Chi-square Analysis Research Articles

Characteristics of Children and Youth Referred for Language Assessment at Different Ages.

Early detection of language delays is essential, as language is key for academic outcomes, well-being, and societal participation. Previous studies have focused on undetected delays in young children. Much less is known about referrals at older ages. In this study, we aimed to (a) establish how many children are referred at toddler age (2-3 years) and how many at lower elementary (4-7 years), upper elementary (8-12 years), and high school (13-16 years) age; (b) evaluate characteristics of the referred children and adolescents across age groups; and (c) assess whether the ensuing classification (no language disorder [LD], developmental LD, LD + additional problems) differed across age groups. We used the 2010-2014 database of the Dutch federation of speech and hearing centers, containing 18,894 cases with target ages. We established the number of referrals in each age group (Q1) and assessed the composition of the age groups in terms of speech, language, behavioral, and cognitive outcomes (Q2), as well as in terms of classification (Q3). To answer Q2 and Q3, we conducted chi-squared analyses with the toddler group as reference group. Late-identified LDs exist: There were new referrals in all age groups. Compared to older age groups, the toddler group contained fewer girls and multilingual children. The toddler group also contained fewer children without an LD and more children with LD + additional problems. Reassuringly, children with multiple language problems are referred earliest. However, late-identified LDs exist, even at high school age. Girls and multilingual children tend to be missed at younger ages. More work on awareness and identification of language delays is needed, requiring awareness, knowledge, and tools for educational professionals.

Slovenia’s social sustainability achievements: An examination of local perspectives and satisfaction levels

Slovenia is regarded as a nation which has prioritized green innovations, social responsibility, and its commitment to sustainable development. Although Slovenia’s environmental achievements have received national visibility, local awareness of its social sustainability initiatives has been limited. This study examined perspectives and satisfaction levels among residents regarding Slovenia’s social sustainability achievements and associated sustainable development goals (4, 10, and 16). Utilizing a survey, these perceptions were assessed among respondents from three distinct regions–Ljubljana, Novo Mesto, and Koper, respectively. Frequency tests indicated that quality education, ethnic integration, and effective governance/partnerships were perceived as being important to achieving social sustainability. From a Chi-square analysis, a positive correlation was revealed between educational level and knowledge of national sustainability initiatives. A Spearman’s rho test showed that age had an influence on satisfaction with ethnic integration. The study provides insights into the social sustainability perspectives of Slovene society and offers implications for future research.

The effect of the Watson model-based psycho-educational intervention on preventing postpartum depression.

Psycho-education application is effective in reducing the risk of postpartum depression (PPD) and increasing the level of social support. The quality of care increases with the implementation of Watson's Theory of Human Caring Model (WTHCM)-based care programs to reduce the risk of PPD. This study aimed to evaluate the impact of a psycho-educational intervention based on the Watson model on pregnant women in preventing PPD. Additionally, the effect of the psycho-educational intervention on women's perceptions of social support in relation to PPD was evaluated. A randomized-controlled pretest-posttest control group intervention study design was used. The sample consisted of 91 women (intervention:45, control:46) in their 20th to 32nd gestational week. While all women received routine care at the family health centre the intervention group was additionally applied a psycho-educational intervention based on the WTHCM. Chi-square and t-test analysis methods were performed to determine the homogeneity of the intervention and control groups. The t-test method was used to compare group scores. Multiple regression analysis was employed to compare multiple variables. Following the psycho-educational intervention, the total Edinburgh Postpartum Depression Scale of the intervention group was found significantly lower than that of the control group, but the total and friend subscale scores on the Multidimensional Scale of Perceived Social Support (MSPSS) were higher (p < 0.05). The regression analysis results indicate that friend and family support, which are sub-dimensions of the MSPSS, exhibited a significant decrease in both groups. Furthermore, this decline had a greater impact on reducing the PPD level in the intervention group compared to the control group. It was found that while the support of the significant other sub-dimension reduced the PPD level in the intervention group, it did not make a significant difference in the control group. The Watson's Theory of Human Caring Model-based psycho-educational intervention program decreased women's risk of PPD and increased their social support levels. It is recommended to use approaches that include psycho-educational intervention in postpartum midwifery care.

Social Media Authentication and Users' Assessments of Health Information: Random Assignment Survey Experiment.

In an effort to signal the authenticity of user accounts, social networking sites (SNSs) such as Facebook and X, formerly known as Twitter, use visual heuristics (blue checkmarks) to signify whether accounts are verified. While these verification badges are generally well recognized (and often coveted) by SNS users, relatively little is known about how they affect users' perceptions of accuracy or their likelihood of engaging with web-based information. This is particularly true in the case of information posted by medical experts and health care professionals. This study aims to use an experimental survey design to assess the effect of these verification badges on SNS users' assessments of information accuracy as well as their proclivity to recirculate health information or follow verified medical experts in their social network. A survey experiment using random assignment was conducted on a representative sample of 534 adult SNS users in Florida, United States. A total of 2 separate experimental scenarios exposed users to vaccine-related posts from verified medical experts on X. In each case, the original post contained a platform-issued verification badge (treatment group), which was subsequently edited out of the image as an experimental control. For each scenario, respondents were randomly assigned to either the treatment or control group, and responses to 3 follow-up questions were assessed through a series of chi-square analyses and 2 logit regression models. Responses were fielded using a stratified quota sampling approach to ensure representativeness of the state's population based on age, sex, race, ethnicity, and political affiliation. Users' assessments of information accuracy were not significantly impacted by the presence or absence of verification badges, and users exposed to the experimental treatment (verification badge) were not any more likely to repost the message or follow the author. While verification badges did not influence users' assessments or subsequent behaviors, reliance on social media for health-related information and political affiliation were substantial predictors of accuracy assessments in both experimental scenarios. In scenario 1, which included a post addressing COVID-19 vaccine efficacy, users who relied on social media "a great deal" for health information were 2 times more likely to assess the post as accurate (odds ratio 2.033, 95% CI 1.129-3.661; P=.01). In scenario 2, which included a post about measles vaccines, registered Republicans were nearly 6 times less likely to assess the post as accurate (odds ratio 0.171, 95% CI 0.097-0.299; P<.001). For health professionals and medical experts wishing to leverage social networks to combat misinformation and spread reliable health-related content, account verification appears to offer little by way of added value. On the basis of prior research, other heuristics and communication strategies are likely to yield better results.

Prevalence of supplement usage and related attitudes and reasons among fitness athletes in the gyms of Kashan and its relationship with feeding behavior: a cross-sectional study

BackgroundThe overuse of supplements among athletes is a widespread issue affecting the health of both male and female athletes. However, research on supplements usage among female fitness athletes is limited, and there is little information on the feeding behavior of fitness athletes who use supplements. This study aimed to fill the gap in knowledge by examining the prevalence of supplement usage and its related attitudes and reasons among fitness athletes in the gyms of Kashan. It further aimed to investigate the correlation between supplements usage and the feeding behavior of fitness athletes.MethodsFor these purposes, in this cross-sectional study, 433 fitness athletes (15‒46 years old) in 28 gyms in the city of Kashan were surveyed using a researcher-made questionnaire in 2023. Five experts confirmed the validity of the questionnaire. The present study considered the supplements based on the Australian Institute of Sport position statement. A Chi-square analysis was conducted to examine the relationship between the study variables and supplement usage.ResultsOverall, 272 male and 161 female fitness athletes participated in this study. The results revealed that 57.9% of participants used supplements, most commonly vitamin C, vitamin D, omega-3 fatty acids, and whey protein. The main reason for using supplements was to speed up body repair after exercise (69.5%). Additionally, 41.8% of these athletes believed that using supplements improves their overall performance, and 21.9% thought that supplements do not harm the body. Moreover, a correlation was observed between feeding behavior and the consumption of supplements. It was found that athletes who use supplements tend to eat more white meat, seeds, and nuts and fewer high-fat dairy products than those who do not consume them.ConclusionUsing supplements among fitness athletes in the gyms of Kashan is common. The main reason for using these substances was to speed up body repair after exercise, and nearly half of the athletes believed that supplements improved their performance. In addition, it was revealed that athletes who take supplements have healthier feeding behaviors than those who do not. Thus, these findings confirm the necessity of informing fitness athletes about using supplements.

Contemporary Axillary Surgical Management in Patients with Pathologically Node Positive Disease After Neoadjuvant Chemotherapy: A Survey of Members of the American Society of Breast Surgeons.

Axillary lymph node dissection (ALND) is increasingly omitted for breast cancer patients with pathologic nodal disease after neoadjuvant chemotherapy (NAC). This study aimed to understand when and why surgeons consider omitting ALND after NAC. The American Society of Breast Surgeons membership was surveyed, and responses were tabulated. To identify patterns, multiple correspondence analyses followed by cluster analysis on coordinates provided by the former were performed. Chi-squared analyses determined whether cluster characteristics were significantly (P < 0.05) associated with omission of ALND. Of members, 328/2172 (15.1%) completed the survey. Most (60.7%) always offer sentinel lymph node surgery to cN1 patients who respond to NAC, and many (43.9%) sometimes omit ALND in the setting of residual nodal disease. Respondents less often consider omitting ALND with increasing volume of pathologic nodal disease after NAC and are less likely to omit ALND among patients with cN1 disease at presentation than cN0 (P < 0.05 across all volumes). Respondents cited radiation administration (74.1%) and belief that ALND would not improve locoregional (48.2%), distant recurrence or survival (47.6%) outcomes when axillary radiation is administered as reasons to omit ALND. The respondent group comprising male private practice surgeons, practicing ≥ 21 years, consider omitting ALND significantly more frequently. Surgeons sometimes consider ALND omission for patients with pathologic nodal disease after NAC but are more likely to do so in cN0 patients and patients with smaller volumes of nodal disease. These decisions are largely based on perceived lack of oncologic benefit despite absence of prospective data supporting this deescalation.

Prevalence of stunting and its correlates among children under 5 in Afghanistan: the potential impact of basic and full vaccination

BackgroundChild stunting is prevalent in low and middle-income countries (LMICs), but an information gap remains regarding its current prevalence, correlates, and the impact of vaccination against this condition in Afghanistan. This study aimed to determine the prevalence and correlates of moderate and severe stunting and the potential impact of basic and full vaccination among children under five in Afghanistan.MethodsThis is a secondary analysis of the 2022-23 Afghanistan Multiple Indicators Cluster Survey (MICS) including 32,989 children under 5. Descriptive statistics were employed to describe the distribution of independent variables and the prevalence of stunting across them. Chi-square analysis was used to examine the association between each independent variable with stunting. Multinomial logistic regression was used to examine the risk of stunting across different independent variables.ResultsA total of 32,989 children under 5 years old were included in this study. Of those 44.7% were stunted with 21.74% being severely stunted. Children aged 24–35 and 36–47 months faced the highest risk as compared to those aged 1–5 months. The prevalence was lower in female children and they were less likely to experience severe stunting. Stunting was more prevalent in rural areas, with children there 1.16 to 1.23 times more likely to be affected than urban counterparts. Lower wealth correlated with higher stunting. Younger maternal age at birth (≤ 18) correlated with increased stunting risks, particularly in severe cases. Parental education was inversely related to stunting; higher education levels in parents, especially fathers, were associated with lower stunting rates. Households with more than seven children showed a 25% and 44% higher risk of moderate and severe stunting, respectively, compared to families with 1–4 children. Improved sanitation, but not drinking water sources, was linked to reduced stunting in the adjusted model. Vaccination had a protective effect; in the adjusted analysis, basic and full vaccinations significantly lowered the risk of severe stunting by 46% and 41%, respectively.ConclusionIn this nationally representative study, the prevalence of stunting was substantial (44.7%) in Afghan children. Additionally, the findings emphasize the critical factors associated with child stunting and underscore the protective role of vaccination against this condition, which provides policymakers with directions for policy efforts and intervention strategies to reduce child stunting in Afghanistan.

The Individual-Level and Community-Level Social Determinants of Burn Injuries: A Single-Institution Study From the Southwestern United States.

Burn injuries are a significant public health concern, causing life-threatening complications and substantial hospitalization costs for patients. It has been shown that burn injuries may affect individuals differently based on demographic factors and socioeconomic status, among other variables. In the Southwestern United States with high ambient temperatures, specific burn etiologies, such as pavement burns, may pose a disproportionately high risk for disadvantaged communities and homeless individuals. This study uniquely explores burn injuries in relation to patients' socioeconomic status in Las Vegas, Nevada by using the Distressed Community Index to quantify socioeconomic status utilizing individual-level and community-level indicators. This single-institution and retrospective study collected data from all patients admitted to a burn center located in Las Vegas. Data were analyzed through Chi-square, one-way ANOVA, and post-hoc analysis with Tukey's test. Patients residing in distressed communities contributed to the greatest number of burn injuries, however there was a lack of significant association between socioeconomic status and burn injury (p = 202). Additionally, specific burn etiologies and demographic characteristics were associated with variations in burn patient hospital course, complications, resources utilized and outcomes. Distressed patients were significantly associated with public insurance (p < 0.001), and public insurance users were associated with pavement burns-one of the most severe burn injuries (p < 0.001). This study emphasizes the importance of developing comprehensive burn prevention resources tailored to vulnerable populations, especially in regions with increased incidence of severe burn injuries, in order to reduce burn burden and mortality.

Cross-sectional study assessing sleep behavior and musculoskeletal symptoms in elite junior badminton athletes.

Sleep inadequacy has previously been associated with increased risk of injury and reduced performance. It is unclear if sleep disorders are associated with musculoskeletal symptoms, which may be a predictor of serious injury and affect performance. The aim was therefore to assess sleep behavior in elite junior badminton players and its association to musculoskeletal symptoms. In 2018, players at the World Junior Badminton Championship completed the Athlete Sleep Behavior Questionnaire and a modified version of the World Olympic Association Musculoskeletal Health Questionnaire. Participants were categorized with poor or moderate/good sleep behavior as the independent variable. Musculoskeletal symptoms were the primary outcome and was categorized using yes/no questions. Relevant musculoskeletal symptoms were defined as pain higher than 30 mm Numeric Rating Scale pain score or more than 30 minutes of joint stiffness a day. Group comparison was performed using chi-square analysis and logistic regression for primary outcome adjusted for age, sex, ethnicity, previous injury, training load, and resting days. Of the 153 participants, 28% reported poor sleep scores. There was no difference between poor and moderate/good sleep score concerning demographic variables such as sex, age, ethnicity, previous injury, training load, and resting days. There were 27% with current musculoskeletal symptoms but with no difference in groups between poor and moderate/good sleep score (P = .376). This yielded an adjusted odds ratio of 1.23 (95% confidence intervals 0.52; 2.90). Twenty-eight percent of the participants reported poor sleep behavior. Twenty-seven percent experienced current musculoskeletal symptoms. We found no statistical differences in reported musculoskeletal symptoms when comparing athletes with poor sleep behavior to athletes with moderate/good sleep behavior.

P-058 The role of sperm selection in improving embryo euploidy rate: a comparison between Swim-up and Microfluidic Sperm Selection

Abstract Study question Does Microfluidic Sperm Selection (MSS) improve the blastocysts’ development rate and the euploidy rate compared to Swim-up sperm selection? Summary answer MSS doesn’t improve the rate of blastocyst development and euploidy compared to Swim-up. Furthermore, in women age ≥ 37 years D6 aneuploid blastocyst rate increases What is known already Sperm defects have been shown to have a negative impact on embryo quality and development. MSS was introduced as an alternative to traditional centrifugation-based sperm preparation techniques to efficiently isolate highly motile and healthy spermatozoa. Centrifugation has been suggested to compromise membrane integrity, motility, mitochondrial energy production, and DNA structure. Less DNA fragmentation and ROS formation was observed in spermatozoa isolated with MSS compared to standard techniques. Our study aims to analyze whether MSS also improves biological outcomes. Study design, size, duration In a prospective study of 51 ICSI/PGT-A cycles performed between September 2022 and November 2023, freshly ejaculated semen sample was divided into two aliquots and processed by Swim-up and MSS. Split sperm sample was used to inject siblings’ mature oocytes (249 vs 274 oocytes in Swim-up vs MSS groups). Inclusion criteria: retrieved MII oocytes ≥8, oligoteratozoospermic and normozoospermic semen. Results were analyzed according to women’s age &amp;lt;37 years (21 cycles) and ≥37 years (30 cycles). Participants/materials, setting, methods Spermatozoa were selected using either conventional Swim-up or a microfluidics device (ZyMōtTM). Post treatment sperm parameters (sperm count; total sperm motility; progressive motility and hyperactivated motility) were examined for both. Embryo culture was performed in Irvine Continuous Culture-NX media until day5 or day6 and biopsy was performed at the blastocyst stage by next generation sequencing. Primary endpoint was fertilization rate, blastocyst development and usable blastocysts rate. Chi-square analysis was performed and p &amp;lt; 0.05 was considered significant Main results and the role of chance There is no significant differences overall between Swim-up and MSS in fertilization rate (73% vs 75%), blastocyst development rate (47% vs 54%) and ploidy rate: aneuploid (47% vs 50%), usable blastocyst (i.e. euploid+mosaics) (53% vs 50%). When considering female age, no significant difference is observed in the primary endpoints in the &amp;lt;37 years group. However, in women aged ≥37 years, the rate of blastocyst development is similar in the two sperm preparation groups, but a significant difference is observed in the timing of blastocyst development: The percentage of blastocysts formed on day 6 in the MSS group is significantly higher than in the Swim-up group (43% vs. 19% p &amp;lt; 0.05). In addition, the aneuploidy rate of blastocysts on day 6 is also significantly higher than in the Swim-up group (79% vs. 50% respectively, p &amp;lt; 0.05). The concentration of sperm recovered post-treatment was similar in Swim-up vs MSS (23 x106 vs 19 x106); total motility and progressive motility were similar in Swim-up compared to MSS (92.7% vs. 95.3% and 85% vs. 87% respectively). Only hyperactivated motility assessed with the SCASCOPE CASA System (Microptic) was significantly higher in MSS vs Swim-up 41% vs 4% respectively (p &amp;lt; 0.0005). Limitations, reasons for caution Our study included couples with different infertility diagnosis and semen parameters. Further studies with an increased number of patients may provide more comprehensive data to better evaluate biological and clinical outcomes to eventually suggest the use of MSS in laboratory routines Wider implications of the findings Recently, some studies reported that microfluidic-sorted sperm showed significantly less ROS formation and DNA fragmentation compared to those treated with conventional Swim-up method. Nevertheless, our data does not currently show the expected increase in embryo euploidy rate to justify the routine use of these expensive devices in male infertility treatment Trial registration number non applicabile

P-468 Relationship between spiritual well-being and prenatal stress level of women conceiving spontaneously or with assisted reproductive techniques

Abstract Study question Is there a relationship between spiritual well-being and prenatal stress level of women who conceived with spontaneous/assisted reproductive techniques (ART)? Summary answer Women Conceiving with ART have higher prenatal stress. As the spiritual well-being of women conceiving with ART increases, the level of prenatal distress decreases. What is known already The negative effects of prenatal stress on maternal-fetal well-being are known. Spirituality provides emotional support by feeling the support of spiritual forces, affirmation in re-meaning life, strengthening the ability to cope with stress with the teachings of the belief system, and increasing hope and harmony. The stress created by fertility treatment may continue during pregnancy. It is thought that spirituality may be effective in coping with stress in pregnancies after ART. Studies in this area are limited. Study design, size, duration he comparative descriptive study was conducted with 202 pregnant women, 115 spontaneous and 87 ART pregnant women, who applied to the obstetrics outpatient clinics of a state hospital between November 2021 and June 2022. Data were collected in an average of 15-20 minutes by face-to-face interview technique. According to the statistical analysis, the effect size was calculated as 0.80 and the statistical power as 99%. Participants/materials, setting, methods Participants (a) who can speak and understand Turkish; (b) 18-49 years of age women; (c) who are 14 and above gestational weeks; (d) who haven’t risk pregnancies were included. The data of the research were collected with the “Personal Information Form”, “Spiritual Well-being Scale “ and “Tilburg Pregnancy Distress Scale”. The research data were evaluated by percentile calculations, averages, Chi-square analysis, Mann Whitney U test, Kruskal Wallis test and Bonferroni test. Main results and the role of chance The average age of women who conceived with ART is 28.91±6.06, and the average age of women who conceived spontaneously is 28.08±5.75. The Spiritual Well-being Scale (SWBS) of the pregnant groups was determined as 124.52±12.00 for the ART group and 123.92±9.02 for the spontaneous group, and there was no statistical significance in terms of spiritual well-being between the groups (p &amp;gt; 0.05). In our study prenatal distress was detected in 12.6% of pregnant women in the ART group (above 28 points) and in 9.6% of spontaneous pregnant women (above 28 points) according to the Tilburg Pregnancy Distress Scale (TPDS) cut-off score. A statistically significant and negative relationship was found between the total SWBS and TPDS (r=-0.256, p &amp;lt; 0.05) in the ART group. A statistically significant and negative relationship was found between the total SWBS and TPDS (r=-0.256, p &amp;lt; 0.05) in the ART group. Limitations, reasons for caution Since the study was conducted in a single center in a province in the west of Turkey, it is a limitation that the results of the study cannot be generalized to the whole population. Wider implications of the findings The ART group experiences higher prenatal distress than the other group. As the spiritual well-being of pregnant women in the ART group increases, the level of prenatal distress decreases. Nurses and midwives should be aware of the prenatal distress-reducing effect on spiritual well-being and provide spiritual counseling. Trial registration number not applicable

P-479 Teenagers’ experiences and attitudes toward sex and fertility education in Japan

Abstract Study question What are the experiences and attitudes of Japanese teenagers toward sex and fertility education? Summary answer The participants received sex education on different items to different degrees, and 70% evaluated that the sex education they received in school as neutral. What is known already Although many studies have revealed younger people’s experiences of sex education and their knowledge regarding fertility, very few, both domestic and international, have identified teenagers’ experiences and attitudes toward fertility education. Since 2018, content on fertility has been included in supplementary reading books for Japanese upper secondary school students, and from 2023, students have begun to learn about fertility with the ‘Health’ textbook based on the revised national curriculum. Therefore, it is necessary to clarify teenagers’ experiences and attitudes toward learning about fertility in school. Study design, size, duration This was a cross-sectional questionnaire survey study. The target group consisted of students who had just enrolled to university, were 18-19 years old, and graduated from upper secondary high school in March 2023. The survey was conducted between July and August 2023. The study protocol was approved by the Ethics Committee (approval date: 2023. 6.1; approval number: 5-1). Participants/materials, setting, methods In liberal arts classes with approximately 80% or more first-year students, 873 students who agreed to participate in this study answered a Google forms questionnaire. Of these, 759 (86.9 %) met the inclusion criteria and were included in the analysis. We used the questionnaire ‘Teenager’s knowledge and attitudes to fertility’ which includes 25 items on whether students received and learned from sex education. Simple aggregation and chi-squared analyses were performed. Main results and the role of chance Regarding sex, 46.4% of the participants were male, 51.1% female, and 2.5% other. Of the participants, 99.2% had received sex education at school; 21.6% rated it as very good or good, 71.3% rated it as neutral, and 7% rated it as poor or very poor.The sex education content received by over 60% of the participants was related to the following: sexually transmitted infections (98.4%), contraception (92.5%), puberty (94.2%), menstrual cycle (90.7%), ovulation (87.6%), pregnancy (87.1%), and abortion (60.5%). Regarding fertility and related content, few participants received education on these in school: fertility (8.8%), fertility window (0.0%), menopause (18.3%), relationship between fertility and lifestyle (34.5%), endometriosis (8.8%), and PCOS (2.6%). Women learned more about the menstrual cycle in school compared to men (p&amp;lt;.05). This was the only significant gender difference.Outside school, 30% or less of the participants had studied all 25 items, and nearly 40% had never studied any of the items. Moreover, 11 items were studied by significantly few students outside school than in school (p&amp;lt;.01). Limitations, reasons for caution A limitation of this study is that only 18-19 year olds who had just entered a national university in 2023 were targeted. Therefore, caution should be exercised when generalising these results to the general Japanese teenage population. Wider implications of the findings Few teenagers have studied fertility and related topics both inside and outside of school. It is necessary to enhance schoolteachers’ abilities to appropriately educate teenagers about fertility. In addition, it would be effective for teenagers to be provided opportunities to learn about fertility outside school through websites or short movies. Trial registration number non applicable

Testosterone levels increase following bariatric surgery - validation of preceding literature in a large-scale population analysis.

The effects of bariatric surgery on testosterone levels in men with obesity and hypogonadism have not been thoroughly explored yet. To investigate the possible effects of bariatric surgery on T levels in obese hypogonadal men by comparing T levels before and after surgery using a comprehensive claims database. The TriNetX US Collaborative Network database was used to identify men ages 18-80 who underwent a bariatric procedure and had a serum T value of<350ng/dL prior to surgery. Men who received testosterone therapy before/or after surgery were excluded. We conducted a retrospective self-matched cohort analysis to examine the difference in serum T levels before and after bariatric surgery. A sub-analysis was carried out to explore differences between men who reached eugonadal status or maintained low T levels following surgery. Descriptive statistics detailed sociodemographic and clinical characteristics, with continuous and categorical data compared using unpaired t-tests and chi-square analysis, respectively. Changes in T levels and body mass index (BMI) before and after surgery were compared using an unpaired t-test with a<0.05 set for significance. All analyses were conducted using the TriNetX platform which utilizes both Python and R software. The study analyzed 69 hypogonadal men who underwent bariatric surgery and had T levels assessed before and after the procedure. The mean (standard deviation) pre-surgery serum T level was 208±79ng/dL, which post-surgery increased to 371±164ng/dL, marking an average increase of 163±164ng/dL. Likewise, the mean (standard deviation) body mass index decreased from 42.9±9.0 to 38.8±5.7kg/m2. Post-surgery, 45% (31 men) achieved eugonadal status, while 55% (38 men) continued to have low T levels. A comparison between the post-surgery eugonadal cohort and the persistent low T cohort revealed that the former had higher pre-surgery serum T levels (235±71ng/dL vs. 184±80.4ng/dL, p=0.007), a higher pre-surgery body mass index (45.5±4.5kg/m2 vs. 41.1±11.5kg/m2, p=0.041), and a significantly greater reduction in body mass index post-surgery (7.3±7.2kg/m2 vs. 2.0±12.8kg/m2, p=0.04). Notably, the increase in T was significantly higher in the eugonadal cohort compared to the persistent low testosterone cohort (257±143ng/dL vs. 95±178ng/dL, p<0.0001). This study provides evidence of bariatric surgery's positive effect on serum T levels in obese men with baseline low T. Almost one out of two men with low T reached normal T levels after bariatric surgery. As the most comprehensive study to date, it validates and substantiates previous work suggesting that weight loss can improve T levels physiologically.

P-050 Microfluidic chip-sorted spermatozoa selection yields embryo euploidy rate and reproductive outcomes similar to density-gradient centrifugation

Abstract Study question Does microfluidic chip-sorted spermatozoa selection (MSS) improve good quality blastocyst (GQB) and embryo euploidy rates compared to density gradient centrifugation (DGC)? Summary answer The use of MSS before intracytoplasmatic sperm injection (ICSI) does not improve good quality blastocist and euploidy rates comparing to DGC. What is known already The integrity of sperm DNA plays a crucial role in embryonic development. Conventional sperm selection methods, such as DGC, may potentially damage sperm DNA due to oxidative stress generated during centrifugation. One of the recent advances in sperm selection techniques is the microfluidic chamber, which, requiring less processing time and eliminating the need for centrifugation, allows for the selection of sperm with better mobility, morphology, and reduced DNA damage. Consequently, improved GQB and euploid embryo rates, as well as enhanced reproductive outcomes, are expected. Study design, size, duration Retrospective study of 1739 blastocysts from 404 couples undergoing 544 autologous cycles of ICSI/PGT-A (preimplantation genetic testing for aneuploidies) from January 2020 to December 2022. Those patients with sperm concentration &amp;lt;5 × 106/mL or motility &amp;lt;10%, altered karyotype, women aged &amp;gt; 43 years, uterine anomalies and thrombophilia were excluded. Besides comparing euploidy rates and blastocyst formation, reproductive outcomes were analyzed and compared. Participants/materials, setting, methods According to the sperm selection technique, two groups were established. One group underwent MSS (ZyMōt ICSI® or ZyMōt Multi®), resulting in 295 blastocysts from 96 cycles. It was compared with a control group (DGC) including 1444 blastocysts from 448 ICSI/PGT-A cycles. PGT-A was performed in day 5/6 using Next Generation Sequencing (NGS) technology. For a 95% confidence interval, statistical significance was considered at p &amp;lt; 0.05. Chi-square analysis was used for the statistical evaluation. Main results and the role of chance Both groups were comparable in terms of demographic data, including age, sperm analysis parameters, and cycle characteristics. There were no significant differences between the DGC and MSS groups in the women’s age (mean ± SD) (37.9 ± 3.9 vs. 38 ± 3.9 years, p = 0.99) or men’s age (38.4 ± 7.1 vs. 39.8 ± 5.9 years, p = 0.11). No significant differences were found between the DGC and MSS groups in terms of GQB rate (49.3% vs. 50.7%, p = 0.55), euploidy rate (35.8% vs. 32.2%, p = 0.23), fertilization rate (69.5% vs. 69.5%, p = 0.99), clinical pregnancy rate per transfer (63% vs. 76%, p = 0.13), clinical miscarriage (9% vs. 21%, p = 0.33), and live birth rate per transfer (44% vs. 37%, p = 0.42). The results also showed a higher number of euploid embryos per initiated cycle in the DGC group (1.154) compared to the MSS group (0.989). Despite this difference, the results were not statistically significant (p &amp;gt; 0.05). Limitations, reasons for caution The limitations of this study include the potential impact of selection bias, as it is a retrospective study in which groups were not randomly assigned. Additionally, the low number of blastocysts in the MSS group and the potential bias of DNA fragmentation, which was not evaluated in the study. Wider implications of the findings Both methods demonstrated similar effectiveness. While MSS could potentially be more effective in samples with high DNA fragmentation and they feature a user-friendly application, its major limitation lies in its challenging application with samples having a low concentration of motile sperm. Specific semen samples may need different sperm selection methods. Trial registration number Not Applicable

O-216 The impact of maternal age on cumulative life birth rates after single euploid embryo transfer: differences between autologous and donor oocyte cycles

Abstract Study question How much of an impact has the maternal age on cumulative life births after euploid Single Embryo Transfer (SET) in autologous and donor oocyte cycles? Summary answer A maternal age ≥ 42 years old affects negatively the cumulative Life Birth Rates (cLBRs) even after euploid SET, but only in the autologous cycles. What is known already Despite the improvements in assisted reproduction technologies (ART) in the last decades, the LBRs remain suboptimal, especially when advanced maternal age is considered. Although several factors could explain these outcomes (i.e. infertility history; uterine pathologies/surgery; advanced paternal age), maternal age-related aneuploidies remain the most limiting factor for a favorable clinical outcome. Thus, the Genetic Testing for Aneuploidies (PGT-A) has been integrated into ART as a strategy to evaluate chromosomal status before transfer. Interestingly, recent studies show that, even after the transfer of euploid blastocyst, the maternal age negatively influences the LBRs. Study design, size, duration This study, carried out in Villa Mafalda Reproductive Medicine Department (Italy), included 568 euploid SET: 542 from autologous cycles (divided in four subgroups according to maternal age: ≤ 34 y.o. (n = 207); 35-38 y.o. (n = 193); 39-41 y.o. (n = 106); ≥ 42 y.o. (n = 36)) and 26 from oocyte donation (OD) cycles (average recipient age is 44.2). All cycles were performed from May 2020 to February 2023. PGT for Monogenic disorders (PGT-M) cycles were excluded. Participants/materials, setting, methods All blastocysts included in this study were analyzed by Next Generation Sequencing (NGS) after a day 5/6 trophectoderm biopsy. For each subgroup was annotated the embryo morphology- divided into good (AA-AB-BA); average (BB-BC-CB) and poor (CC) according to Gardner/Schoolcraft blastocyst grading system- and the day of expanded blastocyst formation (grade 4 of Gardner/Schoolcraft blastocyst grading system). Primary analysis included the cumulative LBRs. Secondarily, blastocyst morphology and blastocyst expansion were examined for all embryo categories considered. Main results and the role of chance The pairwise comparison between groups was performed by Chi-square analysis and p &amp;lt; 0.05 was considered statistically significant. The cLBRs for each subgroup were respectively: ≤ 34 (63.09%); 35-38 (58.47%); 39-41 (56.84%); ≥ 42 (48.57%); OD (69.23%). Data showed that cLBRs decreased with the increase of maternal age, although statistical significance was observed only among women ≤ 34 y.o. and ≥ 42 y.o. (P=0.029). Notably, there was no statistical significance in cLBRs comparing women ≤ 34 y.o. and OD patients (P=0.086). The good-quality blastocyst rate was respectively: ≤ 34 y.o. (54.58%); 35-38 y.o. (47.66%); 39-41 y.o. (60.37%); ≥ 42 y.o. (50%); OD (59.37%). The pairwise comparison showed no significant difference between groups. Furthermore, there was not found significant difference about the day of expanded blastocyst formation: ≤ 34 y.o. (D5: 78.92%; D6 21.07%); 35-38 y.o. (D5: 78.49%; D6: 21.50%); 39-41 y.o. (D5:75.70%;D6: 24.29%); ≥ 42 y.o. (D5:69.44%; D6: 30.55%); OD (D5: 87.5%; D6: 12.5%). Data showed that maternal age ≥ 42 y.o. affects negatively cLBRs even after euploid SET, suggesting that other factors age-related, rather than aneuploidies, influence implantation. Interestingly, these factors do not affect OD recipients, with advanced maternal age, who, instead, reach successful LBRs like patients ≤ 34. Limitations, reasons for caution These results should be evaluated carefully because of the small sample size of the OD patients. A greater number of OD cycles are needed to verify the results obtained. Wider implications of the findings Our findings suggest that embryonic age-related factors - changes in gene expression, metabolism or epigenetics - could influence the embryo capability to, successfully, support implantation other than the ploidy status. This thesis was supported by the OD recipient’s behavior, who had cLBRs comparable to young autologous patients. Trial registration number Not Applicable

P-186 Embryos developing within the optimal morphokinetic range have a 5% higher chance of leading to a Live birth (LB)

Abstract Study question Is there an optimal range of morphokinetic parameters that have a higher LB rate, if so what is the percentage of LB improvement? Summary answer Optimal embryo development range in morphokinetic parameters was identified in t6, t8, tB, t8-t4 and t8-t2 leading to a 5% improvement in LB. What is known already Achieving LB is the main objective in IVF. Traditional embryo assessment based on morphology has drawbacks, with variability among embryologists and limited predictive ability for a single-day assessment. The emergence of AI in IVF, exemplified by CHLOE-EQ, an embryologist’s tool to register embryo morphokinetics and other parameters, presents a solution. This study investigates whether AI-detected morphokinetic parameters can significantly improve LB rates, providing a more precise and predictive approach to embryo assessment. This study investigates if embryos that lead to LB develop under specific morphokinetic optimal ranges. Study design, size, duration Conducted across multiple centres within a private clinic, this retrospective study investigated 7156 embryos with known birth outcome between January 2021 and January 2023. Participants/materials, setting, methods Absolute (tPNf to tEB) and interim morphokinetic parameters that have been previously been found to impact embryo development (CC1, CC2, CC3, S2, S3, t5-t2, t8-t4, t8-t2, tEB-tSB) were automatically annotated by an AI model (CHLOE-EQ, Fairtility Ltd). The interquartile range (Q1-Q3) of embryos that resulted in live birth was analyzed to identify the optimal range. Chi-square analysis compared live birth rates between embryos within and outside this range. Main results and the role of chance A significant Live birth optimal range was found for t6 (47.8-57.3), t8 (51.8-65.8), tB (100.9-113.6), t8-t4 (15.2-25.5), t8-t2 (26.9-39.2), p &amp;lt; 0.05. The following morphokinetic parameters were associated with higher LB rate when the embryo was within the optimal range hours as compared to outside the optimal range: t6 (38%, n = 1012 vs 35% n = 1007, p &amp;lt; 0.05), t8 (38%, n = 947 vs 35%, n = 941, p &amp;lt; 0.05), tB (33%, n = 548 vs 30%, n = 533, p &amp;lt; 0.05), t8-t4 (38%, n = 926 vs 34%, n = 943, p &amp;lt; 0.05), t8-t2 (38%, n = 938 vs 35% n = 936, p &amp;lt; 0.05). No significant LB rate differences were observed for other morphokinetics. Overall, LB rates improved by 3-5% in embryos developing at the optimal rate, with a slightly higher significance in absolute morphokinetic values over interim ones. Limitations, reasons for caution The study’s retrospective nature entails inherent biases. Additionally, this analysis does not account for oocyte origin and male factor as bias elements, which will be considered in future research. Thus results may not be transferrable to clinics that have other clinical practices and different patient demographics. Wider implications of the findings Certain morphokinetic parameters can be added to the already existing range of available LB evaluation methods. Future studies should explore diverse morphokinetic ranges to identify additional optimal intervals for each parameter. AI tools can facilitate automatic annotation and measurement of embryo morphokinetics, enhancing precision in assessment. Trial registration number Not applicable

Gender stereotypes in eating disorder recognition

PurposeEating disorder (ED) awareness is low. We assessed if ED symptom recognition, perceived need for treatment, perceived distress, perceived acceptability, and perceived prevalence differed depending on the gender of the individual with the ED.Methods276 community participants were randomly assigned to one of three gender conditions (female, male, and non-binary), read three vignettes describing three different individuals with ED symptoms [anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED)], and then answered a series of questions related to participants ED symptom recognition, perceived need for treatment, perceived distress associated with having ED symptoms, perceived acceptability (e.g., the extent to which it may not be too bad to have an ED), and perceived prevalence. Mixed ANOVAs and chi-square analyses were conducted to examine differences between groups.ResultsThere were no significant main effects of gender condition across the outcome variables. There were main effects of ED type for problem recognition, perceived need for treatment, perceived level of distress, and perceived prevalence, with participants being more likely to recognize a problem in the AN and BN vignettes than the BED vignettes, refer for treatment and rate a higher perceived level of distress in then AN vignette than the BN and BED vignettes, and perceive a higher prevalence rate in the BN vignette than the AN vignette. There was a significant gender by condition interaction for perceived prevalence, with participants rating a higher prevalence of AN in women and non-binary individuals than men and a higher prevalence of BN in women than non-binary individuals and men.ConclusionThese results highlight the importance of education on EDs and awareness that EDs can occur in any individual, regardless of their gender identification.Level of evidenceLevel I, experimental study with randomization.

Risk practices and awareness of leptospirosis amongst residents of Zaria, Nigeria

This study evaluated the level of risk practices and awareness of leptospirosis among residents of Zaria, Nigeria. A pre-tested questionnaires were administered via face-to-face interview to 100 residents. The data was analyzed using chi-square and multivariate analysis to identify risk factors for leptospirosis. The demography showed that the majority of the respondents were male, aged 21–40 years, and majorly crop farmers. The risk factors identified showed that males were 4.14 times more likely to be affected by leptospirosis (OR 4.14, 95% CI [1.93–5.37], p = 0.02) and the source of animal’s water was 5.56 times more likely to be contaminated by Leptospira spp. (OR 4.14, 95% CI [2.88–8.03], p = 0.01) and these relationships were significant. The majority of respondents were not aware of the disease (OR 1.87, 95% CI [1.22–4.57], p = 0.01) with 78% of the respondents not sure of which of the animal species leptospirosis affected (OR 1.67, 95% CI [1.07–2.62], p = 0.02). This study has demonstrated the existence of risk behaviors, and paucity of knowledge about leptospirosis in the study area. It is therefore recommended to organize an enlightenment program and the need for protective clothing for individuals occupationally at risk of infection by Leptospira spp.

Relationship Between Physical Activity and Body Mass Index with Uric Acid Levels in The Community

Physical activity is related to uric acid levels in the blood, and an increase in body mass index (BMI) is associated with an increase in uric acid levels due to increased triglyceride synthesis in the liver associated with increased purine synthesis by new routes, thereby accelerating uric acid production. The results of Riskesdas in 2018 showed the number of joint diseases from the weighted average results in Ogan Komering Ulu Regency was 1,040. This study aims to determine whether there is a relationship between BMI, physical activity, and uric acid levels in the community in Sukaraya Village, East Baturaja District, Ogan Komering Ulu Regency in 2023. This study used an accidental sampling method with a cross-sectional approach and involved 67 respondents with criteria aged between 26 and 45 years, living in Sukaraya Village, being able to read and communicate well, and being willing to be respondents, while the exclusion criteria in this study were not willing to be respondents and could not communicate, and willing to be a respondent, while the exclusion criteria in this study are not willing to be a respondent and cannot be communicated with. The instruments used were the International Physical Activity Quitioner (IPAQ) questionnaire to measure physical activity, scales to measure body weight and height, and uric acid sticks and digital devices (easytouch) to measure uric acid levels. Data were processed using SPSS and chi-square analysis to determine the relationship between the independent variable and the dependent variable. The results of chi-square data analysis showed a relationship between physical activity and uric acid levels (p-value 0.005) and a relationship between BMI and uric acid levels (p-value 0.000). Physical activity and BMI index correlate with uric acid levels in residents in Sukaraya Village, East Baturaja District, Ogan Komering Ulu Regency. It is necessary to increase knowledge about joint health for the community by providing counseling on joint health and also holding activities such as gymnastics so that physical activity and body mass index can be controlled so as to reduce the risk of high uric acid levels.

Prevalence and characteristics of paediatric burns at the National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Ghana

IntroductionBurn injuries among children have emerged as a significant global public health concern, accounting for substantial morbidity and mortality worldwide. Low and Middle-Income Countries bear a significant burden of paediatric burn injuries. In Ghana, limited data exists on the prevalence, characteristics and outcomes of paediatric burns. This study provides vital data on the local burden and epidemiology of paediatric burns at Ghana’s main burns treatment center. The findings have significant value in informing prevention strategies, allocating resources, and improving quality of paediatric burn care. Study objectiveTo establish the prevalence and characteristics of paediatric burns injuries in Ghana’s leading burn center. MethodologyA retrospective cohort study analyzed data from 662 adult and paediatric patients who presented with burns from all over Ghana between 2020 and 2022. The study encompassed medical records of paediatric burn cases (aged 0–14 years) admitted to the center from January 2020 to December 2022. A purposive sampling technique was used to select cases based on the inclusion criteria and elimination of cases with 20 % missing data. A total of 335 paediatric records were reviewed. Data analytical methodsDescriptive statistics, such as frequencies, mean, percentages were used to establish period prevalence and demographic characteristics of paediatric burns. Chi-square analysis and univariate logistic regression was utilized to explore associations between categorical variables, and predictors of burn outcome. ResultsThe period prevalence of paediatric burns was found to be 50.6 %. Paediatric burn cases predominantly affected males (57.6 %). Majority of cases fell within the age range of 1 to 5 years (70.1 %). Hot water emerged as the leading cause (58.4 %), whiles superficial partial thickness burns (51.9 %) was the predominant type of burn. Most cases involved burns affecting less than 20 % Total Body Surface Area (59.0 %). Multi-part body injuries were common (87.2 %), with the lower limb being the most affected (25.36 %). The mortality rate was calculated to be 21.0 %. Higher TBSA was a significant predictor of mortality (p < 0.001). ConclusionThis study found a high prevalence of paediatric burns with hot water and foods being the predominant causes. Higher TBSA predicted lower chances of survival. The findings have scientific value in informing prevention strategies, allocating resources, and improving the quality of care.