Absence Rates Research Articles

Why is nobody talking about employment fraud?

PurposeA hinderance to businesses across the UK, employment fraud and absenteeism are phenomenons that need to be addressed. Fraud is a topic that remains largely unexplored for the HR profession, and covert surveillance emerges as a brilliant and effective solution to tackle the challenges that hundreds of businesses face when trying to clamp down on employment fraud.Design/methodology/approachThis study provides insight for HR professionals as to how employee surveillance can be harnessed safely to help tackle employment fraud and absenteeism, whilst unlocking a productive and healthy environment.FindingsPublic sector organisations face a particularly significant challenge when grappling with absenteeism, with absence rates nearly double that of the private sector. A key focal point of this research revolves around the startling fact that absence rates in the public sector are alarmingly high. Still, robust investigations into these matters are seldom conducted, leaving the door wide open for fraudulent activities to persist. Covert surveillance offers a proactive approach to identify and address the root causes of almost endemic absenteeism, ensuring a healthier and more efficient workplace.Originality/valueBy embracing the power of covert surveillance, businesses not only protect their legitimate interests but also contribute to a workplace environment that thrives on transparency, honesty and loyalty. This study effectively outlines how HR professionals can effectively deploy covert surveillance to ensure they are staying within the guidelines of the law, whilst still clamping down on bad actors and protecting their bottom line.

Cross-sectional study of psychiatric disorders in patients with chronic musculoskeletal pain and individuals without pain

BackgroundMusculoskeletal chronic pain is a leading cause of global disability and laboral incapacity. However, there is a lack of population-based studies that investigate the relationship between chronic pain and mental disorders with a control group, particularly among low- and middle-income countries. Chronic pain is a serious public health problem in terms of human suffering, and in terms of socioeconomic implications. Frequent association with different mental disorders increases disability, decreases quality of life, and makes diagnosis and treatment challenging. The present study aimed to evaluate the presence of mental disorders in patients with chronic musculoskeletal pain and compare with a control group without pain.MethodsWe selected 100 patients in a regular follow-up at the Musculoskeletal Pain Outpatient Clinic of the University Hospital and compared them with 100 painless individuals from the control group from June 2016 to June 2018. The instruments used were the Mini International Neuropsychiatric Interview (MINI-PLUS) and a structured questionnaire to collect sociodemographic data. Statistical analysis used t-test, chi-square, Fisher’s exact test, Mann-Whitney, Kolmogorov-Smirnov tests, and multiple logistic regression.ResultsIn the sample evaluated, the majority of patients were women (83%), of brown color (54%), with lower-level education (51%), lower salary range (73%) and high absenteeism rate at work (60,7%). Patients with chronic pain had more psychiatric disorders (88% vs. 48% in the control group; p < 0.001). The most frequent diagnoses were anxiety disorders with panic attacks (44%), generalized anxiety (36%), mixed anxiety and depression disorder (33%), social phobia (30%), agoraphobia (29%), suicide risk (28%), and major depression (27%).ConclusionPositive correlations of mental disorders and chronic musculoskeletal pain have been documented. This suggests that psychiatric components must be taken into account in the management of chronic pain syndromes. The use of Mini Plus as a diagnostic tool for psychiatric disorders can contribute to optimizing the diagnosis and treatment of patients with chronic pain and encourage the creation of policies with strategies and criteria for quick access to Multi-professional Services.

Evaluating the impact of school-based influenza vaccination programme on absenteeism and outbreaks at schools in Hong Kong: a retrospective cohort study protocol

IntroductionSeasonal influenza causes annual school breaks and student absenteeism in Hong Kong schools and kindergartens. This proposal aims to conduct a retrospective cohort study to evaluate the impact of a school-based influenza vaccination (SIV) programme on absenteeism and outbreaks at schools in Hong Kong.MethodsThe study will compare schools that implemented the SIV programme with schools that did not. The data will be sourced from school records, encompassing absenteeism records, outbreak reports, and vaccination rates. We will recruit 1000 students from 381 schools and kindergartens in 18 districts of Hong Kong starting June 2024. The primary outcome measures will include absenteeism rates due to influenza and school influenza outbreaks. Secondary outcomes will consist of vaccination coverage rates and the impact of the SIV programme on hospitalisations due to influenza-like illness. A t-test will be conducted to compare the outcomes between schools with and without the SIV programme.Ethics and disseminationThe school completed signing the participants’ informed consent form before reporting the data to us. Our study has been approved by the Hospital Authority Hong Kong West Cluster IRB Committee (IRB No: UW 17–111) and was a subtopic of the research “The estimated age-group specific influenza vaccine coverage rates in Hong Kong and the impact of the school outreach vaccination program”.Trial registrationThis study will be retrospectively registered.

Planned and unplanned hospital admissions and health-related school absence rates in children with neurodisability: Protocol for a population-based study using linked education and hospital data from England.

Neurodisability describes a broad set of conditions affecting the brain and nervous system which result in functional limitations. Children with neurodisability have more hospital admissions than their peers without neurodisability and higher rates of school absence. However, longitudinal evidence comparing rates of hospital admission and school absence in children with neurodisability to peers without neurodisability throughout school is limited, as is understanding about whether differences are greatest for planned care (e.g., scheduled appointments) or unplanned care. This study will describe rates of planned and unplanned hospital admissions and school absence due to illness and medical reasons throughout primary school (Reception to Year 6, ages 4 to 11 in England) for children with neurodisability and all other children, using linked individual-level health and education data. We will use the ECHILD (Education and Child Insights from Linked Data) database, which links educational and health records across England. We will define a primary school cohort of children who were born in National Health Service-funded hospitals in England between 1 st September 2003 and 31 st August 2008, and who were enrolled in Reception (age 4/5) at state-funded schools. We will use hospital admissions records to identify children who have recorded indicators of neurodisability from birth up to the end of primary school (Year 6, age 10/11). We will describe rates of planned and unplanned hospital admissions and health-related school absence for three groups of children: those with a neurodisability indicator first recorded before beginning primary school, those with neurodisability first recorded during primary school, and those without a record of neurodisability before end of primary school. We will further explore whether differences between these group vary across primary school years and by socioeconomic and demographic characteristics.

Research on Teaching Evaluation Algorithm of Engineering Related Majors in the Context of Digitalization of Engineering Education

While the nation's industry building has progressed, so has the area that includes engineering leadership. But the nation's managerial engineering major is in an embryonic phase at the moment because of the difficulty of the beginning decades, or the instructional and operational setup of all courses is additionally in a nascent stage. Kids' faith in educators has declined with the rising absenteeism rate and the objectification of kids' once-dominant positions in the classroom. Individualism and variety are hallmarks of individuals' educational experiences. Despite calls for greater standards in the classroom, most institutions lacked the resources necessary to implement meaningful mechanisms for monitoring teachers' performance. The education of management and engineering majors must be reformed and innovated to better address these issues. Certification in technical courses is fundamentally about making sure that students are competent in their fields. It's a novel approach to determining the quality of course instruction for managerial engineering students, so naturally, there's a lot of academic interest in it. Certification in the teaching of engineering has been widely discussed by academics since it provides a novel way to evaluate the quality of instruction in managerial engineering courses. This research blends artificial intelligence with a credential in the field of engineering, and its foundation is an in-depth analysis of how engineering leadership classes are taught. Universities were surveyed and analyzed, and it was determined that a professional course in managerial engineering teaching students engineering guarantee against the backdrop of machine learning increased attendance among students by about 20%. The percentage of students who successfully complete course goals has grown by around 13%, while the average level of skill among graduates has risen by about 8%.So that current engineering managerial graduates are better able to satisfy the demands of contemporary society, it supported the growth of higher education and raised the overall quality of students as well as the quality of instruction and effectiveness of technical management programs.

How healthy is your workplace? Testing the effectiveness of occupational health programs: insights from Germany

PurposeCompanies are increasingly struggling with the costs of absenteeism due to their employees’ physical and increasing psychological illnesses. At the same time, employers should recognize the value of healthy employees in terms of greater productivity and the development of positive organizational attitudes. Many organizations have implemented workplace health promotion (WHP) programs; however, we still have limited knowledge about the effectiveness of various measures. The present study is an examination of 18 WHP activities and their effect on employees’ perceived health support and actual absence rates.Design/methodology/approachI organized 112 German companies into four groups based on their subjective (employee perception of health promotion) and objective (absence rate) performance. Applying multinomial regression analysis, I assessed a company’s likelihood of falling into one of the four clusters if a specific measure was not implemented in it.FindingsI identified five measures that significantly differ between company clusters: healthy food offerings, sports offerings, having fitness rooms, systematically evaluating WHP programs and smoking cessation courses. Investing in occupational health management can be a strategic asset for organizations. The study results give companies recommendations on how to address WHP and how to implement these concrete measures.Originality/valueThe study’s originality lies in the incorporation of 18 concrete WHP measures and the comparison of their effects in objective and subjective terms. It shows that employers can enhance employee well-being by using simple WHP activities.

School absence of adolescents from single-parent families in Andalusia (Spain): exploring the mediating and moderating role of economic and social resources

This study examines the relationship between growing up in single-parent families and school absence in Andalusia (Spain), considering differences according to adolescents’ social background. Empirical analyses of data from the Social Survey 2010: Education and Housing show that adolescents growing up in single-parent families have, on average, a higher number of school absences than their peers in two-parent families. These disadvantages are greater for adolescents with low social backgrounds, regardless of whether this is measured by parental education or housing tenure. Both economic resources (lower household income) and social resources (poor relationship with absent parent) partially explain the differences in school absence rates amongst adolescents growing up in single-parent families. School environment (teacher–student relationship, atmosphere amongst students, experiences of school violence or ownership of educational institution) are not influential in explaining educational disadvantage amongst adolescents from different family structures, although they are strong predictors of school absence.

Workplace interventions to reduce the risk of SARS-CoV-2 infection outside of healthcare settings.

Workplace interventions to reduce the risk of SARS-CoV-2 infection outside of healthcare settings.

Assessing the Burden of Respiratory Syncytial Virus-related Bronchiolitis in Primary Care and at 15-Day and 6-Month Follow-up Before Prophylaxis in France: A Test-negative Study.

To assess the burden of respiratory syncytial virus (RSV)-related bronchiolitis in primary care and at 15 days and 6 months after a primary care visit. In this test-negative study, children <2 years old with a first episode of bronchiolitis were prospectively enrolled by 45 ambulatory pediatricians in France from February 2021 to April 2023. RSV was assessed with a rapid antigen detection test. The burden of the disease was assessed with a questionnaire, including quality of life (PedsQL 1.0 Infant Scales), at 15-day and 6-month follow-up. Children with a positive RSV test result (RSV+) were compared to those with a negative test result (RSV-). Among the 1591 children enrolled, 750 (47.1%) were RSV+. At 15 days follow-up (data availability: 69%), as compared with RSV- children, RSV+ children more frequently had fever (20.5% vs. 13.7%, P = 0.004) and decreased food intake (27.0% vs. 17.4%, P < 0.001) during the last 3 days. They had higher rates of hospitalization (11.8% vs. 5.8%, P < 0.001), childcare absenteeism (83.5% vs. 66.1%, P < 0.001) and parents who had to stop working to care for them (59.1% vs. 41.0%, P < 0.001) as well as lower quality of life (median PedsQL score 76.2 vs. 78.4, P = 0.03). At 6 months (data availability: 48.5%), the 2 groups did not differ in proportion of medical attendance, hospitalization, antibiotic treatment or quality of life. RSV+ children experienced much more severe disease and follow-up family and societal burden than RSV- children. These data may be used as baseline data as RSV prophylaxis is about to be implemented.

Childhood Maltreatment and Adult Work Absenteeism: Work Meaningfulness as a Double-Edged Sword.

The adverse impacts of childhood maltreatment (CM) on an individual's health and economic welfare are widely recognized, yet its occupational and organizational effects remain less explored. Employee absenteeism, known as absenteeism, is often a sign of workplace maladjustment and may be linked to a history of CM. Some individuals in the helping professions, who exhibit a strong sense of purpose in their employment and pursue it in demanding environments, are CM survivors. This study investigates whether a heightened sense of meaningfulness in their work is associated with increased absenteeism among this subgroup. We recruited 320 helping professionals from a variety of social and mental health settings, one third of whom reported experiencing CM. As hypothesized, CM was positively correlated with work absenteeism. Furthermore, the relationship between work meaningfulness and absenteeism was moderated by their CM history: among those with CM experiences, greater work meaningfulness was associated with higher absenteeism rates. Our findings highlight the possibility that work meaningfulness may operate as a double-edged sword, and the importance of better understanding the challenges that high-functioning survivors of CM face within organizational contexts.

Psychedelic-assisted Therapy Training: Firsthand Experience of Non-Ordinary States of Consciousness in the Development of Competence

Introduction This review explores the benefits of incorporating personal experience(s) with non-ordinary states of consciousness as a core component of Psychedelic-Assisted Therapy (PaT) training.The program incorporates an optional experiential training component. We collaborate with professionals affiliated with a Canadian non-profit organization specializing in PaT experiential training. As do other stakeholders in this field– including program developers, educators, and researchers–we navigate a rapidly evolving and often ambiguous landscape, where infrastructure and regulations are lagging scientific data and best practices. Given the potential for differing perspectives, the authors acknowledge that their personal experiences could be a potential source of bias, influencing objectivity.ObjectivesConversely, these lived experiences could be seen as valuable contributions, enriching perspectives on the role of experiential training. In that context, our intention is to provide a comprehensive review, presenting arguments both in favour of and against the integration of experiential training in PaT.MethodsThere is an urgent need for establishing legal training and practice options, bridging the underground with best practices, with all practitioners operating within a regulated and ethically accountable framework. Such a proactive strategy would mitigate the risks associated with unregulated training in a field with relatively few guidelines on how to develop competency.ResultsAn in-training PaT experience supports personal comfort, self-assuredness, and confidence supporting others in non-ordinary states of consciousness, with contemporary researchers/experts highlighting the specific challenges among therapists who lack lived experience. These might include holding unrealistic expectations, being unaware of the impacts of set and setting, and misunderstandingConclusions Whether or not therapists engage in experiential training - serving a dual in one’s own healing process, it is imperative that they maintain their own wellness practices. This proactive/primary prevention strategy would improve well-being and resilience, reducing secondary mental health consequences for patients and providers. Cultivating a culture of self-care within the mental health field should be an overarching priority for training programs and professional organizations, without which we are left with broken people in support of broken people. Current rates of burnout, absenteeism and early retirement suggest that we are already on that trajectory and should serve as a call to action.Disclosure of InterestNone Declared

Analysis of Coercion-Resistant for E-Voting System based on Blockchain

Abstract: Election absenteeism rates are steadily rising, partly a result of the distance required to cast a vote. The use of electronic voting procedure would eliminate the need for travel and enhance voter turnout. In addition, compared to the conventional paper ballot voting technique, this reduces dangers like manipulations and produces results more quickly. A remotely electronic voting system should, nevertheless, adhere to the highest standards of security, dependability, and transparency given the significance of an election. Numerous remote e-voting systems, many of which are based on blockchain technology, were examined in this literature review. Blockchain technology provides for the removal of the Trusted Third Party (TTP) and the decentralization of transactions while also providing transparent and completely secure data storage, making it a new technical foundation for many different types of IT applications. The use of smart-contract technology, which automates and executes user agreements, is also permitted. The authors of this study examine the most insightful blockchain-based e-voting options. The lack of openness and auditability in conventional voting methods can be addressed by blockchain technology. A reliable computing platform is offered by running a self-enforcing e-voting system on a blockchain for real-time data verification

Agile Leadership: Empowering Teams for Peak Performance

Human resources (HR) play a pivotal role in the development of any country and are indispensable for the success of businesses. Effective leadership is crucial in motivating employees to actively engage in company operations and fostering productive teamwork over the long term. Excessive work stress can lead to adverse outcomes such as decreased performance, higher absenteeism rates, and compromised mental and physical health. Ineffective leadership is often cited as a contributing factor to workplace stress. Furthermore, job dissatisfaction can exacerbate stress levels, leading to reduced motivation and performance. This study aims to identify specific factors contributing to workplace stress, job satisfaction, leadership effectiveness, and performance. A quantitative research approach was employed, utilizing a survey distributed to a population of 1800 employees at Open University, with a sample size of 200 respondents. The survey utilized a questionnaire with five-point Likert scales. Data analysis was conducted using Structural Equation Modeling Partial Least Squares (SEM PLS) techniques. The findings of the research indicate that the influence of agile leadership on performance is negligible, with an F Square value of less than 2, suggesting minimal to no effect (below 0.14). Conversely, job satisfaction significantly and positively impacts performance, demonstrating a stronger influence compared to other variables. Agile leadership was found to have a significant and relatively substantial effect on work stress. Additionally, work stress was found to significantly influence job satisfaction, with a coefficient of 0.915, indicating a strong positive relationship between the two variables.

Quality of life and work functionality in severe asthma patients: the impact of biological therapies

BackgroundSevere asthma can cause poor health status, poor health-related quality of life (HRQoL) and an impaired functioning at work. However, to date, limited data are available on the impact of the biological therapies on such outcomes. Therefore, aim of the present study was to prospectively assess the clinical, quality of life and work functionality issues in severe asthma patients both at baseline and after 6 months of biological therapies and determine which individual, pathological and occupational factors can influence such parameters.MethodsFifty-two patients were enrolled between December 2022 and June 2023. Patients’ personal, clinical, functional and occupational features were assessed. The Short Form Health Survey (SF-12), the Work Productivity and Activity Impairment (WPAI) questionnaire and the Work Ability Index (WAI) were employed to assess HRQoL, the employee’s productivity and perception of work ability, respectively.ResultsAmong the enrolled patients, 30 (57.70%) were employed. Biological therapy induced a significant improvement in clinical and functional parameters, e.g., FEV1% (72 ± 12 vs.87 ± 13%; 72 ± 14 vs. 86 ± 14%), FVC% (92 ± 11 vs. 101 ± 11%; 90 ± 13 vs. 98 ± 14%) and FEV1/FVC (62 ± 11 vs. 71 ± 8%; 64 ± 9 vs. 70 ± 8%) in workers and non-workers, respectively (P < 0.001). Comparably, the perception of life quality significantly improved, as physical and mental health scores, in the overall cohort, increased from 40.7 ± 10.3 and 48.5 ± 8.5 to 46.8 ± 8.6 and 51.6 ± 6.4, respectively (P < 0.001). The work ability perception significantly improved from a moderate to a good one (34 ± 6 vs. 40 ± 6, P = 0.001). A significant reduction in the absenteeism (19 ± 15 vs. 3 ± 11%; P < 0.001) and presenteeism rate (53 ± 24 vs. 29 ± 26%; P < 0.001), and an improvement in daily (40 ± 27.5% vs. 28.9 ± 24.7%, P < 0.001, in the overall population) and work activities (57 ± 25 vs. 29 ± 27%, P < 0.001) was determined. Gender, age, symptoms control and pulmonary functionality were correlated with the physical and mental health perception, daily activity impairment and work ability.ConclusionsOur study pointed out that biological therapies improved clinical, general life and occupational outcomes in patients with severe asthma. The correlation between clinical aspects and psychological and occupational issues suggest the relevance for a multidisciplinary management of the disease for an effective participation of patients in the world of work.

Workers' moral hazard and private insurer effort in disability insurance

AbstractWhile it is well known that supplementary private Disability Insurance (DI) has the potential to increase workers' moral hazard, the extra coverage may also increase incentives for private insurers to reduce caseloads by means of prevention and reintegration activities. With unique administrative data on DI contracts of firms in the Netherlands, this paper aims to disentangle these worker and insurer responses to increased coverage. Supplementary insurance increases the insurers' incentive to lower disability risks, but in our setting it also creates an incentive for the insurers to facilitate partial work resumption of disabled workers who have earnings capacity. Using firm‐ and time‐fixed effects models on the absence and employment rates, we find that insurer effort counteracts workers' moral hazard.

The impact of electronic and self-rostering systems on healthcare organisations and healthcare workers: A mixed-method systematic review.

To synthesise evidence from studies that explored the impact of electronic and self-rostering systems to schedule staff on healthcare organisations and healthcare workers. Mixed-method systematic review. Studies were screened by two independent reviewers and data were extracted using standardised data extraction tables. The quality of studies was assessed, and parallel-results convergent synthesis was conducted. Academic Search Complete, CINAHL, ERIC, MEDLINE, PsycINFO and PsycARTICLES were searched on January 3, 2023. Eighteen studies were included (10 quantitative descriptive studies, seven non-randomised studies and one qualitative study). Studies examined two rostering interventions including self-rostering (n = 12) and electronic rostering (n = 6). It was found that the implementation of electronic and self-rostering systems for staff scheduling impacted positively on both, healthcare workers and healthcare organisations. Benefits included enhanced roster efficiency, staff satisfaction, greater control and empowerment, improved work-life balance, higher staff retention and reduced turnover, decreased absence rates and enhanced healthcare efficiency. However, self-rostering was found to be less equitable than fixed rostering, was associated with increased overtime, and correlated with a higher frequency of staff requests for shift changes. The impact of electronic and self-rostering systems to schedule staff on healthcare organisations and healthcare workers' outcomes was predominantly positive. Further randomised controlled trials and longitudinal studies are warranted to evaluate the long-term impact of various rostering systems, including electronic and self-rostering systems. Rostering is a multifaceted responsibility for healthcare administrators, impacting patient care quality, workforce planning and healthcare expenditure. Given that healthcare staffing costs constitute a substantial portion of global healthcare expenditure, efficient and strategic resource management, inclusive of healthcare staff rostering, is imperative. The 27-item Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. No Patient or Public Contribution.

Evaluation of absenteeism and presenteeism status of factory employees.

While absenteeism refers to not attending work, presenteeism is defined as not being present at work. These two conditions, which negatively affect employee health, can be indicators of work efficiency, work peace, work safety and work engagement. Several factors were evaluated in this study concerning absenteeism and presenteeism among factory workers. This cross-sectional study was conducted among workers in a factory operating in a heavy industry in southern Turkey in 2021. A survey consisting of 57 questions was applied to 152 factory workers by face-to-face interview method. The participants' behaviour over the last month was evaluated regarding absenteeism and presenteeism. It was reported that 24 (15.8%) of all employees were absent from work in the last month (absenteeism), excluding holidays and sick leave, and that 20 (13.2%) employees engaged in presenteeism, working when they should not have been at the workplace. There was a high absenteeism rate among employees who had an acute illness and were dissatisfied with their jobs. Several factors have been associated with presenteeism, including poor economic conditions, family health problems, previous unemployment, working overtime, job dissatisfaction, poor relationships with colleagues and difficulty finding a replacement, acute illness, sleep problems and fatigue. To increase the productivity and commitment of employees, it may be useful to identify the reasons for absenteeism and present behaviours, to facilitate effective interpersonal communication skills by examining the organisational climate of employees, and to regulate workload based on a comprehensive assessment of the health status of employees.

Spillover–Crossover Effect of Work–Family Interface: A Systematic Review

Work and family are essential aspects of adulthood, exerting a substantial impact on well-being and satisfaction. Work–family conflict refers to conflicts that originate at work and then affect family life and vice versa. Higher levels of stress, the emergence of physical and mental health issues, detrimental effects on family relationships, and poorer life satisfaction are a few outcomes that may have an influence on both individuals and other family members. Work–family conflict can have a socioeconomic impact on broader public health, as it may result in poor job performance and high absenteeism rates at work. This current study aims to identify the mechanisms of spillover–crossover within the work–family interferences. Using a systematic literature review from 57 articles collected from three prestigious databases: Scopus, Web of Science, and PsycINFO, the study found that direct crossover is the predominant form of transmission. However, the crossover phenomenon is not only found in marital relationships but includes interactions between parents-children, superiors-subordinates, and employees-customers. This systematic literature review advances a novel framework by synthesizing these findings, thereby promoting a comprehensive understanding of the spillover–crossover effects of work–family conflict. In turn, this understanding can serve as the basis for the formulation of workplace policies, offering a promising path forward for both individuals and society.

Tumor location matters, next generation sequencing mutation profiling of left-sided, rectal, and right-sided colorectal tumors in 552 patients

Despite the introduction of new molecular classifications, advanced colorectal cancer (CRC) is treated with chemotherapy supplemented with anti-EGFR and anti-VEGF targeted therapy. In this study, 552 CRC cases with different primary tumor locations (250 left side, 190 rectum, and 112 right side) were retrospectively analyzed by next generation sequencing for mutations in 50 genes. The most frequently mutated genes were TP53 in left-sided tumors compared to right-sided tumors and BRAF in right-sided tumors compared to left-sided tumors. Mutations in KRAS, NRAS, and BRAF were not detected in 45% of patients with left-sided tumors and in 28.6% of patients with right-sided tumors. Liver metastases were more common in patients with left-sided tumors. Tumors on the right side were larger at diagnosis and had a higher grade (G3) than tumors on the left. Rectal tumors exhibit distinctive biological characteristics when compared to left-sided tumors, including a higher absence rate of KRAS, NRAS, and BRAF mutations (47.4% in rectal versus 42.8% in left-sided tumors). These rectal tumors are also unique in their primary metastasis site, which is predominantly the lungs, and they have varying mutation rates, particularly in genes such as BRAF, FBXW7, and TP53, that distinguish them from tumors found in other locations. Primary tumor location has implications for the potential treatment of CRC with anti-EGFR therapy.

Prospective learning curve analysis of en bloc resection of bladder tumor using an ex vivo porcine model

BackgroundAs a relatively new surgical technique, the learning curve of en bloc resection of bladder tumor (ERBT) in ex vivo models remains unaddressed. This study aimed to explore the learning curve of ERBT in an ex vivo porcine model.MethodsIn this prospective study, eight endoscopists without prior experience in ERBT were divided into two groups: junior endoscopists, with less than 100 transurethral resection of bladder tumor (TURBT) procedure experience, and senior endoscopists, with at least 100 TURBT procedure experience. Each endoscopist performed 30 ERBT procedures on artificial lesions in an ex vivo porcine bladder model. The procedure time, perforation, en bloc resection status, and absence of detrusor muscle (DM) were recorded. The inflection points were identified using cumulative sum (CUSUM) analysis. Procedure results were compared between the two phases and two groups.ResultsIn all, 240 artificial lesions were successfully resected using ERBT. The CUSUM regression line indicated the inflection point at the 16th procedure for the junior endoscopists and at the 13th procedure for the senior endoscopists. In both groups, the procedure time, perforation, piecemeal resection, and DM absence rates were significantly lower in the consolidation phase than in the initial phase. The procedure time for the senior endoscopists was lower than for the junior endoscopists in both phases.ConclusionsERBT performance improved significantly after reaching the inflection point of the learning curve in the ex vivo model. We recommend a minimum of 16 ERBT procedures in ex vivo models for urologists with less than 100 TURBT experience and a minimum of 13 procedures for those with at least 100 TURBT experience before advancing to live animal training or supervised clinical practice.