Wilcoxon Sign Rank Research Articles

Direct Instruction Model On Writing Skills In English Subjects

This research is motivated by English language learning which is still not optimal. The low interest of students in learning to write Indonesian causes students with special needs to express their ideas in written form. And this is supported by the results of the Mid-Semester Assessment (MSA) which are still unsatisfactory for many students. So researchers conducted research using the Direct Instruction model. The aim of the research was to determine the effect of the Direct Teaching model on the English theme writing skills of fifth grade students at SD N 14 Koto Baru. This type of research was carried out using quantitative research methods, design in the form of Pre-Experimental Designs type One-Group Pretest-Posttest Design. The research was conducted at SD N 14 Koto Baru. This research was carried out in the even semester (II) of the 2020/2021 academic year, the research sample was 35 class V students. Based on the results of the Wilcoxon sign rank test, a significance value of 0.000<0.05 was obtained. It can be concluded that there is an influence of the Direct Teaching model on the English theme writing skills of fifth grade students at SD N 14 Koto Baru. Based on research, the Direct instruction model has a good influence on writing skills in English subjects.

The effect of mindfulness-based art therapy on psychological symptoms and happiness levels in patients with migraine: a pilot study

AbstractThe aim of this study was to examine the impact of the Mindfulness-Based Art Therapy Program on the depression, anxiety and stress symptoms, and happiness of participants. This study is a quasi-experimental research with a pretest-posttest design. The independent variable of the study was the Mindfulness-Based Art Therapy Program, which was applied to the study group between the pretest and posttest. The dependent variables of the study were the depression, anxiety, and stress symptoms and happiness of the individuals included in the study group. The study group consisted of a total of 10 participants (8 females and 2 males) between the ages of 24 and 46, who met the inclusion criteria. The Depression-Anxiety-Stress Scale (DASS-21) and the Oxford Happiness Scale Short Form (OHS-SF) were applied to the participants both at the beginning of the study and at the end of 8 weeks. A total of 8 sessions of the Mindfulness-Based Art Therapy Program were applied to the study group. Each session lasted 180 min. The Wilcoxon Signed-Rank Test was used to analyze the data obtained to evaluate the effectiveness of the program. The analyses showed that the Mindfulness-Based Art Therapy Program was effective in reducing the depression and stress symptoms of the participants and increasing their happiness but was not effective in reducing their anxiety symptoms. In conclusion, although positive clinical findings were observed in this pilot study, more studies are needed to confirm these findings about the Mindfulness-Based Art Therapy Program as an alternative treatment method for patients with migraine.

Comparative Performance Analysis of Deep Learning, Classical, and Hybrid Time Series Models in Ecological Footprint Forecasting

In a globalized world, factors such as increasing population, rising production rates, changing consumption habits, and continuous economic growth contribute significantly to climate change. Therefore, successfully forecasting the Ecological Footprint (EF) effectively indicates global sustainable development. Despite the significant role of the EF as one of the indicators of sustainable development, there is a gap in the literature regarding time series methods and forward-looking predictions. To address this gap, Ecological Footprint (EF) forecasting was performed using deep learning methods such as LSTMs, classical time series methods like ARIMA and Holt–Winters, and the developed hybrid ARIMA-SVR model. In the scope of the study, first, a spreadsheet was created using the total Ecological Footprint (EF) worldwide between 1961 and 2022, obtained from the Global Footprint Network database. Second, the forecasting performances of the ARIMA, Holt–Winters, LSTM, and the hybrid ARIMA-SVR models were compared using MAPE and RMSE metrics. Finally, the forecasting performances of the time series models were statistically validated through Wilcoxon Signed-Rank and Friedman tests. The study findings indicate that the proposed ARIMA (1,1,0) model demonstrated better performance with an average MAPE of 2.12%, compared to Holt–Winters (MAPE of 2.27%), LSTM (MAPE of 3.19%), and ARIMA-SVR (MAPE of 2.68%) methods in the test dataset. Additionally, it was observed that the ARIMA model forecasted the EF, which experienced a sudden decrease due to the COVID-19 lockdown, with a lower error compared to other models. These findings highlight the adaptability of the ARIMA model to variable and uncertain conditions.

Using high-resolution imaging to study the impact of the Kalogon wheelchair cushion on blood flow in the gluteal area

This study investigated how the air-bladder offloading mode of the Orbiter by Kalogon wheelchair cushion (Orbiter) affected blood flow in the gluteal region of non-disabled subjects. The hypothesis was that the cushion's offloading mode would improve blood flow, resulting in reduced reactive hyperemia when compared to the static setting, or Loaded Control (LC). Furthermore, the study proposed a technique using a high-resolution image laser speckle contrast system to measure blood flow in the gluteal area. Two procedures were carried out, one with the participant sitting on a cushion in LC, and the second, the cushion was set to offloading mode. Blood flow was measured through data imaging after each procedure. Three trials were performed, starting and ending in different cushion bladders. Customized algorithms were used to select regions of interest on the images for calculations. The Wilcoxon Signed-Rank Test was conducted to compare the offloads and loaded control values of each region of interest. Results were considered significant at α=0.05. Ten healthy, non-disabled adults participated in the study, seven females and three males. There were no significant differences among the participants. However, results showed that seven subjects tended to decrease reactive hyperemia in the offload sequence of trial when the last two bladders offloaded were the sacrum followed by the right ischial tuberosity. The high-resolution imager showed that the Orbiter Offloads helped reduce reactive hyperemia in seven subjects, potentially improving blood flow. More research is necessary to comprehend the mechanisms of these effects fully.

Literasi Digital dan Sosial Emosional untuk Meningkatkan Pengetahuan Pelajar SMA Mengenai Radikalisme Beragama

This community service program aims to enhance digital and emotional social literacy of high school students to prevent them from being easily exposed to religious radicalism. The method of the community service program takes shape via interactive socialization about cognitive and social-emotional digital literacies as an antidote to extremist ideology involving 64 students at SMA Brawijaya Smart School, Malang City. The service evaluation instrument consists of a pre-test and post-test, which are then analyzed inferentially using the Wilcoxon Signed-Rank Test. The results of the socialization showed that the levels of participants’ understanding of radicalism in general, religious radicalism in particular, and cognitive and social-emotional digital literacies were significantly higher at the post-test stage compared to the pre-test stage. The final findings showed that participants positively evaluated the goal, implementation, and outcome from the socialization. Moreover, participants rated that socialization could meet their needs to know more about radicalism in general, religious radicalism in particular, and the cognitive and social-emotional digital literacies to tackle religious extremist ideology.

(112) Efficacy and Safety of Platelet-Rich Plasma Injections for Peyronie’s Disease: A Randomized Double-Blind Placebo-Controlled Cross-Over Study

Abstract Introduction Peyronie's Disease (PD) is currently treated with intralesional collagenase injection, the only FDA-approved medical therapy. Platelet-derived therapies, such as autologous platelet rich plasma (PRP), have shown potential in tissue regeneration. We are investigating the safety and efficacy of PRP in PD with an ongoing randomized, placebo-controlled, crossover study. Objective The objective of this study is to assess the safety and efficacy of autologous platelet-rich plasma (PRP) treatment in Peyronie's Disease (PD) through a randomized, placebo-controlled, crossover trial. Methods We analyzed data from an ongoing trial conducted between April 2021 and June 2023. Men with PD (write degrees/dorsal only etc) were randomly assigned to receive two 0.5 ml injections of PRP obtained using an autologous platelet separator (Arthrex Angel, Arthrex Inc.) or placebo directly into the dominant plaque, with a two-week interval between injections. Immediate post-procedure assessments included Visual Analogue Pain Scale, and follow-up evaluations focused on identifying complications. After three months, participants crossed over to the other treatment arm for two additional injections. Goniometer measurement assessments were performed prior to each crossover (NCT04512287). Related Samples Wilcoxon-Signed Rank test was used for dependent repeated groups, the serial measurements of degree of curvature at different time points for each patient within a specific group. Findings at p< 0.05 were considered statistically significant. Results The analysis includes data from 29 men who completed all injections and the 6-month follow-up. No minor or major adverse events, such as penile bruising, swelling, edema, allergy, or penile fracture, were reported. Regarding efficacy, we observed a significant reduction in curvature after six months compared to baseline. The pretreatment median curvature was 40.0 (IQR: 15), the median post-treatment curvature 30.0 (IQR: 30) (p=0.014). Furthermore, we did not observe worsening of curvature in subsequent evaluations. Conclusions Our findings from our ongoing clinical trial suggest that PRP treatment for Peyronie's Disease is safe, with minimal adverse events reported. The preliminary efficacy data indicates a significant reduction in curvature after 2 injections each of placebo and PRP treatment compared to baseline. Nevertheless, study completion is necessary prior to reporting true efficacy data comparing PRP vs placebo. Disclosure No.

The impact of a statewide insulin copay cap policy for insured patients with diabetes in Utah.

Insulin affordability is a huge concern for patients with diabetes in the United States. On March 30, 2020, Utah signed House Bill 207 into law, aimed at capping copayments for insulin at $30 for a 30-day supply. The bill was enacted on January 1, 2021. To assess patient basal insulin adherence, out-of-pocket costs, health plan costs, total costs on insulin, and hemoglobin A1c (A1c) in prepolicy vs postpolicy periods. This study is a retrospective analysis using data from a regional health plan in Utah from October 1, 2019, to September 30, 2021. Inclusion criteria were fully enrolled members of all ages, under commercial insurance, with at least 1 fill for any type of insulin in both the preperiod and the postperiod. Adherence was measured by proportion of days covered (PDC). Paired t-tests and Wilcoxon sign rank tests were conducted to compare the health and economic outcomes. Out of 24,150 commercially insured individuals, a total of 244 patients were included. Across all 244 patients, there was a significant decline in monthly median out-of-pocket costs of insulin by 58.5% (P < 0.001), whereas the monthly median health plan costs of insulin increased by 22.0% (P < 0.001). The total monthly costs of insulin (the sum of out-of-pocket and health plan costs) were unchanged (P = 0.115). Only 74 patients with enough basal insulin fills in both periods were included in the analysis for PDC changes. PDC change was not statistically significant (P = 0.43). Among the 74 patients with PDC calculations, 29 patients had A1c recorded in both periods. The change in A1c was not statistically significant (P = 0.23). An insulin copayment max of $30 in Utah demonstrated lower patient out-of-pocket costs, subsidized by the health plan. PDC did not change, and HbA1c did not improve. An assessment of a longer period and on a larger population is needed.

Impact of Virtual Navigation on the Education and Access of Patients with Cancer: A National Mixed Methods Investigation.

Despite growing evidence of efficacy, oncology patient navigation is not ubiquitously offered. Navigation may reduce barriers to cancer care, yet geographic location may limit patient access. To overcome geographical barriers and increase patient education in oncology, our medical center developed a virtual navigation program. To examine the efficacy of the Virtual Navigation Program designed to increase patient access and education across local and national contexts. In this mixed-methods study, a total of 105 individuals completed an online survey administered nationally to oncology patients who used the navigation program. Clinical and demographic data were collected. Nonparametric tests were used for group comparisons (Wilcoxon Signed-Ranks test). Virtual navigation increased access as the majority of patients utilized the Virtual Navigation Program beyond the local area; 42% of patients were local; 58% were patients located across the US. 55 (52%) were female; 25% were non-White. Pancreatic cancer was the largest tumor type: 51 (49%). Patients agreed the virtual cancer education helped them make critical health choices (mean 4.89 SD = 84); understand their diagnosis (mean 4.44 SD = .77); were able to make informed decisions (mean 4.43 SD = .83), and empowered to manage their cancer care (mean 4.58 SD = .82). Post navigation, the user experience survey revealed significant increases in a subset of patients' cancer knowledge (P < 0.001), access to quality cancer education (P = 0.045), decision-making in cancer care (P < 0.05), and coordinated cancer care (P = 0.03). This study explores a unique role that virtual navigation may play in helping accommodate healthcare for many cancer patients in underserved areas. The use of innovative aspects of research and education in virtual navigation may be successful in promoting patient empowerment in the cancer continuum. Internet-strategies are needed to inform sustainable patient navigation in low-resource contexts.

Retrospective study assessing the use of angiotensin converting enzyme inhibitors or angiotensin receptor blockers to reduce toxicity from tyrosine kinase inhibitors in metastatic renal cell carcinoma.

411 Background: The main toxicities associated with tyrosine-kinase inhibitors (TKIs) in the treatment of renal cell carcinoma (RCC) are proteinuria and hypertension. Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have established reno-protective and anti-hypertensive effects and can help with toxicity in mRCC. We hypothesize that use of ACEIs/ARBs is an effective method to decrease the degree of proteinuria and hypertension in patients treated with TKIs for metastatic/advanced renal cell carcinoma (mRCC). Methods: Single Institution retrospective study; mRCC patients (pts) who received TKI and ACEIs/ARBs and had urine protein measurements available at baseline and at 4-6 wk follow up post ACEs/ARBs were included in the analysis. Primary endpoints included improvement in grade of proteinuria and BP in mRCC pts on TKI treatment at baseline and with addition of ACEIs/ARBs. Secondary endpoints included number of dose interruptions (DI), BUN and creatinine changes. Paired statistical tests were used to compare the selected outcome variables between baseline and post ACE/ARB measures: for example, nonparametric Wilcoxon Signed-rank test for paired quantitative data and McNemar test for paired binary data. Results: Out of 71 screened patients between 2020-2023, N of 22 mRCC (N=22, 72.7% male, 77.3% white; 9% Hispanic; N=14 for TKI+ immunotherapy; N=8 TKI alone) pts were selected. ACEIs/ARBs treatment was associated with significantly reduced levels of proteinuria at 4–6wk follow-up. At baseline vs. follow-up, pts were found to have significantly lower proteinuria overall after ACEI/ARBs (p=0.0147), and 45.4% of pts had clinically insignificant proteinuria vs. 22.7% at baseline. Additionally, DI rates for TKI were significantly lower for pts placed on ACEIs/ARBs, with an 81% chance that pts with prior DI would not experience similar event in the follow-up period (p=0.003). Reductions in BP, creatinine, and TKI dosing were seen but not statistically significant (p&gt;0.05 for all measures). Conclusions: In our small study, degree of proteinuria was notably reduced with administration of ACEIs/ARBs. Further findings show fewer DI of TKIs with ACEIs/ARBs use. Our findings suggest a potential role for ACEIs/ARBs in managing toxicity in patients undergoing TKI based therapy for mRCC. Future studies are needed to evaluate the use of ACE/ARB from the time of initiation of TKI based therapy to reduce the toxicities and improve the adherence to mRCC treatment which may result in better outcomes.

The impact of COVID-19 on aflibercept treatment of neovascular AMD in Sweden – data from the Swedish Macula Register

BackgroundThe purpose of the study was to compare the real-world aflibercept treatment and visual outcomes, and to examine the adherence to pandemic guidelines in two groups of patients with treatment-naïve neovascular age-related macular degeneration (nAMD) before and during the first year of the COVID-19 pandemic in Sweden up to the 1-year follow-up.MethodsThis is a retrospective observational study including 2915 treatment naïve eyes with nAMD. Using data from the Swedish Macula Register (SMR), 1597 eyes initiating treatment between 1 July 2018 and 31 January 2019 (pre-pandemic group) were compared with 1318 eyes starting treatment between 1 February and 31 August 2020 (pandemic group). The eyes were then followed for 1 year ± 2 months, hence the first group was unaffected by the pandemic while the second group was affected. The focus was on baseline characteristics, visual acuity (VA) change from baseline, number of injections, treatment regimen, number of appointments and the frequency and length of appointment delays. The Wilcoxon Signed-Rank Test was used to compare baseline VA to follow-up VA within the respective groups. The Mann-Whitney U-test and Fisher’s exact test were used to compare outcomes between the groups.ResultsBaseline characteristics were similar between the two groups. The percentage of eyes with an available follow-up VA after 1 year was 58% in the pre-pandemic group vs. 44% in the pandemic group. VA in the pre-pandemic group had increased significantly after 1 year, from 62.2 ± 14.1 letters to 64.8 ± 16.1 letters (n = 921); p < 0.0001. In the pandemic group, VA increased from 61.1 ± 15.8 to 64.9 ± 16.9 (n = 575); p < 0.0001. There was no significant difference in mean VA change between the groups; p = 0.1734. The pre-pandemic group had significantly more delays than the pandemic group, 45% vs. 36%; p < 0.0001.ConclusionsThe pre-pandemic and pandemic groups had similar VA gains at 1-year follow-up, but with a reduced number of available VA in the pandemic group. Clinics were able to implement and prioritize injection visits excluding VA measurements, helping to reduce delays and maintain VA gains during the COVID-19 pandemic.

THE DIFFERENCES IN STRESS SCORES AFTER BEING GIVEN MUROTTAL THERAPY QS AL-ANBIYA 83 – 112 IN HYPERTENSION SUFFERERS

&#x0D; &#x0D; &#x0D; &#x0D; The increasing incidence of hypertension with various accompanying complications is caused by several factors, including excessive sympathetic nerve activity, obesity, food, unhealthy lifestyles, hereditary factors, and stress. The many impacts caused by stress that are not handled immediately require someone to be able to carry out stress management. Non-pharmacological therapy through stress management in cases of hypertension has been widely developed and applied, such as providing yoga relaxation therapy, massage therapy, meditation, and murottal therapy. Murottal therapy has a relaxing effect and improves body cells and creates a sense of comfort in the soul, thereby reducing stress. The purpose of this study was to determine the The effect of murottal QS Al-Anbiya 83–112 on stress levels in hypertension sufferers. The study used a pre-experimental design with a One-group pre-post test design which was carried out on 4th-10 th 2023. The population of this research is 30 of patient with hypertention was spreading at Nglaban Hamlet, Nglaban Village, Loceret District, Nganjuk Regency. A sample of 22 respondents with purposive sampling technique. Measurement of stress levels before and after being given murottal QS Al-Anbiya 83–112 with Depression Anxiety Stress Scales (DASS 42). Provision of Murottal QS Al-Anbiya 83–112 for 9 minutes once a day for seven days. Data analysis used the Wilcoxon sign rank statistical test. The results of the Wilcoxon sign rank statistical test showed P value = 0.000 &lt;α = 0.05 so that there was an effect of murottal QS Al-Anbiya 83–112 on stress levels in hypertension sufferers. Murottal QS Al-Anbiya 83–112 can be applied as an alternative solution in overcoming the stress levels of hypertension sufferers.&#x0D; &#x0D; &#x0D; &#x0D;

Dynamic joint stiffness in individuals with femoroacetabular impingement syndrome pre- and post-hip arthroscopy

BackgroundPatients with hip-related pain often fail to return to their desired level of activity following hip arthroscopy. Lasting biomechanics alterations may be one potential explanation. Dynamic joint stiffness assesses the mechanistic controls of the lower limb during high impact movements, and thus, may provide valuable clinical targets to improving movement and optimizing return to activity after surgery. MethodsTwenty-five participants (13 females) with hip-related pain underwent 3D motion capture during a drop jump task before surgery and six months post-operatively. Nineteen healthy controls (9 females) were collected for comparison. Sagittal plane dynamic joint stiffness was calculated during the initial landing phase. Baseline and 6-month dynamic joint stiffness data were compared 1) between males and females with hip-related pain and 2) between individuals with hip-related pain and controls using Wilcoxon Signed-Rank and Mann Whitney U tests. Sexes were analyzed separately. FindingsFrom baseline to 6 months post-operatively, females with hip-related pain demonstrated decreased dynamic ankle stiffness (2.26 Nm/deg. [0.61] to 1.84 Nm/deg. [0.43]) (p = .005) and males with hip-related pain demonstrated increased dynamic hip stiffness (2.73 [0.90] to 3.88 [1.73]) (p = .013). There were no differences in dynamic stiffness at any joint between individuals with hip-related pain at either timepoint when compared to controls (p ≥ .099). InterpretationFemales and males with hip-related pain may demonstrate unique changes in dynamic joint stiffness after surgery, indicating return to activity may follow different trajectories for each sex. Additional work should examine the relationship between hip joint stiffness and treatment outcomes and identify additional movement-related rehabilitation targets.

Pengaruh Terapi Relaksasi Otot Progresif Terhadap Insomnia Pada Lansia Posbindu Desa Patikraja

Insomnia is one of the main disorders in initiating and maintaining sleep among the elderly. Insomnia is defined as a complaint about a lack of quality sleep caused by one of the reasons why it is difficult to get into sleep, frequent awakenings at night and then difficulty getting back to sleep, waking up too early, and not sleeping well. The poor quality of sleep in the elderly is caused by increased sleep latency, reduced sleep efficiency and early awakening due to the aging process. The purpose of this study was to determine the effect of progressive muscle relaxation therapy on insomnia in the elderly in posbindu, patikraja village. This type of research is one group pretest-posttest with pre-experimental. The sample size used in this study was 19 respondents. The sampling technique used is purposive sampling. Methods of data collection using a questionnaire. The statistical test used in this study was the Wilcoxon Sign Rank Test with 0.05. The results of this study note that there are differences before and after being given progressive muscle relaxation therapy. The results of the analysis of the Wilcoxon Sign Rank Test obtained a p value of 0.000 &lt;0.05, meaning that there is an effect of progressive muscle relaxation therapy on changes in insomnia in the elderly in Posbindu, Patikraja Village.

ROLE OF AYURVEDIC INTERVENTIONS IN TREATING ARTAVAKSHAYA W.S.R.TO OLIGOMENNORRHEA -A CASE REPORT

In this universe, only females have been vested with the power of creation next to the Almighty God. This is why Women are considered reflections of God in this world. Many physiological changes are seen in each stage of life, especially in the reproductive stage. Changes in physical and mental well-being profoundly affect the menstrual cycle. Artavakshaya is more common due to irregular food habits, lifestyle, stress and strain. Ar-tavakshaya occurs due to the involvement of Vata and Kapha, which can be attributed to Marga Avrodha of the Artavavaha Stratos. Using Agneya Dravyas relieves the Kapha, which does Avarana to apanavata and increases the quantity of Artava. Hence, Venu Shatapushpa Kashaya Krushnatila Kashaya, Agneya, Pitta Vardhaka, and Vata Kapha Shamaka were selected for the present study. In the present study,40 female patients aged between 15 and 35 fulfilling the criteria of Artavakshaya were selected and divided into two groups: Group A and Group B, with 20 patients each. Group A was given Venushatpushpa Kashaya 1/2pala BD before food, And Group B was given Krushnatila Kashaya 1/2pala BD before food. The study was carried out for three menstrual cycles. The signs and symptoms were observed before treatment, after treatment, follow up1, follow-up two and then these were compared. Result: Applying the Friedman and Wilcoxon sign rank tests within the group was statistically significant. The Mann Whitney U test was used between the groups, and the results showed statistical significance. Hence, we con-clude that we reject null hypothesis H0 and accept the alternate hypothesis H2. i.e., H2-Venushatapushpa Kashaya does not significantly affect Artavakshaya compared to Artavakshaya Krushnatila Kashaya.

ANALISIS PERBEDAAN RASIO KEUANGAN PADA PERUSAHAAN MANUFAKTUR SEBELUM DAN SELAMA PENDEMI COVID-19

This study aims to obtain empirical evidence on whether there are significant differences in the liquidity ratio (current ratio), leverage ratio (debt to equity ratio), profitability ratio (return on assets), and market ratio (price to earnings ratio) before and during COVID-19 pandemic. The data analysis used to perform the different tests in this study was the Wilcoxon Signed-Rank Test. The final sample used in this study was 94 publicly traded manufacturing companies for the 2019-2020 period bypurposive sampling. The result of the analyzed data shows significant differences in probability ratio (return on assets) and market ratio (price to earnings ratio) before and during the COVID-19 pandemic. On the contrary, the results of this study indicate that there are no significant differences in the liquidity ratio (current ratio) and leverage ratio (debt to equity ratio) before and during the COVID-19 pandemic.

A COMPARATIVE CLINICAL STUDY TO EVALUATE THE EFFICACY OF JEERAKADI LEPA AND MUKHAKANTIKARA LEPA IN THE MANAGEMENT OF VYANGA(MELASMA)

Vyanga is one of the important diseases pertaining to hyper Pigmentation disorders. It is considered Kshudraro-gas, which occurs mainly due to vitiation of Vata, Pitta and Rakta. Vyanga presence of Neeruja, Tanu, Shyavav-arnayukta mandala on Mukhapradesha. Melasma is a hyperpigmented macular lesion that develops slowly and symmetrically over the malar area, bridge of the nose, forehead and upper lips, more commonly seen in females than males. Hyperpigmentation is due to increased melanocytes activity in epidermal and dermal layers. Brhajaka pitta is mainly related to Varna of twacha. So, Pitta is the main culprit to cause Vyanga. Here, all Jeerakadi Lepa's and Mukhakantikara Lepa's ingredients are Pittashamaka, Varnyakara, Raktaprasadaka, Twakprasadaka, Kandughna, Kusthaghna. Methods: A Randomized comparative clinical trial is adopted. In Group A were given Jeerakadi lepa with milk for 30 days application (once in a day).In Group B were given Mukhakantikara lepa with water for 30 days application (once in a day) .Total duration of study was carried out for 45 days. Results: By applying the Friedman test and Wilcoxon sign rank test for within the group it was sta-tistically significant. The Mann Whitney U test is applied between the groups the results showed statistically not significant. Hence, we conclude that we reject null hypothesis H0 and accept the alternate hypothesis H2. i.e H2 : Jeerakadi lepa is more effective than Mukhakantikara lepa in the management of Vyanga.

THE EFFECTIVENESS OF HEALTH EDUCATION PEER EDUCATION METHOD USING AUDIO VISUAL MEDIA ON TEENAGERS' UNDERSTANDING OF SEX EDUCATION CLASS 11 SMAN 1 Boyolangu Tulungagung

Free sex is one of the problems of lack of sex education and some of the problems that can result from casual sex in adolescents in the short term include KTD (unwanted pregnancy), abortion, and STDs (Sexually transmitted diseases). This study was conducted from February 20 until March 20, 2023, and aims to see the Effectiveness of Health Education Peer Education Method with Audio Visual Media on Adolescent Understanding of ''Sex Education'' Grade 11 SMAN 1 Boyolangu Tulungagung in 2023. The research design used in this study quasy experimental with Non-equivalent Control Group Design (Pretest Posttest) The population in this study was all grade XI students of SMAN 1 Boyolangu. While the number of research samples was 82 respondents selected using the Purposive Sampling method. Data processing in the form of editing, coding, tabulating, cleaning, and then analyzing data using non-parametric Wilcoxon sign rank test &amp; Mann – Whitney. From the Wilcoxon Test, both methods show that a significant value p = 0.000 &lt; a (0.05), so H1 is accepted meaning that there is an Effect of Health Counseling. From the results of the Mann - Whitney Test, the Mean Rank of the Peer Education method was obtained with a value of 35.43. And the Mean Rank of the audio-visual method with a value of 47.57. It is known that the Mean Rank of the Audio Visual Method is higher than the Peer Education method. The Mann-Whitney test shows a significance value of p= 0.019. So that H1 is accepted, which means that there is an Effectiveness of Health Counseling with Peer Education and Audio Visual Methods. It can be concluded that the audio-visual method is more effective as a means of health counseling on the understanding of sex education in grade 11 adolescents at SMAN 1 Boyolangu Tulungagung in 2023. For this reason, the audio-visual method is recommended for health counseling to increase adolescent understanding of Sex Education. Keywords: Free Sex; Health Education; Tee

Effects of noise intensity on concentration levels of chainsaw operators and harvesting workers in industrial forest plantation, North Sumatera, Indonesia

Background Noise has the potential to affect the comfort and health of workers. The objective of this research was to determines the effects of noise on the concentration levels of both chainsaw operators and harvesting workers in industrial forest plantation, North Sumatra, Indonesia. Methods This experimental study included 20 respondents which consisted of 10 chainsaw operators/helpers and 10 harvesting workers. All respondents were exposed to the sound of a chainsaw in three different conditions (idle, half gas and racing conditions) with and without personal protective equipment (PPEs: earmuffs, ear plugs and without PPE). The sound intensity produced by the chainsaw and the noise received by the respondents were measured using a sound level meter. Respondents’ perception toward noise was recorded using a Likert scale. Respondents’ concentration level was assessed by giving 25 math-questions to be answered within 10 minutes. Wilcoxon sign rank test was used to analysed paired data. Results The average sound intensity received by respondents’ left and right ears were lower than the average sound intensity produced by the chainsaw. The use of earmuffs leads to better perception towards noise when compared with the use of earplugs and the absence of any PPE. Based on Wilcoxon test, the noise did not have significant impact on the concentration level of chainsaw operators, whilst the contrary result is true for harvesting workers. Conclusions The research indicated that although the noise produced by the chainsaw was considered noisy for both chainsaw operators and harvesting workers, it did not have a significant effect on the concentration level of chainsaw operators and only affected the harvesting workers. Therefore, given that the harvesting workers were still affected by the noise, noise control measures are still needed to ensure occupational safety and health for the workers.

The effects of sustained, low- and high-intensity isometric tasks on performance fatigability and the perceived responses that contributed to task termination.

The present study examined the effects of sustained, isometric low- versus high-intensity tasks on time to task failure (TTF), performance fatigability (PF), ratings of perceived exertion (RPE), and the perceived causes of task termination from a post-test questionnaire (PTQ). Ten men (mean ± SD: age = 21.1 ± 2.3 years; height = 180.2 ± 5.7 cm; body mass = 79.5 ± 8.8 kg) performed maximal voluntary isometric contractions (MVICs) before and after fatiguing, isometric forearm flexion tasks anchored to the torque corresponding to RPE values of 2 (TRQ2FT = 23.8 ± 7.1 N·m) and 8 (TRQ8FT = 60.9 ± 11.4 N·m). In addition, the subjects completed a PTQ which surveyed whether the perceived sensations of fatigue or pain, and/or the psychological factors of loss of focus and motivation contributed to the decision to terminate the task. Repeated measures ANOVAs, Wilcoxon-Signed Rank tests, and Spearman's Rank-Order Correlations were used to analyze the data. Across the fatiguing tasks, there were similar decreases in MVIC torque (95.2 ± 20.3 vs. 68.9 ± 15.6 N·m; p < 0.001) and RPE values (p = 0.122) at task failure for TRQ2FT (7.4 ± 2.7) and TRQ8FT (8.9 ± 1.0), but a longer (p = 0.005) TTF for the TRQ2FT (245.0 ± 177.0 s) than TRQ8FT (36.8 ± 11.1 s). Despite reaching task failure, the subjects were able to perform MVICs that were 100-300% greater than the target torque values within seconds of terminating the tasks. Thus, we hypothesized that task failure was not caused by an inability to produce sufficient torque to sustain the tasks, but rather an unwillingness to continue the task.

Exploring the potential of stratum corneum biomarkers for assessing psychological distress in health care workers: An observational pilot study.

The detection of biomarkers of a stress response in the stratum corneum (SC) could be used as objective assessment of early stress symptoms and monitoring of stress reduction interventions in health care workers (HCWs). The aim of this study is to explore SC biomarkers of immune and hormonal response and skin barrier for assessment of psychological distress (PD) in HCWs. Twenty-five female HCWs and 25 non-HCWs participated. SC samples were collected using adhesive tapes at baseline and 3-5 days later (T1). We analyzed 24 biomarkers (immunological, vascular, hormones, and natural moisturizing factors). Stress symptoms were assessed using three scales of Copenhagen Psychosocial Questionnaire. The study involved: identifying SC biomarkers, correlating stress symptoms and biomarkers at baseline and T1, examining stress symptoms between the groups with a Mann-Whitney test, comparing stress symptoms and biomarkers between groups using Ordinary Least Regression and investigating temporal variability of SC biomarkers at baseline and T1 using a Wilcoxon-signed rank. Fourteen SC biomarkers were identified. We found correlations between general stress and "IL18" (r = 0.55) physical stress and "IL1b" (r = 0.36) and cognitive stress and "MIP3a" (r = 0.38) at baseline and general stress and cortisol (r = -0.49), physical stress and cortisol (r = -0.60) and cortisone (r = -0.67) at T1. We found no differences in stress symptoms and biomarkers between the groups, except for "MIP3a" at baseline. Differences in the biomarker levels between two time points were found for "TARC," "VEGFA," "ILRA," "IL1RA/IL1a," "NMF," and "DHEA." The SC can be suitable biological material to assess biomarkers related to immune response, hormonal response, and skin barrier function. The SC biomarkers, showed strong, moderate and weak correlations with stress symptoms. Notably, these associations include cytokines of innate immunity and well-known stress hormones, cortisol and cortisone.