Job Crafting behaviors increased following the intervention, with 46% increasing structural and social resources (P = .03) and 85% decreasing Hindrance Demands (P = .02). Increased meaning in work was identified by 38% post-intervention (P = .04). No statistically significant differences were identified in Distress Scores at high risk for burnout pre- and post-intervention (86% for both), but 30% of participants had an absolute improvement (decrease) in their Distress Score. A Job Crafting intervention was associated with high rates of satisfaction among participants and was successful in increasing Job Crafting behaviors and perceptions of meaningful work, but did not result in a change in risk for burnout in the short follow-up period.

Evaluation of dietary habits and cooking confidence using virtual teaching kitchens for perimenopausal women

BackgroundThe transition to menopause is a time when women are at increased risk for chronic and cardiovascular diseases, and weight gain. This study evaluates the efficacy of virtual teaching kitchen (TK) interventions on cooking confidence and consumption of a healthy diet in women over 45.MethodsThis teaching kitchen intervention is a synchronous online series of classes for perimenopausal women, with 45 min of live cooking and 15 min of nutrition discussion. From September 2020 through January 2022, participants completed online pre- post-intervention surveys addressing weight, eating habits, cooking confidence and self-efficacy. Analysis used paired samples t-test and Wilcoxon signed rank sum test for normally and non-normal distributed data respectively.ResultsOf the 609 unique participants, 269 women completed both pre and post surveys after attending classes. Participants self-reported a statistically significant decreased weight (p < 0.001), increased daily consumption of fruit/vegetables (p < 0.039), fish (p < 0.001) and beans (p < 0.005), and decreased daily consumption of red meat (p < 0.001), sugary beverages (p < 0.029) and white grains (p < 0.039). There was significant improvement in cooking self-efficacy and confidence.ConclusionsVirtual teaching kitchens were effective in improving culinary and dietary habits among peri- and post-menopausal women. This early evidence suggests that teaching kitchens can effectively reach larger populations for healthy behavioral modification.Trial RegistrationStudy obtained IRB exemption.

Emergency provider preference for powered intraosseous devices and satisfaction with features improving safety, reliability, and ease-of-use

ABSTRACT Background Powered intraosseous (IO) systems are valuable devices for emergent situations, with limited data on user preferences. A simulation/survey-based study was conducted among emergency medical service (EMS) providers to evaluate attitudes toward general powered IO system features to measure preferences/satisfaction for the most-commonly used and a novel powered IO system (with a passive safety needle, battery life indicator, and snap-securement/dressing). Research Design and Methods Forty-two EMS providers completed a simulated activity using both powered IO systems and a 30-item questionnaire, including multiple choice, free-text, ranking, and Likert-like questions. Ranking scores were reported using a scale of 0 (least important/satisfactory) to 100 (most important/satisfactory). Statistical significances were evaluated via Wilcoxon signed-rank sum test. Results Providers indicated driver performance (mean score ± SD; 77.8 ± 27.5) and IO needle safety mechanism (63.1 ± 27.9) as the most important features. Participants reported significantly higher (p < 0.001) satisfaction with the novel IO system overall, and its needle safety, battery life indicator, securement/dressing, and ease-of-use. Powered driver performance satisfaction was similar and favorable for the novel (88.1 ± 18.2) and traditional (87.1 ± 15.3) systems. Conclusions These findings highlight the value of clinician/user input and demonstrate EMS providers are more satisfied with a powered IO system featuring design elements intended to enhance safety and ease-of-use.

The Intersectoral Systemic Risk Shock of Emergency Crisis Events in China’s Financial Market: Nonparametric Methods and Panel Event Study Analyses

By employing two systemic risk methods, the marginal expected shortfall (MES) and the component expected shortfall (CES), this paper measures the systemic risk level of all sectors in China’s financial market from 2014 to 2022; thereby, it researches the total effect of sectoral systemic risk using a panel event study model during the three main emergency crisis events. Moreover, two nonparametric methods are utilized, the Wilcoxon signed rank sum test and the bootstrap Kolmogorov–Smirnov test, in order to investigate the changes in individual effects and the dominant ranks of sectoral systemic risk. The empirical results show that (1) the mean values and volatilities of CES and MES of all sectors have a higher level of magnitude in the extreme risk status than those in the normal risk status; (2) by comparing the total effects of three crisis events, we find that different from the continuous shock effect caused by two other events, sectoral systemic risk has a hysteresis effect on the entire market after the outbreak of COVID-19; (3) the long-term and short-term individual effects of sectoral systemic risk in all sectors are different from each other during three events; and (4) the dominance tests of MES are more sensitive and thus better demonstrate the changes in the rankings of sectoral systemic risk than the dominant tests of CES during the emergency crisis events.

A New Lagrangian Problem Crossover—A Systematic Review and Meta-Analysis of Crossover Standards

The performance of most evolutionary metaheuristic algorithms relies on various operators. The crossover operator is a standard based on population-based algorithms, which is divided into two types: application-dependent and application-independent crossover operators. In the process of optimization, these standards always help to select the best-fit point. The high efficiency of crossover operators allows engineers to minimize errors in engineering application optimization while saving time and avoiding overpricing. There are two crucial objectives behind this paper; first, we provide an overview of the crossover standards classification that has been used by researchers for solving engineering operations and problem representation. This paper proposes a novel standard crossover based on the Lagrangian Dual Function (LDF) to enhance the formulation of the Lagrangian Problem Crossover (LPX). The LPX for 100 generations of different pairs parent chromosomes is compared to Simulated Binary Crossover (SBX) standards and Blended Crossover (BX) for real-coded crossovers. Three unimodal test functions with various random values show that LPX has better performance in most cases and comparative results in other cases. Moreover, the LPB algorithm is used to compare LPX with SBX, BX, and Qubit Crossover (Qubit-X) operators to demonstrate accuracy and performance during exploitation evaluations. Finally, the proposed crossover stand operator results are demonstrated, proved, and analyzed statistically by the Wilcoxon signed-rank sum test.

Comparison of Deep-Learning Image Reconstruction With Hybrid Iterative Reconstruction for Evaluating Lung Nodules With High-Resolution Computed Tomography.

This study aimed to investigate the impact of deep-learning reconstruction (DLR) on the detailed evaluation of solitary lung nodule using high-resolution computed tomography (HRCT) compared with hybrid iterative reconstruction (hybrid IR). This retrospective study was approved by our institutional review board and included 68 consecutive patients (mean ± SD age, 70.1 ± 12.0 years; 37 men and 31 women) who underwent computed tomography between November 2021 and February 2022. High-resolution computed tomography images with a targeted field of view of the unilateral lung were reconstructed using filtered back projection, hybrid IR, and DLR, which is commercially available. Objective image noise was measured by placing the regions of interest on the skeletal muscle and recording the SD of the computed tomography attenuation. Subjective image analyses were performed by 2 blinded radiologists taking into consideration the subjective noise, artifacts, depictions of small structures and nodule rims, and the overall image quality. In subjective analyses, filtered back projection images were used as controls. Data were compared between DLR and hybrid IR using the paired t test and Wilcoxon signed-rank sum test. Objective image noise in DLR (32.7 ± 4.2) was significantly reduced compared with hybrid IR (35.3 ± 4.4) (P < 0.0001). According to both readers, significant improvements in subjective image noise, artifacts, depictions of small structures and nodule rims, and overall image quality were observed in images derived from DLR compared with those from hybrid IR (P < 0.0001 for all). Deep-learning reconstruction provides a better high-resolution computed tomography image with improved quality compared with hybrid IR.

Effectiveness of a cervical cancer prevention program to improve health literacy among Japanese undergraduate females in their 20s: A quasi-experimental study

To improve health literacy (HL) regarding cervical cancer prevention, a health program for females in their 20s was previously developed. The present study aimed to examine the effectiveness of that program. We conducted a quasi-experimental study (with control groups) on female undergraduate students in a private university in Japan. In total, 15 and 60 students were categorized into the experimental and control groups, respectively. Intergroup pair-matching using the identified variables yielded a final assessment population of 28 students (n = 14 in each group). The data analysis consisted of group comparisons of the participants between baseline and final assessment using the Wilcoxon signed-rank sum test and McNemar's test. Experimental group comparisons revealed a significant difference in median HL scale scores (baseline, 57.0; final assessment, 66.0; p =.002), median women's health knowledge test scores (baseline, 14.5; final assessment, 16.0; p =.029), and the percentage of participants who felt confident explaining their own body to a medical practitioner (baseline, Y = 14.3, N = 0.0; final assessment, Y = 100.0, N = 0.0; p<.001); however, no significant difference was found for cervical cancer screening behavior. No changes were seen in any of the variables between baseline and final assessment in the control group. These results indicated that our program was effective for improving HL, confidence in explaining one's own body to a medical practitioner, and women's health knowledge test scores, but not for changing cervical cancer screening behaviors. Further research is needed to determine how to provide more appropriate health programs for females in their 20s.

A Hybrid STA Based on Nelder–Mead Simplex Search and Quadratic Interpolation

State transition algorithm (STA) is a metaheuristic method for global optimization. However, due to the insufficient utilization of historical information, it still suffers from slow convergence speed and low solution accuracy on specific problems in the later stages. This paper proposes a hybrid STA based on Nelder–Mead (NM) simplex search and quadratic interpolation (QI). In the exploration stage, NM simplex search utilizes the historical information of STA to generate promising solutions. In the exploitation stage, QI utilizes the historical information to enhance the local search capacity. The proposed method uses an eagle strategy to maximize the efficiency and stability. The proposed method successfully combines the merits of the three distinct approaches: the powerful exploration capacity of STA, the fast convergence speed of NM simplex search and the strong exploitation capacity of QI. The hybrid STA is evaluated using 15 benchmark functions with dimensions of 20, 30, 50 and 100. Moreover, the results are statistically analyzed using the Wilcoxon signed-rank sum test. In addition, the applicability of the hybrid STA to solve real-world problems is assessed using the wireless sensor network localization problem. Compared with six state-of-the-art metaheuristic methods, the experimental results demonstrate the superiority and effectiveness of the proposed method.

The Carbon Footprint and Cost of Virtual Residency Interviews.

The shift from in-person to virtual residency interviews may impact greenhouse gas emissions (GHGE) and costs but the direction and amount of this change is not yet clear. To estimate GHGE and financial impacts of virtual interviews among applicants and programs. In 2020-2021 we sent a postinterview survey to 1429 applicants from 7 residency programs and 1 clinical psychology program at 1 institution. The survey collected origin of travel and transit type if in-person interviews had been held and excluded responses if the applicant would not have participated in an in-person interview, or if travel type or original city was missing. We used the International Civil Aviation Organization calculator to estimate flight-related GHGE in metric tons of carbon dioxide equivalent (MTCO2e) and Google Maps to estimate ground travel, with a standard CO2e per mile. Flight, hotel, and airport taxi costs were estimated using Expedia.com, Hotels.com, Uber, and Lyft. We aggregated these data and calculated median and interquartile ranges (IQRs) for applicant GHGE and cost savings, and assumed no cost or GHGE from virtual interviews. We used Wilcoxon signed rank sum tests to compare in-person 2019-2020 and virtual 2020-2021 GME program interview budgets. The survey response rate was 565, or 40% of applicants; 543 remained after the exclusion criteria were applied. Reduction in applicant travel due to virtual interviews led to median estimated GHGE savings of 0.47 (IQR 0.30-0.61) MTCO2e and $490 (IQR $392-$544) per applicant, per interview. Programs savings ranged from $7,615 to $33,670 for the interview season. Virtual interviews in 8 GME programs were associated with lower estimated GHGE and costs, for applicants and programs, compared with in-person interviews.

Modified minimally invasive surgery in reconstructing the temporomandibular joint disk by transplantation of the temporalis myofascial flap

ObjectiveThe transplantation of temporalis myofascial flap (TMF) is an indispensable method to treat severe temporomandibular joint disorders with disk failure. How to select the indication and the ways of transplantation is still a challenging topic for achieving the ideal effect. We reported the new methods and follow-up results of the patients treated with pedicled TMF transplantation.MethodsRetrospective case series was performed at Temporomandibular Joint Specialist Clinic, the First Affiliated Hospital of Xinjiang Medical University, from December 2014 to August 2022. 39 patients (50 sides) included anterior disk displacement without reduction and disk perforation who underwent discectomy and immediate reconstruction with pedicled TMF. The initial and postoperative maximum mouth opening (MMO), and pain visual analogue scale (VAS) were compared via paired t-test and Wilcoxon signed-rank sum test, respectively.ResultsThe average of follow-up time was 30.07 months. The reconstructed temporomandibular joints basically achieved stable occlusion, good function, and satisfactory effect. The patients displayed a remarkable reduction of VAS score of pain, and improvement of the MMO compared with that before operation (P < 0.001). MR scanning revealed the grafts in joint space showed band-shaped soft tissue density of medium signal and had the clear edges, without interruption and fragment.ConclusionReconstruction of the temporomandibular joint disk by transplantation of the TMF applying modified minimally invasive surgery was a feasible method, which could improve the function of joints and prevent adhesion, without obvious complications in donor region.