Displaying publications 1 - 20 of 678 in total

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  1. Rajeev V, Arunachalam R, Nayar S, Arunima PR, Ganapathy S, Vedam V
    Eur J Dent, 2017 4 25;11(1):58-63.
    PMID: 28435367 DOI: 10.4103/ejd.ejd_113_16
    OBJECTIVE: This in vitro study was designed to assess shear bond strength (SBS) of ormocer flowable (OF) resin as a luting agent, ormocer as an indirect veneer material with portrayal of modes of failures using scanning electron microscope (SEM).

    MATERIALS AND METHODS: Sixty maxillary central incisors were divided into Group I, II, and III with 20 samples each based on luting cement used. They were OF, self-adhesive (SA) cement, and total etch (TE) cement. These groups were subdivided into "a" and "b" of ten each based on the type of veneering materials used. Veneer discs were fabricated using Ormocer restorative (O) and pressable ceramic (C). Specimens were thermocycled and loaded under universal testing machine for SBS. The statistical analysis was done using one-way ANOVA post hoc Tukey honest significant difference method.

    RESULTS: A significant difference was observed between the Groups I and II (P < 0.05). The highest mean bond strength when using ormocer veneer was obtained with the Group Ia (19.11 ± 1.92 Mpa) and lowest by Group IIa (8.1 ± 1.04 Mpa), whereas the highest mean bond strength while using ceramic veneer was of similar range for Group Ib (18.04 ± 4.08 Mpa) and Group IIIb (18.07 ± 1.40 Mpa). SEM analysis revealed OF and TE presented mixed type of failure when compared with SA where failure mode was totally adhesive.

    CONCLUSION: OF was found equally efficient like TE. Bond strength of ormocer as a veneer was not inferior to ceramic making it one of the promising additions in the field of dentistry.

    Matched MeSH terms: Analysis of Variance
  2. Juliana N, Shahar S, Sahar MA, Ghazali AR, Manaf ZA, Noah RM
    Asia Pac J Clin Nutr, 2017 Mar;26(2):278-286.
    PMID: 28244706 DOI: 10.6133/apjcn.122015.05
    BACKGROUND AND OBJECTIVES: Nutrition and physical activity interventions is beneficial in reversing obesity. However far too little attention has been paid to the effect of these interventions on breast tissues. Thus, the aim of this study was to explore the effect of a home-based dietary and physical activity intervention (the Her Shape Program) on metabolic parameters, blood biomarkers and adiposity at the breast.

    METHODS AND STUDY DESIGN: A randomized controlled study was conducted on obese women with high breast adiposity (<0.1 Sm-1), aged 40-60 years in Klang Valley, Malaysia. Subjects were assigned to intervention (n=16) and control group (n=15). Intervention group received a home based health education package with close monitoring weekly, personal diet consultation and physical training in group. Assessment was ascertained at three time points; baseline, weeks 8 and 16. Outcome measures were the energy intake, physical activity, body composition, blood tests, blood biomarkers and electrical impedance tomography (EIT) quantitative values. Analyses were done using 2-way repeated measures ANOVA.

    RESULTS AND CONCLUSIONS: All subjects completed the program without any drop-out. The HSI group had 100% compliance towards the intervention program; their energy intake was reduced for approximately 35% and their activity score was increased for approximately 11%. A significant interaction effect was found in body weight, body mass index (BMI), total cholesterol/HDL, vitamin C intake and matrix metallopeptidase 9 (MMP-9) (p<0.05). Interestingly, their EIT extremum values were also significantly increased indicating a reduction of breast adiposity. The intervention program was successful in improving body composition, physical activities, MMP9 and breast adipose tissue composition.

    Matched MeSH terms: Analysis of Variance
  3. Agbolade O, Nazri A, Yaakob R, Ghani AA, Cheah YK
    BMC Bioinformatics, 2019 Dec 02;20(1):619.
    PMID: 31791234 DOI: 10.1186/s12859-019-3153-2
    BACKGROUND: Expression in H-sapiens plays a remarkable role when it comes to social communication. The identification of this expression by human beings is relatively easy and accurate. However, achieving the same result in 3D by machine remains a challenge in computer vision. This is due to the current challenges facing facial data acquisition in 3D; such as lack of homology and complex mathematical analysis for facial point digitization. This study proposes facial expression recognition in human with the application of Multi-points Warping for 3D facial landmark by building a template mesh as a reference object. This template mesh is thereby applied to each of the target mesh on Stirling/ESRC and Bosphorus datasets. The semi-landmarks are allowed to slide along tangents to the curves and surfaces until the bending energy between a template and a target form is minimal and localization error is assessed using Procrustes ANOVA. By using Principal Component Analysis (PCA) for feature selection, classification is done using Linear Discriminant Analysis (LDA).

    RESULT: The localization error is validated on the two datasets with superior performance over the state-of-the-art methods and variation in the expression is visualized using Principal Components (PCs). The deformations show various expression regions in the faces. The results indicate that Sad expression has the lowest recognition accuracy on both datasets. The classifier achieved a recognition accuracy of 99.58 and 99.32% on Stirling/ESRC and Bosphorus, respectively.

    CONCLUSION: The results demonstrate that the method is robust and in agreement with the state-of-the-art results.

    Matched MeSH terms: Analysis of Variance
  4. Kamal A, Salman B, Razak NHA, Samsudin ABR
    Eur J Dent, 2020 Oct;14(4):613-620.
    PMID: 32777838 DOI: 10.1055/s-0040-1714765
    OBJECTIVE:  A dry socket is a well-recognized complication of wound healing following tooth extraction. Its etiology is poorly understood and commonly occur among healthy patients. As such, management strategies for dry socket has always been empirical rather than scientific with varying outcome. The aim of this study is to investigate the efficacy of concentrated growth factor (CGF) and low-level laser therapy (LLLT) and compared them to the conventional treatment in the management of dry socket.

    MATERIALS AND METHODS:  Sixty patients with one dry socket each, at University Dental Hospital Sharjah, were divided into three treatment groups based on their choice. In group I (n = 30), conventional treatment comprising of gentle socket curettage and saline irrigation was done. Group II (n = 15) dry sockets were treated with CGF and group III (n = 15) sockets were lased with LLLT. All dry socket patients were seen at day 0 for treatment and subsequently followed-up at 4, 7, 14, and 21 days. Pain score, perisocket inflammation, perisocket tenderness, and amount of granulation tissue formation were noted.

    STATISTICAL ANALYSIS:  Data were analyzed as mean values for each treatment group. Comparisons were made for statistical analysis within the group and among the three groups to rank the efficacy of treatment using one-way analysis of variance (ANOVA). Statistically significant difference is kept at p < 0.05.

    RESULTS:  Conventional treatment group I took more than 7 days to match the healing phase of group II CGF treated socket and group III LLLT irradiated socket (p = 0.001). When healing rate between CGF and LLLT are compared, LLLT group III showed a delay of 4 days compared with CGF in granulation tissue formation and pain control.

    CONCLUSION:  CGF treated socket was superior to LLLT in its ability to generate 75% granulation tissue and eliminate pain symptom by day 7 (p = 0.001).

    Matched MeSH terms: Analysis of Variance
  5. Shirkhorshidi AS, Aghabozorgi S, Wah TY
    PLoS One, 2015;10(12):e0144059.
    PMID: 26658987 DOI: 10.1371/journal.pone.0144059
    Similarity or distance measures are core components used by distance-based clustering algorithms to cluster similar data points into the same clusters, while dissimilar or distant data points are placed into different clusters. The performance of similarity measures is mostly addressed in two or three-dimensional spaces, beyond which, to the best of our knowledge, there is no empirical study that has revealed the behavior of similarity measures when dealing with high-dimensional datasets. To fill this gap, a technical framework is proposed in this study to analyze, compare and benchmark the influence of different similarity measures on the results of distance-based clustering algorithms. For reproducibility purposes, fifteen publicly available datasets were used for this study, and consequently, future distance measures can be evaluated and compared with the results of the measures discussed in this work. These datasets were classified as low and high-dimensional categories to study the performance of each measure against each category. This research should help the research community to identify suitable distance measures for datasets and also to facilitate a comparison and evaluation of the newly proposed similarity or distance measures with traditional ones.
    Matched MeSH terms: Analysis of Variance
  6. Mollah MM, Jamal R, Mokhtar NM, Harun R, Mollah MN
    PLoS One, 2015;10(9):e0138810.
    PMID: 26413858 DOI: 10.1371/journal.pone.0138810
    Identifying genes that are differentially expressed (DE) between two or more conditions with multiple patterns of expression is one of the primary objectives of gene expression data analysis. Several statistical approaches, including one-way analysis of variance (ANOVA), are used to identify DE genes. However, most of these methods provide misleading results for two or more conditions with multiple patterns of expression in the presence of outlying genes. In this paper, an attempt is made to develop a hybrid one-way ANOVA approach that unifies the robustness and efficiency of estimation using the minimum β-divergence method to overcome some problems that arise in the existing robust methods for both small- and large-sample cases with multiple patterns of expression.
    Matched MeSH terms: Analysis of Variance*
  7. Nagesh Chodankar N., Vinoth Kumar, Urban John Arnold D’Souza, Ahmad Faris Abdullah
    MyJurnal
    Introduction: Aerobic power reflects the physical fitness of the individual. Evidences support differences in phys-iological responses to exercise. There is less data on VO2 max among common ethnic population of Sabah. Ob-jective of this study was to investigate VO2 max among Kadazan, Dusun, Brunei Melayu, Bugis, Murut and others of Sabah in male and female young adult population. Methods: A total of 385 participants were randomly selected. Monark 894 E leg bicycle ergo meter was used to measure aerobic power VO2 max. Based on the heart rate male and female respectively 450 & 300 kilogram-force meter/minute was chosen. Based on Astrand rhyming nomogram (age correction factor included-VO2 Max multiplied by 1.05) calculations Vo2Max was calculated in l/min. The age correction done VO2 Max (l/min) was multiplied by 1000 and later divided by the body weight to derive the actual VO2Max in ml/kg/min. The recovery heart rate after 1 minute was taken and the difference were calculated for the further analysis. Data was tabulated and analysed by one way ANOVA test - Hocherberg’s GT2. Results: There was no significant difference in VO2 max between the common ethnic young adult population both in males and fe-males. Conclusion: There is no significant difference in VO2 max among the common ethnic adult but have a similar aerobic capacity in the study group.
    Matched MeSH terms: Analysis of Variance
  8. Palaniappan R, Sundaraj K, Sundaraj S
    BMC Bioinformatics, 2014;15:223.
    PMID: 24970564 DOI: 10.1186/1471-2105-15-223
    Pulmonary acoustic parameters extracted from recorded respiratory sounds provide valuable information for the detection of respiratory pathologies. The automated analysis of pulmonary acoustic signals can serve as a differential diagnosis tool for medical professionals, a learning tool for medical students, and a self-management tool for patients. In this context, we intend to evaluate and compare the performance of the support vector machine (SVM) and K-nearest neighbour (K-nn) classifiers in diagnosis respiratory pathologies using respiratory sounds from R.A.L.E database.
    Matched MeSH terms: Analysis of Variance
  9. Md. Muziman Syah, M. M., Mutalib, H. A., Sharanjeet Kaur, M. S., Khairidzan Khairidzan, M. K.
    MyJurnal
    Introduction: The purpose of this study was to evaluate inter-session repeatability, inter-examiner
    reproducibility and inter-device agreement of corneal power measurements from manual keratometer,
    autokeratometer, topographer, Pentacam high resolution and IOLMaster. Methods: Two sets of mean
    corneal power measurements (n=40) were compared for inter-session repeatability and inter-examiner
    reproducibility in each instrument. Repeatability and reproducibility were evaluated by within-subject
    standard deviation (Sw), coefficient of variation (COV) and intraclass correlation coefficient (ICC). A oneway
    repeated measures analysis of variance was conducted to compare differences in the corneal power
    between each instrument pair. The Bland and Altman analysis and Pearson’s correlation were employed to
    assess agreement and determine strength of relationship between measurements. Results: There were no
    significant differences in mean corneal power measurements between 2 different visits (p > 0.05). The Sw
    and COV values between 2 visits were lower than 0.09 D and 0.20 % respectively. The ICCs were stronger
    than 0.99 in all instruments. For reproducibility of each instrument, differences of the measurements
    between 2 different examiners were also insignificant (p > 0.05). The Sw and COV values between 2
    examiners were lower than 0.11 D and 0.23 % respectively. The ICCs were 0.99 and above in all instruments.
    The 95% limit of agreement between instruments ranged from -0.29 to 1.13 D and the r-values were stronger
    than 0.84. Conclusion: The corneal power measurements using these 5 instruments were repeatable and
    reproducible. These instruments can also be used interchangeably, however the topographer should be used
    with caution.
    Matched MeSH terms: Analysis of Variance
  10. Dzarr AA, Kamal M, Baba AA
    Eur J Oncol Nurs, 2009 Sep;13(4):250-4.
    PMID: 19386547 DOI: 10.1016/j.ejon.2009.03.006
    This study assessed the agreement between infrared tympanic membrane (TM), axillary, corrected axillary (+0.5 degrees C), oral, and corrected oral (+0.3 degrees C) to rectal thermometry as reference standard in neutropenic adults. The sensitivity and specificity of the mentioned thermometries in detecting rectal fever (> or =38 degrees C) were also analysed.
    Matched MeSH terms: Analysis of Variance
  11. Asghar A, Abdul Raman AA, Daud WM
    ScientificWorldJournal, 2014;2014:869120.
    PMID: 25258741 DOI: 10.1155/2014/869120
    In the present study, a comparison of central composite design (CCD) and Taguchi method was established for Fenton oxidation. [Dye]ini, Dye:Fe(+2), H2O2:Fe(+2), and pH were identified control variables while COD and decolorization efficiency were selected responses. L 9 orthogonal array and face-centered CCD were used for the experimental design. Maximum 99% decolorization and 80% COD removal efficiency were obtained under optimum conditions. R squared values of 0.97 and 0.95 for CCD and Taguchi method, respectively, indicate that both models are statistically significant and are in well agreement with each other. Furthermore, Prob > F less than 0.0500 and ANOVA results indicate the good fitting of selected model with experimental results. Nevertheless, possibility of ranking of input variables in terms of percent contribution to the response value has made Taguchi method a suitable approach for scrutinizing the operating parameters. For present case, pH with percent contribution of 87.62% and 66.2% was ranked as the most contributing and significant factor. This finding of Taguchi method was also verified by 3D contour plots of CCD. Therefore, from this comparative study, it is concluded that Taguchi method with 9 experimental runs and simple interaction plots is a suitable alternative to CCD for several chemical engineering applications.
    Matched MeSH terms: Analysis of Variance
  12. Gopal RL, Beaver K, Barnett T, Ismail NS
    Cancer Nurs, 2005 Mar-Apr;28(2):132-40.
    PMID: 15815183
    Little is known about the information needs of women with breast cancer in non-Western societies. This study examined the priority information needs of 100 women with breast cancer in Malaysia and compared the findings to previous work involving 150 women diagnosed with breast cancer in the United Kingdom. The study used a valid and reliable measure, the Information Needs Questionnaire (INQ). The INQ contained 9 items of information related to physical, psychological, and social care, used successfully in Canada and the United Kingdom. The INQ was shown to have cross-cultural relevance and sensitivity. For Malaysian women, information about likelihood of cure, sexual attractiveness, and spread of disease were the most important information needs. For UK women, similar priorities were evident, apart from the item on sexual attractiveness, which was ranked much lower by women in the United Kingdom. The cultural similarities and differences that emerged from this study have implications for nurses in the cancer field caring for people from a diversity of cultural backgrounds. Breast care nurses are not a feature of the Malaysian healthcare system, although the findings from this study support the view that specialist nurses have a vital role to play in meeting the psychosocial needs of women with breast cancer in non-Western societies.
    Matched MeSH terms: Analysis of Variance
  13. Mellor D, Hucker A, Waterhouse M, binti Mamat NH, Xu X, Cochrane J, et al.
    Am J Mens Health, 2014 Nov;8(6):521-31.
    PMID: 24707036 DOI: 10.1177/1557988314528370
    This study investigated how dissatisfaction with particular aspects of the body was associated with overall body dissatisfaction among male adolescents in Western and Asian cultures. One hundred and six Malaysian Malays, 55 Malaysian Chinese, 195 Chinese from China, and 45 non-Asian Australians aged 12 to 19 years completed a questionnaire assessing dissatisfaction with their overall body and dissatisfaction with varying aspects of their body. Dissatisfaction with the face, height, and hair was positively correlated with overall body dissatisfaction among Malaysian Malays after body mass index, age and dissatisfaction with body areas typically included in measures (weight/shape, upper, middle, and lower body, and muscles) had been controlled for. Dissatisfaction with the face was positively correlated with overall body dissatisfaction among Malaysian Chinese. These findings demonstrate the differences in body focus for males from different cultures and the importance of using assessment measures that address all possible areas of body focus.
    Matched MeSH terms: Analysis of Variance
  14. Bajuri MN, Isaksson H, Eliasson P, Thompson MS
    Biomech Model Mechanobiol, 2016 12;15(6):1457-1466.
    PMID: 26951049
    The healing process of ruptured tendons is problematic due to scar tissue formation and deteriorated material properties, and in some cases, it may take nearly a year to complete. Mechanical loading has been shown to positively influence tendon healing; however, the mechanisms remain unclear. Computational mechanobiology methods employed extensively to model bone healing have achieved high fidelity. This study aimed to investigate whether an established hyperelastic fibre-reinforced continuum model introduced by Gasser, Ogden and Holzapfel (GOH) can be used to capture the mechanical behaviour of the Achilles tendon under loading during discrete timepoints of the healing process and to assess the model's sensitivity to its microstructural parameters. Curve fitting of the GOH model against experimental tensile testing data of rat Achilles tendons at four timepoints during the tendon repair was used and achieved excellent fits ([Formula: see text]). A parametric sensitivity study using a three-level central composite design, which is a fractional factorial design method, showed that the collagen-fibre-related parameters in the GOH model-[Formula: see text] and [Formula: see text]-had almost equal influence on the fitting. This study demonstrates that the GOH hyperelastic fibre-reinforced model is capable of describing the mechanical behaviour of healing tendons and that further experiments should focus on establishing the structural and material parameters of collagen fibres in the healing tissue.
    Matched MeSH terms: Analysis of Variance
  15. Ghafari S, Hasan M, Aroua MK
    Bioresour Technol, 2010 Apr;101(7):2236-42.
    PMID: 20015639 DOI: 10.1016/j.biortech.2009.11.068
    In this study the kinetics of autohydrogenotrophic denitrification was studied under optimum solution pH and bicarbonate concentration. The optimal pH and bicarbonate concentration were firstly obtained using a design of experiment (DOE) methodology. For this purpose a total of 11 experiments were carried out. Sodium bicarbonate concentrations ranging of 20-2000 mg/L and pH values from 6.5 to 8.5 were used in the optimization runs. It was found that the pH has a more pronounced effect on the denitrification process as compared to the bicarbonate dose. The developed quadratic model predicted the optimum conditions at pH 8 and 1100 mg NaHCO(3)/L. Using these optimal conditions, the kinetics of denitrification for nitrate and nitrite degradation were investigated in separate experiments. Both processes were found to follow a zero order kinetic model. The ultimate specific degradation rates for nitrate and nitrite remediation were 29.60 mg NO(3)(-)-N/g MLVSS/L and 34.85 mg NO(3)(-)-N/g MLVSS/L respectively, when hydrogen was supplied every 0.5h.
    Matched MeSH terms: Analysis of Variance
  16. J Paediatr Child Health, 1997 Feb;33(1):18-25.
    PMID: 9069039
    OBJECTIVE: To determine the risk factors associated with mortality in very low birthweight (VLBW) infants admitted to the neonatal intensive care units (NIUC) in Malaysia.

    METHOD: A prospective observational study of outcome of all VLBW infants born between 1 January 1993 and 30 June 1993 and admitted to the NICU.

    RESULTS: Data of 868 VLBW neonates from 18 centres in Malaysia were collected. Their mean birthweight was 1223 g (95% confidence intervals: 1208-1238 g). Thirty-seven point four per cent (325/868) of these infants died before discharge. After exclusion of all infants with congenital anomalies (n = 66, and nine of them also had incomplete records) and incomplete records (n = 82), stepwise logistic regression analysis of the remaining 720 infants showed that the risk factors that were significantly associated with increased mortality before discharge were: delivery in district hospitals, Chinese race, lower birthweight, lower gestation age, persistent pulmonary hypertension of the newborn, pulmonary airleak, necrotizing enterocolitis of stage 2 or 3, confirmed sepsis, hypotension, hypothermia, acute renal failure, intermittent positive pressure ventilation, and umbilical arterial catheterization. Factors that were significantly associated with lower risk of mortality were: use of antenatal steroid, oxygen therapy, surfactant therapy and blood transfusion.

    CONCLUSION: The mortality of VLBW infants admitted to the Malaysian NICU was high and was also associated with a number of preventable risk factors.

    Matched MeSH terms: Analysis of Variance
  17. Parsi S, Pandamooz S, Heidari S, Naji M, Morfini G, Ahmadiani A, et al.
    Neuroscience, 2015 Jan 22;284:99-106.
    PMID: 25270904 DOI: 10.1016/j.neuroscience.2014.09.045
    Alzheimer's disease (AD) is characterized by progressive and irreversible cognitive and memory impairment. The discovery of familial forms of AD (fAD) in association with specific gene mutations facilitated the generation of numerous rodent models. These models in turn proved valuable for the study of molecular mechanisms underlying AD pathogenesis, and facilitated translational research and preclinical drug development. This study aimed to introduce a new rat model of AD simulating some aspects of the sporadic cases of disease.
    Matched MeSH terms: Analysis of Variance
  18. Baroutian S, Aroua MK, Raman AA, Sulaiman NM
    Bioresour Technol, 2011 Jan;102(2):1095-102.
    PMID: 20888219 DOI: 10.1016/j.biortech.2010.08.076
    In this study, a novel continuous reactor has been developed to produce high quality methyl esters (biodiesel) from palm oil. A microporous TiO2/Al2O3 membrane was packed with potassium hydroxide catalyst supported on palm shell activated carbon. The central composite design (CCD) of response surface methodology (RSM) was employed to investigate the effects of reaction temperature, catalyst amount and cross flow circulation velocity on the production of biodiesel in the packed bed membrane reactor. The highest conversion of palm oil to biodiesel in the reactor was obtained at 70 °C employing 157.04 g catalyst per unit volume of the reactor and 0.21 cm/s cross flow circulation velocity. The physical and chemical properties of the produced biodiesel were determined and compared with the standard specifications. High quality palm oil biodiesel was produced by combination of heterogeneous alkali transesterification and separation processes in the packed bed membrane reactor.
    Matched MeSH terms: Analysis of Variance
  19. Choi EM, Kim YH
    Food Chem Toxicol, 2008 Jan;46(1):375-9.
    PMID: 17904263 DOI: 10.1016/j.fct.2007.08.018
    The present study was undertaken to determine whether Ligularia fischeri leaf extract (LF) is efficacious against collagen-induced arthritis (CIA) in mice. DBA/1J mice were immunized with bovine type II collagen and treated with LF (100 and 200 mg/kg) for 49 days. Mice were assessed regularly for signs of arthritis and the levels of rheumatoid factor, anti-type II collagen antibody, cytokines, AST, ALT, and creatinine in serum were also examined after the animals were killed. The arthritis score and paw edema were markedly suppressed in the groups treated with LF. Moreover, levels of rheumatoid factor, anti-type II collagen antibody, tumor necrosis factor-alpha, interleukin (IL)-1, and IL-6 in sera were reduced by LF administration. These data suggest that L. fischeri might be effective for the treatment of inflammatory arthritis like human rheumatoid arthritis.
    Matched MeSH terms: Analysis of Variance
  20. Ilic D, Nordin RB, Glasziou P, Tilson JK, Villanueva E
    BMC Med Educ, 2015;15:39.
    PMID: 25884717 DOI: 10.1186/s12909-015-0321-6
    BACKGROUND: Few studies have been performed to inform how best to teach evidence-based medicine (EBM) to medical trainees. Current evidence can only conclude that any form of teaching increases EBM competency, but cannot distinguish which form of teaching is most effective at increasing student competency in EBM. This study compared the effectiveness of a blended learning (BL) versus didactic learning (DL) approach of teaching EBM to medical students with respect to competency, self-efficacy, attitudes and behaviour toward EBM.
    METHODS: A mixed methods study consisting of a randomised controlled trial (RCT) and qualitative case study was performed with medical students undertaking their first clinical year of training in EBM. Students were randomly assigned to receive EBM teaching via either a BL approach or the incumbent DL approach. Competency in EBM was assessed using the Berlin questionnaire and the 'Assessing Competency in EBM' (ACE) tool. Students' self-efficacy, attitudes and behaviour was also assessed. A series of focus groups was also performed to contextualise the quantitative results.
    RESULTS: A total of 147 students completed the RCT, and a further 29 students participated in six focus group discussions. Students who received the BL approach to teaching EBM had significantly higher scores in 5 out of 6 behaviour domains, 3 out of 4 attitude domains and 10 out of 14 self-efficacy domains. Competency in EBM did not differ significantly between students receiving the BL approach versus those receiving the DL approach [Mean Difference (MD)=-0.68, (95% CI-1.71, 0.34), p=0.19]. No significant difference was observed between sites (p=0.89) or by student type (p=0.58). Focus group discussions suggested a strong student preference for teaching using a BL approach, which integrates lectures, online learning and small group activities.
    CONCLUSIONS: BL is no more effective than DL at increasing medical students' knowledge and skills in EBM, but was significantly more effective at increasing student attitudes toward EBM and self-reported use of EBM in clinical practice. Given the various learning styles preferred by students, a multifaceted approach (incorporating BL) may be best suited when teaching EBM to medical students. Further research on the cost-effectiveness of EBM teaching modalities is required.
    Matched MeSH terms: Analysis of Variance
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