Medicine and Health Sciences Commons^™

Effectiveness And Predictors Of Home-Based Postacute Stroke Care, Yuan-Ting Lo, Wen-Chih Lin, Lin-Fu Lee, Willy Chou

Rehabilitation Practice and Science

Introduction: Stroke is the leading cause of disability in adults. In 2014, Taiwan's National Health Insurance Administration started to provide inpatient postacute care, and the results indicated that this model improves the overall functional status of patients with stroke. In 2017, home-based postacute stroke care was initiated; however, no study has evaluated its effectiveness. Therefore, we explored the functional recovery of patients with stroke after 6 weeks of postacute care at home and the factors that influenced their functional improvement. Method: We recruited patients with stroke who received a score of 3 or 4 on the modified Rankin Scale between …

Effects Of Supervised Exercise Training On Health-Related Physical Fitness In Community Dwellers Aged Over 50 Years, Chun-Yi Lee, Tieh-Cheng Fu, Jong-Shyan Wang, Chih-Chin Hsu

Rehabilitation Practice and Science

Effects of supervised aerobic exercise training on physical fitness in aging community residents were highlighted in the study. 76 community-dwellers aged ＞ 50 years who completed an 8-week cohort study were included. All participants were instructed to walk ≥ 8000 steps per day (stp/d) and wore a smart watch to record the every-day step amount. The average number of everyday step amount in a week was used as the mean walking steps per day in a week. Among them, 39 participants were randomized to the supervised exercise training (SET) and 37 were allocated to the home exercise training (HET) groups. …

Age-Related Sonoanatomical Change Of The Knee In Children, Shu-Mei Yang, Chia-Wei Lin, Wen-Shiang Chen

Rehabilitation Practice and Science

Ultrasound has been thoroughly studied and become a well-established tool for assessment of adult patients' musculoskeletal system both in research and clinical practice. However, the use of musculoskeletal ultrasound in pediatric populations is still limited. The age-dependent variability of normal sonoanatomy dueto bone maturation and ossification in children is the main limitation to establishing its validity as an imaging tool. Also, standardized definitions of gray-scale and power Doppler ultrasonography findings in different age groups of children is still lacking. Nonetheless, ultrasound is a readily accessible imaging modality that is well tolerated by children. It also allows physicians to perform a …

The Use Of Ultrasonography In Suspected Tibia Plateau Fracture With Lipohemarthrosis: A Casereport, Wei-Nung Hsu, Pon-An Chen, Sen-Wei Tsai

Rehabilitation Practice and Science

Knee pain is a common complaint in rehabilitation outpatient clinics. Plain radiography is typically used to detect knee pain and trauma. However, a slight depression plateau fracture could be easily overlooked on plain radiography. This is a casereport of a 57-year-old woman with left knee pain who visited the outpatient clinic for help. Ultrasonography showed fat-fluid level, but plain radiography did not reveal any fracture. Magnetic resonance examination confirmed the depression fracture of the tibial plateau and the lipohemarthrosis. Lipohemarthrosis is a highly sensitive predictor of intra-articular surface fractures. Ultrasound is a convenient and reliable tool to detect lipohemarthrosisof the …

Application Of Ultrasonography In The Diagnosis And Treatment (5% Dextrose Hydrodissection) For Entrapment Of Spinal Accessory Nerve: A Casereport, Tien-Lee Hsieh, Wei-Ting Wu, Chun-Ping Wang, Liang-Chun Chien, Lin-Fen Hsieh

Rehabilitation Practice and Science

The anatomical structure of the neck area is exceedingly complex; thus, cervical nerve damage during surgical procedures is not uncommon. A 25-year-old woman underwent excisional biopsy for neck lymphadenopathy. The patient reported left upper back pain and left shoulder weakness 1 day after the surgery. Physical examination revealed weakness of the left upper trapezius muscle and winging of the left scapula. A nerve conduction study indicated decreased compound muscle action potential amplitude on stimulation of the left spinal accessory nerve (SAN); electromyography also revealed denervation changes with the presence of voluntary motor unit action potentials in the left upper trapezius …

A Casereport Of Speech Therapy Combined With Repetitive Transcranial Magnetic Stimulation In Patients With Global Aphasia, Shih-Chen Lai, Yan-Ting Lin, Long-Wei Dai

Rehabilitation Practice and Science

For patients with stroke-induced aphasia, speech therapy is the most common speech rehabilitation program. In recent years, increasing empirical discussions have been conducted on the application of repetitive transcranial magnetic stimulation in treating stroke-related comorbidities; however, such discussions are lacking in Chinese. The present casereport investigated a patient with global aphasia who received frequent sessions of conventional speech therapy (2.5 hours per week) in conjunction with repetitive transcranial magnetic stimulation (5 sessions per week). The total intervention period was 6 months. The Concise Chinese Aphasia Test was used to conduct a pretest and posttest before and after the intervention. This …

Compartment Syndrome With Severe Neurovascular Complications After Trans-Radial Approach Of Percutaneous Coronary Intervention: A Casereport And Literature Reviewarticle, Pei-Yi Chen, Hong-Yi Lin

Rehabilitation Practice and Science

The gold standard for the acute coronary syndrome is percutaneous coronary intervention. Access site practice has shifted from transfemoral to transradialaccess (TRA), with the latter being more popular in Europe and Asia due to higher success rates, fewer site-related vascular complications, mortality, and shorter hospital stay. Significant complications following TRA of percutaneous coronary intervention have been reported, including spasm, occlusion, perforation, pseudoaneurysm formation, arteriovenous fistula, and rarely, compartment syndrome and complex regional pain syndrome (CRPS). Here, we report the case of a 66-y-old male who had persistent right-hand painful swelling, clawed hand, and sensory disturbance for 2 months following TRA …

Viscosity Of Commercial Thickeners In Combination With Different Beverages Of Honey- And Nectar-Like Consistency And Their Change Over Time, Wei-Chun Che, Yuan-Ching Tsai, Meng-I Kuo, Tsan-Hon Liou

Rehabilitation Practice and Science

Objective: This study investigated the viscosity of four beverages (green tea, grape juice, sugar-free soy milk, and Ensure®) thickened to a nectar- and honey-like consistency with five thickening products (Resource® Thickenup® Clear, Toromeal, Toromi-up, eNutrition, and Sentosa) marketed in Taiwan. The sample viscosity over time was compared. Furthermore, the results were compared with the guidelines of National Dysphagia Diet (NDD) established by the American Dietetic Association. Methods: The viscosity was measured using the Brookfield RVDV-II+ Pro viscometer with small sample adaptor, shear rate set at 50 s-1, temperature at 25℃. Results: The results showed that almost all thickening products in …

An Investigation Of The Relationship Between Oral Sucking Habits And Types Of Articulation Errors In Preschool Children With Phonological Impairment, Hsiang-Chan Yen, Ching-Fei Lee, Su-Fen Liao

Rehabilitation Practice and Science

Background: Phonological impairment (PI) is the most common impairment in preschool children with speech sound disorder (SSD). In preschool children with phonological disorders, the most common process is substitution, including fronting, backing, and devoicing. The parents of children with PI always complain that it is difficult for them to abstain from pacifier use or thumb sucking. The purpose of this study was to investigate the oral sucking habits of preschool children with PI, and to explore whether different sucking habits affect different types of PI. Methods: Children aged from 36 months to 72 months, who visited the Physical Medicine and …

Swallowing Function In Parkinson's Disease: Correlation With Disease Duration And Hoehn And Yahr Stage, Yi-Ya Pan, Hsueh-Pei Wang, Ruey-Meei Wu, Tyng-Guey Wang

Rehabilitation Practice and Science

Oropharyngeal dysphagia is a common complication of Parkinson's disease (PD). Swallowing assessment scales, videofluoroscopics wallowing study (VFSS), and fiberoptic endoscopic evaluation of swallowing (FEES) are used to evaluate the swallowing function of patients with dysphagia. However, few studies have been conducted that assessed tongue muscle strength and hyoid bone movement in patients with PD. To better understand the correlation between disease duration, Hoehn and Yahr (H&Y) stage and swallowing function in patients with PD, this study evaluated the swallowing function in patients with PD using ultrasonography and Iowa Oral Performance Instrument (IOPI). Ultrasonography was performed to evaluate hyoid movement, and …

Ganglion Cyst Of Lumbrical Muscles: A Casereport, Pao-Sheng Wu, Chun-Te Lu, Valeria Chiu

Rehabilitation Practice and Science

Ganglion cysts arising from joints or tendons are commonly seen in our daily work as physiatrists, but those originating from muscles have been infrequently reported. In this casereport, we present a patient with a ganglion cyst arising from the fascia of the fourth lumbrical muscle in an occupational therapist, which has never been reported before. The lumbrical muscles of the hand vary greatly from other intrinsic muscles, because of their distinctive structure and function. A ganglion cyst that arises from the lumbrical muscle is supposed to affect the precise movement of the occupational therapist's hand. As a result, the early …

Herpes Zoster And Resultant Segmental Zoster Paresis: A Casereport And Literature Reviewarticle, Yen-Jou Ho, Hong-Yi Lin, Yao-Jen Chen

Rehabilitation Practice and Science

Herpes zoster (HZV) is ascribed to the reactivation of the dormant varicella-zoster virus (VZV) in the dorsal root ganglia. The most commonly seen manifestation is a painful skin rash. However, several additional complications have been documented in the literature. A less-mentioned yet severe complication is segmental zoster paresis (SZP), which can cause limb paralysis. SZP's mechanism is still under debate, and a direct invasion of motor fibers due to anatomical adjacency has been proposed. Here we report a patient who had sudden onset of left upper limb paresis and gradually developed a skin rash afterward, which a dermatologist confirmed as …

Pengaruh Tingkat Pendidikan Dan Pengetahuan Terhadap Kepemilikan Bpjs Ketenagakerjaan Pada Relawan Penanggulangan Bencana Gunung Semeru Tahun 2021, Rahmat Adi Prasetyo, Afifa Nur Chabibah, Setya Haksama

Preventia: The Indonesian Journal of Public Health

Humanitarian workers or volunteers are included in non-wage workers which are one of the sectors that can be protected by BPJS Ketenagakerjaan. The research results in 6 provinces show that BPJS Ketenagakerjaan participants are 3.7 percent and haven’t reached the 6 percent target. Based on the interviews results with deskrelawan admin also stated that many volunteers didn’t have BPJS Ketenagakerjaan. Individual awareness in insurance is marked by openness in accepting and utilizing insurance. This awareness can be influenced by various factors, including: age, gender, occupation, education. This research is quantitative research with cross-sectional design. It is a descriptive analysis with …

Perbedaan Edukasi Pemberian Makan Balita Dengan Metode Emotional Demonstration Dan Metode Ceramah Terhadap Pengetahuan Dan Sikap Ibu Balita Di Rt 06 Rw 08 Kelurahan Keputih Kota Surabaya, Anugrah Linda Mutiarani, Pratiwi Hariyani Putri, Kartika Yuliani

Preventia: The Indonesian Journal of Public Health

Undernutrition under five years old has a variety of health risks. In Surabaya, the SSGI 2021 report that underweight cases were 16,6 percent. One of the causes of nutritional problems for toddlers is the behavior of mothers in feeding toddlers which will affect the growth and development of toddlers. The right educational method is needed to change behavior, namely Emotional Demonstration (Emo Demo). This study aimed to analyze the differences in emo demo education and lectures on the knowledge and attitudes of mothers in feeding toddlers. The design for this research is quasi-experimental with a Pre-Postest Control Group. The total …

Perceived Covid-19 Threat, Perceived Healthcare System Inequities, Personal Experiences Of Healthcare Discrimination And Their Associations With Covid-19 Preventive Behavioral Intentions Among College Students In The Us, Juliana S. Sherchan, Jessica R. Fernandez, Shan Qiao, Arie W. Kruglanski, Allana T. Forde

Faculty Publications

College students are often reluctant to follow U.S. preventive guidelines to lower their risk of COVID-19 infection, despite an increased risk of transmission in college settings. Prior research suggested that college students who perceived greater COVID-19 severity and susceptibility (i.e., COVID-19 threat) were more likely to engage in COVID-19 preventive behaviors, yet there is limited research examining whether perceived COVID-19 threat, perceived U.S. healthcare system inequities, and personal experiences of healthcare discrimination collectively influence college students’ COVID-19 preventive behaviors. This study identified latent classes of perceived COVID-19 threat, perceived U.S. healthcare system inequities, and personal experiences of healthcare discrimination, examined …

Haircare Practice And Dandruff Problems Among Indonesian Medical Students, Jessica Rosemary Wikanto, Lorettha Wijaya, Yunisa Astiarani, Regina Regina

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Dandruff is an understated hair and scalp problem that causes striking social and concentration issues among medical students. Haircare practice among them may or may not be related to the dandruff incident.

Methods: A cross-sectional study was conducted on 74 pre-clinical medical students at Atma Jaya Catholic University of Indonesia. Trained health staff assessed dandruff prevalence by physical examination, and the haircare practice was measured using a questionnaire. Bivariate analysis was utilized to assess the association between haircare practice and dandruff prevalence’s.

Result: Among respondents, 85.1% of them have dandruff. Respondents who shampooed less than five …

Clinicodemographic And Laboratory Characteristics Of Cutaneous Tuberculosis At Tertiary Referral Hospital In West Java, Indonesia, Anisa Sediadini, Hendra Gunawan, Risa Miliawati Nurul Hidayah

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Cutaneous tuberculosis (TB) is a chronic infectious disease affecting the skin caused by Mycobacterium tuberculosis (M. tuberculosis). It constitutes 1–1.5% of extrapulmonary TB, with Indonesia being the third-highest TB burden country worldwide. Cutaneous TB is difficult to diagnose due to its varied presentations. This study aimed to describe the clinicodemographic and laboratory characteristics of cutaneous TB in a tertiary referral hospital in West Java, Indonesia.

Methods: This was a descriptive retrospective cross-sectional study. Data were obtained from the medical record of patients with cutaneous TB in the Tropical Dermatology Clinic of Hasan Sadikin Hospital Bandung, West Java, …

The Difference In Transepidermal Water Loss (Tewl) Values Between Sun-Exposed And Non-Sun-Exposed Skin Among Male Medical Students, Ihsany Arafiasetyanto Prihadi, Endra Yustin Ellistasari, Arie Kusumawardani

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Transepidermal Water Loss (TEWL) is the amount of water released from the human body into the atmosphere through a diffusion process per unit of time. Changes in TEWL indicate impaired skin barrier function. Exposure to ultraviolet light for an extended period can cause photoaging, characterized by rough and dry skin (xerosis cutis). TEWL will increase significantly in the skin exposed to ultraviolet radiation. This study aims to determine the difference in the TEWL values among male medical students in the sun-exposed and non-sun-exposed skin areas.

Methods: An analytical observational cross-sectional study was conducted at the Dermatology and …

Risk Factors For Hiv-Positive Status In Condyloma Acuminata, Izazi Hari Purwoko, Putri Laksmi Karim, Suroso Adi Nugroho, Theresia Toruan, Fitriani .

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Condyloma acuminata (CA) is a sexually transmitted infection (STI) caused by human papillomavirus (HPV), especially types 6 and 11. The number of HPV infections increases in immunosuppressed conditions, such as human immunodeficiency virus (HIV) infection. Risk factors in CA patients such as gender, sexual partner, sexual orientation, and sexual intercourse can increase HIV status.

Methods: This is a descriptive-analytic study with a cohort retrospective design. The subjects are all CA patients who visited the polyclinic STI Dr. Mohammad Hoesin, General Hospital, Palembang, Indonesia, between 2016-2020. The number of CA patients included in the study were 115 patients …

A Case Of Longitudinal Melanonychia In A Child: Benign Or Malignant?, Heffi Anindya Putri, Ennesta Asri, Qaira Anum

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Longitudinal melanonychia (LM) describes a longitudinal brown-to-black band of discoloration affecting a finger, thumb, or toenail. Discoloration of the nails can be a sign of benign or malignant nail disorders. Although nail melanoma rarely occurs in children, health practitioners should be aware of melanonychia. Dermoscopy and histopathology are helpful in the diagnosis.

Case Illustration: A case of LM in a thirteen-year-old girl was reported with a complaint of brownish-black discoloration, sometimes painful, on her right thumb since 1 year ago. She had no history of trauma, nail damage, or bleeding tendency. Dermatological examination found a homogeneous brownish-black …

Seborrheic Keratosis Profile At Dr. Hasan Sadikin Central General Hospital Bandung 2015-2019, Eva Krishna Sutedja, Resti Gradia, Tri Aswila Latifah

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Seborrheic keratosis (SK) is adults’ most prevalent benign skin tumor. SK originates from the proliferation of keratinocyte cells with varying morphology and degree of pigmentation. The lesions often resemble other types of malignancy. There are still many discrepancies in SK in Indonesia; hence, SK needs further understanding. This study aimed to describe the profile of seborrheic keratosis cases based on age, sex, location of lesions, and therapy at Dr. Hasan Sadikin Central General Hospital, Bandung, for five years

Methods: This was a retrospective descriptive study with total sampling. Secondary data were collected from medical records of SK …

Non-Pustular Annular Psoriasis With Signs Of High Disease Activity, Nevi Yasnova, Windy Keumala Budianti, Melody Febriana Andardewi

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Non-pustular annular psoriasis is a rare condition in which a type of plaque psoriasis appears with ring-like lesions and a clearer central appearance. The disease activities in psoriasis may be evaluated clinically. It is essential to provide a more meaningful approach to treatment management.

Case illustration: A 33-year-old woman complained of a one-year history of multiple erythematous, scaly, and annular plaques with central clearing. Some lesions were surrounded by discrete pinpoint papules on several parts of her body. The lesions worsened during seven weeks of topical and systemic therapy.

Discussion: Psoriasis is a chronic, multisystem inflammatory …

Association Between Early Antibiotic Administration And In-Hospital Mortality In Moderate And Severe Covid-19 Patients, Lie Khie Chen, Jason Nathanael, Sharifah Shakinah, Adeline Pasaribu, Robert Sinto, Leonard Nainggolan, Adityo Susilo

Jurnal Penyakit Dalam Indonesia

Introduction. Patients with moderate and severe COVID-19 generally receive antibiotic therapy with consideration of the possibility of co-infection or secondary bacterial infection which clinically is difficult to distinguish from COVID-19 symptoms. Overuse of antibiotics can lead to an increased risk of bacterial resistance to antibiotics which is associated with poor outcomes in COVID-19 patients. This study aimed to assess the effect of early antibiotic administration on mortality in moderate and severe COVID-19 patients. Methods. An observational study with a retrospective cohort design was conducted at Dr. Cipto Mangunkusumo Hospital. Data were obtained from medical records of patients admitted from March …

Second-Line Therapy Tyrosine Kinase Inhibitor For Chronic Phase Chronic Myeloid Leukemia Resistant To Imatinib, Chici Pratiwi, Wulyo Rajabto

Jurnal Penyakit Dalam Indonesia

Since the era of tyrosine kinase inhibitor (TKI) therapy, there has been an increase in the median survival of chronic myeloid leukemia. Nevertheless, nowadays there were several cases of chronic myeloid leukemia that are resistant to the first-line TKIs, so that several second-line TKIs were introduced. Assessment of the therapeutic response was performed using a complete peripheral blood examination, bone marrow aspiration cytogenetic examination, and quantitative BCR-ABL examination. The treatment failure criteria were applied based on the ELN criteria. In selecting the second line TKI should be based on the results of mutation analysis and consider the safety profile of …

Gambaran Tingkat Kecukupan Energi Dan Tingkat Kecukupan Protein Ibu Hamil Di Kota Malang, Rany Ekawati, Windi Chusniah Rahmawati, Farah Paramita, Dini Elita Berliana, Alfinadelasari Putri Fariadi

Preventia: The Indonesian Journal of Public Health

Chronic energy deficiency (CED) in pregnant women is still a nutritional problem in Indonesia. CED in pregnant women is caused by low energy and protein intake in pregnant women. The low energy and protein intake in pregnant women can cause disturbances in pregnancy and the baby in the womb. This research objective is to provide an overview of the level of energy and protein adequacy of pregnant women in the city of Malang. This study is a quantitative study with a cross-sectional design. The sample in this study was 64 pregnant women. The variables of energy adequacy and protein adequacy …

Perbedaan Pemberian Bioaktivator Dalam Kompos Takakura Terhadap Pertumbuhan Tanaman Tomat (Lycopersicum Esculentum), Anjali Putri Agustin, Septa Indra Puspikawati, Mohammad Zainal Fatah

Preventia: The Indonesian Journal of Public Health

Indonesia's population is increasing from year to year which has an impact on increasing the amount of waste and has a negative impact on public health and the environment. One of the proper waste handling methods is simple, practical, and efficient composting using the Takakura composting method. This study aims to determine the differences in stem height and number of leaves of tomato plants (Lycopersicum esculentum) between the control group and the treatment group with the addition of 4 bioactivators in Takakura compost. The research method uses an experimental design conducted in Banyuwangi during March-April 2022. Statistical analysis using T-test …

Systematic Review: Analisis Pengadaan Musik Kerja Terhadap Produktivitas Kerja Tenaga Kerja, Afan Alfayad, Endang Dwiyanti

Preventia: The Indonesian Journal of Public Health

This research was conducted to see the effectiveness of the procurement of work music on labor productivity. This study uses a systematic review method by finding 15 types of research articles, research articles are considered inclusion criteria based on PICOS (Population, Intervention, Comparison, Study Design Results, Year of Publication, and Language) as follows: 1) human sample, 2) work music intervention, 3) comparison of giving work music and not giving work music, 4) results: work productivity, 5) research articles, 6) articles published in 2012 until 2022, 7) in English and Indonesian. Procurement of work music is associated with increased worker productivity. …

Evaluation Of The Efficacy Of The Anti-Ulcer Oral Mucosal Protective Agent Radoralex® In The Prevention And Treatment Of Radiation-Induced Oral Mucosal Reactions Induced During Treatment Of Nasopharyngeal Carcinoma, Jun Yin, Jirui Xie, Jiawei Lin, Chengyin Weng, Shun Lu, Peng Xu, Shuo Zhang, Cheng Luo, Yecai Huang, Lu Li, Jinyi Lang, Mei Feng

Faculty, Staff and Student Publications

The aim of this study was to evaluate the efficacy and safety of antiulcer oral mucosal protectant-RADoralex® in the prevention and treatment of radiation-induced oral mucosal reactions elicited during intensity-modulated radiation therapy (IMRT). for locally advanced nasopharyngeal carcinoma (NPC). A total of 90 patients with locally advanced NPC who developed post-treatment grade 1 oral mucositis were selected for this study. They were randomly assigned to the experimental group (n = 44) treated by mouth rinsing with the RADoralex® during radiochemotherapy and the control group (n = 43) treated by mouth rinsing with sodium bicarbonate solution, and the patients’ oral mucosal …

Voices, Stories And Experiences Of Black Women: Informing The Establishment Of A Trenton-Based Maternal And Infant Health Innovation And Research Center, Tirzah R. Spencer Phd, Mph, Barbara George Johnson Mph, J.D., Consuelo Bonillas

Center for Health Policy Development

The establishment of a Maternal and Infant Health Innovation and Research Center is one of nine recommendations outlined by the 2021 Nurture NJ Strategic Plan to reduce maternal and infant mortality and morbidity and ensure equity in care and in outcomes for mothers and infants of all ethnic groups. The purpose of this environmental scan is to provide input for the design of a Maternal and Infant Health Innovation and Research Center within Trenton.

Building on the Nurture NJ Initiative, this project is a deeper dive in its focus on Black and Latina women living in Trenton and surrounding areas. …

Knowledge, Attitudes And Practices On Urinary Schistosomiasis-Related Morbidity Among Communities In Itilima District, Tanzania, Coletha Yohana, Safari M. Kinung’Hi, Bruno A. Nyundo, Peter F. Rambau, Jared S. Bakuza

Tanzania Journal of Science

Long-term infections by urinary schistosomiasis can result in urinary tract morbidities and increase the threats to public health. Information on the community’s knowledge, attitudes, and practices (KAP) on various aspects of urinary schistosomiasis, caused by Schistosoma haematobium has been lacking in Itilima District, which is likely to perpetuate the transmission of the disease and its negative health consequences. This study assessed knowledge, attitudes and practices on schistosomiasis-related morbidities in Itilima District from February to June 2021. A cross-sectional survey using a structured questionnaire was used, and a total of 657 participants were involved in the study. A total of 575 …