Non-parametric Wilcoxon Test Research Articles

Immersive Virtual Reality as Computer-Assisted Cognitive–Motor Dual-Task Training in Patients with Parkinson’s Disease

Background and Objectives: The aim of this study was to determine the effect of immersive virtual reality used as a short-term multifaceted activity with a focus on motor and cognitive function in patients with Parkinson’s Disease. The sub-objective focused on quality of life in the study group of patients. Materials and Methods: Nineteen patients (64.2 ± 12.8 years) were included in this study. Inclusion criteria for this study: adult patients in Hoehn and Yahr’s stage 1–3, cooperative, with stable health status, independent and mobile. IVR therapy was performed twice a week for 20 min for one month. Input and output measurements were taken within 14 days of starting or ending therapy. The 10 Meter Walk test was used to examine and assess both comfortable and fast walking, and the Timed Up and Go (TUG) + s dual task was applied to quickly assess the highest possible level of functional mobility. The Berg Balance Scale test (BBS) was used to assess balance with a 14-item balance scale containing specific movement tasks. The standardized Parkinson’s Disease Questionnaire (PDQ-39) was used to assess quality of life. Data were processed in the PAST program using a nonparametric paired Wilcoxon test. The significance level was set at α = 0.05. The value of the r score was used to evaluate the effect size. Results: A significant reduction in the time in the fast walk 10MWT (p = 0.006; r = 0.63) and TUG (p < 0.001; r = 0.80) parameter were found after therapy. Significant improvement in the BBS score was found after applied therapy (p = 0.016; r = 0.55). In the PDQ-39 questionnaire, significant improvements were found in the study group after therapy in the domains of mobility (p = 0.027; r = 0.51) and emotional well-being (p = 0.011; r = 0.58). Conclusions: The results of this study indicate a positive effect of virtual reality therapy on balance and gait, which is also good in terms of reducing the risk of falls in the study group. Therapy also promoted quality of life in the study group.

Effects of perioperative oxycodone as the sole opioid on immunity within a multi-modal analgesia framework in patients undergoing cervical cancer surgery: A randomised controlled trial

Background and Aims: Current views on oxycodone’s effects on immunity are inconsistent. Our objective was to compare the effects of perioperative oxycodone as the sole opioid in a multi-modal analgesia regimen with conventional opioid regimens on immunity in cervical cancer. Methods: In this randomised controlled trial (RCT), patients scheduled for laparoscopic radical hysterectomy for cervical cancer were randomised to receive either oxycodone (Group O) or conventional opioid regimens (Group C). The primary outcome was the CD4+/CD8+ ratios postoperatively at 24 and 48 h. Student’s t-test was used for normally distributed variables, the non-parametric Wilcoxon test for non-normally distributed variables, and Chi-square/Fisher’s exact test for qualitative variables, with differences significant set at P < 0.05. Results: We included 56 patients in the final analysis. The postoperative CD4+/CD8+ ratios were comparable between groups. However, the mean arterial pressures (MAPs) at extubation and 5 minutes thereafter were lower in Group O than in Group C (both P < 0.001), as were the heart rates (HRs) (P = 0.001 and 0.018, respectively). Within 24 h postoperatively, the visual analogue scale (VAS) scores for resting and movement-evoked pain were lower in Group O than in Group C (all P < 0.001), and the same was observed at 48 h postoperatively (both P = 0.002), as was the incidence of catheter-related bladder discomfort (P = 0.001). The VASs for postoperative analgesia satisfaction were higher in Group O than in Group C (P = 0.006). Conclusion: In laparoscopic surgery for cervical cancer, perioperative oxycodone as the sole opioid within a multi-modal analgesia framework does not yield anticipated benefits in immunopreservation compared to conventional opioid regimens but improves postoperative pain management and haemodynamic stability.

Pricing for Multi-Indication Drugs in the Italian Regulatory Context.

The authorization of new therapeutic indications for drugs already reimbursed by the Italian National Health Service (NHS) represents a matter of importance. This study aims to estimate the additional discount attributed to the extension of indications (EoIs) to explore the potential correlation between spending and negotiated discounts and to find specific factors (determinants) that impact on discount. The study focused on drugs approved in Italy between 2003 and 2017 with at least four therapeutic indications, including the first approved and EoIs, with follow-up extended until 2021 to acquire all the information on the negotiation process that has been completed. Data were obtained from reimbursement and pricing dossiers, and negotiation assessments. Trends in the number of EoIs submitted and the additional discounts negotiated were analyzed, along with the relationship between the negotiated discount and subsequent drug expenditure. Determinants influencing the extent of the negotiated discount were assessed, including drug type, orphan drug designation, innovativeness status, number of EoIs, disease incidence and prevalence, estimated number of patients, revenue projections, availability of therapeutic alternatives, and efficacy outcomes. A Wilcoxon nonparametric test was used to evaluate the associations between determinants and the negotiated additional discount, with a significance level of 0.05. The study identified nine medicines: five of these were used in onco-hematologic therapeutic areas, while the remaining four were immunosuppressants for dermatologic and/or rheumatologic conditions. These nine active substances accounted for 65 approved therapeutic indications, of which 50 were reimbursed by the Italian NHS, including the first indication; the analysis focused only on 40 reimbursed EoIs. The additional discount obtained for EoIs averages approximately 12.5% (95% CI 9.4-16.6%), with a median value of approximately 11%. This latter value was used as the threshold in the analysis of the determinants potentially impacting the negotiated discount amount. Discounts greater than 11% were significantly associated with EoI beyond the fifth and oncology drugs. The additional discount seemed small when compared with the increased spending. AML seems to incur substantial direct economic expenses. Reducing the days of hospitalization can significantly decrease the economic burden of AML in the European Union. Moreover, there is a necessity for studies that comprehensively evaluate the economic implications, particularly concerning total and indirect costs. The study provides valuable insights into the negotiation outcomes for medicines with multiple therapeutic indications, particularly in onco-hematologic and immunosuppressive areas. The analysis revealed that additional discounts for EoIs averaged 12.5%, with a median of 11%, a value used to assess the impact of specific determinants. A discount higher than 11% was statistically correlated with drugs having more than five indications and oncology treatments, showing their influence in negotiations. However, the savings from discounts were modest relative to the increased drug spending as more indications were approved. This suggests an imbalance between the cost control achieved through discounts and the rising expenditure due to expanded drug use.

P1077 Early detection of non-response to non-anti-TNF treatment in Inflammatory Bowel Disease patients using neutrophil-to-lymphocyte ratio as a biomarker

Abstract Background The neutrophil-to-lymphocyte ratio (NLR) has been proposed as a potential marker of subclinical inflammation. Previous studies suggest NLR may predict therapeutic response to anti-tumor necrosis factor (anti-TNF) drugs1,2. However, there is a lack of published data investigating the role of NLR as a predictor for non-anti-TNF treatments. Methods In this retrospective analysis, medical records of 55 patients followed in the inflammatory bowel disease (IBD) outpatient department from January 1, 2020, to July 1, 2024, were reviewed. All patients initiated non-anti-TNF biologic treatment during this period. NLR was measured at week 4 of treatment, and non-response (NR) was assessed at week 16. Patients were divided into two groups: Group A (n = 11)/non-responders and Group B (n = 44)/responders. Statistical analysis of NLR measurements was performed using R. Logistic regression was conducted to evaluate the relationship between NR and ln(NLR). Results The study included 55 IBD patients (27 with ulcerative colitis [UC] and 28 with Crohn’s disease [CD]), with a mean age of 49.81 years. The cohort comprised 23 females and 32 males. Treatment distribution was as follows: ustekinumab (n = 26), vedolizumab (n = 22), upadacitinib (n = 6) and tofacitinib (n = 1).The non-parametric Wilcoxon test revealed statistically significant differences in median NLR between Group A and Group B (P = 0.01464 < 0.05). Logistic regression demonstrated a significant relationship between NR and ln(NLR) (P = 0.024844 < 0.05). The ROC curve analysis yielded an area under the curve (AUC) of 0.7407, with a threshold achieving a sensitivity of 0.9091 and a specificity of 0.5227. Conclusion NLR shows promise as a non-invasive, accessible, and cost-effective biomarker for the early detection of non-response to non-anti-TNF biologic therapy in IBD patients.

CHARACTERISTICS OF THE BLOOD PLASMA "LIPID PEROXIDATION - ANTIOXIDANT PROTECTION" SYSTEM DEPENDING ON NASAL MUCOSA MICROFLORA COMPOSITION IN VARIOUS CHRONIC RHINITIS PHENOTYPES

Abstract Chronic rhinitis is the most common ENT disease. Over the past decade, there has been an increased incidence of chronic rhinitis. In all forms of chronic rhinitis, there is a decrease in the protective properties of nasal mucous membrane, which can be accompanied by activation of nasal bacterial microflora. Dysbiosis of nasal mucous microbiota contributes to the development of inflammation, activation of immune cells with the development of immune reactions, activation of lipid peroxidation processes and changes in the activity of antioxidant defense factors in nasal cavity and blood. There is evidence that different phenotypic variants of chronic rhinitis are characterized by own specific spectrum of microorganisms in the nasal cavity, which significantly affects the course of diseases, as well as the state of the POL-AOZ system. The aim of our work was to comparatively assess quantitative composition of the microbial flora and indicators of the POL-AOZ system in patients with various forms of chronic rhinitis. The article presents the results of a laboratory examination of 165 patients with chronic rhinitis, including 45 patients with chronic allergic rhinitis, 49 patients with chronic vasomotor rhinitis, 32 patients with chronic atrophic rhinitis, and 39 patients with chronic infectious rhinitis. The control group consisted of 40 apparently healthy donors. In accordance with the study design, at the first stage, all subjects underwent a bacteriological examination of nasal mucous membrane and a quantitative assessment of the isolated microflora representatives. At the second stage, the LPO-AOP indices were determined in the blood plasma using a spectrophotometric method. Statistical analysis of the obtained results was performed using the Statistica 8.0 software package. To assess differences in the groups, the Kruskal-Wallis, Mann-Whitney, and Wilcoxon nonparametric tests were used. The critical level of statistical significance for testing scientific hypotheses was considered equal to p˂0.05. The data are presented as a median (Me) and interquartile range (Q25 – Q75). Changes in nasal mucosa microbiome induce a decrease in the activity of antioxidant defense factors in all studied phenotypic forms of chronic rhinitis. In cases of chronic allergic, vasomotor and infectious rhinitis, a significant increase in the level of both primary and secondary lipid peroxidation products is observed. Studies show that the greatest increase in lipid peroxidation activity is recorded in chronic infectious rhinitis, as well as the greatest nasal mucosa dysbiosis is revealed in this phenotype. Thus, the leading pathogenetic mechanism in chronic rhinitis is presented by hypoxia due to intermittent nasal congestion, which contributes to changes in the POL-AOZ system. At the same time, activated microbial flora also contributes to aggravation of such changes.

Therapeutic effect of proprioceptive dolphin assisted activities on health-related quality of life and muscle tension, biomechanical and viscoelastic properties in major depressive disorder adults: case analysis.

The case analysis method is widely used in evaluating dolphin assisted activities due to the lack of research participants. Despite other present diagnostic features adults with major depressive disorder experience psychomotor changes, dysphoria, anhedonia, impaired concentration, and suicidal thoughts. Increasing studies assess the positive effect of proprioceptive exercises in various depressive cases. 14 adults diagnosed major depressive disorder included in this case study between September 2022 to April 2024. A two-week proprioceptive dolphin assisted activity program was applied for each with a two-day break after half applied activities, in total 10 activities for each were organised. Proprioceptive dolphin assisted activities varied from heavy muscle work to muscles and joints pressure which was held in a special therapeutic pool, where adults wore wetsuits. The SF-36 scale was used, with levels of QoL compared among: (a) before dolphin assisted activities, (b) after two-week proprioceptive dolphin assisted activities, (c) in a year after two-week proprioceptive dolphin assisted activities. The MyotonPro portable device was used for measuring muscle tension, biomechanical and viscoelastic properties each day of participation: (a) before dolphin assisted activities and (b) after dolphin assisted activities. The MyotonPro was applied to measure the upper (descending) part of the trapezius muscle, lateral part of the deltoids muscle, middle point of the flexor carpi radialis muscle, middle point of the long head of the biceps brachii muscle, the gastrocnemius muscle (plural gastrocnemii), and quadriceps femoris muscle. The measuring results of SF-36 scale showed statistically significant changes in 5 subscales out of 8 (Friedman's test p-value less than 0.05) and in one more scale a partially significant change (p < 0.1). The physical activity that increased after dolphin therapy (from 68.5 to 85) remained the same in one year. There were no statistically significant changes in role limitations due to physical health. However, role limitations due to emotional problems and partially significant changes were recorded, the situation slightly worsened a year later, but there was no statistically significant deterioration. The non-parametric Wilcoxon test was used to compare two dependent samples measured by the MyotonPro. Although the improvement was recorded in almost all muscle groups, statistically significant changes were observed only in trapezius muscle md p right, measuring stiffness, relaxation and creep; trapezius md p left measuring frequency, stiffness, relaxation and decrement; and deltoids muscle left, measuring frequency, stiffness and relaxation, i.e., the p-values of Wilcoxon test are less than 0.05. Two-weeks of proprioceptive dolphin assisted activities for adults with major depression have statistically significant long-term change in better physical parameters. Emotional betterment parameters were less stable. The quick reactivity of trapezius muscle revealed that dolphin assisted activities acts as stress relief, and deltoids muscle as relief of negative emotions, such as fear and anger.

A Preliminary Study: The Effect of Slow Deep Breathing Exercise (SDBE) on Resting Heart Rate and Respiration Rate of Hypertension Patients

The prevalence of hypertension in Indonesia increases with age. Examination of vital signs such as resting pulse and respiratory rate are parameters of hypertension morbidity. One alternative therapy for hypertension is slow, deep breathing exercises. This study aimed to determine the effect of slow, deep breathing exercises on hypertensive patients' resting heart rate and respiratory rate. The research design used was pre-experimental with one group pretest and posttest on 26 hypertensive patients at Posyandu Lansia Waras Winangun, Banyumas. The sampling method used was the total sampling technique. Participants were treated with slow, deep breathing exercises three times a week for six weeks. Resting heart and respiratory rates were examined before and after the intervention of slow, deep breathing exercises. Data analysis of the results in this study used the Wilcoxon non-parametric test. Slow deep breathing exercises significantly decreased resting heart rate (p=0.001), but the respiratory rate was not found to decrease significantly (p=0.209). It can be concluded that the administration of slow, deep breathing exercises affected the resting heart rate but did not affect the respiration rate.

Three-Dimensional Assessment of Dental Enamel Microcrack Progression After Orthodontic Bracket Debonding Using Optical Coherence Tomography.

The current study aimed to quantify the length progression of enamel microcracks (EMCs) after debonding metal and ceramic brackets, implementing OCT as a diagnostic tool. The secondary objectives included a three-dimensional assessment of EMC width and depth and the formation of new EMCs. OCT imaging was performed on 16 extracted human premolars before bonding and after debonding. Debonding was conducted with a universal Instron machine, with ARI values recorded. Additionally, 2D and 3D OCT images were employed to detect EMC formation and progression. Enface images quantified the length, width, and number of EMCs, and the length and width were analyzed using Image J (1.54f) and MATLAB (R2014b), respectively. Sagittal cross-sectional images were used for EMC depth analysis. A paired t-test showed significant differences in the length, width, and number of EMCs after debonding (p-value < 0.05), while the Wilcoxon non-parametric test indicated significant EMC depth changes (p-value < 0.05). No significant results were identified for the EMC number in ceramic brackets and EMC depth in metal brackets. Three-dimensional OCT imaging monitored existing EMCs at higher risk of progression and detected new EMCs following orthodontic bracket debonding. This study provides novel insights into EMC progression regarding the length, width, depth, and number after debonding.

EFFECT OF ORAL TRIPEPTIDE-COLLAGEN ON MICROCIRCULATION (NAIL FOLDS) AND SKIN WRINKLES

Background: Accelerated aging is associated with increased exposure to reactive oxygen species (ROS), leading to lower collagen and elastin levels in the body. This reduction reduces microvascular activity, causing microcirculatory disorders and skin wrinkles. Administering collagen tripeptides can help improve the microcirculation system. Objective: This study aims to investigate the effects of collagen tripeptide on improving microcirculation, reducing skin wrinkles, and lowering excessive ROS toxicity. Method: The research method used is experimental with a pre-post study approach without using a control group and descriptive quantitative data analysis. We measured microcirculation using a microscope, quantified ROS levels with the QYM-DI microscope, and assessed nasolabial fold depth with an acupuncture needle. Results: The study results indicate that collagen tripeptide significantly improves microcirculation, reduces skin wrinkles, and decreases excessive ROS toxicity. The non-parametric Wilcoxon test results are as follows: (1) there is a significant difference before and after collagen tripeptide consumption in terms of microcirculation improvement (p = 0.000), reduction of skin wrinkles on the nasolabial folds (p = 0.008), and reduction of ROS (p = 0.000). This improves microcirculation, which in turn reduces skin wrinkles on the nasolabial folds. Conclusion: Consuming collagen tripeptide for three months can improve microcirculation, reduce skin wrinkles on the nasolabial folds, and reduces ROS.

Indexes of systemic inflammation in hemorrhagic stroke with effective blood flow: a dynamic observation

Increasing evidence suggests that stroke is a systemic disease affecting multiple organs. Systemic inflammatory response and immune dysregulation associated with hemorrhagic stroke, may play an important role in brain injury, its recovery, and stroke outcomes. However, it is worth of note that, from our point of view, the classical concepts about inflammation in pathophysiology and general pathology do not entirely meet the needs of modern medical practice. The existence of this problem is also typical for assessing pathogenesis, as well as for optimizing pathogenetic therapy of severe strokes. Therefore, within the framework of this work, a dynamic observation and assessment of pathogenesis in severe intracerebral hemorrhage was carried out using the criteria of a systemic inflammation scale. The study included patients with intracerebral hemorrhage and effective cerebral blood flow. Blood sampling was carried out on days 1-3 and 5-7 after clinical manifestation of intracerebral hemorrhage. To determine markers of systemic inflammation in the blood plasma of patients, the levels of IL-6, IL-8, IL-10, TNFá, procalcitonin, cortisol, myoglobin, troponin I and D-dimers were examined using an enzyme-linked immunosorbent assay. The Kolmogorov–Smirnov test was used to confirm the normal data distribution. Further comparison of quantitative data was carried out using the nonparametric Wilcoxon test for paired comparisons. All results were considered statistically significant at p 0.05. In patients on days 1-3 and 5-7, statistically significant differences were not observed in almost all studied markers of systemic inflammation, except for IL-8 and tumor necrosis factor-á. Such increased contents of pro-inflammatory cytokines may indicate increased systemic inflammation over time in the patients with intracerebral hemorrhage and effective cerebral blood flow. Hence, the condition of such patients may worsen on days 5-7 after manifestations of intracerebral hemorrhage, thus requiring more careful monitoring of patients’ blood counts and therapy aimed at suppression of increasing inflammation.

Exploring the production of discourse particles by persons with aphasia

ABSTRACT Background Discourse production is a fundamental aspect of everyday life. There is a growing body of research on discourse production in persons with aphasia (PWA) but one understudied aspect of discourse production is the use of discourse particles. Understanding the role of discourse particles in PWA is crucial given the recent shift in clinical practice towards therapy at discourse level, addressing functional communication in everyday life situations. The limited available literature does not provide clear answers on how Dutch PWA use discourse particles. Because in Dutch discourse particles are more frequent and have other types of functions compared to, for example, English, studying the use of Dutch discourse particles by PWA can provide valuable insights in their discourse production. Aims This study aims to compare the proportion of produced discourse particles between Dutch-speaking persons with and without aphasia, to investigate the distributions of the discourse particles produced, and to explore the functions of the discourse particles of interest. Methods & Procedures Discourse samples elicited by the adapted version of the Amsterdam Nijmegen Everyday Language Test from 27 persons with aphasia and 23 neurotypically healthy speakers were analysed for the use of discourse particles. Proportions of discourse particles were contrasted between persons with and without aphasia using a Wilcoxon non-parametric test. The distributions of the discourse particles were analysed using a linear mixed-effects model, and the functions of the discourse particles were examined qualitatively. Outcomes & Results The results show that persons with aphasia produce a larger proportion of discourse particles compared to neurotypically healthy speakers. The distribution of the discourse particles differs between the two groups, and we find that at least some discourse particles are used differently. Conclusions This study reveals that Dutch-speaking persons with aphasia still employ some discourse particles effectively despite language difficulties. It furthermore shows that the frequency and manner in which these particles are used, as well as their role in communication, may differ significantly among the different discourse particles. This insight may inform therapeutic approaches.

New Metaheuristics to Solve the Internet Shopping Optimization Problem with Sensitive Prices

In this research, two new methods for solving the Internet shopping optimization problem with sensitive prices are proposed, incorporating adaptive adjustment of control parameters. This problem is classified as NP-hard and is relevant to current electronic commerce. The first proposed solution method corresponds to a Memetic Algorithm incorporating improved local search and adaptive adjustment of control parameters. The second proposed solution method is a particle swarm optimization algorithm that adds a technique for diversification and adaptive adjustment of control parameters. We assess the effectiveness of the proposed algorithms by comparing them with the Branch and Bound algorithm, which presents the most favorable outcomes of the state-of-the-art method. Nine instances of three different sizes are used: small, medium, and large. For performance validation, the Wilcoxon and Friedman non-parametric tests are applied. The results show that the proposed algorithms exhibit comparable performance and outperform the Branch and Bound algorithm.

The Effectiveness of a Specific Exercise Program in Alleviating Work-Related Neck and Upper Back Pain and Improving Mood State in Various Occupational Populations-A Randomized Controlled Trial.

Background and Objectives: The COVID-19 pandemic brought significant challenges across governmental, industrial, and social systems. Additionally, numerous studies have reported a sharp increase in both mental health issues and musculoskeletal disorders worldwide. This study aimed to investigate whether a specific exercise program could alleviate neck and upper back pain symptoms and improve mood state among healthcare and office employees during the post-COVID-19 period. Materials and Methods: This was an unblinded (open label) randomized controlled trial (both the participants and the researchers knew which treatment or intervention was being administered). In total, 40 healthcare employees from a public hospital and 98 remote office employees, all of whom reported neck and upper back pain, were randomly assigned to an experimental (EG) and control group (CG). The experimental groups underwent the same exercise protocol, while their corresponding control groups underwent the assessments only. Pain assessment using the Visual Analogue Scale (VAS) and mood state using the Feeling Scale (FS) questionnaires of the participants were recorded at baseline (pre-intervention) and immediately following the exercise intervention period of 6 weeks (post-intervention). The intervention consisted of 18 exercise sessions conducted over a 6-week period, with remote office workers participating online and healthcare workers attending exercise sessions on site (at the hospital). Statistical analysis was performed using non-parametric Mann-Whitney and Wilcoxon tests, as appropriate. Results: Following the six-week intervention, the percentage of workers in the EG reporting pain decreased significantly (from 75% to 45% for healthcare workers and from 54% to 25% for office employees), whereas no change was observed for their corresponding control groups. Similarly, the mood state of the EGs significantly improved compared with the control groups, as measured between pre- and post-intervention sessions. Conclusions: The COVID-19 period exacerbated stress and musculoskeletal strain, particularly for workers in demanding occupational roles. To mitigate these effects, exercise programs that can be applied while at work should be implemented, as they are effective in enhancing mood and managing neck pain in employees with physical exertion.

Effects of Medical Material-Based Play Therapy on Pain Levels in Hospitalized Preschool Children Aged 3-6 Years

Introduction: Pain is a stressor of hospitalization that, if not managed properly, can have physical and psychological impacts on children. One intervention that can be provided to reduce pain in preschool-aged children is play therapy. Objective: This study aims to determine the effect of play therapy using medical materials on the pain levels of hospitalized preschool-aged children. Method: This study uses a pre-experimental design with a one group pretest-posttest design approach. The number of respondents in this study was 25 preschool-aged children who were treated in the Dahlia Pediatric Ward at TK. II R. W. Mongisidi hospital Manado, selected using purposive sampling based on inclusion criteria. Pain measurement was carried out using the Wong Baker FACES Pain Rating Scale. Data analysis was performed using the Nonparametric Wilcoxon test. Results: The Wilcoxon statistical test results showed a p-value of 0.000 (p&lt;0.05), indicating a significant difference in pain levels before and after the play therapy intervention using medical equipment. Conclusion: Based on the analysis, it can be concluded that there is an effect of play therapy using medical materials on the pain levels of hospitalized preschool-aged children. Future researchers interested in this study are encouraged to use a quasi-experimental method with a two-group pretest-posttest design.

Near-Infrared Autofluorescence or Intraoperative Parathyroid Hormone Determination as a Surgical Support Tool in Primary Hyperparathyroidism: Too Close to Call?

Background: This study investigates the use of near-infrared fluorescence imaging (NIFI) as an alternative to intraoperative parathyroid hormone (ioPTH) measurement in patients with primary hyperparathyroidism (PHP) due to parathyroid adenoma (PA) with two preoperative imaging examinations in agreement on the position of the altered parathyroid gland. Methods: Fifty patients who underwent minimally invasive parathyroidectomy (MIP) from March 2021 to April 2024 were enrolled. MIPs utilised both NIFI and ioPTH, comparing the time to adenoma excision with NIFI against the total surgical time, including ioPTH measurement wait time. Results: Results showed successful MIPs in all patients, with a mean excision time of 44.7 min (SD ± 25.2) and a total procedure time of 85.5 min (SD ± 37.1). The median of the duration of the surgical procedure until adenoma excision was 35.0 min (IQR 38.8), while the median duration of the entire procedure was 74.5 min (IQR 40.5). This difference in medians is statistically significant using the Wilcoxon non-parametric test for paired samples (p < 0.001). The average wait for ioPTH results post-excision was 37 min (SD ± 12.2). Three fluorescence patterns were identified: "cap" (46%), heterogeneous (30%), and homogeneous (24%). Conclusions: If preoperative imaging confirms PA location, NIFI could replace ioPTH reducing surgical time without compromising success rates.

Italian validation of the pelvic floor Impact questionnaire − 7 (PFIQ-7)

Introduction and hypothesisThis study aims to translate and validate the Pelvic Floor Impact Questionnaire − short form 7 (PFIQ-7) in Italian, assessing its validity, internal consistency, and test–retest reliability. MethodsThe final version of the questionnaire was submitted to women referred to urogynecological outpatient care for genital prolapse or urinary incontinence and who either reported sexual disorders (controls) or not (cases). The questionnaire was translated into Italian using established procedural stages. Two weeks later, cases got the questionnaire for the test–retest evaluation. The non-parametric Wilcoxon test was employed to evaluate the variations between the case and control groups. Convergent validity was tested using the Italian version of the PFDI-20. The internal consistency was measured using Cronbach’s Alpha. Using Cohen’s kappa, the degree of concordance/agreement was determined. The test–retest results for different individuals were evaluated for absolute agreement using the intraclass correlation coefficient (ICC). ResultsThe study then included 45 women with a mean age of 38.0 ± 11.7 years who answered the questionnaire with no dropouts or missing items. Participants were categorized into cases and controls based on their self-reported symptoms. The questionnaire demonstrated significant construct validity by effectively distinguishing between symptomatic and asymptomatic individuals. Convergent validity testing with the PFDI-20 showed a strong linear correlation (F < 0.001) between scores. Internal consistency was excellent, with Cronbach’s Alpha values ranging from 0.90 to 0.93. Test-retest reliability was confirmed, with Cohen’s Kappa values ranging from 0.62 to 0.92 and intraclass correlation coefficients from 0.88 to 0.94, indicating high reliability. ConclusionThe Italian version of the PFIQ-7 is reliable, valid, and consistent.

Double Materiality Approach and Sustainable Business Model Paradigm: A Three-Fold Analysis

Adopting the United Nations 2030 Agenda for Sustainable Development, governments commit to the 17 goals and 169 associated targets in areas of critical importance for humanity and planet, while companies manifest a growing interest in playing a significant role to SDGs prioritisation. Researchers, policymakers, stakeholders, and analysts are all preoccupied about responsible ways of redesigning the business model to mitigate the growing concerns, such as companies’ failures, global multidimensional crisis, and sustainability-related issues. Under the light of institutional theory, legitimacy theory, stakeholder theory, the aim of this research is to investigate how environmental, social and governance (ESG) policies and practices included in a sustainable business model may respond to the double materiality approach in order to contribute to a balance among divergent interests of managers, investors, and other stakeholders. The financial materiality is conceptualized using ESG data, that mainly targets investor’s needs. Stakeholder materiality, is concerned with external impact of companies, embodied in societal-level outcomes measured as the number of SDGs addressed in corporate reporting. In this study, company-year data are collected from Refinitiv Eikon database, starting with 2015, until current reporting period and analysed using frequency, univariate and correlation analyses. Based on Levene homogeneity, the ANOVA parametric t-test results are validated by Mann-Whitney Wilcoxon and Krushkal Wallis non-parametric tests. Three main research questions are responded. First, the findings examine and discuss the evolution of sustainability reporting measured with ESG scores, decomposed by the three pillars and ten categories, along with the SDGs prioritisation. Second, statistically significant differences in ESG and SDGs variables reported by various groups clustered on industry-related corporate characteristics are discussed. Third, the significant associations between ESG measures and SDGs are analysed from the double materiality perspective. The study contributes to the academic and practical understanding of the evolving business model under normative dimension of institutional theory, incorporating the decision to engage in current sustainability frameworks and policies.

The Influence of Autogenic Relaxation Therapy on Sleep Quality in Elderly Residents at the Rumoh Seujahtra Geunaseh Sayang Social Home, Ulee Kareng, Banda Aceh

Aging is a stage in life marked by a decline in the body’s ability to adapt to its surroundings, leading to various health issues, including impaired sleep quality. One non-pharmacological intervention to address sleep disturbances is autogenic relaxation therapy, which helps modulate physiological responses and can enhance sleep quality for elderly. This study aimed to assess the impact of autogenic relaxation therapy on the sleep quality of elderly residents at the Rumoh Seujahtra Geunaseh Sayang Social Home in Ulee Kareng, Banda Aceh. This pre-experimental research employed a one-group pretest-posttest design. The population consisted of 59 elderly individuals, with a purposive sampling technique used to select a sample of 37 participants. Data were collected using a structured questionnaire. The study was conducted from May 17-19, 2024, at the Rumoh Seujahtra Geunaseh Sayang Social Home. The findings revealed that prior to the intervention, the majority of participants (78.9%, or 29 respondents) had poor sleep quality, while after receiving autogenic relaxation therapy, 59.5% (22 respondents) exhibited good sleep quality. Statistical analysis using the non-parametric Wilcoxon test showed a significant improvement in sleep quality with a p-value of 0.000 (p &lt; 0.05). The study concluded that autogenic relaxation therapy has a positive effect on improving sleep quality in the elderly at the Rumoh Seujahtra Geunaseh Sayang Social Home, Ulee Kareng, Banda Aceh. It is recommended that elderly residents incorporate autogenic relaxation therapy into their routines to enhance sleep quality.

ASSESSMENT OF ORAL BEHAVIORS AND PSYCHOSOCIAL ASPECTS OF FEDERAL POLICE OFFICERS

Objective: To evaluate the oral behaviors and psychosocial aspects of adults belonging to the Federal Police class. Methods: An observational longitudinal study was conducted with 30 adult individuals from the special group of Federal Police from the city of Curitiba, Paraná. The median age of participants was 39.70 (± 7.35) years. Quality of life, anxiety and perceived stress were assessed using the SF-36, GAD-7 and PSS-14 questionnaires respectively. Awake bruxism was evaluated using the Ecological Momentary Assessment method with the WhatsApp mobile application. Messages were sent 15 times a day, seven days a week, between 9:00 am and 7:00 pm, at random times, to choose one of five oral behaviors: teeth contact, teeth clenching, teeth grinding, mandibular bracing, and relaxed jaw muscles. Cronbach's alpha test, Shapiro-Wilk’s test, Wilcoxon's non-parametric test for paired samples, Friedman's non-parametric test for paired samples, Spearman's non-parametric correlation test, and Kruskal-Wallis non-parametric test, followed by Dunn's 2–2 comparison test were employed. Results: The most frequent oral behaviors during the week were relaxed jaw muscles (49.75 ± 29.28), teeth contact (31.50 ± 24.71), mandibular bracing (10.42± 18.99), teeth clenching (6.82 ± 8.96), and teeth grinding (1.48 ± 3.04). Quality of life was considered excellent, anxiety was low, and there was no stress. There was no correlation between stress, anxiety and quality of life and awake bruxism. Conclusion: The federal police officers evaluated showed a high frequency of awake bruxism, but the psychosocial aspects were considered excellent.

Efektivitas Modul dan Film Pendek Check Up Diabetic Foot: Ipswch Touch Test dalam Meningkatkan Pengetahuan dan Ketrampilan Mendeteksi Neuropati Sensori Diabetes Mellitus Tenaga Kesehatan di Kabupaten Bima

Early detection of diabetic neuropathy is very important for patients with type 2 diabetes mellitus because early prevention can reduce morbidity and mortality. One of the examinations to detect diabetic neuropathy is the Ipswich Touch Test (IpTT). The purpose of this study was to determine the Effectiveness of the Diabetic Foot Check Up Module and Short Film: Ipswich Touch Test in Improving Knowledge and Skills in Detecting Sensory Neuropathy of Diabetes Mellitus Health Workers. The research method used was Quasi-experimental with a pre-test and post-test with control group design with a non-parametric Wilcoxon test to analyze knowledge and skills before and after treatment, a total of 60 respondents. A significant test result of 0.0001 was obtained for the intervention group, namely there was a difference in skills before and after treatment in the form of counseling with media in the form of short films, while in the control group a significant test result of 0.0001 was obtained, namely there was a difference in skills before and after treatment in the form of counseling with media in the form of modules with a significance level of 0.05 because p value &lt;0.05. The results of the significant test were obtained at 0.0001 for the intervention group, namely there was a difference in knowledge before and after being given treatment in the form of counseling with media in the form of short films, while in the control group the results of the significant test were obtained at 0.0001, namely there was a difference in knowledge before and after being given treatment in the form of counseling with media in the form of modules with a significance level of 0.05 because the p value &lt;0.05. The conclusion on the results of knowledge in the intervention group before being given intervention in the form of education, modules and short films was that they had good knowledge as much as 50% and after being given education they had good knowledge as much as 90% meaning that there was an increase in knowledge before and after being given intervention, meaning that there was an increase of 40%, while in the intervention group they had good skills 0%, enough 90%, less 10% after being given intervention there was a change to good as much as 83.3% meaning that there was a significant change before being given treatment and after being given treatment.