Chi-square Research Articles

Epidemiological characteristics of pediatric patients with COVID-19 in General Cabrera, Córdoba, Argentina, across 3 periods of the pandemic.

Introduction. The onset of the SARS-CoV-2 pandemic raised questions about its behavior in different scenarios. Objective. To describe the clinical and epidemiological behavior of COVID-19 in pediatric patients living in an agricultural-industrial city across 3 periods (2020 to 2022). Population and methods. Observational, analytical study of children under 18 years diagnosed with COVID-19 in General Cabrera. Sex, age, symptoms, comorbidities, hospitalization, and death were analyzed. The χ² test was used to analyze the association between symptoms and period and the KruskalWallis test, to analyze differences in symptom duration per period. Confidence level: 95%. Results. In the study period, 194 cases in children under 18 years were confirmed. Only 1% required hospitalization; no deaths were recorded. Children's median age was 14 years; 51% were boys; 68% were asymptomatic; 2% had associated comorbidities. Conclusion. SARS-CoV-2 infection was low in pediatrics and showed a distinct behavior by period.

Evaluating the Evidence Base for TikTok Videos on Strategies for Becoming Pregnant

The top 100 TikTok videos under the hashtag “#ttc” (trying to conceive) that featured strategies to improve the chances of becoming pregnant without treatment were assessed for medical accuracy. Videos were also characterized by creators’ professional qualifications and each video’s potential for profit through marketing links. Descriptive statistics and χ2 tests were used to examine relationships among these domains. More than half (57.0%) of the videos highlighted strategies that do not have a scientific evidence base. Health care professionals were less likely to promote misinformation than non–health care professionals (P<.001), but the majority of top content was created by nonprofessionals (62.0%). Non–evidence-based information was featured in 72.2% of for-profit videos. This study demonstrates high exposure and engagement with misinformation among people who are trying to become pregnant.

Mycoplasma pneumoniae incidence, phenotype, and severity in children and adolescents in Denmark before, during, and after the COVID-19 pandemic: a nationwide multicentre population-based cohort study

Mycoplasma pneumoniae infections resurged globally in 2023-2024 after a three-year decline during the COVID-19 pandemic. We explored the incidence and severity of M pneumoniae infections in children and adolescents before, during, and after the pandemic. This nationwide, population-based cohort study included all Danish children and adolescents aged 0-17 years with a positive M pneumoniae PCR test from May 1, 2016, to April 30, 2024. We obtained clinical details for patients hospitalised for 24h or more. Risk ratios for infections, hospitalisations, and disease manifestations in 2023-2024 versus pre-COVID-19 seasons were calculated using Fisher's exact and Pearson's χ2 tests. A season was defined from May 1 to April30. Among the Danish population of 1,152,000 children and adolescents, 14,241 with a positive PCR test for Mpneumoniae were included. In 2023-2024, children and adolescents with a positive PCR rose 2.9-fold (95% CI 2.8-3.1; p<0.0001) compared to the pre-COVID-19 seasons, and hospitalisations rose 2.6-fold (95% CI 2.0-3.3; p<0.0001). Mpneumoniae-induced rash and mucositis increased 5.3-fold (95% CI 1.8-15.3; p=0.0007). In 2023-2024 compared to the pre-COVID-19 seasons, there was no difference in the proportion of hospitalisation (360 [4%] of 8165 versus 230 [4%] of 6009; p=0.09), the median duration of hospital stay (3 days [IQR 2-5] versus 3 days [IQR2-5]; p=0.84), or paediatric intensive care unit admission (14 [4%] of 360 versus 9 [4%] of 230 p=1.00). In Denmark, M pneumoniae infections and hospitalisations increased three-fold in 2023-2024 compared with the pre-COVID-19 seasons, indicating an immunity debt caused by the decline in M pneumoniae during the COVID-19 pandemic. While the severity of M pneumoniae infections did not change in 2023-2024, the five-fold increase in M pneumoniae-induced rash and mucositis in children and adolescents highlights Mpneumoniae as an important pathogen causing mucocutaneous eruptions. Innovation Fund Denmark and Rigshospitalets Forskningsfond.

Normative Data for the D-KEFS Color-Word Interference and Trail Making Tests Adapted in Greek Adult Population 20-49 Years Old.

This study was designed to adapt the Delis-Kaplan Executive System (D-KEFS) version of the Color-Word Interference (CWIT) and Trail Making Tests (TMTs) for the Greek adult population from 20 to 49 years old, since it is of research as well as clinical importance to detect executive functions' impairment in young adults with neurological or/and psychiatric conditions. Norms for the Greek adult population have been calculated to be available for neuropsychologists and health professionals who work in relevant settings. The study sample consisted of 101 healthy adults (41% male and 60% female) aged 20 to 49 years (M = 32.16, SD = 11.57) with education from 12 to 19 years of schooling (M = 14.51, SD = 0.89). A Pearson correlation test as well as a chi square test were conducted to examine potential associations between gender, age, education, and participants' performance. Afterwards, we calculated normative data using raw scores and transformed them into percentile scores. Finally, Greek norms were compared to the original raw scores, which were transformed into scaled scores by Delis et al. (2001). The findings showed that age was the only variable which affected CWIT, whereas level of education as well as age were predictive factors for most TMT conditions, except for the visual scanning test (Condition 1). Gender did not affect both tests. Finally, D-KEFS norms for CWIT and TMT are available for the Greek adult population to help clinicians detect executive functions' deficits and therefore adjust tailored therapeutic strategies. Additionally, it is of great importance to use these tests for research purposes. Given that executive functions are assumed as high-level skills, which are highly related to everyday functionality, adapted tests contribute not only to assess the progression of any existing neurological as well as psychiatric disorders, but they can also be used to evaluate patients' ability to live independently, as well as their access to work.

A study to assess the effectiveness of informational booklet on knowledge regarding early signs and immediate management of myocardial infarction among the undergraduate students in selected colleges in Udupi

Methods: An evaluative approach with pre-experimental, one group pretest posttest design research design, were used to assess the effectiveness of informational booklet on knowledge regarding early signs and immediate management of myocardial infarction among undergraduate students. In the view of nature of the problem and accomplish the objectives of the study, a structured self-administered knowledge questionnaire was prepared to assess the knowledge among undergraduate students regarding early signs and immediate management of myocardial infarction. Reliability of the tool was tested and validity was ensured in consultation with guides and experts in field of Nursing and Medicine. The pilot study was conducted from 7/6/23 to 14/6/23 after obtaining permission from Dr. G Shankar Government Women’s First Grade College, Udupi. The final study was conducted from 17/6/23 to 24/6/23 after obtaining permission from the authority of Poornaprajna College, Udupi. Subjects were chosen by purposive sampling technique. The researcher introduced self to the subjects and purpose of the study was explained. She obtained written consent from those who were willing to participate in the study. Instructions were given and the tool was administered. Pretest was conducted on 17/6/23 at 9.00 am onwards. Time to conduct pre test was about 35 mts and on the same day informational booklet was given. The respondents were thanked at the end of the class. Post test was conducted on 24/6/23. Results: The mean post-test knowledge scores 28, is higher than mean pre-test knowledge scores 11.5. The computed value 22.59 (p &lt;0.05) showed that there is highly significant difference between the pretest and post-test mean knowledge scores 16.5. Hence, hypothesis H1 is accepted. This indicates that the informational booklet is effective in increasing the knowledge scores on early signs and immediate management of myocardial infarction.The chi square value of like variable such as age, gender, religion, class of study, dietary pattern, area of residence, previous information and source of information at 0.05 level of significance does not show any significant association. Hence, the hypothesis H2 is rejected. Interpretation and conclusion: The study revealed that during pretest majority 83 (83%) undergraduate students had poor knowledge level, 17 (17%) had moderate knowledge on early signs and immediate management of myocardial infarction. During posttest majority of 49 (49%) gained excellent knowledge, 48 (48%) got good knowledge and 3 (3%) undergraduate students gained moderate knowledge. This indicates that the informational booklet is effective in increasing the knowledge scores on early signs and immediate management of myocardial infarction. There was no statistically significant association found between knowledge score and demographic variables.

Acute hepatitis in children: A wide clinical spectrum

Introduction: Acute hepatitis remains an important health problem in children. viral hepatitis particularly hepatitis A remains the most common cause. Nevertheless, other causes such as non A non B hepatitis and mixed infections like enteric fever are other causes particularly in developing countries like India. The spectrum of acute hepatitis is also varied with many atypical presentations in the form of fever along with icterus as presenting features. Use of lab parameters as prognostic markers for development of acute liver failure (ALF) needs further exploration as it can be used to identify patients who need better monitoring and may be the potential candidates for liver transplantation. In our study we have tried to find a possible association between liver enzyme values and number of children who develop ALF. Methods: Children between 1 and 15 years of age who presented with features of acute hepatitis were enrolled in the study after taking informed consent from their parents. Data was collected about their epidemiological and clinical characteristics in a predesigned study performa. Quantitative data were described as means and standard deviations and qualitative data were computed into frequency (No) and percentages (%). Chi-square (χ2) test was used to determine the statistical difference between the categorical variables, while means were compared using student’s t test. For all statistical analyses, p value &lt; 0.05 was adopted as level of significance. Results: We enrolled 68 patients of acute hepatitis. Most of them were males (78%) and majority were in 6 to 10 years age category. The most common clinical presentation was with abdominal pain followed by fever and icterus. Liver enzymes were raised to the tune of 10 to 20 times in the second week of illness. Serum bilirubin mean value was 5.3. Serum bilirubin values remained almost constant over 3 weeks period while liver enzymes showed a decline. 26% patients presented with ALF. Also, liver enzyme values in the second week showed a positive association with development of ALF with higher values associated with a higher chance of development of ALF. Conclusion: Hepatitis A was the most important cause of acute hepatitis in children and albeit early, a significant proportion of them develop features of ALF. Regular monitoring of liver enzymes can serve as a prognostic marker for development of ALF. It requires larger level studies to use liver enzymes as prognostic markers of ALF in paediatric patients.

Effects of Heavy Grazing on Interspecific Relationships at Different Spatial Scales in Desert Steppe of China

This study investigates the effects of grazing intensity and spatial scale on the important values, interspecific relationships, and community stability of desert steppe plant communities in Siziwang Banner, Inner Mongolia, China. Using vegetation data collected at three spatial scales (50 m × 50 m, 25 m × 25 m, and 2.5 m × 2.5 m) under two grazing conditions (no grazing and heavy grazing), we employed ecological statistics, including variance ratio analysis, χ2 tests, and the Jaccard index, to analyze species interactions and community structure. The results indicated that the important values of species vary with both spatial scale and grazing intensity; for example, Stipa breviflori and Chenopodium aristatum exhibited significantly higher important values in heavily grazed areas. Larger spatial scales enhanced the dominance of Cleistogenes songorica and Chenopodium aristatum, while smaller scales favored Stipa breviflori and Caragana stenophylla. Furthermore, interspecific associations were stronger in heavy grazing conditions. The community demonstrated consistent instability; however, no grazing areas were more stable than heavily grazed ones. These findings highlight that species importance, interspecific relationships, and community stability are closely linked to grazing intensity and spatial scale, emphasizing the critical role of sustainable grazing management in maintaining the long-term stability and resilience of desert steppe ecosystems. By emphasizing the need for targeted and sustainable management strategies, this study aims to contribute to the restoration and preservation of these vital ecosystems.

Short-term fluctuation of intraocular pressure and influencing factors following intravitreal injection in patients with retinal vascular diseases

AIM: To investigate the patterns of short-term intraocular pressure (IOP) fluctuations and identify the contributing factors following intravitreal injection in patients with retinal vascular diseases. METHODS: Totally 81 patients were enrolled in this case control study. Eyes were categorized into 7 groups, including age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV), idiopathic choroidal neovascularization (CNV), proliferative diabetic retinopathy (PDR), diabetic macular edema (DME), macular edema secondary to branch (BVOME) and central (CVOME) retinal vein occlusion. IOP was measured in all patients using rebound tonometer at 7 preset time points perioperatively. Additionally, based on the administered medication, the eyes were classified into three treatment groups, including dexamethasone intravitreal implant (IVO), intravitreal conbercept (IVC), and intravitreal ranibizumab (IVR). To compare IOP values at various time points across groups, we employed one-way ANOVA, independent sample t-test or χ2 test and multivariate logistic regression analysis. RESULTS: Peak IOP values across all groups were observed at 40s, and 5min after intravitreal injection. Statistical differences in IOP were detected at the 5min among the 7 indication groups (F=2.50, P=0.029). When examing the impact of medications, the IVO group exhibited lower average IOP values at both 40s and 5min compared to the IVC and IVR groups (P&amp;#x003C;0.001; P=0.007). The IOP values at 40s and 5min were significantly higher in BVOME and CVOME group compared to non-retinal vein occlusion-secondary macular edema (RVOME) group (P&amp;#x003C;0.001). Multivariate logistic regression analysis further confirmed that IOP measurement at 40s was significantly higher in CVOME group than in non-RVOME group (OR=1.64, 95%CI: 1.09-2.47; P=0.018). CONCLUSION: Needle size plays a crucial role in the transient changes of IOP following intravitreal injection. Before administering intravitreal injection to patients with central retinal vein occlusion, it is essential to exclude any underlysing causes of increased IOP.

Effect of Intravenous Contrast on CT Body Composition Measurements in Patients with Intraductal Papillary Mucinous Neoplasm

Background: The effect of differing post-contrast phases on CT body composition measurements is not yet known. Methods: A fully automated AI-based body composition analysis using DAFS was performed on a retrospective cohort of 278 subjects undergoing pre-treatment triple-phase CT for pancreatic intraductal papillary mucinous neoplasm. The CT contrast phases included noncontrast (NON), arterial (ART), and venous (VEN) phases. The software selected a single axial CT image at mid-L3 on each phase for body compartment segmentation. The areas (cm2) were calculated for skeletal muscle (SM), intermuscular adipose tissue (IMAT), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). The mean Hounsfield units of skeletal muscle (SMHU) within the segmented regions were calculated. Bland–Altman and Chi Square analyses were performed. Results: SM-NON had a lower percentage of bias [LOA] than SM-ART, −0.7 [−7.6, 6.2], and SM-VEN, −0.3 [−7.6, 7.0]; VAT-NON had a higher percentage of bias than ART, 3.4 [−18.2, 25.0], and VEN, 5.8 [−15.0, 26.6]; and this value was lower for SAT-NON than ART, −0.4 [−14.9, 14.2], and VEN, −0.5 [−14.3, 13.4];] and higher for IMAT-NON than ART, 5.9 [−17.9, 29.7], and VEN, 9.5 [−17.0, 36.1]. The bias in SMHU NON [LOA] was lower than that in ART, −3.8 HU [−9.8, 2.1], and VEN, −7.8 HU [−14.8, −0.8]. Conclusions: IV contrast affects the voxel HU of fat and muscle, impacting CT analysis of body composition. We noted a relatively smaller bias in the SM, VAT, and SAT areas across the contrast phases. However, SMHU and IMAT experienced larger bias. During threshold risk stratification for CT-based measurements of SMHU and IMAT, the IV contrast phase should be taken into consideration.

Influence of teachers’ appraisal on teaching methods on students’ academic performance in public schools for Kenya certificate of secondary education

The Universal Declaration of Human Rights has declared that education is fundamental human rights to the well-being of any society. Therefore, the study was motivated by the need to improve students’ academic performance in Kenya Certificate of Secondary Education examination, a case in Laikipia County, Kenya. The study was guided by one objective. To examine how appraisal of teachers teaching methodology influences students’ performance in Kenya Certificate of Secondary Education in Laikipia County. The study targeted 94 public secondary schools which comprises of 94 principals and 1100 teachers in Laikipia County. Purposive sampling was used to select 45 principals while simple random sampling was used to select 300 teachers. Questionnaires were used to collect data from principals and teachers. The findings of the null hypothesis there is no significant relationship between teacher appraisal on teaching methods and students’ academic performance using Chi square test was = 0.9625 3.84l. The null hypothesis was rejected hence there is a significant relationship between teacher appraisal on teaching methods and students’ academic performance. The study recommends TSC to establish, amend, the current appraisal process and provide professional development growth of teachers to enable them to be motivated when preparing and planning for instruction. To teachers, there is need to have high levels of commitments in preparation and planning, use of relevant teaching /learning materials and use diverse methods which leads to quality teachings and learning process in all classes

Factors Militating the Effective Utilization of the Nursing Process in Patient Care: A Descriptive Survey of Nurses in a Tertiary Hospital in North West, Nigeria

Nursing process is the systematic, patient-centered approach used by nurses to guides individualized nursing care; thereby enhance quality of patient care and outcomes for both the patient and family members, as an organized framework for the practice of nursing. The purpose of this study was to investigate the factors militating against effective utilization of nursing process in patient's care among nurses in a Tertiary Hospital in north-west, Nigeria. The research design employed in the study was across sectional survey, sample size of 108 but 97 valid for data analysis. The nurses who were proportionately selected participated in the study. The data were derived from the administration of copies of questionnaire. The instrument was validated by the researcher’s supervisor and two other experts from faculty of nursing Ladoke Akintola University of technology. A Cronbach’s alpha reliability coefficient of 0.82 is indicative of the reliability of the instrument. Data collected were analysed using SPSS version 20 version. Hypothesis was tested using Chi square set at p value 0.05. The findings revealed that greater number (92%) understood that nursing process is a problem solving technique for nurses and (80, 83%) utilizes nursing process in patients care. Majority of participants 63.9% (Mean = 1.71) established that shortage of human resources, 59.8% (Mean = 1.86) lack motivation and 53.6% (Mean = 1.53) different approaches adopted by nurses were seen to impact the use negatively. Experience, and educational Level were statistically found to be significant determinants for nursing process utilization (p=0.00, and 0.02). Based on the findings, it can be concluded that there exist a significant relationship between nurse’s years of experience and knowledge of nursing process utilization and the rate of utilization. Recommendation that adequate and relevant materials be provided for nurses in order to achieve and perform their respective tasks at the optimal best, the management should equally employed more nurses to breech the chronic shortage of man power.

Prevalence of Kala-Azar and Its Contributing Factors Among Rural Population in Selected Community of West Bengal

Background: Kala-azar is a serious form of leishmaniasis. It is a long-term infectious disease. The study was aimed to assess the prevalence of Kala-azar, and it’s contributing factors among the rural population. Methods: In this retrospective study population was previously treated Kala-azar patients (Visceral Leishmaniasis and Post Kala-azar Dermal Leishmaniasis) from 2017 to 2021. The settings were villages under Kushmondi and Harirampur Rural Hospital under Dakshin Dinajpur. 90 samples were selected through Non-Probability Purposive sampling technique. Demographic data were collected by applying Semi structured interviewed schedule. Record analysis format was used to identify the prevalence of Kala-azar and the disease profile. An observational checklist and structured interview schedule were used to assess the contributing factors of Kala-azar. Results: Maximum prevalence of Kala-azar (1.4%) seen in the year 2017. There were statistically significant mean differences among the contributing factors as the ANOVA test calculated F-value (2507.18) is higher than table value of F (2.60) with df (3, 356) at 0.05 level of significance. Environmental factors contributed more than other factors as the mean value (13.00) was more than other factors. There is a statistically significant relation between environmental factor with utilization of services, economic factors with socio- cultural factors &amp; utilization of services, as well as socio- cultural factors with utilization of services as the p-value is &lt;0.05, at 0.05 level of significance. There was a statistically significant association between contributing factors and selected demographic variables like age, gender as the calculated value of chi square 7.391 and 4.888 is higher than table value c² (df)2=5.99 p ,c² (df)1=3.84 p &lt;0.05 at 0.05 level of significance. Conclusion: The study has implications in nursing practice through the awareness of the rural population about the contributing factors of Kala-azar. The study concluded that the trends of prevalence were decreasing in nature and the environmental factors contributed more than other factors. Keywords: Prevalence, Kala-azar case, Environmental factors, Economic factors, Socio- cultural factors &amp; Utilization of services.

Fractures in the Transgender Population: A Retrospective Study

Introduction. While data on the bone health of transgender individuals exist, less is known about related fractures. The authors aimed to compare the anatomic locations of and impact of co-morbidities on fractures between transgender and cisgender populations at a single institution. Methods. The authors conducted a retrospective chart review of patients with fractures at a single institution between January 2020 and January 2021. Demographics, fracture locations, and comorbidities were identified and compared between cisgender and transgender individuals. Statistical analyses included χ2 or Fisher exact tests for proportions and independent t-tests or Wilcoxon rank-sum tests for continuous measures. Results. Transgender patients, compared to cisgender patients, were younger (W=258823, p&lt;0.001) and had a higher incidence of shoulder/upper arm fractures (10/26 [38%] vs 1,847/12,463 [15%], p=0.003) but no lumbar spine fractures. There were no other significant differences in fracture locations. The transgender group had a higher prevalence of depression (14/26 [54%] vs 2,696/12,463 [22%], p&lt;0.001), while hypertension was more common in the cisgender population (6,211/12,463 [50%] vs 5/26 [19%], p=0.003). While most fractures in the transgender group were not due to high-energy trauma, none of the individuals had a history of bone mineral density disorders. Conclusions. Our findings show that there were no significant differences in fracture locations between transgender and cisgender patients, except at one site. Larger studies, including longitudinal prospective studies, are needed to better understand bone health and fracture risk among transgender patients, particularly regarding changes over time with gender-affirming treatment.

Epidemiology of cleft lip and palate in Bhutan, 2015-2022.

The epidemiology of cleft lip (CL) and cleft palate (CLP) has not previously been described in the context of the Bhutan and Bhutanese populations. Using National Birth Defects Surveillance Data and other vital statistics, we present the comprehensive epidemiology of the cleft lip and palate in Bhutan. The National Birth Defects Surveillance Data Registry from 2015 to 2022 is reviewed retrospectively, covering 8 years of birth defect surveillance in the country from records maintained with three referral hospitals in the country. The baseline prevalence and incidence of cleft lip and palate have been presented over the years. The incidence of cleft lip and palate was defined as the number of cases per 1000 live births. We used Poisson's regression to compute the incidence of cleft lip and palate. Pearson chi-square tests (χ2) were used to examine the associations of maternal and child characteristics with cleft lip and palate. A total of 1401 newborns with various birth defects were born among the 89,078 live births from 2015 to 2022 in Bhutan. Of these, 122 (8.7%) constituted orofacial clefts. The prevalence of orofacial clefts tended to increase, with a period prevalence of 1.37 per 1000 live births. There were more cases in males (72) than in females (50). The incidence rate ratio ranged from 1.2 to 2.0 compared with the 2015 baseline year, indicating increased rates over time. Orofacial clefts constituted 8.7% of total birth defects and 1.37 per 1000 live births over the years. The increasing prevalence trends and incidence rate ratios over the years underscore the importance of ongoing surveillance and interventions to address the burden of orofacial clefts in Bhutan. Not applicable.

T1 mapping-based radiomics in the identification of histological types of lung cancer: a reproducibility and feasibility study.

T1 mapping can quantify the longitudinal relaxation time of tissues. This study aimed to investigate the repeatability and reproducibility of T1 mapping radiomics features of lung cancer and the feasibility of T1 mapping-based radiomics model to predict its pathological types. The chest T1 mapping images and clinical characteristics of 112 lung cancer patients (54 with adenocarcinoma and 58 with other types of lung cancer) were collected retrospectively. 54 patients underwent twice short-term T1 mapping scans. Regions of interest were manually delineated on T1 mapping pseudo-color images to measure the mean native T1 values of lung cancer, and radiomics features were extracted using the semi-automatic segmentation method by two independent observers. The patients were randomly divided into training group (77 cases) and validation group (35 cases) with the ratio of 7:3. Interclass correlation coefficients (ICCs), Student's t-test or Mann-Whitney U tests and least absolute shrinkage and selection operator (LASSO) were used for feature selection. The optimum features were selected to establish a logistic regression (LR) radiomics model. Independent sample t-test, Mann Whitney U-test or chi square test were used to compare the differences of clinical characteristics and T1 values. Performance was compared by the area under the receiver operating characteristic (ROC) curve (AUC). In the training group, smoking history, lesion type and native T1 values were different between adenocarcinoma and non-adenocarcinoma patients (P = 0.004-0.038). There were 1035 (54.30%) radiomics features meet the intra-and inter-observer, and test-retest reproducibility with ICC > 0.80. After feature dimensionality reduction and model construction, the AUC of T1 mapping-based radiomics model for predicting the pathological types of lung cancer was 0.833 and 0.843, respectively, in the training and validation cohorts. The AUCs of T1 value and clinical model (including smoking history and lesion type) were 0.657 and 0.692 in the training group, and 0.722 and 0.686 in the validation group. Combined with T1 mapping radiomics, clinical model and T1 value to establish a combined model, the prediction efficiency was further improved to 0.895 and 0.915 in the training and validation groups. About 50% of the T1 mapping-based radiomics features displayed relatively poor repeatability and reproducibility. While T1 mapping-based radiomics model is valuable in identification of histological types of lung cancer despite the measurement variability. Combination of T1 mapping radiomics model, clinical characteristics and native T1 value can improve the predictive value of pathological types of lung cancer.

Potential Prognostic Protein Biomarkers in Tears From Noninfectious Uveitis Patients Under Biologic Treatment as a Prelude to Personalized Medicine.

Adalimumab (ADA) is a systemic biological treatment option approved for the treatment of noninfectious uveitis (NIU); however, up to 40% of patients do not respond to the drug, either in a primary or secondary manner. Here, we evaluated the proteomic profile of patients with NIU who fail to ADA to identify proteins implicated in intraocular inflammation, as well as potential biomarkers for treatment response and novel therapeutic targets. Cross-sectional observational study of patients with NIU under ADA treatment for six or more months. Tears were collected with microcapillary tubes and protein analyzed by data-independent acquisition/sequential window acquisition of all theoretical mass spectra. Differentially expressed proteins (DEPs) were defined based on the fold change between their expression in nonresponders (NR) and responders (R). Protein network and gene ontology analysis were performed. The χ2 test for trend and receiver operating characteristic (ROC) curves were used to evaluate potential biomarkers of treatment response. Twenty-nine DEPs, 14 upregulated and 15 downregulated, were detected in NR. These proteins were mainly related to enhanced neutrophil effector functions and redox imbalance. ROC analysis identified defensin-1,3 (DEF-1,3), biotinidase, and ATP-binding cassette transporter A1 as potential biomarkers for treatment response. This is the first study on a clinical cohort of patients with noninfectious uveitis that identifies tear proteins related to neutrophil hyperactivation as drivers of the persistent intraocular inflammation observed in NR to ADA and provides evidence that targeting interleukin 6, Janus kinases, or the complement cascade could be potential alternative therapeutic strategies in these patients. Our results indicate the potential of high-throughput proteomics to provide insights into the underlying pathological mechanisms of persistent intraocular inflammation observed in patients who do not adequately respond to anti-TNF treatment and the value of tear proteomics as a tool for personalized medicine.

Laparoscopic access is the modern standard for extended liver resection

Objective. To evaluate the safety and early results of laparoscopic extended liver resection in case of focal liver pathology by retrospective comparison with the relevant parameters of a similar open intervention. Materials and methods. The study involved 162 patients who were divided into two groups: Group 1 – 50 patients who underwent laparoscopic extended liver resection, and Group 2 – 112 patients who underwent open extended liver resection. The groups were compared by age structure, sex, body mass index, type of pathology (benign/malignant), as well as by characteristics of surgical intervention and postoperative period. Statistical analysis included a t–test for independent samples, Pearson's chi–square test, and other appropriate methods with the calculation of the confidence level p (parametric criterion). The difference in indicators was considered statistically significant at p &lt; 0.05. Results. Laparoscopic osshire for liver resection was longer (p = 0.0012), but was associated with a lower level of pain according to the visual analog scale (p = 0.02) and fewer bed days to discharge (p = 0.0007) than a similar open intervention. There was no statistically significant difference between the groups in terms of age structure, body mass index, number of liver tumors, blood loss, complication rate, and degree of ischemic liver damage. Conclusions. Laparoscopic extended liver resection is a less invasive method than open liver resection, and patients recover faster after it, although its duration is longer. At the same time, laparoscopic and open intervention had a similar incidence of complications, which indicates acceptable safety and high clinical efficacy of the laparoscopic approach in the treatment of patients with liver disease.

BN SO26 - Predicting successful and safe day-case laparoscopic cholecystectomy: Validation of the Cholecystectomy as a Day Case (CAAD) score

Abstract Background Day case surgery is a major target for the NHS as it improves patient satisfaction and reduces financial costs. The CAAD score, using pre-operative variables from clinic letters and electronic sources, aids in selecting patients for day-case lists. This study assessed the validity of the CAAD score in predicting successful and safe day-case laparoscopic cholecystectomy (LC) at an isolated day unit. Method A retrospective analysis was performed on patients scheduled for elective LC between January 2020 and March 2022. Outcomes (same day discharge rate, length of stay, conversion to open, bile leak, mortality) were stratified by CAAD score (≤5, &amp;gt;5). Statistical analyses included Chi square and independent t-tests using SPSS 28.0. Results 58 patients were analysed.18/38 patients with CAAD ≤5 achieved same day discharge compared to 4/20 with CAAD &amp;gt;5 (p&amp;lt;0.05). 36 patients stayed for ≥1 day. The mean length of hospitalization was 1.38 days (range 1-2) for the 13 patients with CAAD ≤5. 15 patients with CAAD &amp;gt;5 stayed significantly longer i.e. 2.53 days (range 1-10) (p &amp;lt;0.05). Longer stay for scores &amp;gt;5 was due to difficult dissection (13%), conversion to open (13%) and drain insertion (7%). For scores ≤5, reasons were drain insertion, postoperative pain, nausea, and difficult dissection, each at 8%. No major complications were noted in either group. Conclusion The CAAD score is a predictive tool for successful and safe day-case LC, correlating lower scores with higher success rates and shorter hospital stays. Implementing the CAAD score can improve patient selection, potentially reduce unnecessary overnight stays, and support operational efficiency in isolated day units.

OGC SO33 - Resection Margins in Gastrectomy Patients – Are Current Guidelines Fit for Purpose? An Observational Study from a Tertiary Centre

Abstract Background Positive resection margins in cancer surgery are associated with higher likelihood of locoregional recurrence and poor outcomes. The Association of Upper GI Surgeons (AUGIS) outlined a target of less than 5% margin positivity for gastric resections, a goal not met in repeated national audits (NOGCA). Our study aimed to evaluate the positive resection margin rate after a gastrectomy in a tertiary centre and identify associated factors to assess the current guideline's suitability. Our hypothesis is that positive longitudinal margins are more related to tumour factors, such as proximity to the intended margin, rather than poor surgical technique. Method All records of patients who underwent gastrectomy from June 2015 to September 2021 were retrospectively reviewed. Data collection included demographic details, type of gastrectomy, exposure to neoadjuvant chemotherapy, and post operative histopathological information such as tumour differentiation, presence of signet ring (SR) morphology and linitis-plastica (LP), and resection margin(RM) status. Chi square tests of association were utilised to determine associations between the resection margin status and the potential determinant factors. Results Our study included 144 subjects (100 males, mean age 66, range 27-87). Types of gastrectomy were subtotal (38.9%), proximal (4.2%), total (29.2%), extended total (ETG) (27.8%). Positive RMs were found in 13.2%, with 8.3% having positive longitudinal margins and 6.3% positive circumferential margins. Neoadjuvant-chemotherapy was completed by 73% of subjects. Poor tumour differentiation was seen in 59.7%, SR presence in 12.5%, and LP in 3.5%. Significant associations were noted between positive margins and LP (80%, p&amp;lt;0.001) and age (&amp;lt;65: 15%, &amp;gt;=65: 4%, p=0.028). ETGs had double the rate of positive margins (12.5%) than that of other gastrectomies (6.7%,p=0.314). Conclusion The overall positive longitudinal margin rate was higher than the national guideline, replicating NOGCA audits. Our hypothesis was not proved: although the longitudinal positive margin rate in ETGs was almost double that of other gastrectomies, this did not reach statistical significance. Positive margin rates were higher in younger patients, and those with LP. Further large-scale audit is urgently required to determine if the recommended margin rate is appropriate or whether it should be adjusted for factors such as tumour location, presence of LP and age when the risk of a positive margin is higher.

OGC O02 - Measurement of functional, psychosocial, and quality of life impacts of Robotic versus Hybrid Oesophago-gastrectomy

Abstract Background Since the introduction of Robotic-Assisted Minimally-Invasive Oesophago-gastrectomy (RAMIO), comparisons to other surgical approaches have focussed primarily on peri-operative and oncological outcomes. Few studies have focused on quality-of-life measures once the patient has been discharged home. We sought to compare physical, psychosocial, sleep, pain and employment related measures at six weeks following discharge in patients undergoing RAMIO versus Hybrid Oesophago-gastrectomy. Method We performed a prospective cohort study comparing RAMIO and Hybrid Oesophago-gastrectomy. Twenty-five consecutive patients on a curative surgical pathway were recruited to each group. Participants were contacted via telephone pre-operatively and six weeks post-operatively. Parameters studied were: physical activity, social activity, sleep, pain control, and employment. Psychological wellbeing was measured using the Hospital Anxiety and Depression Scale, and quality of life with the European Organisation for Research and Treatment of Cancer questionnaires C30 (all cancer patients) and OG25 (patients undergoing oesophago-gastric cancer treatment). Results were analysed using Chi Square and Mann-Whitney-U statistical tests. Results There were no differences in age, ASA, or anaerobic threshold between study groups. At six weeks the RAMIO group was more likely than Hybrid to have returned to pre-operative physical and social activity (physical 7/25 vs. 1/25, p=0.04, social 13/25 vs. 5/25, p=0.03). The RAMIO group stopped regular analgesia earlier, and required fewer opiates. Patients were more likely to return to work in the RAMIO group (7/15 vs. 1/12,p=0.04). The RAMIO group had fewer cases of depression (2 vs. 9, p=0.03), lower QLQ C30 and OG25 scores, and reported higher overall health and quality of life scores (p=0.001). Conclusion We have demonstrated an improvement in physical and social activity, a faster return to work, a reduction in analgesia requirements, lower rates of depression and improved health and quality of life, six weeks post-operatively when comparing RAMIO to hybrid oesophago-gastrectomy. This study has highlighted additional considerations for the selection of surgical modality in oesophago-gastrectomy beyond peri-operative outcomes. Further investigation across a larger sample size and longer time frame to quantify the full spectrum of potential benefits of robotic oesophago-gastric surgery is warranted.