Search results for: clinical/non-clinical sample

Authors: Thiago Fabrizio Gavilano Farje, Marcelo Patricio Herrera Malpartida

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This study examines the influence of artificial intelligence (AI) on the work efficiency of administrative employees in the financial sector of Metropolitan Lima, Peru, during the year 2024. Focusing on the relationship between AI implementation and work efficiency, it addresses specific variables such as decision-making, motivation, and employee productivity. To accomplish the analysis between AI and work efficiency within the financial sector of Metropolitan Lima, it is necessary to evaluate how AI optimizes time in administrative tasks, examine how AI impacts the agility of the process of making decisions, and investigate the influence of AI on the satisfaction and motivation of employees. The research adopts a correlational and explanatory approach, designed to establish and understand the connections between AI and work efficiency. A survey design adapted from an OECD study is used, applying questionnaires to a representative sample of administrative workers in the financial sector who incorporate AI into their functions. The target population includes administrative workers in the financial sector of Metropolitan Lima, estimated at 73,097 employees based on data from the Censo Nacional de Empresas y Establecimientos and studies by the BCRP. The sample, selected through simple random sampling, comprises 246 workers.

Keywords: business management, artificial intelligence, decision making, labor efficiency, financial sector

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Authors: Ali H. Muhammad

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The present study examines some antecedents and consequences of employee job involvement in Kuwaiti business organization. The model presented in the current study suggests that job satisfaction and organizational commitments are determinates of job involvements. Employees who are satisfied with their jobs tend to be more attached to their jobs and view their jobs as an essential part of their existence. Similarly, employees who are committed to organizational goals, and identify with organizational values, tend to have high level of involvement. Furthermore, our model suggests that job involvement is positively related to work performance and organizational citizenship behavior. The negative consequences of job involvement include burnout and work family conflict. To test the hypotheses, a sample of 204 Kuwaiti employees representing 8 Kuwaiti work organizations is used. The sample covers a variety of business sectors in Kuwait, including manufacturing, services, and transportation. The data were analyzed using non-parametric tests, Pearson correlations, and structural equation modeling. Results indicate that job satisfaction and organizational commitment have significant positive effects on job involvement. Furthermore, findings reveal that job involvement is positively associated with performance, organization citizenship behavior, and work family conflict. Findings are discussed, and future areas of research are identified.

Keywords: job involvement, organizational citizenship behavior, work family conflict, burnout

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Authors: Luana Guerra, Silvio C. Sampaio, Vladimir Pavan Margarido, Ralpho R. Reis

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Brazil is the world's largest consumer of pesticides. The excessive use of these compounds has negative impacts on animal and human life, the environment, and food security. Bees, crucial for pollination, are exposed to pesticides during the collection of nectar and pollen, posing risks to their health and the food chain, including honey contamination. Aquatic sediments are also affected, impacting water quality and the microbiota. Therefore, the analysis of aquatic sediments and bee honey is essential to identify environmental contamination and monitor ecosystems. The aim of this study was to use samples of honey from honeybees (Apis mellifera) and aquatic sediment as bioindicators of environmental contamination by pesticides and their relationship with agricultural use in the surrounding areas. The sample collections of sediment and honey were carried out in two stages. The first stage was conducted in the Bituruna municipality region in the second half of the year 2022, and the second stage took place in the regions of Laranjeiras do Sul, Quedas do Iguaçu, and Nova Laranjeiras in the first half of the year 2023. In total, 10 collection points were selected, with 5 points in the first stage and 5 points in the second stage, where one sediment sample and one honey sample were collected for each point, totaling 20 samples. The honey and sediment samples were analyzed at the Laboratory of the Paraná Institute of Technology, with ten samples of honey and ten samples of sediment. The selected extraction method was QuEChERS, and the analysis of the components present in the sample was performed using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). The pesticides Azoxystrobin, Epoxiconazole, Boscalid, Carbendazim, Haloxifope, Fomesafen, Fipronil, Chlorantraniliprole, Imidacloprid, and Bifenthrin were detected in the sediment samples from the study area in Laranjeiras do Sul, Paraná, with Carbendazim being the compound with the highest concentration (0.47 mg/kg). The honey samples obtained from the apiaries showed satisfactory results, as they did not show any detection or quantification of the analyzed pesticides, except for Point 9, which had the fungicide tebuconazole but with a concentration Keywords: contamination, water research, agrochemicals, beekeeping activity

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Authors: Arezou Hajhashemi, Karim Asgari, Masoud Etemadifar, Maryam Keyvani, Ali Hekmatnia

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Multiple Sclerosis (MS) is one of the most prevalent demyelinating diseases in CNS. As in other chronic cerebral diseases, impairment in cognitive functioning and in memory is popular. Because of the inflammatory and demyelinating nature of the disease, the localization of plaques in different parts of the Prefrontal and Limbic System, may lead to memorial symptoms. This investigation was intended to study relationship between frequency of plaques and memorial symptoms arising from dysfunction limbic system and prefrontal of patients with MS. The sample was selected randomly from patients with MS with memory problem, who have been referred to Isfahan Multiple Sclerosis Society. Brain System Test and Memory Test was administered to the sample, and their MRI's were analyzed by specialist in order to indentify two different parts of plaques. The data was analyzed by SPSS. The results showed that there were significant relationship between MS plaques and prefrontal's dysfunction and memorial symptom related to prefrontal area; however, there were no significant relationship between MS plaques and limbic system's dysfunction and memorial symptoms related to limbic system area. The results of this study suggest that memorial symptoms due to injury regions of the brain have the most significant relationship to prefrontal. Better judgment about these results needs more studies in future.

Keywords: multiple sclerosis, magnetic image, brain injury, behavior disorder

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Authors: Saleem Z. Ramadan

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This paper discusses the effects of using progressive Type-I right censoring on the design of the Simple Step Accelerated Life testing using Bayesian approach for Weibull life products under the assumption of cumulative exposure model. The optimization criterion used in this paper is to minimize the expected pre-posterior variance of the PTH percentile time of failures. The model variables are the stress changing time and the stress value for the first step. A comparison between the conventional and the progressive Type-I right censoring is provided. The results have shown that the progressive Type-I right censoring reduces the cost of testing on the expense of the test precision when the sample size is small. Moreover, the results have shown that using strong priors or large sample size reduces the sensitivity of the test precision to the censoring proportion. Hence, the progressive Type-I right censoring is recommended in these cases as progressive Type-I right censoring reduces the cost of the test and doesn't affect the precision of the test a lot. Moreover, the results have shown that using direct or indirect priors affects the precision of the test.

Keywords: reliability, accelerated life testing, cumulative exposure model, Bayesian estimation, progressive type-I censoring, Weibull distribution

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Authors: Wen-Chung Chiang, Lun-Jou Lo, Hsiu-Hsia Lin

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This study aimed to improve the evaluation of facial symmetry, which is crucial for planning and assessing outcomes in orthognathic surgery (OGS). Facial symmetry plays a key role in both aesthetic and functional aspects of OGS, making its accurate evaluation essential for optimal surgical results. To address the limitations of traditional methods, a different approach was developed, combining three-dimensional (3D) facial contour mapping with hyperdimensional (HD) computing to enhance precision and efficiency in symmetry assessments. The study was conducted at Chang Gung Memorial Hospital, where data were collected from 2018 to 2023 using 3D cone beam computed tomography (CBCT), a highly detailed imaging technique. A large and comprehensive dataset was compiled, consisting of 150 normal individuals and 2,800 patients, totaling 5,750 preoperative and postoperative facial images. These data were critical for training a machine learning model designed to analyze and quantify facial symmetry. The machine learning model was trained to process 3D contour data from the CBCT images, with HD computing employed to power the facial symmetry quantification system. This combination of technologies allowed for an objective and detailed analysis of facial features, surpassing the accuracy and reliability of traditional symmetry assessments, which often rely on subjective visual evaluations by clinicians. In addition to developing the system, the researchers conducted a retrospective review of 3D CBCT data from 300 patients who had undergone OGS. The patients’ facial images were analyzed both before and after surgery to assess the clinical utility of the proposed system. The results showed that the facial symmetry algorithm achieved an overall accuracy of 82.5%, indicating its robustness in real-world clinical applications. Postoperative analysis revealed a significant improvement in facial symmetry, with an average score increase of 51%. The mean symmetry score rose from 2.53 preoperatively to 3.89 postoperatively, demonstrating the system's effectiveness in quantifying improvements after OGS. These results underscore the system's potential for providing valuable feedback to surgeons and aiding in the refinement of surgical techniques. The study also led to the development of a web-based system that automates facial symmetry assessment. This system integrates HD computing and 3D contour mapping into a user-friendly platform that allows for rapid and accurate evaluations. Clinicians can easily access this system to perform detailed symmetry assessments, making it a practical tool for clinical settings. Additionally, the system facilitates better communication between clinicians and patients by providing objective, easy-to-understand symmetry scores, which can help patients visualize the expected outcomes of their surgery. In conclusion, this study introduced a valuable and highly effective approach to facial symmetry evaluation in OGS, combining 3D contour mapping, HD computing, and machine learning. The resulting system achieved high accuracy and offers a streamlined, automated solution for clinical use. The development of the web-based platform further enhances its practicality, making it a valuable tool for improving surgical outcomes and patient satisfaction in orthognathic surgery.

Keywords: facial symmetry, orthognathic surgery, facial contour mapping, hyperdimensional computing

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Authors: Shatabdi Goon

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OBJECTIVE: To determine the prevalence and associations between breakfast skipping and health status for university professionals in Bangladesh. DESIGN: A cross-sectional descriptive study design was performed using information on respondent’s sociodemographic status and eating behavior. Factors associated with breakfast skipping were identified using multivariate regression models. SETTINGS: Data obtained from a representative sample (n 120) of university professionals randomly selected from two distinct universities in Dhaka city, Bangladesh. SUBJECT: A total number of one hundred and twenty university professionals with a mean age of 29 years. RESULT: Results indicated that approximately 35.8% of the sample skipped breakfast. Gender was the only statistically significant sociodemographic variable, with females skipping at over two times the rate of males (OR 95% CI: 1.9; 0.90-4.13). The reasons given for skipping breakfast were almost exclusively habit (39.5%), work pressure (23.2%) and lack of time (16.2%). Skippers were significantly more likely to be obese (OR 2.4; 95% CI 1.02- 5.7), less energetic (OR 3.5; 95% CI 1.5-8.6), associated with health problems (OR 4.3; 95% CI 1.8- 10.17) and eating tendency of fast food (OR 2.5; 95% CI 1.13 - 5.5). Gastric and heart burn (X2=4.19, p<0.05) and high blood pressure (X2=5.027, p<0.05) were detected among 34.9% and 27.9 % of those employees respectively identified as breakfast skippers and they showed significantly high prevalence. CONCLUSION: Breakfast skipping is highly prevalent among university professionals with significant association of different health problems in Bangladesh. Health promotion strategies should be used to encourage all adults to eat breakfast regularly.

Keywords: breakfast, healthy lifestyle, breakfast skipping, health status, university professionals

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Authors: Tonya P. Bowers

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Background: The community/patient-focused quality improvement (QI) project has resolved a clinical problem using a quantitative design evaluating behavior change practices in a convenience sample from a multi-cultural congregation in a faith-based setting. AD is a legal document that speaks for the patient when they are unable to speak for themselves. The AD provides detailed information regarding critical medical decisions on behalf of the patient if they’re unable to make decisions themselves. The goal of an AD is to improve EOL care renderings that align with the patient’s desires. The AD diminishes anxiety and stress associated with making difficult EOL care decisions for patients and their families. Method: The project has two intervention strategies: pre-intervention and post-intervention formative surveys and a final summative survey. Most of the data collection takes place during implementation. The Let’s Talk About It Program utilized an online meeting platform for presentation. Participants were asked to complete informed consent and surveys via an online portal. Education included slide presentation, Advance Directive demonstration, video clips, discussions and 1:1 assistance with AD completion with a project manager. Results: Considering the overwhelming likelihood responses where 87.5% identified they “definitely would” hold an End-Of-Life conversation with their healthcare provider or family, and 81.25% indicated their likelihood that they “definitely would” complete an advance directive. In addition, the final summative post-intervention survey (n-14) also demonstrated an overwhelming 93% positive response. Which undoubtedly demonstrates favorable outcomes for the project. Conclusion: the Let’s Talk About It Program demonstrated effectiveness in improving participants' attitudes and acceptance towards Advance Directives and expanding End-of-Life care discussions. Emphasis on program sustainment within the church is imperative in fostering continued awareness and improved health outcomes for the local community with low health literacy.

Keywords: advance directive, end of life, advance care planning, palliative care, low health literacy, faith-based

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Authors: Majid Habib Khan, Jinwei Zhao, Xinhong Hei, Liu Jiedong, Rana Shahzad Noor, Muhammad Imran

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Deep learning is increasingly employed in image classification, yet the scarcity and high cost of labeled data for training remain a challenge. Limited samples often lead to overfitting due to biased sample distribution. This paper introduces a dynamic distribution calibration method for few-shot learning. Initially, base and new class samples undergo normalization to mitigate disparate feature magnitudes. A pre-trained model then extracts feature vectors from both classes. The method dynamically selects distribution characteristics from base classes (both adjacent and remote) in the embedding space, using a threshold value approach for new class samples. Given the propensity of similar classes to share feature distributions like mean and variance, this research assumes a Gaussian distribution for feature vectors. Subsequently, distributional features of new class samples are calibrated using a corrected hyperparameter, derived from the distribution features of both adjacent and distant base classes. This calibration augments the new class sample set. The technique demonstrates significant improvements, with up to 4% accuracy gains in few-shot classification challenges, as evidenced by tests on miniImagenet and CUB datasets.

Keywords: deep learning, computer vision, image classification, few-shot learning, threshold

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Authors: Manahil Alfuraydan, Jodie Croxall, Lisa Hurt, Mike Kerr, Sinead Brophy

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Autism Spectrum Disorder (ASD) is a developmental condition characterised by impairment in terms of social communication, social interaction, and a repetitive or restricted pattern of interest, behaviour, and activity. There is a significant delay between seeking help and a confirmed diagnosis of ASD. This may result in delay in receiving early intervention services, which are critical for positive outcomes. The long wait times also cause stress for the individuals and their families. Telehealth potentially offers a way of improving the diagnostic pathway for ASD. This review of the literature aims to examine which telehealth approaches have been used in the diagnosis and assessment of autism in children and adults, whether they are feasible and acceptable, and how they compare with face-to-face diagnosis and assessment methods. A comprehensive search of following databases- MEDLINE, CINAHL Plus with Full text, Business Sources Complete, Web of Science, Scopus, PsycINFO and trail and systematic review databases including Cochrane Library, Health Technology Assessment, Database of Abstracts and Reviews of Effectiveness and NHS Economic Evaluation was conducted, combining the terms of autism and telehealth from 2000 to 2018. A total of 10 studies were identified for inclusion in the review. This review of the literature found there to be two methods of using telehealth: (a) video conferencing to enable teams in different areas to consult with the families and to assess the child/adult in real time and (b) a video upload to a web portal that enables the clinical assessment of behaviours in the family home. The findings were positive, finding there to be high agreement in terms of the diagnosis between remote methods and face to face methods and with high levels of satisfaction among the families and clinicians. This field is in the very early stages, and so only studies with small sample size were identified, but the findings suggest that there is potential for telehealth methods to improve assessment and diagnosis of autism used in conjunction with existing methods, especially for those with clear autism traits and adults with autism. Larger randomised controlled trials of this technology are warranted.

Keywords: assessment, autism spectrum disorder, diagnosis, telehealth

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Authors: M. Draman, S. Z. Muhamad Yassin, M. S. Alias, Z. Lambak, M. I. Zulkifli, S. N. Padhi, K. N. Baharim, F. Maskuriy, A. I. A. Rahim

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The performance of Malay automatic speech recognition (ASR) system for the call centre environment is presented. The system utilizes Kaldi toolkit as the platform to the entire library and algorithm used in performing the ASR task. The acoustic model implemented in this system uses a deep neural network (DNN) method to model the acoustic signal and the standard (n-gram) model for language modelling. With 80 hours of training data from the call centre recordings, the ASR system can achieve 72% of accuracy that corresponds to 28% of word error rate (WER). The testing was done using 20 hours of audio data. Despite the implementation of DNN, the system shows a low accuracy owing to the varieties of noises, accent and dialect that typically occurs in Malaysian call centre environment. This significant variation of speakers is reflected by the large standard deviation of the average word error rate (WERav) (i.e., ~ 10%). It is observed that the lowest WER (13.8%) was obtained from recording sample with a standard Malay dialect (central Malaysia) of native speaker as compared to 49% of the sample with the highest WER that contains conversation of the speaker that uses non-standard Malay dialect.

Keywords: conversational speech recognition, deep neural network, Malay language, speech recognition

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Authors: Marta Fernández Olmos, Ana Gargallo Castel, Alice Salami

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The literature has shown the importance of studying the issue of business survival in highly competitive environments. In particular, the wine sector has certain characteristics that make it interesting to study factors that increase the possibility of wineries' survival, such as individual productivity, winery size, age, innovation efforts or the maturity of the industry itself, among others. Due to the importance of these factors, this research aims to analyze whether the possibility of wineries' survival increases if they are family businesses or if there is gender diversity in senior management. To this end, a nationwide survey was carried out. The sample was made up of wineries from all the Spanish appellations of origin, using this sample to analyze the survival of the diverse types of wineries according to the factors to be studied. The main results indicate that family wineries survive longer, suggesting that this may be due to the fact that the main objective of family wineries is the continuity of the business in the long term. Regarding gender diversity, wineries that have a female presence in top roles in management, adding gender diversity, survive more than those with a predominantly male presence. Based on these results, it is advisable to consider the importance of family businesses, especially in this type of sector. In addition, support should be provided for the inclusion of a female labor force to improve the possibility of survival.

Keywords: gender, family business, wine industry, survival

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Authors: Yanxue Shang, Jingbin Zeng

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Chlorobenzene homologues (CBHs) are a category of environmental pollutants that can not be ignored. They can stay in the environment for a long period and are potentially carcinogenic. The traditional degradation method of CBHs is dechlorination followed by sample preparation and analysis. This is not only time-consuming and laborious, but the detection and analysis processes are used in conjunction with large-scale instruments. Therefore, this can not achieve rapid and low-cost detection. Compared with traditional sensing methods, colorimetric sensing is simpler and more convenient. In recent years, chromaticity sensors based on fluorescence have attracted more and more attention. Compared with sensing methods based on changes in fluorescence intensity, changes in color gradients are easier to recognize by the naked eye. Accordingly, this work proposes to use single drop microextraction (SDME) technology to solve the above problems. After the dechlorination reaction was completed, the organic droplet extracts Cl⁻ and realizes fluorescence colorimetric sensing at the same time. This method was integrated sample processing and visual in-situ detection, simplifying the detection process. As a fluorescence colorimetric sensor material, CsPbBr₃ was encapsulated in MOF-5 to construct CsPbBr₃@MOF-5 fluorescence colorimetric composite. Then the fluorescence colorimetric sensor was constructed by dispersing the composite in SDME organic droplets. When the Br⁻ in CsPbBr₃ exchanges with Cl⁻ produced by the dechlorination reactions, it is converted into CsPbCl₃. The fluorescence color of the single droplet of SDME will change from green to blue emission, thereby realizing visual observation. Therein, SDME can enhance the concentration and enrichment of Cl⁻ and instead of sample pretreatment. The fluorescence color change of CsPbBr₃@MOF-5 can replace the detection process of large-scale instruments to achieve real-time rapid detection. Due to the absorption ability of MOF-5, it can not only improve the stability of CsPbBr₃, but induce the adsorption of Cl⁻. Simultaneously, accelerate the exchange of Br- and Cl⁻ in CsPbBr₃ and the detection process of Cl⁻. The absorption process was verified by density functional theory (DFT) calculations. This method exhibits exceptional linearity for Cl⁻ in the range of 10⁻² - 10⁻⁶ M (10000 μM - 1 μM) with a limit of detection of 10⁻⁷ M. Whereafter, the dechlorination reactions of different kinds of CBHs were also carried out with this method, and all had satisfactory detection ability. Also verified the accuracy by gas chromatography (GC), and it was found that the SDME we developed in this work had high credibility. In summary, the in-situ visualization method of dechlorination reaction detection was a combination of sample processing and fluorescence colorimetric sensing. Thus, the strategy researched herein represents a promising method for the visual detection of dechlorination reactions and can be extended for applications in environments, chemical industries, and foods.

Keywords: chlorobenzene homologues, colorimetric sensor, metal halide perovskite, metal-organic frameworks, single drop microextraction

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Authors: Eyal Rosen

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This study is aimed to report a possible effect of the presence of dental implants on the development of crown or root fractures in adjacent natural teeth. A series of 26 cases of teeth diagnosed with crown or root fractures following the placement of adjacent dental implants is presented. In addition, a comprehensive systematic review of the literature was performed to detect other studies that evaluated this possible complication. The case series analysis revealed that all crown-fractured teeth were non-endodontically treated teeth (n=18), and all root fractured teeth were endodontically treated teeth (n=8). The time from implant loading to the diagnosis of a fracture in an adjacent tooth was longer than 1 year in 78% of cases. The majority of crown or root fractures occurred in female patients, over 50 years of age, with an average age of 59 in the crown fractures group, and 54 in the root fractures group. Most of the patients received 2 or more implants. Nine (50%) of the teeth with crown fracture were molars, 7 (39%) were mandibular premolars, and 2 (11%) were incisor teeth. The majority of teeth with root fracture were premolar or mandibular molar teeth (6 (75%)). The systematic review of the literature did not reveal additional studies that reported on this possible complication. To the best of the author’s knowledge this case series, although limited in its extent, is the first clinical report of a possible serious complication of implants, associated fractures in adjacent endodontically and non-endodontically treated natural teeth. The most common patient profile found in this series was a woman over 50 years of age, having a fractured premolar tooth, which was diagnosed more than 1 year after reconstruction that was based on multiple adjacent implants. Additional clinical studies are required in order to shed light on this potential serious complication.

Keywords: complications, dental implants, endodontics, fractured teeth

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Authors: Athanasios Triantafyllou, Georgios Papagiannis, Vassilios Nikolaou, Panayiotis J. Papagelopoulos, George C. Babis

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In vitro measurements are widely used in order to predict THAs wear rate implementing gait kinematic and kinetic parameters. Clinical tests of materials and designs are crucial to prove the accuracy and validate such measurements. The purpose of this study is to examine the affection of THA gait kinematics and kinetics on wear during gait, the essential functional activity of humans, by comparing in vivo gait data to in vitro results. Our study hypothesis is that both implants will present the same hip joint kinematics and kinetics during gait. 127 unilateral primary cementless total hip arthroplasties were included in the research. Independent t-tests were used to identify a statistically significant difference in kinetic and kinematic data extracted from 3D gait analysis. No statistically significant differences observed at mean peak abduction, flexion and extension moments between the two groups (P.abduction= 0,125, P.flexion= 0,218, P.extension= 0,082). The kinematic measurements show no statistically significant differences too (Prom flexion-extension= 0,687, Prom abduction-adduction= 0,679). THA kinematics and kinetics during gait are important biomechanical parameters directly associated with implants wear. In vitro studies report less wear in CoC than CoXLPE when tested with the same gait cycle kinematic protocol. Our findings confirm that both implants behave identically in terms of kinematics in the clinical environment, thus strengthening in vitro results of CoC advantage. Correlated to all other significant factors that affect THA wear could address in a complete prism the wear on CoC and CoXLPE.

Keywords: total hip arthroplasty biomechanics, THA gait analysis, ceramic on ceramic kinematics, ceramic on XLPE kinetics, total hip replacement wear

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Authors: Jan C. Droste, Justine Burns, Nithin Narayan

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Introduction: Life-threatening detrimental effects of inappropriate adrenaline (epinephrine) administration, e.g., by giving the wrong dose, in the context of anaphylaxis management is well documented in the medical literature. Half of the fatal anaphylactic reactions in the UK are iatrogenic, and the median time to a cardio-respiratory arrest can be as short as 5 minutes. It is therefore imperative that hospital doctors of all grades have active and accurate knowledge of the correct route, site, and dosage of administration of adrenaline. Given this time constraint and the potential fatal outcome with inappropriate management of anaphylaxis, it is alarming that surveys over the last 15 years have repeatedly shown only a minority of doctors to have accurate knowledge of adrenaline administration as recommended by the UK Resuscitation Council guidelines (2008 updated 2012). This comparison of survey results of the medical workforce over several years in a small NHS District General Hospital was conducted in order to establish the effect of the employment of multiple educational methods regarding adrenaline administration in anaphylaxis in adults. Methods: Between 2010 and 2017, several education methods and tools were used to repeatedly inform the medical workforce (doctors and advanced clinical practitioners) in a single district general hospital regarding the treatment of anaphylaxis in adults. Whilst the senior staff remained largely the same cohort, junior staff had changed fully in every survey. Examples included: (i) Formal teaching -in Grand Rounds; during the junior doctors’ induction process; advanced life support courses (ii) In-situ simulation training performed by the clinical skills simulation team –several ad hoc sessions and one 3-day event in 2017 visiting 16 separate clinical areas performing an acute anaphylaxis scenario using actors- around 100 individuals from multi-disciplinary teams were involved (iii) Hospital-wide distribution of the simulation event via the Trust’s Simulation Newsletter (iv) Laminated algorithms were attached to the 'crash trolleys' (v) A short email 'alert' was sent to all medical staff 3 weeks prior to the survey detailing the emergency treatment of anaphylaxis (vi) In addition, the performance of the surveys themselves represented a teaching opportunity when gaps in knowledge could be addressed. Face to face surveys were carried out in 2010 ('pre-intervention), 2015, and 2017, in the latter two occasions including advanced clinical practitioners (ACP). All surveys consisted of convenience samples. If verbal consent to conduct the survey was obtained, the medical practitioners' answers were recorded immediately on a data collection sheet. Results: There was a sustained improvement in the knowledge of the medical workforce from 2010 to 2017: Answers improved regarding correct drug by 11% (84%, 95%, and 95%); the correct route by 20% (76%, 90%, and 96%); correct site by 40% (43%, 83%, and 83%) and the correct dose by 45% (27%, 54%, and 72%). Overall, knowledge of all components -correct drug, route, site, and dose-improved from 13% in 2010 to 62% in 2017. Conclusion: This survey comparison shows knowledge of the medical workforce regarding adrenaline administration for treatment of anaphylaxis in adults can be considerably improved by employing a variety of educational methods.

Keywords: adrenaline, anaphylaxis, epinephrine, medical education, patient safety

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Authors: Sajad A. Rather, F. A. Masoodi, Rehana Akhter, S. M. Wani, Adil Gani

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Modern trend towards convenience foods has resulted in increased production and consumption of restructured meat products and are of great importance to the meat industry. In meat products fat plays an important role in cooking properties, texture & sensory scores, however, high fat contents in particular animal fats provide high amounts of saturated fatty acids and cholesterol and are associated with several types of non communicable diseases such as obesity, hypertension and coronary heart diseases. Thus, fat reduction has generally been seen as an important strategy to produce healthier meat products. This study examined the effects of reducing fat level from 20% to 10% and substituting mutton back fat with guar gum (0.5%, 1% & 1.5%) on cooking properties, proximate composition, lipid and protein oxidation, texture, microstructure and sensory characteristics of goshtaba- a traditional meat product of J & K, India were investigated and compared with high fat counterparts. Reduced- fat goshtaba samples containing guar gum had significantly (p ≤ 0.05) higher yield, less shrinkage, more moisture retention and more protein content than the control sample. TBARs and protein oxidation (carbonyl content) values of the control was significantly (p ≤ 0.05) higher than reduced fat goshtaba samples and showed a positive correlation between lipid and protein oxidation. Hardness, gumminess & chewiness of the control (20%) were significantly higher than reduced fat goshtaba samples. Microstructural differences were significant (p ≤ 0.05) between control and treated samples due to an increased moisture content in the reduced fat samples. Sensory evaluation showed significant (p ≤ 0.05) reduction in texture, flavour and overall acceptability scores of treatment products; however the scores for 0.5% and 1% treated samples were in the range of acceptability. Guar gum may also be used as a source of soluble dietary fibre in food products and a number of clinical studies have shown a reduction in postprandial glycemia and insulinemia on consumption of guar gum, with the mechanism being attributed to an increased transit time in the stomach and small intestine, which may have been due to the viscosity of the meal hindering the access of glucose to the epithelium.

Keywords: goshtaba, guar gum, traditional, fat reduction, acceptability

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Authors: Joseph Mary Ssembatya, Blessing Michael Taremwa

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Background: Multiple schwannomas are typically associated with neurofibromatosis type 1 (NF1), but rare cases occur independently of neurofibromatosis. Schwannomas are benign, slow-growing tumors, primarily affecting the cervical and lumbar spine. When large, they may extend over multiple vertebral levels, posing surgical challenges. Case Presentation: A 13-year-old Ugandan Munyankore female patient, presented with a 6-year history of progressive quadriparesis, particularly in the lower limbs. Clinical examination showed hypertonia and hyperreflexia, with no indicators of neurofibromatosis or prior trauma. MRI revealed two “kissing” schwannomas extending from C2 to T2 in the cervical spine. Decompressive surgery was performed through laminoplasty and partial lesion resection, and histology confirmed schwannoma. Two weeks postoperatively, the patient experienced cerebrospinal fluid (CSF) leakage, neck pain, and headache, which required re-operation and duraplasty. Following these interventions, the patient’s neurological status stabilized, with noted improvement in lower limb strength. Discussion: “Kissing” schwannomas are most frequently documented in the cerebellopontine angle, rarely in the spine, and even more rarely in children. While multiple schwannomas are often associated with NF2, this case had no family history or clinical signs of the disorder. Giant invasive spinal schwannomas (GISS) that span multiple vertebrae demand intricate surgical approaches due to their proximity to neurovascular structures. Conclusion: This is the first reported case of kissing cervical schwannomas in a young patient from a low- to middle-income country. Surgical decompression, though challenging, is critical for neurological recovery in such advanced cases.

Keywords: kissing schwannoma, cervical spine, low resource, young, uganda

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Authors: Jeong-Moh John Yahng, Angelika Na

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Introduction: Increasing numbers of general surgical patients are being prescribed antiplatelet and anticoagulant medications (APAC) for various cardiovascular and cerebrovascular conditions. Surgical patients who are on APAC present a management challenge as bleeding risk needs to be balanced with thromboembolic risk. Although guidelines exist in regards to APAC management in elective surgery, there is a lack of guidelines in the emergency surgery setting. In this study we aim to characterise APAC usage in emergency general surgical patients admitted to a rural hospital. We also assess the impact of APAC usage on clinical management of these patients. Methods: Prospective study of emergency general surgical admissions at Northeast Health Wangaratta (Victoria) from 2 July to 25 Oct 2014. Questionnaire collected demographics data, admission diagnosis, APAC usage, anaesthesia techniques, operation types, transfusion requirement and morbidity / mortality data. Results: During the 4 month study, 118 patients were classified into two groups: non-APAC (n=96, 81%) and APAC (n=22, 19%). Patients in the APAC group were older compared to the non-APAC patients (mean age 72 vs 42 years old). Amongst patients younger than 60 years old, only 1% of them were on APAC. In contrast, 49% of patients older than 60 years old were on APAC (p<0.001). Patients who were admitted with a bleeding problem were more likely to be on APAC (p<0.05). 19% of emergency general surgery patients were on APAC. The majority (91%) of them were on antiplatelet medication, with two patients being on dual antiplatelet agents (aspirin + clopidogrel or ticagrelor). 15% of emergency general surgical patients requiring operations were on APAC. 11% of all laparotomies and 33% of gastroscopy for haematemesis/melaena patients were on APAC. Both of the patients operated for bleeding following surgery at another hospital were in the APAC group. In regards to impact on clinical management, 59% of APAC patients had their medications interrupted or ceased, on average by 3.5 days (range 1-13 days). 2 out of 75 operations were delayed due to APAC usage. There was no difference in the use of central venous or arterial line for increased monitoring (p=0.14) or in the use of warming blanket (Bair Hugger™) (p=0.94). Overall, transfusion rate was higher amongst APAC patients (14% vs 3%) (p 0.04). The recorded morbidity (n=2) and mortality (n=1) in this study were all in the APAC group. Discussion: Nineteen percent of emergency general surgical admissions and fifteen percent of operated patients were on APAC. The prevalence of APAC usage was higher in those aged sixty and above. General surgical patients who were admitted with a bleeding problem were more likely to be on APAC. Two patients who were operated for bleeding following surgery at another hospital were in the APAC group. Note that there was no patient in the non-APAC group who was admitted for post-operative bleeding. We observed two cases in which operation was delayed due to APAC usage. Transfusion, morbidity and mortality rate were higher in the APAC group. Conclusion: In this study, nineteen percent of emergency general surgical admissions were on APAC. The use of APAC is more prevalent in the older age group, particularly those aged sixty and above. Higher proportion of APAC compared to non-APAC patients were admitted and operated for bleeding problems. There is an urgent need for clinical guidelines regarding APAC management in emergency general surgical patients.

Keywords: antiplatelet, anticoagulants, emergency general surgery, rural general surgery, morbidity, mortality

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Authors: M. Umar Hafeez, Furqan Khursheed Hashmi, Nadeem Irfan Bukhari, Shahzad Ali, Muzammil Ali

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The trend of self-medication is increasing due to various factors and is associated with a large number of complications. A cross-sectional study was aimed to investigate self-medication trend in an urban community and its correlates such as level of education, gender and behavior of using psychoactive medicines. A validated questionnaire was used to collect the data from different locations of Lahore, provincial capital of Punjab, Pakistan. The trend of self-medication was noted in reference to difference in educational level and in gender. This study showed that total 110 respondents, all literate,were found to be self-medicating, and their educational status was as 73.13% primary, 63.15% secondary, 61.12% higher secondary and 62.15% university going. In this sample 74.99% were males and 48.00%were females. Twenty nine (26.36%) of the total sample were found to be using psychoactive agents without consulting the physician. The trend of self-medication was 10% higher in individuals having primary level education, whereas there was not much difference of self-medication trend in other levels of education. The main reasons involved in self-medication trend were socio-economic status, medicine accessibility, religious and cultural beliefs, lack of awareness about risks associated with medicine, non-prescription sale of medicines and previous medication experience. The trend of self-medication of psychotropic agents is quite significant.

Keywords: self-medication, educated community, psychotropic drugs, education levels

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Authors: R. Periyasamy, Deepak Joshi, Sneh Anand

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Foot posture assessment is important to evaluate foot type, causing gait and postural defects in all age groups. Although different methods are used for classification of foot arch type in clinical/research examination, there is no clear approach for selecting the most appropriate measurement system. Therefore, the aim of this study was to develop a system for evaluation of foot type as clinical decision-making aids for diagnosis of flat and normal arch based on the Arch Index (AI) and foot pressure distribution parameter - Power Ratio (PR) data. The accuracy of the system was evaluated for 27 subjects with age ranging from 24 to 65 years. Foot area measurements (hind foot, mid foot, and forefoot) were acquired simultaneously from foot pressure intensity image using portable PedoPowerGraph system and analysis of the image in frequency domain to obtain foot pressure distribution parameter - PR data. From our results, we obtain 100% classification accuracy of normal and flat foot by using the linear discriminant analysis method. We observe there is no misclassification of foot types because of incorporating foot pressure distribution data instead of only arch index (AI). We found that the mid-foot pressure distribution ratio data and arch index (AI) value are well correlated to foot arch type based on visual analysis. Therefore, this paper suggests that the proposed system is accurate and easy to determine foot arch type from arch index (AI), as well as incorporating mid-foot pressure distribution ratio data instead of physical area of contact. Hence, such computational tool based system can help the clinicians for assessment of foot structure and cross-check their diagnosis of flat foot from mid-foot pressure distribution.

Keywords: arch index, computational tool, static foot pressure intensity image, foot pressure distribution, linear discriminant analysis

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Authors: Jovana Nikolov, Natasa Todorovic, Ivana Stojkovic

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Monitoring of 222Rn in drinking or surface waters, as well as in groundwater has been performed in connection with geological, hydrogeological and hydrological surveys and health hazard studies. Liquid scintillation counting (LSC) is often preferred analytical method for 222Rn measurements in waters because it allows multiple-sample automatic analysis. LSC method implies mixing of water samples with organic scintillation cocktail, which triggers radon diffusion from the aqueous into organic phase for which it has a much greater affinity, eliminating possibility of radon emanation in that manner. Two direct LSC methods that assume different sample composition have been presented, optimized and evaluated in this study. One-phase method assumed direct mixing of 10 ml sample with 10 ml of emulsifying cocktail (Ultima Gold AB scintillation cocktail is used). Two-phase method involved usage of water-immiscible cocktails (in this study High Efficiency Mineral Oil Scintillator, Opti-Fluor O and Ultima Gold F are used). Calibration samples were prepared with aqueous 226Ra standard in glass 20 ml vials and counted on ultra-low background spectrometer Quantulus 1220TM equipped with PSA (Pulse Shape Analysis) circuit which discriminates alpha/beta spectra. Since calibration procedure is carried out with 226Ra standard, which has both alpha and beta progenies, it is clear that PSA discriminator has vital importance in order to provide reliable and precise spectra separation. Consequentially, calibration procedure was done through investigation of PSA discriminator level influence on 222Rn efficiency detection, using 226Ra calibration standard in wide range of activity concentrations. Evaluation of presented methods was based on obtained efficiency detections and achieved Minimal Detectable Activity (MDA). Comparison of presented methods, accuracy and precision as well as different scintillation cocktail’s performance was considered from results of measurements of 226Ra spiked water samples with known activity and environmental samples.

Keywords: 222Rn in water, Quantulus1220TM, scintillation cocktail, PSA parameter

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Authors: Stella Sten, Peter Hedström, Joakim Odqvist, Susanne Norgren

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Two functionally graded cemented carbide samples have been produced by local addition of Titanium carbide (TiC) to a pressed Tungsten carbide and Cobalt, WC-10 wt% Co, green body prior to sintering, with the aim of creating a gradient in both composition and grain size in the as-sintered component. The two samples differ only by the in-going WC particle size, where one sub-micron and one coarse WC particle size have been chosen for comparison. The produced sintered samples had a gradient, thus a non-homogenous structure. The Titanium (Ti), Cobalt (Co), and Carbon (C) concentration profiles have been investigated using SEM-EDS and WDS; in addition, the Vickers hardness profile has been measured. Moreover, the Ti concentration profile has been simulated using DICTRA software and compared with experimental results. The concentration and hardness profiles show a similar trend for both samples. Ti and C levels decrease, as expected from the area of TiC application, whereas Co increases towards the edge of the samples. The non-homogenous composition affects the number of stable phases and WC grain size evolution. The sample with finer in-going WC grain size shows a shorter gamma (γ) phase zone and a larger difference in WC grain size compared to the coarse-grained sample. Both samples show, independent of the composition, the presence of abnormally large grains.

Keywords: cemented carbide, functional gradient material, grain growth, sintering

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Authors: Sozan H. Omar, Lina L. Al-Rewaili

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The current study aimed to measure the fifth Grade student skills of reading illustrates in physical and chemical chapter included in science textbook, as well as identity the tasks the dispersants related to designing these illustrates which obstruct the students to read them properly. The researcher applied the test instrument of open discuss questions to measure the skill of: recognizing, description, interpretation and assessment for a sample of this research consisted of (269) students who read three illustrates, and conduct an interview with sample of them (27) students to recognize the dispersants related to designing of these illustrates. The study results showed that there are poor levels in illustrated drawing reading skills: description, interpretation, and assessment. The most important dispersants which obstruct the students to read theses illustrates properly representing: Art impacts of these illustrates, there are some elements which don’t serve these illustrates. In the light of the above results, the researcher provided some recommendations such as training the students on using the images and illustrates properly in science textbooks, as well as create simple designs of illustrates and they should be free of crowded elements and impacts which don’t serve the illustrates.

Keywords: reading illustrated drawings skills, fifth grade science, physical and chemical changes

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Authors: Da-Ming Huang, Ya-Ting Tsai, Shyh-Hau Wang

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Ultrasound signals backscattered from the soft tissues are mainly depending on the size, density, distribution, and other elastic properties of scatterers in the interrogated sample volume. The quantitative analysis of ultrasonic backscattering is frequently implemented using the statistical approach due to that of backscattering signals tends to be with the nature of the random variable. Thus, the statistical analysis, such as Nakagami statistics, has been applied to characterize the density and distribution of scatterers of a sample. Yet, the accuracy of statistical analysis could be readily affected by the receiving signals associated with the nature of incident ultrasound wave and acoustical properties of samples. Thus, in the present study, efforts were made to explore such effects as the ultrasound operational modes and attenuation of biological tissue on the estimation of corresponding Nakagami statistical parameter (m parameter). In vitro measurements were performed from healthy and pathological fibrosis porcine livers using different single-element ultrasound transducers and duty cycles of incident tone burst ranging respectively from 3.5 to 7.5 MHz and 10 to 50%. Results demonstrated that the estimated m parameter tends to be sensitively affected by the use of ultrasound operational modes as well as the tissue attenuation. The healthy and pathological tissues may be characterized quantitatively by m parameter under fixed measurement conditions and proper calibration.

Keywords: ultrasound backscattering, statistical analysis, operational mode, attenuation

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Authors: Yina F. Muñoz, Alexander Paz, Hanns De La Fuente-Mella, Joaquin V. Fariña, Guilherme M. Sales

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The primary approach for estimating bridge deterioration uses Markov-chain models and regression analysis. Traditional Markov models have problems in estimating the required transition probabilities when a small sample size is used. Often, reliable bridge data have not been taken over large periods, thus large data sets may not be available. This study presents an important change to the traditional approach by using the Small Data Method to estimate transition probabilities. The results illustrate that the Small Data Method and traditional approach both provide similar estimates; however, the former method provides results that are more conservative. That is, Small Data Method provided slightly lower than expected bridge condition ratings compared with the traditional approach. Considering that bridges are critical infrastructures, the Small Data Method, which uses more information and provides more conservative estimates, may be more appropriate when the available sample size is small. In addition, regression analysis was used to calculate bridge deterioration. Condition ratings were determined for bridge groups, and the best regression model was selected for each group. The results obtained were very similar to those obtained when using Markov chains; however, it is desirable to use more data for better results.

Keywords: concrete bridges, deterioration, Markov chains, probability matrix

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Authors: Bency Ann Massinello, Nancy Day, Janet Fellini

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Background: The use of an appropriate mode of communication among the multidisciplinary care team members regarding coordination of care is an extremely complicated yet important patient safety initiative. Effective communication among the team members(nursing staff, medical staff, respiratory therapists, rehabilitation therapists, patient-family services team…) become essential to develop a culture of trust and collaboration to deliver the highest quality care to patients are their families. The inpatient post-acute pediatrics, where children and their caregivers come for continuity of care, is no exceptions to the increasing use of text messages as a means to communication among clinicians. One such platform is the Vocera Communications (Vocera Smart Mobile App called Vocera Edge) allows the teams to use the application and share sensitive patient information through an encrypted platform using IOS company provided shared and assigned mobile devices. Objective: This paper discusses the quality initiative of implementing the transition from Vocera Smartbage to Vocera Edge Mobile App, technology advantage, use case expansion, and lessons learned about a secure alternative modality that allows sending and receiving secure text messages in a pediatric post-acute setting using an IOS device. This implementation process included all direct care staff, ancillary teams, and administrative teams on the clinical units. Methods: Our institution launched this transition from voice prompted hands-free Vocera Smartbage to Vocera Edge mobile based app for secure care team texting using a big bang approach during the first PDSA cycle. The pre and post implementation data was gathered using a qualitative survey of about 500 multidisciplinary team members to determine the ease of use of the application and its efficiency in care coordination. The technology was further expanded in its use by implementing clinical alerts and alarms notification using middleware integration with patient monitoring (Masimo) and life safety (Nurse call) systems. Additional use of the smart mobile iPhone use include pushing out apps like Lexicomp and Up to Date to have it readily available for users for evident-based practice in medication and disease management. Results: Successful implementation of the communication system in a shared and assigned model with all of the multidisciplinary teams in our pediatric post-acute setting. In just a 3-monthperiod post implementation, we noticed a 14% increase from 7,993 messages in 6 days in December 2020 to 9,116messages in March 2021. This confirmed that all clinical and non-clinical teams were using this mode of communication for coordinating the care for their patients. System generated data analytics used in addition to the pre and post implementation staff survey for process evaluation. Conclusion: A secure texting option using a mobile device is a safe and efficient mode for care team communication and collaboration using technology in real time. This allows for the settings like post-acute pediatric care areas to be in line with the widespread use of mobile apps and technology in our mainstream healthcare.

Keywords: nursing informatics, mobile secure texting, multidisciplinary communication, pediatrics post acute care

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Authors: Munawar Malik, Muntaha Ahmad, Khalil Ullah Khan

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Linguistic abilities in students with hearing impairment yet remain a concern for educationists. The emerging technological support and provisions in recent era vows to have addressed the situation and claims significant contribution in terms of linguistic repertoire. Being a descriptive and quantitative paradigm of study, the purpose of this research set forth was to assess linguistic competencies of students with hearing impairment in English language. The goals were further broken down to identify level of reading abilities in the subject population. The population involved students with HI studying at higher secondary level in Lahore. Simple random sampling technique was used to choose a sample of fifty students. A purposive curriculum-based assessment was designed in line with accelerated learning program by Punjab Government, to assess Linguistic competence among the sample. Further to it, an Informal Reading Inventory (IRI) corresponding to reading levels was also developed by researchers duly validated and piloted before the final use. Descriptive and inferential statistics were utilized to reach to the findings. Spearman’s correlation was used to find out relationship between degree of hearing loss, grade level, gender and type of amplification device. Independent sample t-test was used to compare means among groups. Major findings of the study revealed that students with hearing impairment exhibit significant deviation from the mean scores when compared in terms of grades, severity and amplification device. The study divulged that respective students with HI have yet failed to qualify an independent level of reading according to their grades as majority falls at frustration level of word recognition and passage comprehension. The poorer performance can be attributed to lower linguistic competence as it shows in the frustration levels of reading, writing and comprehension. The correlation analysis did reflect an improved performance grade wise, however scores could only correspond to frustration level and independent levels was never achieved. Reported achievements at instructional level of subject population may further to linguistic skills if practiced purposively.

Keywords: linguistic competence, hearing impairment, reading levels, educationist

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Authors: Mohand Yaghi, O. Kehinde

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Background: For the diagnosis of prostate cancer Trans-rectal prostate biopsy (TRPB) is used commonly, the procedure is associated with infective complications. There is evidence that antibiotics (ABx) decrease infective events after TRPB, but different regimens are used. Aim: To systematically review different regimens of prophylactic oral antibiotics in TRPB. Design: Medline, Embase, Clinical trials site, and Cochrane library were searched, experts were consulted about relevant studies. Randomized clinical trials (RCT) conducted in the last twenty years, which investigated different oral antibiotic regimens in TRPB, and compared their efficacy to reduce infectious complications were analyzed. Measurements: Primary outcomes were bacteriuria, urinary tract infection (UTI), fever, bacteremia, sepsis. Secondary outcomes were hospitalization rate, and the prevalence of ABx-resistant bacteria. Results: Nine trials were eligible with 3012 patients. Antibiotics prevented bacteriuria (3.5% vs. 9.88%), UTI (4.46% vs. 9.75%), and hospitalization (0.21% vs. 2.13%) significantly in comparison with placebo or no treatment. No significant difference was found in all outcomes of the review between the single dose regimen and the 3 days. The single dose regimen was as effective as the multiple dose except in Bacteriuria (6.75% vs. 3.25%), and the prevalence of ABx-resistant bacteria (1.57% vs. 0.27%). Quinolones reduced only UTI significantly in comparison with other antibiotics. Lastly, Ciprofloxacin is the best Quinolone to prevent UTI, and hospitalization. Conclusion: it is essential to prescribe prophylactic Antibiotics in TRPB. No conclusive evidence could be claimed about the superiority of the multiple or the 3 days regimens to the single dose regimen. Unexpectedly, ABx-resistant bacteria was identified more often in the single dose cohorts.

Keywords: infection, prostate cancer, sepsis, TRPB

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Authors: Lívia Pinheiro Carvalho, Luciana Di Thommazo-Luporini, Rafael Luís Luporini, José Carlos Bonjorno Junior, Renata Pedrolongo Basso Vanelli, Manoel Carneiro de Oliveira Junior, Rodolfo de Paula Vieira, Renata Trimer, Renata G. Mendes, Mylène Aubertin-Leheudre, Audrey Borghi-Silva

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Rationale: Cardiorespiratory fitness (CRF) and functional capacity in young obese and normal-weight people are associated with metabolic and cardiovascular diseases and mortality. However, it remains unclear whether their metabolically healthy (MH) or at risk (AR) phenotype influences cardiorespiratory fitness in this vulnerable population such as obese adults but also in normal-weight people. HOMA insulin resistance index (HI) and leptin-adiponectin ratio (LA) are strong markers for characterizing those phenotypes that we hypothesized to be associated with physical fitness. We also hypothesized that an easy and feasible exercise test could identify a subpopulation at risk to develop metabolic and related disorders. Methods: Thirty-nine sedentary men and women (20-45y; 18.530 kg.m-2) underwent a clinical evaluation, including the six-minute step test (ST), a well-validated and reliable test for young people. Body composition assessment was done by a tetrapolar bioimpedance in a fasting state and in the folicular phase for women. A maximal cardiopulmonary exercise testing, as well as the ST, evaluated the oxygen uptake at the peak of the test (VO2peak) by an ergospirometer Oxycon Mobile. Lipids, glucose, insulin were analysed and the ELISA method quantified the serum leptin and adiponectin from blood samples. Volunteers were divided in two groups: AR or MH according to a HI cutoff of 1.95, which was previously determined in the literature. T-test for comparison between groups, Pearson´s test to correlate main variables and ROC analysis for discriminating AR from up-and-down cycles in ST (SC) were applied (p<0.05). Results: Higher LA, fat mass (FM) and lower HDL, SC, leg lean mass (LM) and VO2peak were found in AR than in MH. Significant correlations were found between VO2peak and SC (r= 0.80) as well as between LA and FM (r=0.87), VO2peak (r=-0.73), and SC (r=-0.65). Area under de curve showed moderate accuracy (0.75) of SC <173 to discriminate AR phenotype. Conclusion: Our study found that at risk obese and normal-weight subjects showed an unhealthy metabolism as well as a poor CRF and functional daily activity capacity. Additionally, a simple and less costly functional test associated with above-mentioned aspects is able to identify ‘at risk’ subjects for primary intervention with important clinical and health implications.

Keywords: aerobic capacity, exercise, fitness, metabolism, obesity, 6MST

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