Acceptance Rate Research Articles

Experience of a peer prereview service including a junior reviewer program in a professional association.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Scientific journals have reportedly low acceptance rates. Peer review support services offering manuscript review before journal submission are uncommon but may increase success with the publication process. The purpose of this report is to describe the development and experience with a peer prereview (PPR) service offered by the Clinical Pharmacy and Pharmacology (CPP) section of the Society of Critical Care Medicine. The CPP PPR service provides comprehensive review on research manuscripts before submission to a scientific journal. A junior reviewer program provides an opportunity for mentorship and professional development of reviewers. After the review is complete, authors and reviewers complete a survey regarding their experience with the service. Authors are also contacted biannually to determine their manuscript's status. From the program's start in 2011 through June 2022, 64% of the 58 manuscripts reviewed were accepted or published in journals with impact factors ranging from 0.915 to 9.296. Of the 31 (82%) authors responding to the survey, 94% said that the service met or exceeded their expectations and 84% would recommend the service to a colleague. Of the 29 (76%) reviewers responding to the survey, 100% said that the service met or exceeded their expectations and 92% would be willing to review again. The majority of manuscripts that went through the CPP PPR service were accepted for publication, and both authors and reviewers were highly satisfied with their experience. The CPP PPR service can be used as a framework for other institutions to implement.

Pediatric Cranial Stereotactic Radiosurgery: Meta-Analysis and International Stereotactic Radiosurgery Society Practice Guidelines.

There are limited data on the use of stereotactic radiosurgery (SRS) for pediatric patients. The aim of this systematic review was to summarize indications and outcomes specific to pediatric cranial SRS to inform consensus guidelines on behalf of the International Stereotactic Radiosurgery Society (ISRS). A systematic review, using the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), analyzed English-language articles on SRS, published between 1989 and 2021, that included outcomes for at least 5 pediatric patients. MEDLINE database terms included tumor types and locations, and radiosurgical and age-specific terms. We excluded nonclinical reports, expert opinions, commentaries, and review articles. Meta-regressions for associations with local control were performed for medulloblastoma, craniopharyngioma, ependymoma, glioma, and arteriovenous malformation (AVM). Of the 113 articles identified for review, 68 met the inclusion criteria. These articles described approximately 400 pediatric patients with benign and malignant brain tumors and 5119 with AVMs who underwent cranial SRS. The rates of local control for benign tumors, malignant tumors, and AVMs were 89% (95% CI, 82%-95%), 71% (95% CI, 59%-82%), and 65% (95% CI, 60%-69%), respectively. No significant associations were identified for local control with patient-, tumor-, or treatment-related variables. This review is the first to summarize outcomes specific to SRS for pediatric brain tumors and AVMs. Although data reporting is limited for pediatric patients, SRS appears to provide acceptable rates of local control. We present ISRS consensus guidelines to inform the judicious use of cranial SRS for pediatric patients.

Surface Roughness Evaluation of Blast-Cleaned Structural Steel Plates Considering Measurement Deviation

AbstractSurface roughness is an important characteristic of blast-cleaned structural steel plates. This is because the adhesion of the coating and the frictional grip of the bolted connections are related to surface roughness. Surface roughness is usually measured using a surface roughness meter. Because the roughness of blast-cleaned surfaces is not uniform, it varies from position to position. The surface roughness test results obtained from a broad area are more valuable than those obtained from a narrow area. Because the measured values contain deviations, they are measured multiple times and averaged to reduce the influence of deviations. However, to evaluate roughness, it is necessary to clarify the measurement conditions to obtain accurate results. Consider combining these sentences as follows: In this study, the surface roughness of the blast-cleaned structural steel sample was measured at multiple locations to obtain its distribution characteristics. During each sample measurement, the detection sensor of the surface roughness meter was lifted and placed on the steel sample to determine deviations from the actual results. The surface roughness distributions of five blast-cleaned samples were the same under the identical measurement conditions. This indicates that accurate results can be obtained by measuring representative samples, without the need for measuring all samples; actually, 17 measurements were adequate to obtain a mean surface roughness value with a 95% confidence level and a 5% acceptable error rate.

Long-term results of artificial urinary sphincter in women: A retrospective monocentric study

BackgroundStress urinary incontinence (SUI) is a public health issue, with major impact on quality of life. An efficient treatment for intrinsic sphincter deficiency (ISD) is the artificial urinary sphincter (AUS). ObjectivesAnalyzing patient survival in terms of revision-free survival, removal-free survival and global survival without reintervention long-term results concerning continence status and complications. DesignWomen with severe ISD and negative Bonney test who were treated with AUS first implantation between 1987 and 2022 were included. ResultsIn our study, 478 patients were treated by AUS first implantation with a mean age of 59.7. The median follow-up time was 13.2years. The median revision-free survival was 19.5years with survival rates at 10, 20 and 30years were 86%, 47% and 32% respectively. Removal-free survival rates at 10, 20 and 30years were 84%, 80% and 60% respectively. Median reintervention-free survival was 17.5years. Survival was negatively affected by neurological etiology of the ISD, history of previous incontinence treatment and intraoperative complications with more early removals in the latter group. The absence of previous incontinence surgery was a protecting factor. Continence status was assessed at 10, 20 and 30years follow-up with a fully continence rate of respectively 83%, 68% and 61%. Intraoperative complication rate was 17.7%, explantation rate was 14% and the revision rate was 23%. ConclusionWomen treated with AUS have an excellent revision-free, removal-free and global survival rate. AUS is a very efficient treatment for women with ISD in terms of continence results with an acceptable intraoperative and long-term complication rate of which patients should be well informed before choosing this treatment for their SUI.

Influence of Plant Density and Fungicides on Downy Mildew (<i>Peronospora Destructor</i>) and Bulb Yield of Onion in Ethiopia

Onion is a popular vegetable crop, which has been produced for its daily uses and economic benefits. Downey mildew caused by the fungus <i>Peronospora</i> <i>destructor</i> is among the most important yield-reducing factor in onion production. The effect of three different levels of plant population and fungicide frequency with two different fungicides was studied on downy mildew severity and yield of onion. Nineteen treatment of this Experiment included two fungicides mancozeb + metalaxyl and copper hydrox-ide, three different spraying interval with (10 days, 15 days and 21 days) and three level of plant population (0.71, 0.95 and 1.2 million plants/ha). The experiment was laid out in a randomized block design with three replications for two year at Fogera and for one year at Dera districts of South Gondar zone Ethiopia. Data on disease severity, bulb yield, bulb number and bulb size were recorded during the time of harvest. The price of bulb yield was assessed from the local market and the total price of the yield obtained from each treatment was computed on hectare basis. Input costs like seed, fungicides and labor were converted into hectare basis according to their frequencies used. Fungicides cost was estimated based on the price of the local market. Cost of the labor was in Birr per man-days; cost of spray and spray equipment to spray per hectare were also calculated. Based on the obtained data from the above mentioned parameters economic analysis was performed. The lowest disease severity was recorded in treatment were lowest level of plant population (0.71 million plant/hectare) spraying with fungicide mancozeb + metalaxyl within 15days interval. In this treatment bulb yield and bulb weight were the highest. The economic evaluation showed that the highest net benefit with acceptable marginal rate of return was obtained from T3 (0.71million plants/ha spraying with fungicide mancozeb + metalaxyl within 15days interval).

Effects of NPS Fertilizer Rate on Yield and Yield Components of Bread Wheat Production in Degem District, North Shewa Zone, Oromia, Ethiopia

Productivity of wheat was low due to depleted soil fertility and the blanket use of fertilizers. Fertilizer is the most vital input, contributing significantly to final wheat yields although wheat yields have long been low due to a lack of soil test-based site-specific fertilizer recommendations. This study aimed to determine an economically appropriate rate of NPS fertilizer based on calibrated Phosphorus for bread wheat production in the Degem district. The experiments laid out in randomized complete block design (RCBD) with three replications. The treatments were based on already determined Phosphorous critical and requirement factors and consisted of 100% Pc from TSP fertilizer, 25%, 50%, 75%, and 100% Pc from NPS fertilizer and control (without fertilizer). The phosphorus requirement factor (Pf) (5.85), phosphorus critical (Pc) (22 ppm), and optimum nitrogen optimum nitrogen (92 kg ha<sup>-1</sup>) were used from previous studies. Improved bread wheat variety senete was used at 150 kg/ ha seeds rate. The results of a statistical analysis of variance demonstrated that NPS fertilizer rates based on calibrated phosphorus had significant effects on bread wheat production. Partial budget analysis shows the maximum net benefit (101,570.65 Birr ha<sup>-1</sup>) with an acceptable marginal rate of return (MRR) (932’52 %) through the application of 75% of Pc from NPS with optimum nitrogen fertilizer use. Consequently, 75% Pc from NPS should be used in the Degem district for bread wheat production, with the optimum nitrogen. Thus, further scaled-up and demonstration of the technologies for bread wheat production in the Degem district.

Technology acceptance of balcony solar systems in Hungary – exploring influencing factors in a late-adopter country

PurposeBalcony solar panels are popular and widespread in most EU Member States, except in Hungary, where their use is currently banned. However, the lifting of this strict ban is expected to be approved in the near future. The aim of this research is to investigate which factors influence residents’ intention to use balcony solar panels in Hungary and how strong these impacts are.Design/methodology/approachUnified theory of acceptance and use of technology 2 (UTAUT2) is applied to predict which factors may influence residents’ behavioral intention to use this technology. Six components are tested: performance expectancy, effort expectancy, social influence, facilitating conditions, hedonic motivation and price value. Data were gathered in Hungary in 2023 using an online survey. A quota sampling method was employed during the data-collection process.FindingsOur results confirm the importance of all components except effort expectancy. In addition to the economic benefits that can be achieved, citizens consider energy independence and a sense of freedom to be important in the adoption of such systems.Research limitations/implicationsDespite the large share of positive responses (expressed intention) that is identified, a gap between intention and action can be expected.Practical implicationsTo increase the rate of acceptance, transparent regulation, simplified administration and the application of nudges may be crucially important. However, the widespread use of balcony solar systems is hindered by the lack of a modern, energy-efficient building stock, emphasizing the urgency of deep renovation in the Hungarian household sector.Originality/valueThis research is the first to use the UTAUT2 model to analyze the technology acceptance of balcony solar systems in a late-adopter country.

Clinical study on the intervention effect of digital therapy on children with attention deficit hyperactivity disorder (ADHD)

To evaluate the efficacy and safety of digital therapy for children aged 6 to 12 years with attention deficit hyperactivity disorder (ADHD). From January to March 2023, 52 children aged 6 to 12 years with attention deficit hyperactivity disorder (ADHD) from Wuhan Children’s Hospital, Hubei Province, China were selected for intervention using the “MindPro1” attention training software developed by Jiangsu Ruinao Qizhi Medical Technology Co., Ltd. Before the intervention, the children were in a stable treatment state, and no modifications were made to the original treatment plan during the MindPro1 intervention. Subjects with severe mental illness or other conditions that may affect the implementation and evaluation of disease treatment were excluded. Subjects completed the planned 4-week intervention, and changes in attention-related variables were assessed using the Test of Attention Variables (TOVA) and the parent version of the 18-item SNAP-IV scale (Swanson, Nolan, and Pelham, version IV scale) before and after the intervention. After 4 weeks of intervention, the lower limit of the 95% confidence interval of the response rate of the 18-item SNAP-IV-Parent scale, which was ≥ 30% improvement from baseline, was higher than 27.5% (better than similar products on the market); the SNAP-IV parent score improved (P < 0.001), with statistical significance; the TOVA-ACS score improved (P < 0.05), with statistical significance. The acceptance rate of parents of children was 100%, and the average compliance rate was 95%. There were 4 cases (7.69%) of adverse reactions that may be related to the device in this trial, which recovered spontaneously within 2 days of discontinuation, and no serious adverse events occurred. After 4 weeks of treatment with ADHD auxiliary treatment software, the objective attention assessment data and attention function assessment scale were significantly improved. Parents had a high acceptance of the software, the average compliance rate of participants was high, and the incidence of related adverse events was low and mild.

The HYsteroscopic Miscarriage MaNagement (HYMMN) pilot randomized-controlled trial

ObjectiveTo evaluate the feasibility of performing a full-scale, adequately powered, multi-center randomized controlled trial (RCT) assessing the effectiveness of office hysteroscopy (OH) for the treatment of retained pregnancy tissue (RPT) after miscarriage, compared with standard treatment (ST) (expectant/medical/surgical), on future pregnancy outcome. Study designSingle-center pilot RCT performed at Birmingham Women’s Hospital, UK. Patients opting for non-surgical miscarriage management at ≤14 weeks gestation who wanted to conceive as soon as possible were recruited and offered a transvaginal ultrasound scan (TVUS) eight weeks later to check for the presence of RPT. Patients with RPT were randomized in a 1:1 ratio using a computer-generated online random allocation sequence to either OH (performed using the TruClear 5.0 hysteroscopic tissue retrieval system) or ST (the type of which was recommended based on symptoms, urinary pregnancy test and scan findings). Results158 participants were approached for inclusion into the trial, of which 149 (94.3%) agreed. Of the 126 that underwent TVUS, RPT were diagnosed in 42 patients (33.3%). 21 patients were randomized to OH, of whom 18 underwent the procedure because three fell pregnant after their TVUS. OH was deemed acceptable to all patients without any serious complications. 21 patients were randomized to ST where 16 patients (76%) were recommended expectant management and five (24%) were recommended surgical management. 115 patients (91%) were able to provide pregnancy data, however, the study was not powered to show a clinically significant difference. ConclusionA full-scale, adequately powered, randomized clinical trial investigating OH against ST for the treatment of RPT following miscarriage is clinically relevant and feasible owing to high rates of participation, acceptability and satisfaction and low rates of attrition associated with the proposed interventions.

Analysis and Research on Intelligent Logistics Data under Internet of Things and Blockchain

ABSTRACT To explore the security performance of logistics data transmission in an Intelligent Logistics System (ILS) under the Internet of Things (IoT) and Blockchain (BC), IoT is introduced to optimize the logistics transportation process. First, BC is adopted to improve the ILS under IoT, and ILS under IoT combined with BC is established. Next, an analysis of the relationship between the information service provider and the transportation provider in the logistics transaction process is conducted to perform data analysis and to establish an incentive mechanism for logistics transportation under BC. Finally, the simulation analysis of the constructed model is implemented. The results reveal that the constructed model is highly efficient. It can effectively solve the traceability problem of logistics transaction information, and the calculation cost is stable within 1,000 ms. In the comparative analysis of system transmission performance, the model exhibits outstanding results in transmission latency, consistently maintaining an average delay of approximately 350 ms. This stability is primarily attributed to the seamless integration of BC technology, which optimizes data packet transmission paths and mitigates waiting time. Furthermore, the system efficiently manages high data volumes while upholding robust data processing capabilities, owing to the optimization of smart contracts and decentralized storage mechanisms. As for energy consumption, the model notably reduces overall energy usage within the logistics network by curtailing unnecessary data transmission and computation, particularly in mobile nodes and wireless communication channels. The proposed algorithm excels across various transmission metrics, including transmission delay, data successful acceptance rate, network throughput, and energy consumption are all shown to be the best transmission performance of the proposed algorithm, in which the data successful acceptance rate is close to 1. As a result, the developed ILS model not only guarantees low latency performance but also demonstrates high data transmission security, facilitating more efficient and precise real-time information transmission. In this study, within the ILS framework, the relationship between information service providers and transportation service providers is established through BC, and an incentive mechanism is constructed. However, some shortcomings in this incentive mechanism are recognized. For instance, during the initial stages of BC integration, there are issues of information asymmetry concerning factors such as credit, transportation capacity, and effort level. Moreover, the open access policy of couriers in the model raises concerns, as the access policy itself constitutes sensitive information, which may result in privacy breaches. Hence, as part of future work, the introduction of attribute encryption schemes is planned to obfuscate access policies, thereby safeguarding the privacy of logistics personnel’s access policies.

Performance of large language artificial intelligence models on solving restorative dentistry and endodontics student assessments

ObjectivesThe advent of artificial intelligence (AI) and large language model (LLM)-based AI applications (LLMAs) has tremendous implications for our society. This study analyzed the performance of LLMAs on solving restorative dentistry and endodontics (RDE) student assessment questions.Materials and methods151 questions from a RDE question pool were prepared for prompting using LLMAs from OpenAI (ChatGPT-3.5,-4.0 and -4.0o) and Google (Gemini 1.0). Multiple-choice questions were sorted into four question subcategories, entered into LLMAs and answers recorded for analysis. P-value and chi-square statistical analyses were performed using Python 3.9.16.ResultsThe total answer accuracy of ChatGPT-4.0o was the highest, followed by ChatGPT-4.0, Gemini 1.0 and ChatGPT-3.5 (72%, 62%, 44% and 25%, respectively) with significant differences between all LLMAs except GPT-4.0 models. The performance on subcategories direct restorations and caries was the highest, followed by indirect restorations and endodontics.ConclusionsOverall, there are large performance differences among LLMAs. Only the ChatGPT-4 models achieved a success ratio that could be used with caution to support the dental academic curriculum.Clinical relevanceWhile LLMAs could support clinicians to answer dental field-related questions, this capacity depends strongly on the employed model. The most performant model ChatGPT-4.0o achieved acceptable accuracy rates in some subject sub-categories analyzed.

Single-port laparoscopic reversal of Hartmann's procedure through the colostomy site: technical aspects and early postoperative outcomes.

Single-port laparoscopic surgical approaches offer improved cosmetic outcomes and enhance recovery following surgery. The purpose of the study was to assess the reliability and efficacy of a single-port laparoscopic Hartmann's reversal(SPL-HR) through the colostomy site. Prospective data from consecutive patients who underwent SPL-HR between 2020 and 2024 was analysed. Once the colostomy was detached from abdominal wall, a single-port device was introduced through the colostomy site. After mobilizing the rectal stump and afferent colon, colorectal anastomosis was carried out using a circular stapler transanally under laparoscopic vision. Postoperative care and discharge decisions were made following the ERAS protocol. Patient demographics, details of Hartmann's procedure, intraoperative outcomes, and early postoperative outcomes were evaluated. SPL-HR was successfully performed in 23 of 27 patients (85.1%), with a median operation time of 92 (50-172) min and a median blood loss of 100 (10-360) mL. Five patients (21.7%) experienced a postoperative complication. Two of them experienced grade 3a complications according to Clavien-Dindo classification: one with an intraabdominal abscess and one with a hematoma at the colostomy site, both requiring drainage under local anaesthesia. Anastomotic leak or mortality wasn't observed in patients. Functional recovery measures such as first flatus time and time to resuming a soft diet were favourable, with a median length of hospital stay of 4 (2-9) days. The SPL-HR technique is a reliable and efficient method that is easy to perform. It has acceptable complication rates while improving postoperative recovery and reducing the length of hospital stay.

Video-assisted retroperitoneal debridement for necrotizing pancreatitis: a single center experience in Colombia.

Acute pancreatitis (AP) is a common and potentially lethal disease. Approximately 10-20% of the patients progress to necrotizing pancreatitis (NP). The step-up approach is the gold standard approach to managing an infected necrotizing pancreatitis with acceptable morbidity and mortality rates. Video-assisted retroperitoneal debridement (VARD) has been described as a safe and feasible approach with high success rates. Multiple studies in the American, European, and Asian populations evaluating the outcomes of VARD have been published; nevertheless, outcomes in the Latin American population are unknown. This study aims to describe a single-center experience of VARD for necrotizing pancreatitis in Colombia with a long-term follow-up. A prospective cohort study was conducted between 2016 and 2024. All patients over 18 years old who underwent VARD for necrotizing pancreatitis were included. Demographic, clinical variables, and postoperative outcomes at 30-day follow-up were described. A total of 12 patients were included. The mean age was 55.9 years old (SD 13.73). The median follow-up was 365 days (P25 60; P75 547). Bile origin was the most frequent cause of pancreatitis in 90.1% of the patients. The mean time between diagnosis and surgical management was 78.5 days (SD 22.93). The mean size of the collection was 10.5cm (SD 3.51). There was no evidence of intraoperative complications. The mean in-hospital length of stay was 65.18 days (SD 26.46). One patient died in a 30-day follow-up. One patient presented an incisional hernia one year after surgery, and there was no evidence of endocrine insufficiency at the follow-up. According to our data, the VARD procedure presents similar outcomes to those reported in the literature; a standardized procedure following the STEP-UP procedure minimizes the requirement of postoperative drainages. Long-term follow-up should be performed to rule out pancreatic insufficiency.

Building a Fingerprint Recognition Structure as a Security Mechanism to Verify the Identities of Users in Cloud Environment through Resnet-18

Objectives: To authenticate users employing fingerprint recognition thereby strengthening a security mechanism in a cloud environment. Methods: This study presents a novel approach for fingerprint detection in cloud systems by combining deep learning with metaheuristic optimization. A novel approach based on ResNet-18 for feature extraction and Thermal Exchange Optimization (TEO) classification is presented. This method aims to reduce data duplicity and provide safe access rights. When tested on 80% of the NIST and BDAL datasets, the proposed ResNet-18-TEO method outperforms existing models concerning recognition rates of 95.3% and 94.3% respectively. Findings: The experimental results reveal a False Acceptance Rate (FAR) spanning 0.6% to 4.8% and a False Rejection Rate (FRR) spanning 1.1% to 5.3%. Novelty: The proposed method would help cloud-based security since its fingerprint recognition time is substantially less than 25 seconds in training and 15 seconds in testing that of existing processes. In future work, this research will improvise using several deep learning techniques which are adopted using real time or research dataset. Keywords: Fingerprint recognition, Cloud, Security, Authentication, Privacy

Reconsidering Public Attitudes Toward Deceased Organ Donation Registration.

Background: The aim of the current study is to understand Americans' attitudes toward deceased organ donation and to assess their level of acceptance on positions toward organ donation. Methods: In summer and winter of 2023, 2 national samples completed measures of attitudes toward donation, reported their registration status, rated positions related to donation, and provided demographic information. Results: Data from 2 samples indicated registration estimates between 50% and 57% and a significant proportion of those unregistered reported reluctance to register. The believability of national registry estimates and ratings of acceptability of 9 organ donation positions differed by registration status. Conclusion: Mass media and motor vehicles interventions seeking to increase registration rates should take into consideration individual attitudes and support toward donation may not be as strong as once thought.

Use of sirolimus-coated balloon in de novo coronary lesions; long-term clinical outcomes from a multi-center real-world population.

Sirolimus-coated balloon (SCB), a relatively novel technology appears attractive due to the drug properties (safety and efficacy) and sirolimus remains the drug of choice in stents. However, there is limited data long-term data on SCB. In this study, we have explored the clinical outcomes following the use of SCB in de-novo lesions from a real-world practice. To report long-term clinical outcomes following the use of Siroliumus coated balloon in de novo lesions. We analyzed all patients treated with an SCB in de novo lesions between 2016 and 2023 at four high-volume centers in UK and Italy. The outcomes measured included cardiac death, target vessel myocardial infarction (TVMI), target lesion revascularization (TLR) and major adverse cardiac events (MACE). During the study period, 771 patients had SCB in de novo lesions. Diabetes mellitus was noted in 36% of patients (n = 280), of which 14% (n = 108) were insulin dependent. Fifteen percent (n = 117) had chronic kidney disease, Fifty-two percent (n = 398) of cases were in the setting acute coronary syndrome (ACS) and of which 51 cases (7%) were ST-segment elevation myocardial infarction. Small vessels (<3.0 mm) accounted for 78% (n = 601) of cases and 76% (n = 584) were long lesions ( 20 mm). The mean diameter of SCB was 2.6 ± 0.4 mm and the mean length was 25 ± 10.39 mm. Bailout stenting following SCB was required in 9% lesions (n = 67). During the median follow-up 640 days, total death occurred in 39 (5%) patients and of which, cardiac death occurred in 10 patients (1.3%). TVMI occurred in 20 patients (2.6%). TLR and TVR were 5.6% and 5.8% respectively. The overall MACE rate was 8%. We had no documented case of acute vessel closure. The results from this long-term follow-up in a real-world population are encouraging with low rates of hard endpoints and acceptable rates of TLR and MACE despite a complex group of patients. Our data suggest that SCBs are safe in coronary intervention with good clinical outcomes in the long term.

Performance assessment of the Surpass Evolve flow diverter for the treatment of intracranial aneurysms: A systematic review and meta-analysis.

The Surpass Evolve (SE) has emerged as a promising alternative treatment from the flow diverter series. The utilization of the SE has gradually increased, however, there is a scarcity of comprehensive data on the solidity of this technology in the endovascular treatment of intracranial aneurysms (IAs). This meta-analysis aimed to evaluate the safety and effectiveness of the SE flow diverter. A systematic literature search from inception to April 2024 was conducted across five databases for studies involving IAs treated with the SE. The primary effectiveness outcome was the proportion of complete aneurysm occlusion at the final follow-up, and the primary safety outcome comprised a composite of early and delayed complications. Subgroup analyses based on aneurysm size, anatomical location, and rupture status were also conducted. Our analysis included nine studies with 645 patients and 722 IAs. Effectiveness outcomes revealed an overall complete aneurysm occlusion rate of 69% (95% confidence interval (CI) = 58%-78%; I2 = 72%) and a favorable aneurysm occlusion rate of 91% (95% CI = 82%-96%; I2 = 49%). Safety outcomes demonstrated an overall complications rate of 6% (95% CI = 3%-12%; I2 = 66%), with an early complications rate of 6% (95% CI = 4%-11%; I2 = 0%), and a delayed complications rate of 0% (95% CI = 0%-7%; I2 = 0%). Our findings suggest a favorable outcome with a high rate of complete aneurysm occlusion at the last follow-up, with acceptable rates of neurological complications. Future research efforts should focus on larger, prospective studies with standardized outcome measures to further elucidate the clinical utility of the SE flow diverter in the management of IAs.

A-203 A Disconnect Between Detectable Patient Error Rates and QC Understanding

Abstract Background ISO 14971 defines “risk evaluation as the process of comparing the estimated risk against given risk criteria to determine the acceptability of the risk. Effective QC processes would detect if a stable acceptable error rate became unacceptable. Methods A survey was circulated through LinkedIn and Labvine. Forty respondents who included their credentials were included in the final analysis. Questions included: 1. What is the best choice for acceptable error rate when an analytical process is stable and in control, 2. If an analytical process “fails,” how many errors are you willing to report before the lab should stop reporting, and 3. “If an analytical process has a 5% stable error, how high would the error rate after failure need to become for a 1-2s rule to detect failure with one QC sample in a single QC run?” This interactive poster will allow viewers to cast their vote for Question 4 and then reveal an LJ chart depicting a stable error rate of 5% with a shift to show the number of 1-2s failures with their chosen acceptable post-failure error rate. Results During stable operation, only 8% wanted zero errors while 38% voted that they would allow up to 5% errors; After failure, 66% wanted to report zero errors and only 10% would allow 5% failure. 69% believed they would see a 1-2s failure in one run if the error rate rose to less than 50%; 19% believed it required a 100% error rate. Conclusions There is a strange disconnect where most believed it was acceptable to report more errors during stable operation than if the method failed. There is a widespread misunderstanding of the logic that connects management of acceptable patient risk with the capabilities of statistical QC.

A-202 Quality control design survey reveals 399 ways to do it wrong

Abstract Background The effectiveness of statistical quality control processes to detect unacceptable patient risk depends on the choices that laboratory professionals make for the design of quality control charts and acceptable patient risk. Recommended best practice consists of putting a meaningful recent mean and SD on the QC chart, selecting rules based on the method’s margin for error to unacceptable risk or Sigma value, and basing acceptable risk on clinical need. Methods A survey was circulated through LinkedIn and Labvine. Forty respondents who included their credentials were included in the final analysis. Respondents were asked to select the one most correct answer four questions regarding the parameters that govern the effectiveness of quality control processes. 1. The best source of the mean on the QC chart? (Four choices) 2. Best source of the SD on the QC chart? (Five choices) 3. Best way to select QC rules for each QC sample? (Six choices) 4. If an analytical process “fails,” we should stop reporting before [errors are reported.] (Five choices) A total of 400 potential patterns of QC selections were chosen. (4 * 5 * 5 * 4). Results When asked acceptable error rate if an analytical process “fails,” responses were More than 5% errors are reported - 11%. Any errors are reported - 66% It varies with clinical use of the test - 16% It varies with capabilities of our method - 8% While most respondents chose at least one of the recommended answers for QC chart design and rules, only three chose the best choice for all parameters. Conclusions Despite decades of recommendations of best practice for quality control, typical practice throughout the laboratory community in general does not reflect this. It is time to consider a new approach to teaching, validating and certifying competency in medical laboratory quality control.

Efficacy of flexible ureterorenoscopy in treating multiple renal stones: a cohort study.

While the efficacy of flexibleureterorenoscopy (URS) in managing solitary kidney stones (KSs) is widely acknowledged, its effectiveness intreating multiple stones has scarcely been investigated. This study aims to assess the effectiveness and safety of retrogradeintrarenal surgery (RIRS) utilizing flexible URS and laser lithotripsy in the management of multiple KSs. Methods: This study was a single-group cohort study conducted on patients with multiple KSs who underwent treatment withRIRS using flexible URS and laser lithotripsy. Stone-free status was considered as the lack of residual stone fragments or anyresidual stone of any size. The first follow-up appointment was arranged 3-4 weeks following the procedure. If significant residualstones were present, patients underwent reintervention within 2-4 weeks. A total of 110 patients with multiple KSs were included. The mean stone burden was 27.5 ± 7.9 mm, and the mean duration of the operation was 54.9 ± 19.7 minutes. Seven cases(6.3%) experienced intraoperative complications, while postoperative complications were found in eight cases (7.3%). Afterfour weeks, a stone-free rate (SFR) was documented in 80.9% of the cases, and this rate increased to 93.6% after three months.The SFR after three months was significant with Guy's stone score (p < 0.001); however, it did not reach a significant level with any other parameters. Conclusions: The RIRS with flexible URS may be an effective and potentially safe procedure for treating multiple KSs. It mayyield a favorable SFR with an acceptable complication rate.