Analysis Of Continuous Variables Research Articles

The Limited Utility of Hemoglobin A1c as a Predictor for Periprosthetic Joint Infection Following Total Joint Arthroplasty: A Continuous Variable Analysis.

Patients who have poorly controlled diabetes mellitus are at increased risk of periprosthetic joint infection (PJI). Nevertheless, an optimal preoperative hemoglobin A1c (HbA1c) threshold has not been established. This study sought to identify preoperative HbA1c thresholds that were predictive of adverse outcomes for total hip (THA) and total knee arthroplasty (TKA) patients. A healthcare database was used to identify primary THAs or TKAs performed from 2016 to 2021 with a preoperative HbA1c value within 28 days of surgery. The primary outcome was PJI within 90 days postoperatively. Secondary outcomes included aggregate medical and surgical complications. Restricted cubic splines (RCSs) were generated using logistic regression to quantify the impact of HbA1c as a continuous variable on the risk of PJI. Between HbA1c values of 5% and 12%, relevant sensitivity and specificity measurements were calculated at intervals of 0.5%. A Youden's J statistic identified clinically relevant preoperative HbA1c thresholds. In total, 17,481 elective arthroplasty patients who had a preoperative HbA1c were identified. The mean preoperative HbA1c was 6.5%. For TKA, a PJI threshold of 9.7% was identified (sensitivity: 19.4%, specificity: 99.1%), while for THA, a PJI threshold of 7.8% was identified (sensitivity: 22.7%, specificity: 89.9%). The threshold for aggregate medical complications was 6.8% for TKA (sensitivity: 53.7%, specificity: 59.1%) and 6.5% for THA (sensitivity: 45.5%, specificity: 66.5%). No association was observed between HbA1c and aggregate surgical complications for either THA or TKA. This study identified PJI and medical complication HbA1c thresholds above which patients were at a significantly increased risk of early postoperative complications. While our findings suggest that HbA1c has limited predictive utility for postoperative complications, it remains an accessible biomarker that can aid in preoperative risk stratification. Future studies should explore other promising or complementary biomarkers that may be more effective for preoperative risk stratification.

Autografts versus Allografts for Anterior Cruciate Ligament (ACL) reconstruction: Comparison of clinical outcomes by pooled meta-analysis of randomized controlled trials

Background We conducted this meta-analysis to evaluate the clinical outcomes of the two procedures using a pooled analysis of multiple scales, as there has been dispute among the research on the use of autografts or allografts. Methods We searched PubMed, Scopus, and Web of Science databases for articles that fulfilled our aim. The search strategy was based on three main keywords: “Autograft”, “Allograft”, and “Anterior Cruciate Ligament. The resulting articles were collected and uploaded to Rayyan. All statistical procedures were performed using Review Manager software version 5.4. We conducted a pooled analysis of continuous variables using mean difference (MD), while for dichotomous variables, we used the pooled analysis of odds ratio (OR) by extraction of event and total. Results Autograft showed better outcomes regarding IKDC score compared to allograft with MD of 1.89 (95%CI: 0.37, 3.42. p=0.02), and I2=66%, p=0.002. It was also associated with better Lysholm and Tegner scores with MD of 1.48 (95%CI: 0.19, 2.77, p=0.02), and 0.32 (0.15, 0.49, p=0.0003), respectively, with no significant heterogeneity in both. Autografts were associated with a higher OR of grade 0 in the Lachmann score with an OR of 2.6 (95%CI: 1.26, 5.38, p=0.01), while allografts had higher odds of having grades 2 and 3 (OR, 0.53 (95%CI, 0.31, 0.93; p=0.03), and 0.48 (95%CI: 0.27, 0.84, p=0.01), respectively Conclusion Compared to allografts, the use of autografts in ACL reconstruction is associated with better functional, structural, stability, and satisfaction outcomes, as observed by statistically significant differences in IKDC, Tegner, Lachmann, Pivot shift test, and Lysholm. However, no differences were observed in ROM, Daniel’s one-leg hop test, or Harner’s vertical jump.

Prevalence of Maternal Anemia in Southern Jordan: Findings from a Cross-Sectional Study and 5-Year Review

Background: The literature underrepresents maternal anemia in southern Jordan, and national studies often have small sample sizes. According to the 2019 Jordan National Micronutrient Survey, maternal anemia in Jordan accounted for 19.1% of cases, with the majority experiencing mild anemia (17.1%). Among the 29 pregnant women recruited from the southern region, 56.5% had anemia, of which 34.8% had mild and 21.7% had moderate anemia. The current study provides an update on the prevalence of anemia during pregnancy in southern Jordan. Methods: This cross-sectional study was conducted at a government referral hospital in southern Jordan. Pregnant women who visited outpatient clinics were included in the study. Data were collected through face-to-face interviews, and blood samples were collected to measure hemoglobin levels. Descriptive analyses of continuous and categorical variables were performed. Maternal anemia risk factors were assessed using the chi-square test, Fisher’s exact test, and multivariate logistic regression analysis. Statistical significance was defined at p < 0.05. Results: Of the 474 pregnant women who agreed to participate, 36.8% had anemia. Education, income, diet (number of meals and meat consumption), regularity of antenatal care, and supplement use were factors that significantly affected hemoglobin levels (p < 0.05). The adolescent pregnancy rate was 5.3%, and 48% had mild to moderate anemia. Conclusions: Maternal anemia rates in southern Jordan remained high, despite a slow decline. Reducing this burden requires improved access to healthcare and health education, particularly for rural residents who are at greater risk of disease.

Efficacy and Safety of Platelet-rich Plasma in the Management of Lumbar Disc Herniation: A Systematic Review and Meta-analysis

Background Lumbar radicular discomfort is often induced by mechanical compression of the nerve root and inflammatory reactions. Platelet-rich plasma (PRP) is an efficacious therapy modality, albeit ongoing controversies regarding its effectiveness, and it possesses the advantage of minimal side effects. Therefore, we conducted the current systematic review and meta-analysis to investigate the efficacy and safety of PRP in the treatment of lumbar disc herniation (LDH). Methods We conducted our database searching on PubMed, Scopus, and Web of Science from inception till August 2024 to look for articles that fulfil our aim. The search strategy was based on three main keywords: “Platelet-rich plasma” AND “Lumbar” AND “Hernia*”. We conducted the pooled analysis of continuous variables using mean difference (MD) and we used pooled odds ratio (OR) for dichotomous variables with 95% confidence intervals (CI). Results The use of PRP was statistically significant associated with reduced visual analogue scale (VAS) compared with no PRP with MD of -0.44 (95%CI:-0.76, -0.11, p=0.008), and Oswestry Disability Index (ODI) with MD of -5.36 (95%CI: -8.25, -2.48, p=0.0003). However, no significant difference was observed regarding Japanese Orthopedic Association (JOA) with MD of 2.52 (95%CI:-0.8, 5.84, p=0.14) with non-significant heterogeneity. PRP was also associated with reduced risk of complications with OR of 0.22 (95%CI:0.07, 0.68, p=0.009) and non-significant heterogeneity. Conclusion PRP use in patients with LDH is associated with positive outcomes presented in reduction of pain, and disability (decrease in ODI scale) in addition to being safe with less incidence of complications compared with patients not receiving PRP.

Composite dietary antioxidant index mediates the effect of epilepsy on psychiatric disorders: results from NHANES 2013-2018.

Psychiatric disorders is a major public health problem and epilepsy contributes significantly to depression. We aimed to explore the relationship between dietary patterns and mental illness in patients with epilepsy. The data presented here are based on the 2013-2018 National Health and Nutrition Examination Survey (NHANES). In this study, the t-test and chi-square tests or one-way analysis of variance (ANOVA) were employed for the analysis of continuous and categorical variables, respectively. Restricted cubic splines (RCSs) with four knots were employed to investigate the linear relationship and trend between the Composite Dietary Antioxidant Index (CDAI) and epilepsy and psychiatric disorders, respectively. In instances where the linear relationship was not deemed to be applicable, the CDAI was categorized into four groups based on quartiles. A logistic regression analysis was employed to investigate the relationship between epilepsy and mental disorders under four distinct models. A mediation analysis was employed to ascertain whether CDAI acted as a mediator in the relationship between epilepsy and mental disorders. Patients with epilepsy had a significantly lower CDAI (p < 0.001) and a significantly higher prevalence of psychiatric disorders (p = 0.02) compared with non-epileptic patients. Mediation modeling showed that CDAI mediated between 3.17 and 5.21% of epilepsy-related psychiatric disorders. In stratified analyses, the prevalence of psychiatric disorders was increased in the second quartile subgroup and the third quartile subgroup of the CDAI dietary index in patients with epilepsy compared with non-epileptic patients. Our findings suggest that patients with epilepsy have a high risk of developing psychiatric disorders and that the Composite Dietary Antioxidant Index (CDAI) plays a key role in mediating the relationship between epilepsy and psychiatric disorders.

Pathologic Features of Rectal Adenocarcinoma after Preoperative Neoadjuvant Chemoradiation Therapy and the Prognostic Factors for Local Recurrence: A Retrospective Study at Maharaj Nakorn Chiang Mai Hospital.

Colorectal cancer is a significant global health concern, with Thailand reporting notable incidence rates. Locally advanced rectal cancer demands effective treatment strategies to reduce the risk of local recurrence post-surgery; however, the predictive factors for local recurrence are uncertain.. This study investigated patients with rectal adenocarcinoma undergoing preoperative concurrent chemoradiation (CCRT). The pathological findings and predictors of local recurrence in rectal adenocarcinoma were examined following preoperative CCRT. A retrospective cohort study was conducted in patients with rectal adenocarcinoma who underwent preoperative CCRT and surgery at the Maharaj Nakorn Chiang Mai Hospital from January 2018 to December 2022. Data were collected from patients to investigate the associations between pathological prognostic factors and local recurrence of rectal adenocarcinoma. For the analysis of continuous variables, the Student's t-test was employed to assess univariate associations. In the case of categorical variables, comparisons were made using the chi-square test and the Kruskal-Wallis test. Furthermore, the Kaplan-Meier method, supplemented by the log-rank test, was utilized to examine the relationships between baseline prognostic variables and disease-free survival endpoints. Of the 70 patients who received preoperative CCRT, 14 (20%) experienced recurrence. Univariate log-rank analysis identified five pathologic predictors of the disease-free survival of preoperative CCRT patients: ypT stage (p = 0.0030), lymphatic space invasion (p = 0.0033), venous invasion (p = 0.0345), circumferential resection margin (CRM) (p = 0.0003), and TNM staging (p = 0.0109). In multivariate Cox regression analysis, ypTNM stage and CRM status were independent predictors for disease progression of preoperative CCRT patients. ypTNM staging and CRM status emerged as independent predictors of local recurrence. The study also identified age and gender variations in rectal cancer incidence, highlighting the importance of tailored screening approaches.

Current approaches for management of gastric varices in the United States: a survey of providers’ attitudes and practices

Introduction Bleeding from gastric varices (GV) is more drastic and associated with higher mortality than that from esophageal varices. There are multiple therapeutic approaches for GV bleeding. Although endoscopic cyanoacrylate glue injection (ECGI) is recommended as the first-line management for GV bleeding worldwide, its implementation in the US is limited. We conducted a survey among health care providers to examine attitudes and practice related to GV management. Methods Collected data were cleaned using SPSS V24. Summary statistics and graphical analyses for continuous and categorical variables were used to describe the data. Continuous variables with a normal distribution are presented as mean ± standard deviation. Results A total of 339 providers completed the survey, for a response rate of 16.95%. Nearly a quarter of respondents reported performing ECGI in patients with GV bleeding. Male healthcare providers (odds ratio [OR]: 2.1, 95% confidence interval [CI] = 1.22-3.75, P = 0.006), transplant hepatologists (OR: 2.6, 95% CI = 1.25-4.87, P = 0.019), and those working in hospitals with liver transplantation centers (OR: 2.5, 95% CI = 1.35-4.62, P = 0.002) were more likely to perform ECGI in GV bleeding cases. However, only gender was significant in the multivariate model. Conclusions Our results indicate the underutilization of ECGI in GV patients among US endoscopists. Key hurdles are lack of training and approval from the US Food and Drug Administration.

Rate And Grade of Postoperative Pancreatic Fistula After Modified Blumgart Pancreaticojejunostomy in Pancreaticoduodenectomy

Introduction: Pancreaticoduodenectomy (PD), commonly known as the Whipple procedure, is the standard surgical approach for treating pancreatic and periampullary cancers. Despite advancements in surgical techniques, postoperative pancreatic fistula (POPF) remains one of the most significant complications following PD, contributing to increased morbidity. This study aims to evaluate the development and severity of POPF in patients undergoing PD with the Modified Blumgart Pancreaticojejunostomy. Methods: This Cross-sectional Observational study was carried out among the indoor patients of surgery units in Dhaka Medical College &amp; Hospital, Dhaka, from January 2023 to December 2023. All patients who experienced Pancreatoduodenectomy in the Surgery department of Dhaka Medical College &amp; Hospital during the study period were considered as the study population. A total of 30 patients were selected as study subjects by purposive sampling technique. Consent from patients and relevant authorities was taken. Univariate and multivariate analysis of the data was carried out using a statistical analysis software program. Descriptive analysis of continuous variables was carried out and showed as the means ± SD. Result: This study involved 30 patients, with the majority (36.6%) aged between 40-50 years and male predominance (63.3%). Most patients (50%) were diagnosed preoperatively with periampullary carcinoma, followed by pancreatic carcinoma (40%). Postoperative pancreatic fistula occurred in 13.3% of patients, with the majority (75%) being Grade B fistulas, and 25% classified as Grade A. No Grade C fistulas were observed. Conclusion: Placing sutures between the pancreatic tissue and the jejunum carries a risk of pancreatic juice leakage due to needle holes or injury to the pancreatic tissue, particularly in patients with a soft pancreas. Therefore, this study suggests that an anastomosis technique utilizing fewer sutures may be more advantageous. The original Blumgart anastomosis employed four to six trans pancreatic/jejunal seromuscular sutures, whereas our approach utilized only one to three. Additionally, the modified Blumgart technique ensured complete coverage of the pancreatic stump with jejunal serosa through the modified lateral suture that penetrates the seromuscular layer of the jejunum

Different levels of lipids, Hb1Ac and cytokines among patients with coronary artery disease

BackgroundDifferent risk factors are responsible for the occurrence of coronary artery disease (CAD). Among these, the main factors are dyslipidemia, dysglycaemia, and endothelial inflammation. The aim of the study was to analyze the levels of lipids, glucose, and cytokine in patients with different coronary heart diseases. MethodsA total of 2147 patients diagnosed with coronary atherosclerosis, stable angina, unstable angina, acute non-ST-segment elevation infarction (NSTEMI) and acute ST-segment-elevation myocardial infarction (STEMI) at the Cardiovascular Center of Beijing Tongren Hospital from February 2022 to April 2023. The data were gathered from the medical record system.Nonparametric Wilcoxon test was used for statistical analysis of continuous variables, and chi-square test was used for statistical analysis of categorical variables among multiple groups. ResultsCompared with coronary atherosclerosis group, acute myocardial infarction group showed a significant increase in IL-6 level (p < 0.001). Compared with stable angina group, acute myocardial infarction group showed a significant increase in IL-6 and decrease in INF-γlevels (p < 0.001). Compared with unstable angina group, acute myocardial infarction group showed a significant increase in IL-6 level and decrease in IL-17, as well as INF-γlevels (p < 0.001). Compared with NSTEMI group, the proportion of younger, males, glycemic-lowering drugs, as well as the levels of TC, LDL-C in STEMI group increased significantly, while the proportion of hypertension, IFG/IGT/DM, hyperlipidemia and Hb1Ac level decreased significantly. STEMI group showed a significant increase in IL-2 and IL-6 levels (p < 0.05). ConclusionsThe levels of lipids, Hb1Ac, IL-2 and IL-6 were varying in patients with different stages of coronary heart diseases.The data would contribute to a deeper understanding of the roles of lipids, glucose, and inflammation in the occurrence and development of CAD.

Early Tracheostomy in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation

BackgroundEarly tracheostomy (ET) can decrease length of stay and mortality. The benefits of ET in patients requiring venovenous (VV) extracorporeal membrane oxygenation (ECMO) remain contentious. We assessed the influence of ET on outcomes in patients requiring VV ECMO. MethodsWe queried a multiinstitutional ECMO registry to evaluate patients requiring VV ECMO for severe acute respiratory distress syndrome and compared outcomes between ET and late tracheostomy (LT) groups. Outcomes of interest included time to decannulation, extubation, discharge, survival, hospital, and intensive care unit length of stay (LOS). Univariate analyses of continuous and categorical variables were performed using t tests and χ2 tests where appropriate. Multistate Cox proportional hazards models and generalized linear models were used for multivariable analysis. ResultsOur sample comprised 133 patients, 88 who underwent ET and 45 who underwent LT. Patients who underwent ET were younger (P = .046), had a higher body mass index (P = .046), and had higher respiratory ECMO survival prediction (RESP) scores (P < .001). The number of days from ECMO to tracheostomy was 1.65 ± 1.26 days in the ET group and 13.6 ± 10 days in the LT group. There were no statistically significant differences in time to decannulation between the 2 groups. Univariate analysis demonstrated that patients with ET had a shorter interval and higher survival to extubation. Multivariable analysis demonstrated that patients with ET had a shorter duration to extubation (P = .03), time to discharge (P = .013), intensive care unit LOS (P = .012), and hospital LOS (P = .044). There was no significant difference in survival (P = .83) or time to decannulation (P = .12) between the 2 cohorts. ConclusionsExtracorporeal support involves high-intensity resource use. ET in patients requiring VV ECMO may improve outcomes and decrease resource consumption.

Predictive value of neutrophil to lymphocyte ratio for clinical outcome in patients with atrial fibrillation: a systematic review and meta-analysis.

The association between the Neutrophil-to-Lymphocyte Ratio (NLR) and the prognosis of Atrial Fibrillation (AF) has been extensively studied, yet clinical outcomes have varied. Consequently, this analysis was undertaken to explore the link between NLR and the prognostic markers of AF. We conducted an exhaustive search across electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Library, to investigate the correlation between the NLR and indicators of adverse clinical outcomes associated with AF from the database establishment date through March 31, 2024. In this study, the recurrence rate of AF was the primary outcome measure, while the secondary outcome measures were mortality, stroke, and left atrial thrombus. Odds ratio (OR), relative risk (RR), hazard ratio (HR) and standard mean difference (SMD) with a 95% confidence interval (CI) were integrated for assessment, and the stability of prognostic outcomes and publication bias were verified by sensitivity analysis and Egger's test, respectively. Subgroup analyses were performed to pinpoint the sources of heterogeneity. This analysis included 20 studies, encompassing a total of 59,256 patients. Our statistical analysis of both categorical and continuous variables revealed that an elevated NLR was significantly associated with increased risks in AF patients for recurrence (categorical variable: OR = 1.39, 95% CI = 1.21-1.60; continuous variable: SMD = 0.49, 95% CI = 0.24-0.74), mortality (categorical variable: OR = 1.87, 95% CI = 1.59-2.20), stroke (categorical variable: OR = 1.56, 95% CI = 1.13-2.17; continuous variable: SMD = 0.77, 95% CI = 0.63-0.91), and left atrial thrombus (categorical variable: OR = 1.87, 95% CI = 1.27-2.75; continuous variable: SMD = 0.59, 95% CI = 0.30-0.89). Subgroup analyses found that high NLR was significantly linked to AF recurrence when the NLR was >3. High NLR was significantly linked to the risk of stroke in AF when the NLR was ≤3. This study suggested that a high NLR is significantly linked to prognostic risk markers of AF, and NLR may be an effective biomarker for the prognosis of AF in clinical practice. PROSPERO (CRD42024530970).

The Role of Diet and Lifestyle Modifications in the Management of Esophageal Reflux Disease in local population

Background: Gastroesophageal reflux disease (GERD) is a very common medical complication connected with regurgitation of the gastric contents into the esophagus which caused heartburn and esophageal irritation. Objectives: The objective of this research was to assess practicality of diet and lifestyle changes in the management of GERD in local population. Pharmacotherapy remains the mainstay of management of GERD; however, diet and lifestyle changes have emerged as popular non-pharmacological interventions. Methodology: An observational study was conducted on 200 patients with GERD. Participants were divided into two groups: Group A received standard pharmacological treatment, while Group B received a structured diet and lifestyle modification program in addition to pharmacological management. Lifestyle changes included avoiding heartburn-triggering foods such as spicy meals, caffeine, and fatty foods, along with weight reduction, smoking cessation, and increased sleeping height. The effectiveness of the treatments was assessed based on symptom severity, endoscopic findings, and inflammatory biomarkers over 12 months. SPSS version 26.0 was used for statistical analysis, employing paired and independent t-tests for continuous variables and chi-square tests for categorical data. Results were considered significant at p ≤ 0.05. Results: Group B showed a significant reduction in symptom severity (35%) compared to Group A (20%) (p &lt; 0.001). Endoscopy revealed better healing in Group B (70% vs. 50%, p = 0.02). Weight loss and smoking cessation positively influenced outcomes. Conclusion: Diet and lifestyle modifications, combined with medical management, positively impact GERD outcomes in the local population.

Which ERP components are effective in measuring cognitive load in multimedia learning? A meta-analysis based on relevant studies.

The open and generative nature of multimedia learning environments tends to cause cognitive overload in learners, and cognitive load is difficult for researchers to observe objectively because of its implicit and complex nature. Event-related potentials (ERP), a method of studying potential changes associated with specific events or stimuli by recording the electroencephalogram (EEG), has become an important method of measuring cognitive load in cognitive psychology. Although many studies have relied on ERP output measurements to compare different levels of cognitive load in multimedia learning, the results of the effect of cognitive load on ERP have been inconsistent. In this study, we used a meta-analysis of evidence-based research to quantitatively analyze 17 experimental studies to quantitatively evaluate which ERP component (amplitude) is most sensitive to cognitive load. Forty five effect sizes from 26 studies involving 360 participants were calculated. (1) The results of the studies analyzed in subgroups indicated high level effect sizes for P300 and P200 (2) Analyses of moderating variables for signal acquisition did not find that different methods of signal acquisition had a significant effect on the measurement of cognitive load (3) Analyses of moderating variables for task design found that a task system with feedback was more convenient for the measurement of cognitive load, and that designing for 3 levels of cognitive load was more convenient for the measurement of cognitive load than for 2 levels of cognitive load. (4) Analyses of continuous moderating variables for subject characteristics did not find significant effects of age, gender, or sample size on the results.

Loneliness, office space arrangement and mental well-being of Gen Z PR professionals. Falling into the trap of an agile office?

PurposeThe purpose of the study was to assess how the well-being and loneliness of public relations and communication professionals are impacted by the post-pandemic characteristics of the work environment: flexible work schemes, non-territorial office arrangements and video communication technologies. It was hypothesised that the post-pandemic workplace landscape poses several new challenges to the practice of PR – an industry which invariably relies on working with other people and demands a good level of social resilience. Loneliness and well-being both depend on the experience of having good and efficient social relationships, but the pandemic has directly and indirectly led to their deterioration.Design/methodology/approachThe project employed a correlational design and used an online survey system to collect responses from Gen Z professionals employed in the public relations and communications industry in the UK and the US via the Prolific platform. Demographical and workplace-related characteristics were assessed to investigate links with loneliness (measured using a three-item scale adopted from Russell et al., 1980 in Hughes, 2004) and well-being (using a short Warwick-Edinburgh Mental Well-being Scale scale). Causal relationships between data were tested using regression analysis for continuous variables and analysis of covariance for categorical factors. Bootstrapping was used to test mediated relationships that explain loneliness, job satisfaction and the well-being of Gen Z PR professionals.FindingsSeveral types of flexible working schemes, defined as the ability to work from home on any number of weeks, showed an impact on loneliness and job satisfaction but not on well-being. However, all remaining aspects of the post-pandemic office did manifest as important predictors. In the sample, 30% of Gen Z PR professionals showed signs of mild to clinical levels of depression, and the best protection from this state was the presence of a significant other. Lower levels of loneliness were related to non-territorial office arrangements and job satisfaction. The use of hot desks and open-plan arrangements led to a significantly lower level of job satisfaction than a traditional, cellular office. Both excessive online meetings and face-to-face only interactions led to marginally lower levels of loneliness and job satisfaction.Research limitations/implicationsThe present research is limited in several aspects. Firstly, while the project evaluated loneliness, job satisfaction and mental well-being (with each of these elements including a component of the requirement for building effective relationships), the quality of relationships built by PR professionals was not measured. Secondly, the project focused only on post-pandemic aspects of the workplace and did not cover other important components of job satisfaction. Lastly, the measure of online meetings was declarative rather than behavioural, and greater control of the number of online meetings held would be required to show more reliable links between variables.Practical implicationsThis study calls for proposing recommendations for employers to develop organisational-level measures and programmes to counteract loneliness. While traditionally intimate relationships of employees were not a direct focus of HR programmes, employers should develop elements of organisational culture that would support employees in building effective intimate relationships. Separately from this, despite immediate financial benefits, employers should avoid using open-space and hot desk policies, as they contribute negatively to job satisfaction (and indirectly to well-being). The sample of UK and US professionals was chosen for analysis because in these countries employers have more capacity to introduce changes to tangible characteristics of the workplace and work culture, which may positively impact the well-being of their employees.Social implicationsIt is expected that both employers and employees will revisit their approach to post-pandemic financial and logistic challenges related to the workplace. A lower level of job satisfaction and well-being is linked to the lack of assigned office space, but the ability to work exclusively from home leads to loneliness. Employees – when offered this possibility – should work in offices they are provided. Employers must appreciate the negative link between open and hot-desking policies and job satisfaction and well-being of their employees.Originality/valueThis study is the first to examine the post-pandemic workplace and personal characteristics of public relations and communications professionals in the UK and US and show how they impact job satisfaction and well-being. The study shows that 30% of employed in the PR industry are at risk of depression or anxiety. The connecting factor between personal and work-related characteristics that explains this problem is loneliness.

The impact of diabetes on bronchiectasis

Objective: To study the impact of diabetes on bronchiectasis. Methods: From January 1 2017 to December 31 2021, data of 1 310 inpatients with bronchiectasis were retrospectively collected from Shanghai Pulmonary Hospital, Tongji University. This cohort inclueded 78 patients with bronchiectasis and diabetes (bronchiectasis-diabetes group) and 1 232 patients of bronchiectasis without diabetes (simple bronchiectasis group). To mitigate confounding variables, 269 patients with bronchiectasis but without diabetes (bronchiectasis non-diabetes group) were matched with 78 patients of bronchiectasis with diabetes (bronchiectasis-diabetes group) using the propensity score method in a 1∶4 ratio. A comparative analysis of clinical characteristics, laboratory test results, pathogenic infections, and disease severity was performed between the two groups. Analysis of continuous variables was performed using either a t-test or non-parametric test, while categorical data was assessed using the chi-square test. Results: The mean age of individuals in the bronchiectasis-diabetes group (62.99±8.09 years) was significantly higher than that of subjects in the simple bronchiectasis group (57.05±13.07 years) (t=-6.012, P<0.001). After propensity score matching, the pre-albumin level in the bronchiectasis-diabetes group (188.44±71.65 g/L) was found to be lower than in the bronchiectasis non-diabetes group (208.17±62.50 g/L) (t=2.023, P=0.044). In addition, the hospitalization cost for the bronchiectasis-diabetes group [1.59 (1.34, 2.15) Ten thousand yuan] was higher than that in the bronchiectasis non-diabetes group [1.39 (1.23, 1.62) Ten thousand yuan] (U=-3.744, P<0.001).The severity of mMRC in the bronchiectasis-diabetes group was significantly higher than that in the bronchiectasis non-diabetes group (χ2=25.392, P<0.001), and the frequency of previous hospitalization due to aggravation and acute exacerbation within the previous year were higher than in bronchiectasis non-diabetes group (χ2=34.031, 40.841, respectively, P<0.001). In additional, the BSI score was significantly increased in patients with bronchiectasis-diabetes compared to those with bronchiectasis non-diabetes (8.07±4.07 vs. 10.44±3.82) (P<0.001). Furthermore, fasting blood glucose concentration, urine glucose level, and BSI score exhibited positive correlations, whereas pre-albumin concentration showed a negative correlation with the BSI score (all P<0.05). Conclusion: Compared to those without diabetes, patients of bronchiectasis with diabetes have poorer nutritional status, more severe symptoms, increased risk of acute exacerbation, higher BSI score severity, and greater financial burden.

Association between Helicobacter pylori infection, MASLD, and liver fibrosis in patients with severe obesity: a single-center experience.

Our study sought to evaluate if an association exists between Helicobacter pylori (H. pylori), metabolic dysfunction- associated steatotic liver disease (MASLD), and liver fibrosis in patients with severe obesity (BMI > 35). Our retrospective study included 584 patients over the age of 18years with severe obesity, who underwent preoperative liver transient elastography (VCTE), upper endoscopy, blood work, and intra-operative liver biopsy concurrent with bariatric surgery at a single institution from July 2020 to September 2021. Liver fibrosis scores including FIB-4, APRI, NAFLD fibrosis score, BARD score, AST: ALT ratio, and NAFLD activity score (NAS) were calculated from the laboratory results and liver biopsy findings. The presence or absence of H. pylori was determined based on gastric biopsies obtained during upper endoscopy. Other variables collected included age, gender, mean preoperative weight, BMI, and the presence or absence of comorbidities. Student's t-test and non-parametric testing were used for the analysis of continuous variables and Chi-square analysis was used for categorical data. Of the 584 patients, 14.7% were H. pylori positive and 85.3% were negative. Liver fibrosis scores including FIB-4, APRI, and NAFLD fibrosis scores were significantly higher in the positive group (p < 0.05), but there was no difference in AST: ALT ratio and BARD score. A significantly higher VCTE steatosis and fibrosis scores were noted in the H. pylori-positive group (p < 0.05). Similarly, a significantly higher NAS (NAFLD activity score) on liver biopsies was noted in the positive group, with all the individual components of NAS (steatosis, lobular inflammation, and hepatocyte ballooning) being significantly higher in the positive group (p < 0.05). A significantly higher incidence of fibrosis on liver biopsies was noted in the positive group overall and across all stages of fibrosis (p < 0.05). There were no significant differences between the groups in relation to gender, mean weight, BMI, presence of comorbidities including Diabetes Mellitus, and laboratory values. Our study demonstrates that H. pylori colonization or infection is associated with a higher risk of development of MASLD and progression to fibrosis. Further, population-based studies are needed to corroborate our findings.

A study on the correlation between hyperuricemia and TG/HDL-c ratio in the Naxi ethnic group at high-altitude regions of Yunnan.

The study aimed to explore the risk factors for hyperuricemia (HUA) in the Naxi ethnic population residing in high-altitude areas of Yunnan, China, and assess the clinical value of the triglyceride/high-density lipoprotein cholesterol (TG/HDL-c) ratio as a diagnostic marker. In this cross-sectional study, clinical data were collected from the health checkup population in the People's Hospital of Yulong Naxi Autonomous County, Yunnan Province, from January 2021 to January 2023. Participants were divided into quartiles based on the TG/HDL-c ratio (Q1, Q2, Q3, and Q4) for group analysis using chi-square tests, t-tests, and rank sum tests. Logistic regression analysis and linear regression models were employed to further investigate the correlation between the prevalence of hyperuricemia and TG/HDL-c ratio in this high-altitude Naxi population. A total of 714 participants from the health checkup population were included in the study, of whom 61.5% were male participants and 38.5% were female participants, and the average age was 41.21 ± 11.69 years. The mean uric acid level was 388.51 ± 99.24. After correcting for confounding factors, TG/HDL-c, serum creatinine (Scr), blood urea nitrogen (BUN), triglyceride (TG), high-density lipoprotein cholesterol (HDL-c), red blood cells (RBCs), and hemoglobin (Hb) showed a positive correlation with blood uric acid. Further analysis involved categorizing the TG/HDL-c ratio from a continuous variable to a categorical variable using quartiles. The fully adjusted model showed results that were consistent with the trend observed in the continuous variable analysis when considering the TG/HDL-c ratio as a categorical variable. In addition, in all unadjusted and adjusted models, the serum uric acid (SUA) levels in the high TG/HDL-c ratio group were significantly higher than those in the low TG/HDL-c ratio group (trend p < 0.001). Further linear relationship analysis indicated that after adjusting for covariates, there was an approximate linear relationship between the TG/HDL-c and SUA levels, with a coefficient (β) of 5.421. The prevalence of hyperuricemia is greater in high-altitude areas of Yunnan, showing a nearly linear positive correlation with the TG/HDL-c ratio. Monitoring TG/HDL-c levels may benefit patients with hyperuricemia.

(012) USE OF REAR TIP EXTENDERS IS ASSOCIATED WITH INCREASED RISK OF POST-OPERATIVE COMPLICATIONS AND PENILE PROSTHESIS REVISION IN PATIENTS UNDERGOING PRIMARY INFLATABLE PENILE PROSTHESIS PLACEMENT: RESULTS FROM A LARGE MULTI-INSTITUTIONAL COLLABORATIVE

Abstract Introduction The utilization of rear tip extenders (RTE) is often imperative during Inflatable Penile Prosthesis (IPP) placement. The impact of RTE on perioperative morbidity of IPP surgery is underexplored. Objective In this study, we assess intraoperative and postoperative outcomes among patients undergoing primary IPP implantation with or without RTE. Methods We performed a multicenter, retrospective analysis of men undergoing primary IPP placement between July 2016 and July 2021. A total of 4308 patients were identified, of which 2963 had no RTE and 1345 had RTE. After 1:1 propensity score matching for all confounding variables, 840 patients without RTE were compared to patients with RTE for intraoperative and postoperative outcomes. Chi-square and Mann–Whitney tests were used for statistical analysis for categorial and continuous variables respectively. For multivariable analysis, we used a forward stepwise model and included significant variables found on preoperative characteristics of patients. Kaplan–Meier time to event analysis were compared with Mantel-Cox log-rank test. Results Patients with RTE use had more postoperative complications (9.6% vs 5.2%, p &amp;lt; 0.001). More specifically, RTE patients had more episodes of postoperative hematoma and bleeding (2.0% vs 0.7%, p = 0.033), device malfunction (2.7% vs 1.8%, p = 0.006), and glans-related complications (0.8% vs 0, p = 0.015). On multivariable analysis, use of RTE (OR 1.58, 95% CI 1.07-2.34, p = 0.021), AMS 700 series device (OR 1.93, 95% CI 1.27-2.94, p = 0.002), penoscrotal approach (OR 2.60, 95% CI 1.61-4.18, p &amp;lt; 0.001), and older age (OR 1.02, 95% CI 1.00-1.04, p = 0.035) were associated with increased risk of postoperative complications. Patients with RTE use had increased rate of postoperative IPP revision (5.0% vs 2.1%, p = 0.002). The use of RTE (OR 1.71, 95% CI 1.00-2.90, p = 0.046), AMS 700 series device (OR 1.73, 95% CI 1.01-2.97, p = 0.048), penoscrotal approach (OR 3.16, 95% CI 1.63-6.17, p &amp;lt; 0.001), and history of Peyronie’s disease (OR 2.24, 95% CI 1.31-3.82, p = 0.003) were associated with increased risk of postoperative IPP revision or explantation. On Kaplan–Meier analysis, use of RTE was associated with increased risk of postoperative complications and IPP revision or explantation within 48 months (log rank p = 0.001 and p = 0.002 respectively). Conclusions In this large multi-institutional cohort, patients with RTE experienced more hematoma, device malfunctioning, and glans related post operative complications. The use of RTE is an independent predictor of post-operative complications and IPP revision or explanation. Disclosure No.

(092) TESTICULAR CORE EXTRACTION REDUCES NEED FOR MICROSCOPIC TESTICULAR SPERM EXTRACTION BY 75% IN MEN WITH NON-OBSTRUCTIVE AZOOSPERMIA

Abstract Introduction Current AUA guidelines recommend proceeding to microTESE (mTESE) for patients with non-obstructive azoospermia (NOA). Herein, we propose that that conventional Testicular Sperm Extraction (cTESE) is an effective and preferred first-line technique for sperm retrieval in men with NOA who first undergo a diagnostic testicular core extraction (TCE). Objective To comprehensively characterize TCE and cTESE as important diagnostic and therapeutic tools, respectively, we present a large cohort study to confirm our proposed algorithm. Methods We identified 187 patients presenting with NOA in our clinic from January 1, 2019 – March 25, 2024. All patients underwent diagnostic TCE that if positive for sperm was followed by cTESE. Chart review was performed, and summary statistics were calculated for tested variables, using chi squared analysis for categorical variables and Kruskal Wallis analysis for non-parametric continuous variables. P &amp;lt; 0.05 deemed significance. Results Under current guidelines, all 66 patients who underwent cTESE for NOA would have undergone mTESE. Of these patients, 97.8% had sperm on cTESE sufficient for IVF/ICSI. Those patients who did not have sperm on TCE were offered mTESE. 16 elected to proceed, of which 4 (25%) were found to have sufficient sperm at the time of egg retrieval. In patients with NOA, the only significant predictor of cTESE success was TCE. Other covariates that significantly differed between patients with sperm and those without on TCE included lower FSH (p = 0.001) and LH (p = 0.005). However, these variables were not significant in predicting TCE efficacy for NOA patients. Conclusions TCE was the only tested variable statistically associated with cTESE outcome. By pretesting NOA patients with TCE as a method of selection we achieved a 97.8% sensitivity of predicting a positive cTESE outcome in NOA patients and spared 75% of those patients from mTESE. This algorithm for NOA patient management costs significantly less while maintaining efficacy. Disclosure No.

(164) AN UPTICK IN IPP INFECTIONS WITH 0.05% CHLORHEXIDINE GLUCONATE

Abstract Introduction The optimal irrigation solution with inflatable penile prosthesis (IPP) remains controversial. Objective We sought to determine the impact of the type of fluid used for dipping and irrigation (D&amp;I) on the risk of IPP infections. Methods This is a retrospective, consecutive cohort study that includes individuals who underwent initial Coloplast IPP insertion or revision between January 2021 and May 2024. Cases done from January 2021 to August 2022 (20 months) underwent Rifampin/Gentamycin for dipping and Vancomycin/Gentamycin for irrigation (Group 1), whereas those from October 2022 to May 2024 (20 months) utilized 0.05% chlorhexidine gluconate for both D &amp; I (Group 2). Surgeon, operative time, age, diabetes mellitus (DM), perioperative level of HbA1C, history of acute urinary retention (AUR), positive urine culture, and oral antibiotic (AB) regimen at discharge were obtained. The rate of infection between the two study groups and the association of risk factors with developing infection were explored by t-test and chi-square analysis for continuous and discrete variables, respectively. P-value less than 0.05 was considered statistically significant. Results In comparison of two study groups, infection rate was significantly higher in group 2 at 2.5% (8/314) than group 1 which did not have any infection (0/280) (P = 0.008). There was no significant association between the study group and operative time (P = 0.45), DM (P = 0.29), HbA1C level (P = 0.20) and AUR (P = 0.87) or surgeon (Table 1). Notably, two clinical infections were from non-virulent organisms (Streptococcus Constellatus &amp; Staphylococcus Lugdunensis). Two of three patients undergoing malleable salvage failed. Since no infection was observed in group1, infection risk predictors were only analyzed in group 2. The patients in group 2 were stratified based on their diabetes mellitus (DM) status, and analyses were conducted to investigate the effect of a positive DM history on the risk of infection. The results indicated that having DM significantly increased the risk of infection, with 75% (6/8) of patients with DM developing an infection compared to 26% (78/306) of those without DM (P = 0.006) (Table 2). Notably, three of eight infections occurred in patients discharged on Augmentin or cefdinir secondary to drug interaction warning (our typical post op prophylaxis is Bactrim or ciprofloxacin). Conclusions Type of antiseptic fluid for D&amp;I and DM were associated with IPP infection following surgery in our patient cohort. Disclosure No.