Wilcoxon Test Research Articles

The Effect of C-Arm Position on Femoral Tunnel Placement in Medial Patellofemoral Ligament Reconstruction.

Medial patellofemoral ligament (MPFL) reconstruction is a common treatment for patellar instability. Yet nearly 40% of revisions result from femoral tunnel misplacement. One reason may be the positioning of the C-arm relative to the knee. To assess how the C-arm's position affects femoral MPFL placement when the image receptor is positioned either contralateral or ipsilateral to the operated knee. Controlled laboratory study. Ten human cadaveric knee specimens were dissected, and the femoral MPFL insertion site was identified and marked using a 10-mm eyelet. According to the possible clinical scenarios, true lateral radiographs in 2 different C-arm positions were taken. In the first scenario, the image receptor was on the ipsilateral side, being 5 cm away from the knee with the x-ray beam directed from medial to lateral (ML5). In the second scenario, the image receptor was on the contralateral side, being 25 cm away from the knee with the x-ray beam directed from lateral to medial (LM25). In each radiograph, the eyelet position was recorded and the distance (proximal-distal and anterior-posterior) from the optimal radiographic insertion point according to the literature was determined. Differences between the groups were calculated using the Wilcoxon signed-rank test, and a P value of <.05 was considered significant. The anatomic femoral MPFL insertion in the ML5-position was located a mean of 2.7 ± 2.4 mm proximal and 4.5 ± 5.5 mm anterior to the Schöttle point. This resulted in an absolute distance of 7.2 ± 3.0 mm. In the LM25-position, it was located a mean of -0.7 ± 1.8 mm distal and 3.0 ± 5.3 mm anterior, which resulted in an absolute distance of 5.4 ± 3.2 mm. The ML5 was located more anterior (1.5 ± 2.1 mm) and proximal (3.4 ± 2.4 mm) compared with the LM25 position. Measurements following methods described in the literature significantly differed in both axes in the LM25 view when compared with the ML5 view measurements (P = .005). Compared with the ipsilateral C-arm position (ML5), the contralateral C-arm position (LM25) showed a smaller range with a lower standard deviation in identifying the femoral MPFL approach across all measurement methods. When applying the method according to Schöttle et al to locate the femoral MPFL insertion point, it should be noted that in the proximal-distal orientation, the femoral MPFL insertion point is situated proximal to the Blumensaat line in the contralateral view (LM25). In contrast, when using the ipsilateral view (ML5), the femoral MPFL footprint is positioned just distal to the proximal edge of the medial condyle.

Clinical Risk Factors for High-Dose Methotrexate-Induced Oral Mucositis Following Individualized Dosing.

Oral mucositis affects about 20% of children undergoing high-dose methotrexate (HDMTX) for acute lymphoblastic leukemia (ALL), despite existing management strategies. Personalized HDMTX dosing, adjusted by pharmacokinetics and leukemia risk, has reduced mucositis incidence, but variations still occur with similar 24-h methotrexate levels. This retrospective study investigated risk factors for oral mucositis under individualized methotrexate protocols. Data from patients with ≥ Grade 2 oral mucositis (CTCAE v4.0) were analyzed from the St. Jude Children's Research Hospital total 16 trial. A 1:1 case-control matching method considered age, sex, risk classification, immunophenotype, and methotrexate course. McNemar's, Bowker's symmetry, and Wilcoxon signed-rank tests were used for statistical analyses. Risk factors for recurrent mucositis were identified in a case-only analysis. The study found significant associations between methotrexate-induced mucositis and new-onset skin rashes (p = 0.0027), fever (p = 0.0016), neutropenic fever (p = 0.0008), lower absolute neutrophil count (p < 0.0001), acute kidney injury (AKI) (p = 0.0164), delayed methotrexate clearance (p = 0.0133), and higher 42-h methotrexate levels (p = 0.0179). In the standard/high-risk group, mercaptopurine dose was also linked to mucositis (p = 0.0495). Multivariable analysis showed that skin rashes (OR 6.5, p = 0.0016), fever (OR 2.8, p = 0.009), and neutropenia (OR 2.3, p = 0.0106) were independent risk factors for mucositis. Female sex (OR 7.12, p = 0.015) and AKI (OR 3.819, p = 0.037) were associated with recurrent mucositis. Fever, skin rashes, AKI, delayed methotrexate clearance, and higher 42-h methotrexate levels were key risk factors for HDMTX-induced oral mucositis. Skin rashes, fever, and neutropenia were independent predictors, while female sex and AKI were linked to recurrent mucositis.

Comparison of masticatory performance and oral hygiene status using cream-type denture adhesives and home liners: A cross-sectional study using propensity-score matching.

Differences in the effects of cream-type denture adhesives and home liners remain unclear. This cross-sectional study aimed to clarify the differences in the oral-hygiene status and masticatory performance between participants using cream-type denture adhesives and those using home liners. Masticatory performance with and without cream-type denture adhesives and home liners was evaluated using colour-changeable chewing gum. Oral hygiene was assessed using the tongue coating index (TCI). Propensity-score matching was performed using oral moisture, presence of palatal or mandibular protuberances, type of residual ridge, denture type (complete or partial denture), and denture retention as background factors. Wilcoxon signed-rank test was used to examine the differences in masticatory performance with and without cream-type denture adhesives and home liners and differences in masticatory performance and TCI between the cream-type denture adhesive and home-liner groups. This study included 38 and 40 cream-type adhesive and home-liner users, respectively, and 17 pairs were obtained after propensity-score matching. The Wilcoxon signed-rank tests showed that masticatory performance was significantly different with and without the use of home liners, and higher values were obtained with the use of home-liners. However, the cream-type denture adhesive and home-liner groups showed no significant differences in terms of the change in masticatory performance with the use of them. Furthermore, Wilcoxon signed-rank tests showed that TCI values were significantly high in the cream-type adhesive group. The findings in this study suggest that home liners improve masticatory performance and that participants regularly using cream-type denture adhesives have poorer oral hygiene.

Nature-based interventions for individuals with rare skeletal disorders: evaluation of a 5-day sailing program on health-related quality of life

Individuals with rare skeletal disorders like Multiple Osteochondromas and Ollier Disease often experience physical and psychological burdens. Adventure therapy, with activities like sailing in outdoor settings, promotes personal growth and psychological well-being, potentially improving health-related quality of life (HRQoL). This study aimed to evaluate the impact of a sailing program on health-related quality of life and participant satisfaction in individuals with Multiple Osteochondromas and Ollier Disease. A quasi-experimental one-group pre-post design was employed, with HRQoL assessed using the EQ-5D® instrument and participant satisfaction measured via a feedback survey. Data were collected before and after the five-day sailing program conducted in the Mediterranean Sea in 2022 and 2023, involving participants diagnosed with Multiple Osteochondromas and Ollier Disease. Statistical analyses were performed using the Wilcoxon signed-rank test and McNemar’s test for paired data. A significance level of p < 0.05 and p < 0.10 was considered. A total of 25 participants, predominantly male (52%), with a median age of 16 years (ranking from 11 to 31), were included in the study. The sailing program had mixed impact on HRQoL. Specifically, individuals who were female (p = 0.03), aged 16 and older (p = 0.04), with higher educational attainment (p = 0.10) or stronger self-management (p = 0.09), resilience (p = 0.01) and self-engagement (p = 0.09) skills experienced enhanced HRQoL. Conversely, other participants exhibited an increase in self-care difficulties (p = 0.02) and a trend towards worsening pain/discomfort (p = 0.38). Overall satisfaction with the program was high, with 90% of participants expressing satisfaction.This is the first study which examined HRQoL in Multiple Osteochondromas and Ollier Disease patients within an outdoor adventure therapy setting. Findings suggest that adventure therapy, integrated into healthcare strategies, may offer a valuable complement to conventional treatments for rare skeletal disorders. Future research, including randomized controlled trials, are necessary to confirm these results and develop robust interventions for improving the well-being in this population.

Choroid Plexus Volume in Pediatric-Onset Multiple Sclerosis.

Recent studies suggest that the choroid plexus (CP) may function as a site of access of inflammatory cells into the CNS in multiple sclerosis (MS). Pediatric-onset MS (POMS) is characterized by a high inflammatory burden, as evidenced by a high relapse rate and volume of T2 lesions, making patients with POMS an informative population to evaluate choroid plexus volume (CPV). The objectives of the study were (1) to evaluate CPV at symptom onset in participants with POMS compared with healthy controls (HCs); (2) to evaluate changes in CPV in the first year of disease in participants with POMS; and (3) to evaluate associations between CPV, brain volumes, relapse activity, and disability in participants with POMS. Baseline 1.5T MRI scans were acquired from 23 participants with POMS and 23 age-matched and sex-matched HCs; 18 participants with POMS also had 12-month follow-up MRI scans. The CP of the lateral ventricles was segmented manually. CP and brain structure volumes were normalized for total intracranial volume. The number of relapses, T2 and gadolinium-enhancing T1 lesion counts, and Expanded Disability Status Scale (EDSS) scores at 12 months were also analyzed. Baseline CPVs were compared between groups using the Wilcoxon exact test, and CPV change from baseline to 12 months in participants with POMS was compared using the Wilcoxon signed-rank test. The relationship between CPV and brain volumetric measures, T2 lesion volumes, lesion count, number of relapses, and EDSS scores was assessed through Spearman correlation. The median normalized CPV was 1.51 × 10-3 (interquartile range [IQR]: 1.32-1.76) in POMS baseline scans and 1.21 × 10-3 (IQR: 1.1-1.47) in HC scans (p = 0.001). CPV did not significantly change at 12 months in the 18 participants with POMS with follow-up scans (p = 0.352). CPV in participants with POMS and HCs correlated with lateral ventricular volume (p = 0.012 for both groups) but did not correlate with brain and T2 lesion volumes or lesion count at baseline, nor with relapse activity or EDSS scores at 12 months in participants with POMS. CPV measured at baseline is greater in participants with POMS than in HCs. Baseline CPV did not predict higher disease activity or worse neurologic outcomes over 1 year. While higher CPV may be an early feature of inflammation in MS, its strong correlation with ventricular volumes could also reflect enlargement secondary to the mechanical attachment of CP to the ventricular wall.

Long-term course and factors influencing work ability and return to work in post-COVID patients 12 months after inpatient rehabilitation

BackgroundRehabilitation plays a crucial role in restoring work ability and facilitating the reintegration of post-COVID patients into the workforce. The impact of rehabilitation on work ability and return to work (RTW) of post-COVID patients remains poorly understood. This study was conducted to assess the work ability and RTW of post-COVID patients before rehabilitation and 12 months after rehabilitation and to identify physical and neuropsychological health factors influencing RTW 12 months after rehabilitation.MethodsThis longitudinal observational study included 114 post-COVID patients with work-related SARS-CoV-2 infection who underwent inpatient post-COVID rehabilitation with indicative focus on pulmonology and/or psychotraumatology (interval between date of SARS-CoV-2 infection and start of rehabilitation: M = 412.90 days). Employment status, work ability, and the subjective prognosis of employment (SPE) scale were assessed before rehabilitation (T1) and 12 months after rehabilitation (T4). The predictors analysed at T4 were functional exercise capacity, physical activity, subjective physical and mental health status, fatigue, depression, and cognitive function. Longitudinal analyses were performed via the Wilcoxon signed-rank test. Logistic and linear regression analyses identified predictors of work ability and return to work (RTW), whereas mediation analyses examined the relationships between these predictors and work ability.ResultsAt T4, the median of WAI total score indicated poor work ability, which significantly worsened over time (p < 0.001; r = 0.484). The SPE scale significantly increased from T1 to T4 (p = 0.022, r = -0.216). A total of 48.6% of patients had returned to work 12 months after rehabilitation. Fatigue was identified as the main predictor of reduced work ability and RTW, with each unit increase in fatigue severity decreasing the odds of RTW by 3.1%. In addition, physical capacity and subjective health status were significant predictors of perceived work ability.ConclusionsThe findings highlight the significant challenges that post-COVID patients face in regaining work ability and achieving successful RTW 12 months after rehabilitation. Fatigue appears to be an important predictor of work ability and RTW. To optimize recovery and enhance both biopsychosocial health and work ability, it is crucial to develop and implement personalised interventions that address fatigue, improve physical capacity, and support mental health.Trial registrationThis study is registered in the German Clinical Trials Register under DRKS00022928.

Effects of speech tracking method using hearing aids for hearing disorder in older people.

Speech tracking is defined as a complex act or task of listening in which the learner tracks the speech heard and repeats it as accurately as possible while paying attention to incoming contextual information. This ability involves auditory input, speech output, repetition, and divided attention. In this small-scale study, we aimed to use a speech-tracking method to train older adults with hearing loss and examine its effects on hearing loss from multiple perspectives, including hearing handicap, frailty, and neuropsychological testing. Auditory rehabilitation was provided to older patients who purchased hearing aids at the clinic and wanted to engage in rehabilitation. The Hearing Handicap Inventory for the Elderly, Nursing Home Hearing Handicap Index, speech-tracking rate, Token Test, Communication Activities of Daily Living, Kihon Checklist, Mini-Mental State Examination, Digit Symbol Substitution Test, symbol search, and word recall were used for assessments before and after rehabilitation using the speech-tracking method. Changes in scores of each assessment item and sub-item were examined using Wilcoxon's signed-rank test, and changes per question were examined using the sign test. The speech tracking rate (p<0.001), Token Test score (p<0.001), and Mini-Mental State Examination score (p=0.035) improved significantly after the training. Notably, the speech-tracking rate improved for 31 of the 33 participants, with a maximum increase of 19.6 phrases per minute. The combination of a hearing aid and the speech-tracking method improved auditory comprehension.

SsVERDICT: Self-supervised VERDICT-MRI for enhanced prostate tumor characterization.

Demonstrating and assessing self-supervised machine-learning fitting of the VERDICT (vascular, extracellular and restricted diffusion for cytometry in tumors) model for prostate cancer. We derive a self-supervised neural network for fitting VERDICT (ssVERDICT) that estimates parameter maps without training data. We compare the performance of ssVERDICT to two established baseline methods for fitting diffusion MRI models: conventional nonlinear least squares and supervised deep learning. We do this quantitatively on simulated data by comparing the Pearson's correlation coefficient, mean-squared error, bias, and variance with respect to the simulated ground truth. We also calculate in vivo parameter maps on a cohort of 20 prostate cancer patients and compare the methods' performance in discriminating benign from cancerous tissue via Wilcoxon's signed-rank test. In simulations, ssVERDICT outperforms the baseline methods (nonlinear least squares and supervised deep learning) in estimating all the parameters from the VERDICT prostate model in terms of Pearson's correlation coefficient, bias, and mean-squared error. In vivo, ssVERDICT shows stronger lesion conspicuity across all parameter maps, and improves discrimination between benign and cancerous tissue over the baseline methods. ssVERDICT significantly outperforms state-of-the-art methods for VERDICT model fitting and shows, for the first time, fitting of a detailed multicompartment biophysical diffusion MRI model with machine learning without the requirement of explicit training labels.

Co-mutation of TP53 and TTN is Correlated with the Efficacy of Immunotherapy in Lung Squamous Cell Carcinoma.

Immunotherapy has been a promising treatment in advanced lung cancer. However, only a few patients could benefit from it. Herein, we aimed to explore mutationrelated predictive biomarkers in lung squamous cell carcinoma (LUSC), which could help develop clinical immunotherapy strategies and screen beneficial populations. Co-occurrence and mutually exclusive analysis was conducted on the TCGA-LUSC cohort. Correlations between the gene mutation status and tumor mutation burden (TMB) levels, and neo-antigen levels were analyzed by Wilcoxon test. Kaplan-Meier method was employed to analyze the progression-free survival (PFS) of lung cancer patients with immunotherapy. Gene set enrichment analysis (GSEA) was used to investigate the functional changes affected by TP53mut/TTNmut. The immune cell infiltration landscape in co-mutation subgroups was analyzed using CIBERSORT. 1) TP53, TTN, CSMD3, MUC16, RYR2, LRP1B, USH2A, SYNE1, ZFHX4, FAM135B, KMT2D, and NAV3 were frequently mutated in LUSC patients. 2) TMB levels in highly mutated groups were higher than that in wild type groups. 3) There were higher neoantigen levels in mutation group compared to the wild-type group, and LUSC patients in mutation group had longer PFS. 4) TP53mut/TTNmut co-mutation group exhibited higher TMB levels and better response to immunotherapy. 5) A host of immune-related signaling pathways was inhibited in TP53mut/TTNmut subgroup. 6) There were more T follicular helper cells and NK cells were in TP53mut/TTNmut subgroup than in the WT subgroup. The LUSC patients with TP53 and TTN co-mutation had higher TMB levels and better response to immunotherapy. The TP53 and TTN co-mutation is a promising novel biomarker to assist LUSC immunotherapy evaluation.

Enhancing pediatric comfort: a comprehensive approach to managing molar-incisor hypomineralization with preemptive analgesia and behavioral strategies.

Preemptive analgesia is an important strategy used in pediatric dentistry to intercept pain signals in neural pathways early, thus mitigating the perception of pain and enhancing overall patient comfort. Pedodontists often encounter challenges in conducting the therapy and managing uncooperative patients, when addressing enamel defects of the Molar-incisor hypomineralization (MIH) type. The aim of this study is to demonstrate the impact of preemptive analgesia on optimizing behavioral management and restorative treatment strategies for immature permanent molars exhibiting severe MIH and Treatment need index 4 (TNI), through the effective control of pain. This study comprised 27 cases with MIH level 3 Posteruptive breakdown (PEB), indicating post-eruptive enamel breakdown, with initial hypersensitivity scores exceeding 4 on the Wong-Baker Scale, was conducted over 12 months, between January 2023-January 2024. Data on pediatric patients aged between 5 years and 4 months and 7 years and 1 month with varying degrees of sensitivity in their permanent first molars before the completion of the eruption process were collected. Pain intensity was systematically evaluated at six specific time points: before and after the administration of analgesic medication as well as during restorative treatment using the Wong-Baker scale and data from the Face, Legs, Activity, Cry, Consolability index (FLACC). Statistical analysis for Wong-Baker scores and FLACC index indicated statistical significance (p < 0.05) for Mann-Whitney and Wilcoxon tests, respectively t-test. The comparison of mean scores recorded before and after preemptive analgesia during rotary instrumentation moments for the Wong-Baker index (4 > 0.29) and for the FLACC index (8.47 > 1.71) indicates the positive influence of administering ibuprofen. In conclusion, preemptive analgesia, alongside standardized anesthesia, significantly improved intraoperative pain management and behavioral outcomes.

THE EFFECTS OF VIRTUAL REALITY ON PAIN, ANXIETY, AND COMFORT DURING THE CHEST TUBE REMOVAL PROCEDURE: A RANDOMIZED CLINICAL TRIAL

PurposeThe purpose of the current study is to determine the effects of virtual reality on pain, anxiety, and comfort during chest tube removal. Materials and MethodsThe research was conducted in the Cardiovascular Surgery Department of Atatürk University Health Practice and Research Hospital between January 2023 and April 2024. The study was performed as a randomized controlled experimental trial with a pretest-posttest control group. Eighty-two patients (41 in the intervention group and 41 in the control group) were included in the research. Patients in the intervention group watched a video with virtual reality glasses during chest tube removal. The “Descriptive Information Form,” “Visual Analog Scale,” “Verbal Pain Scale,” “State Anxiety Inventory,” and “Comfort Scale” were used to collect data. Number, percentage, mean, standard deviation, chi-square, paired sample t-test, independent sample t-test, Mann-Whitney U test, Wilcoxon test, and linear regression analysis were used in data evaluation. Our study was recorded in the Clinical Trials database with protocol number “NCT06550323.” ResultsThe groups had similar descriptive characteristics (p>0.05). The pre-procedural mean pain, anxiety, and comfort scores were similar in the two groups (p>0.05). The post-procedural mean VAS and verbal pain scores, mean anxiety, and comfort scores of the intervention group were lower in comparison with the control group (p<0.05). ConclusionThe research findings showed that virtual reality significantly reduced pain and anxiety while increasing comfort levels during chest tube removal. Therefore, it is recommended that virtual reality be used during chest tube removal.

Contraceptive Choice and Sexual Behaviors in Both-Sex Attracted Adolescents: A Retrospective Cohort Study

Study ObjectiveBisexual adolescents have higher rates of unintended pregnancy than their heterosexual peers and increased rates of high-risk sexual behaviors. They may be less likely to use effective contraception, though limited data is available. This study sought to compare contraceptive choice and sexual risk behaviors of both-sex attracted and opposite-sex attracted adolescents and young adults (AYA) presenting to a contraception clinic. MethodsA retrospective chart review of AYA aged 14-24 years who presented for an initial visit to a contraception clinic from 2014 to 2020. The primary outcome was contraceptive choice (long-acting reversible contraception (LARC), non-LARC, or nothing). Secondary outcomes included sexual behaviors. Results were analyzed using Pearson's chi-square and Wilcoxon tests. Results2369 AYA were included in this study. Both-sex attracted and opposite-sex attracted patients were similar in age, race, and ethnicity. There was no difference between groups in percent selecting LARC (71% vs 66.1%, p=0.11). Both-sex attracted patients reported a younger age at first sex (14.6 years vs 15.5 years, p < .001), more lifetime sexual partners (4.1 vs 2.8, p < .001), and a higher prevalence of forced intercourse (21.9% vs 8.8%, p < .001). ConclusionsBoth-sex attracted and opposite-sex attracted AYA patients chose LARCs at similar rates in a setting with standardized contraceptive counseling. Both-sex attracted patients had more sexual risk behaviors. Healthcare providers should be inclusive in their approach to obtaining sexual health histories and providing contraceptive counseling and be cognizant that adolescents with both-sex attraction may be at higher risk of forced intercourse.

Myocardial Fibrosis Assessment at 3-T versus 5-T Myocardial Late Gadolinium Enhancement MRI: Early Results.

Background Cardiac MRI at 5 T has recently become available and potentially improves tissue contrast enhancement at gadolinium chelate-enhanced T1-weighted imaging. Purpose To evaluate the feasibility of 5-T myocardial late gadolinium enhancement (LGE) MRI in assessing myocardial fibrosis by comparing image quality and LGE quantification with reference-standard 3-T myocardial LGE MRI. Materials and Methods Consecutive patients with confirmed myocardial fibrosis on previous 3-T MRI scans between January 2023 and July 2023 prospectively underwent follow-up imaging from August 2023 to November 2023. Each participant underwent follow-up 5-T imaging using an identical dose of contrast agent. Radiologist scoring of image quality using a Likert scale (range, 1-5), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), contrast ratio, and semiautomatic quantitative LGE assessment were obtained and reported as medians and IQRs. Paired Wilcoxon signed rank tests were used to compare characteristics derived at 3-T and 5-T imaging. Results A total of 18 participants (mean age, 49 years ± 17 [SD]; nine male participants) were included, with a mean interval of 6.2 months ± 2.3 between undergoing 3-T and 5-T MRI. Median image quality scores were 4.0 (IQR, 3.0-4.2) at 3 T and 4.0 (IQR, 3.0-4.4) at 5 T (P = .45). SNR at 5 T was higher than at 3 T (183.7 [IQR, 147.2-255.9] vs 125.8 [IQR, 108.2-171.6], respectively; P = .002). Median CNR at 5 T was higher than at 3 T in normal myocardium (50.8 [IQR, 35.4-67.9] vs 16.5 [IQR, 11.3-24.6], respectively) and pericardial fat (21.4 [IQR, 7.1-29.3] vs -5.0 [IQR, -16.4 to -2.3], respectively) (both P < .001). There was no evidence of a difference in the percentage of LGE quantified between 5 T and 3 T (median, 11.8% [IQR, 7.7%-20.5%] vs 12.6% [IQR, 6.6%-20.4%], respectively; P = .81). Conclusion Myocardial LGE MRI at 5 T was found to be feasible, with no evidence of differences in subjective image quality and myocardial fibrosis quantification compared with 3-T myocardial LGE MRI. Furthermore, with use of identical contrast agent doses, SNRs and CNRs were improved at 5 T. Published under a CC BY 4.0 license. Supplemental material is available for this article. See also the editorial by Czum in this issue.

Comparative analysis of communication strategies impact on the effectiveness of interaction with an AI chatbot

Introduction. The integration of artificial intelligence (AI) into everyday human interactions, particularly through chatbots, has significantly increased in recent years. AI-based chatbots successfully mimic human conversations by understanding user requests and responding appropriately. Improving the effectiveness of educational and professional activities related to text processing in these conditions seems extremely relevant and predetermines the goal of our study: comparing the effectiveness of interaction with ChatGPT when formulating queries in various communication strategies. Procedure and methods. The study on the effectiveness of interacting with ChatGPT was conducted using a natural experiment scheme with preliminary training. The subjects of the study were 34 employees (15 men, 19 women, aged 25-36; M = 31.6; SD = 1.8) from the marketing department of the company "Technologies of Trust". These employees performed rewriting tasks by interacting with ChatGPT within the framework of specially adapted communication strategies (persuasive and cooperative) and evaluated the chatbot's usability and the quality of the text generated by ChatGPT. The Wilcoxon signed-rank test for dependent samples was used to identify the effects of communication strategies on interaction efficiency, and exploratory factor analysis with subsequent varimax rotation was employed to identify latent variables of interaction under different communication strategies. Research Results. Comparison of the results of the ChatGPT interaction performance evaluation when using 2 strategies (cooperative and persuasive) showed that for all 11 usability indicators, there is a significant advantage of the cooperative communicative strategy at the significance level of p&lt;0.05. However, on 6 indicators of text quality obtained through rewriting, the persuasive strategy shows advantages and on 4 of them at a significance level of p&lt;0.05. In the course of the study it was found that the factor solutions for the studied communicative strategies differ significantly: the key factor in using the persuasive strategy is speed and accuracy in achieving goals, while in the cooperative strategy the adequate response of chatbots to objections is critical. Conclusion. The results obtained in the study contribute significantly to the understanding of communication with AI chatbots, highlighting the nuances of interacting through linguistic means typical for human communication. The findings demonstrate the complexity of choosing the optimal strategy for interacting with ChatGPT and uncover the factors that determine the features of subjective evaluation of the interaction.

Benefits of an educational intervention on functional capacity in community-dwelling older adults with frailty phenotype: A randomized controlled trial

BackgroundThere is an urgent demand for nurses to expand their knowledge and skills in managing frailty in primary care. Frailty is a multifaceted condition that is prevalent among older adults and often leads to reduced functional capacity. Currently, there is a limited understanding of the effectiveness of educational interventions aimed at improving functional capacity among community-dwelling frail older adults in a primary care setting. ObjectiveThis study aimed to evaluate the impact of an educational program on functional capacity among pre-frail and frail older adults living in the community. DesignA 12-month, multicenter, randomized controlled trial. SettingsThe FRAGSALUD study was conducted across 14 healthcare centers situated within the regions of Cadiz and Malaga, Spain. ParticipantsA total of 199 frail/pre-frail community-dwelling older adults (74.2 ± 6.4 years). MethodsParticipants who met at least one Fried's criteria were assigned to either the control group (n = 90), which received usual healthcare assistance, or the intervention group (n = 109). The 6-month intervention comprised four group sessions and six telephone calls conducted by professional nurses, sport scientists, and nutritionists. This educational program focused on guidelines for physical activity, nutritional habits, cognition, and psychosocial well-being. Functional capacity was assessed using questionnaires for basic (Barthel Index) and instrumental (Lawton & Brody Scale) activities of daily living. All outcome measures were evaluated at baseline, immediately after the intervention (6-month), and six months after the intervention as a follow-up (12-month). Differences in functional capacity (Barthel Index and Lawton and Brody Scale scores) across the three time points were analyzed using Friedman's ANOVA, with Wilcoxon signed-rank test for pairwise comparisons. ResultsAt both 6-month and 12-month assessments, the control group showed a statistically significant decline in basic and instrumental activities of daily living compared to the intervention group, which maintained similar levels, preventing this age-related decline. ConclusionsThe educational intervention, designed for easy implementation within healthcare systems, especially for nurses, successfully maintained levels of functional capacity in basic and instrumental activities of daily living, while the control group experienced a decline in functional capacity during the 12-month follow-up. Thus, educational interventions are encouraged for preserving the functional independence of frail/pre-frail older adults living in the community. RegistrationThis trial was registered at ClinicalTrials.gov (Identifier: NCT05610605) and the first participant was registered in March 2022.Tweetable abstract: The FRAGSALUD educational intervention prevents the age-related decline in functional independence over 12 months in frail older adults.

Outcomes of laser hemorrhoidoplasty for grade II-IV hemorrhoidal disease in Bangladesh.

Laser hemorrhoidoplasty is a minimally invasive procedure to treat hemorrhoids and has shown better outcomes. Less is known about its utility in a lower middle-income country; Bangladesh. Between March 2023 and December 2023, 86 patients with grade II-IV hemorrhoids underwent laser hemorroidoplasty. Follow up was assessed on 1st week, 2nd week, and 6th week including pain, satisfaction, symptom improvement, incapacity for work, complications, reduction, and recurrence. The study included 86 patients, with a higher proportion of male participants (73.3%) and a mean age of 55.43±13.6 years. The majority of subjects (68.60%) had grade 3 hemorrhoids. The average surgery duration was 14.70±4.70minutes All individuals experienced substantial decreases in the size of their hemorrhoids (100%) and reported high levels of satisfaction after the operation (97.7%). The use of the Wilcoxon signed-rank test demonstrated a statistically significant reduction in both the Visual Analog Scale (VAS) and Patient Global Impression of Improvement (PGI-I) ratings during the three subsequent observation periods (1st week, 2nd week, and 6th week). The 6th week complication rate was 19.8%. Additional mucopexy was performed on all patients with grade IV and three patients with grade III hemorrhoids. Laser hemorroidoplasty is a day-care procedure, that is safe and efficacious and can be used in rural area settings with good patient satisfaction. Mucopexy is required in some cases of large hemorrhoidal mass to prevent recurrence.

Simulation-free magnetic resonance-guided radiation therapy of prostate cancer

Background and purposeDespite recent advances of online image-guided high-precision patient positioning and adaptation using magnetic resonance imaging (MRI) or cone-beam computed tomography (CT), standard radiation therapy pathway still involves a dedicated simulation scan. The aim of this study was to evaluate the feasibility and planning quality of integrating a simulation-free treatment planning workflow for adaptive online MRI-guided radiation therapy on a 1.5 T MRI linear accelerator (MRI-Linac) in prostate cancer using diagnostic CT (dCT) scans. Materials and methodsFor ten patients with prostate cancer previously treated at the MRI-Linac with adaptive radiation therapy (42.7 Gy in 7 fractions), simulation-free reference plans based on dCT were retrospectively created, and adaptive plans were simulated for the first treatment fraction. Reference and adapted plans derived from both standard and simulation-free workflows were compared with regard to institutional dose volume criteria, followed by statistical assessment using the paired Wilcoxon signed-rank test with a Bonferroni-corrected significance level of α = 0.025. ResultsSimulation-free reference and adapted plans consistently met dose volume criteria. Statistical analysis revealed no significant differences between both workflows, except median values for near-maximum dose (D2%) in the planning target volume: 44.2 Gy (standard) vs. 44.5 Gy (simulation-free) in reference plans (p = 0.014), and 44.5 Gy vs. 44.6 Gy in adapted plans (p = 0.009). ConclusionThis study demonstrated the feasibility of simulation-free radiation therapy planning using dCT. Comparable treatment plan quality was observed for both reference and adapted radiation therapy plans in a curative setting for patients with prostate cancer.

The Effect of an Educational Program on the Knowledge and Attitude of Medical Sciences Students About Social Determinants of Health in Iranian University Students: A Quasi-Experimental Study.

Given the importance of social determinants on health outcomes, training medical sciences students in addressing social determinants of health can enhance their effectiveness and social accountability. The aim of this study was to assess the effect of an educational program on the knowledge and attitude of medical sciences students regarding social determinants of health. Using a one-group pretest-posttest quasi-experimental design, this study selected 200 students from a medical university in Iran through simple random sampling. A tailored educational intervention, grounded in the conceptual framework for action on social determinants of health, was implemented. To assess the program's effect, data were collected using a validated questionnaire that measured the students' knowledge and attitudes towards social determinants of health both at baseline (pretest) and 1 month following the intervention (posttest). The application of the Wilcoxon Signed-Ranks Test revealed a significant increase in the median scores for knowledge and attitude postintervention. Specifically, the posttest median scores were significantly elevated compared to the pretest knowledge score (Z = -11.89, p < 0.001) and attitude score (Z = -11.60, p < 0.001). This indicates that the educational intervention significantly improved the students' knowledge and attitudes concerning social determinants of health. The study outcomes suggest that educational interventions focused on social determinants of health effectively improve students' knowledge and attitudes. We recommend integrating such programs into the medical sciences curriculum and experiential training. By doing so, we can better prepare future healthcare professionals to address social determinants of health-related issues. This approach has the potential to reduce health disparities and also addresses broader social challenges affecting population health.

Effect of home based tele pilates on pelvic girdle pain and lumbo pelvic stability among pregnant women – A randomized controlled trial

Introduction. Pelvic girdle pain is one of the common musculoskeletal problems in pregnancy, resulting from hormonal variations and biomechanical alterations in the muscles that support lumbo-pelvic stability. The Pilates method, which includes mind-body approaches and focuses on core strength, provides relief from pelvic pain. In recent years, tele-rehabilitation has emerged as one of the most popular solutions in clinical practice. Aim. To find out the effect of home-based Tele Pilates on pelvic girdle pain and lumbo-pelvic stability among pregnant women. Materials and methods. A randomized controlled trial was conducted in Sri Ramachandra Hospital, Chennai, from January 2023 to June 2023. Pregnant women with pelvic girdle pain from 20-30 weeks of gestation were screened and randomly divided into a Pilates exercise group (n = 19) and a control group (n = 19). Subjects in the Pilates group followed the exercise thrice a week for eight weeks. Subjects in the control group followed standardized antenatal exercises and education. The outcome measures used were Visual Analogue Scale (VAS) for pain level, Pelvic Girdle Questionnaire (PGQ) for functional disability, and Pressure Biofeedback for lumbo-pelvic stability. Mann-Whitney test, Wilcoxon signed rank test, and ‘t’ test were performed to examine the pain score, Pelvic Girdle Questionnaire, and the lumbo-pelvic stability. Results. Baseline parameters are similar and comparable. (p &lt; 0.05). Between-group analysis revealed that the experimental group showed improvement in the pain and disability with a significant difference (p ≤ 0.001). Both groups showed significant improvement in lumbo-pelvic stability in the within-group analysis (p &lt; 0.001). Conclusion. Home-based tele Pilates (HTPE) can be recommended as an effective and safe method for decreasing pain levels and improving lumbo-pelvic stability among pregnant women with pelvic girdle pain.

Effectiveness of biopsychosocial approach for subacute neck pain among geriatrics

Background: The geriatric Population faces common health challenges such as Frailty and neck Pain, which increases the risk for adverse ADL. It leads to a greater level of disability &amp; Headache risk, lower physical functioning and reduced quality of life. A Biopsychosocial Approach centred on activities, emphasizing the enhancement of Biological factors, Psychological factors and Social functional performance to achieve the goals of the Biopsychosocial Approach. This involves intensifying exercise training by leveraging the environment, conducting thorough task analysis, providing feedback and consistently repeating training sessions. Objective: To determine the effects of the Biopsychosocial Approach on Subacute Neck Pain in the geriatric population, focusing on pain, neck-specific disability and work status. Methods: 64 samples were randomly allocated into two groups. The experimental group received the Biopsychosocial Approach, which integrated biological, psychological and social aspects activity-centred, emphasizing repeated training sessions over 8 weeks. The control group underwent Conservative Management 3 days/week for the same duration. Pre and post-test assessments were conducted using the PCS, NDI and AQoL-8D. Results: The significant improvements in the experimental group compared to the control group were demonstrated by the Wilcoxon Signed Rank Test and Mann-Whitney Rank scores (p &lt; 0.001). Specifically, participants in the experimental group experienced reduced neck pain, enhanced neck function, and improved quality outcomes. The results suggest that the Biopsychosocial Approach effectively addressed the multifaceted nature of pain. Conclusion: The study provides compelling evidence supporting Biopsychosocial in reducing neck pain and improving overall quality of life among geriatric populations.