Chi-square Research Articles

The Relationship Between Knowledge and Early Mobilization in Postoperative Laparatomy Patients in The Inpatient Room RSUD Praya Inpatient Room

Background & Objective: Surgery is an invasive action (affecting the integrity of body tissue) by opening up parts of the body for repair. (WHO) revealed that the number of patients undergoing surgery from year to year has increased significantly. In 2011 there were 140 million patients in all hospitals in the world, while in 2012 there was an increase of 148 million. The purpose of the study was to determine the relationship between knowledge and mobilization in postoperative laparatomy patients. Method: The research design used in this study was analytic observation. The population amounted to 55 laparatomy patients. The sample was 48 laparatomy patients. The sampling technique was purposive sampling. Data analysis using Chi Square. Result: Based on the results of statistical tests of bivariate analysis using the Chi Square test, the results obtained ρ value = 0.000 <0.05 Based on the rules for rejecting the hypothesis, H0 is rejected, this means and H1 is accepted. Conclusion: There is a relationship between knowledge and early mobilization in postoperative laparatomy patients. This means that the better the patient's knowledge about early mobilization, the more aware the patient is of the importance of early mobilization after laparatomy surgery.

Influence of sacroiliac joint variation on clinical features of axial spondyloarthritis: a comparative analysis

ObjectivesAnatomical variation of the sacroiliac (SI) joints is common and specific variants are associated with erosions and bone marrow oedema on imaging. Our investigation aims to evaluate whether anatomical variations...

A Study of Performance-Based Incentive Systems on Employee Engagement in Pharmaceutical Companies in Bhopal

The study identified employee motivation along with performance levels and organizational culture and employee turnover and market competition as major contributors to declining employee engagement within Bhopal's pharmaceutical industries. The research investigated the relationship between work engagement and performance dynamics in pharmaceutical organizations operating in Bhopal through this study. Researchers built their investigation on the Two Factor Theory which Frederick Herzberg introduced in 1959. A survey research methodology allowed the study to analyze senior personnel working at 136 pharmaceutical production businesses operating within Bhopal. The analysis utilized Percentage method and Chi square method to validate the created hypotheses. Employee work engagement demonstrated a powerful positive association with performance-based incentive systems across Bhopal's pharmaceutical sector businesses. Workers exhibited higher engagement levels whenever receiving performance-based incentives and complementary benefits according to study results. Organizational regulation consistency depends on including performance-based incentives according to the research findings. A definition of performance-based evaluation standards needs to be established to determine employee qualification for incentives.

Methicillin-resistant Staphylococcus aureus (MRSA) carriage among the critical care personnel in a tertiary care hospital in Sikkim: An observational study

Background & objectives Persistent nasal colonisation of methicillin-resistant Staphylococcus aureus (MRSA) among healthcare personnel (HCP) remains a significant challenge. MRSA carriers are crucial to the spread of the infection, with healthcare professionals often acting as vectors for both hospital- and community-acquired MRSA. This study aimed to evaluate the MRSA carriage rate among healthcare professionals from critical care units at a tertiary care hospital in Gangtok, Sikkim. Furthermore, the study undertook to analyse antibiotic susceptibility patterns of isolated MSSA and MRSA strains, and identify associated risk factors for MRSA infection. Methods Three hundred samples from healthcare workers (HCW) posted in the critical care units of a tertiary care hospital were cultured and identified by routine biochemical methods. Antibiotic susceptibility test was performed by Kirby Bauer disk diffusion method for all MRSA and MSSA isolates. Association with various risk factors was understood by the Chi square test. Results Nineteen of the 300 participants were identified as nasal MRSA carriers having an overall carriage rate of 6.33 per cent in this study. The prevalence of MRSA was seen to be the highest among the attendants (9.52%), and the highest carriers were from the surgical Intensive Care Unit (ICUs). All the MRSA and MSSA isolates showed 100 per cent resistance to penicillin and 100 per cent susceptibility to linezolid. A significant correlation among hand hygiene practices and patient contact was reported from this study. Interpretation & conclusions Despite existing infection control policies, the MRSA carriage seen in HCWs in critical care units was 6.33 per cent, highlighting the need for regular systematic screening and decolonisation of all healthcare professionals to decrease the carrier status and prevent the spread of infection.

The Effect of Vitamin D Level on The Prediction of The Success of Secondary Alveolar Cleft Grafting: A Retrospective Study.

Alveolar cleft grafting plays a vital role in the treatment of individuals with cleft lip and palate. Vitamin D plays a crucial role in bone healing. The study involved 40 patients with cleft alveolus who were seeking alveolar cleft grafting (ACG). Participants were categorized into 2 groups-study and control-based on their vitamin D levels: those with levels below 20 were placed in the control group, while those with levels above 20 were assigned to the study group. Assessment of alveolar cleft grafting success rate was done by Bergland Scale assessment. The assessment using χ2 showed that the bone level in the study group was better than the control. However, the improvement was not statistically significant (P=0.2). Assessment of volumetric bone fill was done on the CBCT. The results were statistically checked by independent t-test and showed that the bone fill in the study group (224±78.4mm3) was better than the control (176±135mm3). However, the improvement was not statistically significant (P=0.17). Assessment of the incidence of fistula recurrence was done using the χ2 test. In the study group, the incidence of fistula was 5%, while in the control group, it was 30%. The incidence of success in reducing fistula recurrence was statistically significant (P=0.04). Adjustment of vitamin D level may be a successful tool in predicting the success of the alveolar cleft grafting procedure, especially regarding the elimination of fistula recurrence.

External Validation of the Simple Postoperative Acute Kidney Injury Risk Index in Patients Admitted to the Intensive Care Unit After Noncardiac Surgery.

The Simple Postoperative AKI Risk (SPARK) index is a novel model for predicting risk of postoperative acute kidney injury (PO-AKI) among patients after noncardiac surgery. However, the performance of the index has been inconsistent partly due to heterogeneity in case mix and effects of the involved clinical features. To clarify potential reasons for poor performance, we tested the SPARK index in a cohort of high-risk patients requiring intensive care unit (ICU) care after noncardiac surgery and examined whether model modification by refitting coefficients of clinical features could optimize model performance. This was a single-center prospective cohort study. Preoperative variables of the SPARK index were extracted from electronic medical records. PO-AKI was defined by an increase in sCr ≥26.5 mmol/L within 48 hours or 150% compared with the preoperative baseline value within 7 days after surgery, whereas critical AKI was defined as AKI stage 2 or greater and/or any AKI connected to postoperative death or requiring renal replacement therapy during the hospital stay. Discrimination was evaluated by the area under the receiver operating characteristic curve (AUC), and calibration was evaluated by the Hosmer-Lemeshow χ2 test and calibration plot. Model modification was performed by rebuilding the model with the original variables of the SPARK index through proportional odds logistic regression among participants in the earlier study period and was validated in the later one. A total of 973 patients were enrolled, among whom 79 (8.1%) PO-AKI cases and 14 (1.4%) critical AKI cases occurred. Our study participants demonstrated a higher SPARK risk score than the SPARK discovery cohort (eg, 8.02% vs 1.20% allocated in the highest risk group), and the incidence of both outcomes increased through the classes of the score (incidence proportion of PO-AKI increased from 2.56% in the lowest risk group to 25.64% in the highest risk group). The AUCs for PO-AKI and critical AKI were 0.703 (95% confidence interval [CI], 0.641-0.765) and 0.699 (95% CI, 0.550-0.848), respectively. The sensitivity, specificity, negative predictive value and positive predictive value were 68.35%, 57.49%, 95.36%, and 12.44%, respectively, when using 10% of predicted probability of PO-AKI as threshold. Calibration plots suggested acceptable consistency between the predicted and actual risk. After model modification, external validation demonstrated a significantly improved AUC for PO-AKI. The SPARK index showed fair discrimination and calibration among patients admitted to the ICU after noncardiac surgery. Modification of the model improved the performance of the model in terms of predicting PO-AKI.

Remote Site Delayed Extradural Hematoma Secondary to Decompressive Craniectomy for Traumatic Brain Injury: Incidence, Predictors, Characteristics, and Outcomes.

Remote site delayed extradural hematoma (RDEDH) is an uncommon but serious complication that can occur after decompressive craniectomy (DC) in patients with traumatic brain injury (TBI). This study aims to clarify the incidence, predictors, clinical and radiological characteristics, and outcomes of RDEDH to improve the authors' understanding and management of this complication. This study identified 36 patients with TBI who developed RDEDH after DC. The incidence, predictors, clinical and radiological characteristics, and outcomes were analyzed retrospectively. Continuous variables were compared using the student t test, whereas categorical variables were assessed using the χ2 test. Variables with a P value of <0.05 in univariable analysis were included in the multivariable logistic regression analysis. The incidence of RDEDH after DC was 14.6%. Preoperative pupillary dilation [bilaterally; odds ratio (OR): 8.797; 95% CI: 1.969-39.297; P = 0.004], intraoperative acute brain swelling (OR: 33.696; 95% CI: 5.073-227.005; P < 0.001), and pupillary abnormalities after DC (OR: 8.141; 95% CI: 2.117-31.307; P = 0.002) were identified as independent risk factors for the development of RDEDH after DC. The average length of hospitalization in the RDEDH group was significantly longer than that in the non-RDEDH group (P = 0.018). The Glasgow Outcome Scale score at 6 months in the RDEDH group was significantly lower than that in the non-RDEDH group (P = 0.01). The incidence of poor prognosis in the RDEDH group (80.6%) was significantly higher than that in the non-RDEDH group (59.8%; P = 0.017). Preoperative bilateral pupillary dilation, intraoperative brain swelling, and pupillary abnormalities after surgery were independent risk factors for the development of RDEDH after DC in patients with TBI. The occurrence of RDEDH in patients with TBI after DC did not significantly increase mortality, it was associated with a prolonged length of stay and an increased incidence of poor prognosis.

The relationship between anxiety and cardiometabolic risk factors in adolescents with obesity: propensity scores

BackgroundIt has been described that there is a relationship between metabolic health and anxiety.ObjectiveTo determine the relationship between anxiety and metabolic syndrome, as well as cardiometabolic risk factors, in adolescents with obesity.MethodsWe conducted a comparative cross-sectional study of adolescents with obesity between January 2019 and December 2022. In each patient, we recorded somatometric measurements, lipid profiles, and serum insulin levels. Anxiety was measured using the Spence Children’s Anxiety Scale. Participants were divided into those with and without anxiety. Patients with anxiety were matched to patients without anxiety using propensity scores based on z-score body mass index (zBMI). Mann–Whitney U tests and χ2 tests were used.ResultsOf the 564 adolescents, 32.6% (n = 184) suffered from anxiety. In the overall study population, no differences in biochemical and cardiometabolic parameters were observed between the adolescents with and without anxiety prior to adjusting the groups based on zBMI. After matching using their zBMI, we found that the adolescents with anxiety had higher serum uric acid levels (5.9 mg/dl vs. 5.4 mg/dl, p = 0.041), an increased incidence of metabolic syndrome (39.1% vs. 15.9%, p = 0.002), hyperglycemia (21.7% vs. 8.6%, p = 0.020), and lower HDLc (67.3% vs. 34.7%, p &amp;lt; 0.001), than those without anxiety. Girls with anxiety had a higher proportion of cardiometabolic risk factors compared to those without anxiety.ConclusionsAdolescents with obesity and anxiety had higher cardiometabolic risk factors than those without anxiety.

Medical students' knowledge, attitudes, and motivation towards antimicrobial resistance efforts in Eastern Uganda.

Learning beyond the classroom is important for holistic engagement in antimicrobial resistance(AMR) mitigation. Extracurricular interventions can catalyze multidisciplinary engagement and inspire innovative solutions. This study aimed to determine the knowledge, attitudes, and motivations influencing medical students' engagement in AMR Club initiatives at Busitema University, Uganda. This was a descriptive cross-sectional study conducted at Busitema University among undergraduate students pursuing Bachelors of Medicine and Surgery, Bachelor of Science in Nursing, and Bachelor of Science in Anesthesia and Critical care. Data collection was performed using a semi-structured, pre-tested questionnaire and administered to the participants The Bloom's cut-off method was used to analyse the knowledge of the participants, while bivariate analysis was conducted using the chi square test. Multivariable logistic regression analysis was used to identify factors independently associated with students' engagement in AMR club activities. Of the 193 study participants, 71.5%(n) demonstrated sufficient knowledge about antimicrobial resistance (AMR), as determined using Bloom's cutoff categories (≥60% classified as sufficient, <60% as insufficient), with an average knowledge score of 68.18% (SD ±16.12). Additionally, 90% of participants acknowledged the significance of incorporating AMR topics into their curriculum, while 87.5% emphasized the need for AMR training using a One Health approach. The major motivations for students to engage in extracurricular activities addressing AMR were peer influence (n = 42), university support (n = 35), and inspiration drawn from peer mentors' work (n = 35). The students demonstrated a high level of knowledge and positive attitudes towards AMR but highlighted the need for further in-depth training. Participation in extra-curricular activities such as involvement in an AMR Club, was found to significantly influence students' engagement in AMR related interventions.

Investigating factors influencing utilization of trauma-focused cognitive behavioral therapy among unaccompanied young refugees: an exploratory analysis

BackgroundUnaccompanied young refugees (UYRs) exhibit elevated levels of mental distress, including posttraumatic stress symptoms (PTSS), depression and anxiety. Despite the considerable psychological burden, UYRs frequently lack access to mental health care (MHC). The factors that contribute to higher rates of treatment utilization among UYR remain poorly understood. Untreated PTSS can result in chronic impairment, underscoring the importance of identifying these factors. The aim of this study is to investigate factors associated with the intention and actual utilization of MHC of UYRs living in child and youth welfare facilities in Germany.MethodThis study is part of the multi-site project BETTER CARE which aims to implement a stepped and collaborative care approach. A sample of N = 139 UYRs who had received a treatment recommendation for trauma-focused cognitive behavioral therapy (TF-CBT) was analyzed. Binomial logistic regression was performed to identify factors predicting the likelihood of intention to seek MHC. In addition, the association between intention to seek MHC and actual utilization was determined using a chi square test.ResultsThe results demonstrated a significant correlation between age (η = 0.25, p <.01), length of stay in Germany (η = 0.28, p <.01), and severity of PTSD symptoms (η = 0.26, p <.01) with intention to use MHC. In the logistic regression analysis, PTSD emerged as a significant predictor of intended use (B = 2.66, p <.05). The utilization of MHC was found to be closely associated with the initial intention to use (χ²(1) = 88.846, p <.001).ConclusionsThe findings contribute to an expanding body of literature on the mental health requirements and service utilization patterns among UYRs, offering insights for policymakers, mental health professionals, and child welfare services striving to enhance care for this vulnerable population.

Analysis of Nurses' Compliance with Patient Safety in the Inpatient Room of RSI Malahayati Medan

A patient safety program is a system that ensures hospitals make care or health services for patients safer. Patient safety is concerned with patient care, incidents that can be avoided or should not occur and have been considered a discipline. However, it must be admitted that in these quality services there are still shortcomings in patient services, especially related to patient safety incidents. The purpose of the study was to analyze the factors that affect nurses' compliance with patient safety in the inpatient room at RSI Malahayati Medan. The research design used in this study is an analytical survey with a cross sectional design. The population in this study is all inpatient room nurses at Malahayati Hospital Medan. The number of nurses in the inpatient room is 45 people. The number of samples to be studied is 45 people. Data analysis was carried out by univariate, bivariate and multivariate analysis. The arial tests used are chi square and ariable regression tests. The results of the chi square test research show that there is an influence of 7 variables, namely leadership, rewards. Structure, job design, age, tenure and education have a p-value &lt;α 0.05, meaning leadership, rewards. Structure, job design, age, working period and education affect nurse compliance at RSI Malahayati Medan and the multivariate test has 7 variables affecting leadership, rewards. Structure, job design, age, working period and education with the results of the multiple variable regression test showed that the most dominant ariable-reward with an odds ratio (OR) of 6,916 means 6 times affecting nurses' compliance with patient safety. It was concluded that the reward variable had the most influence on nurses' compliance with patient safety at RSI Malahayati Medan. It is recommended for the hospital to build more positive leadership for the employee environment, facilitate employees to continue learning, pay attention to a good organizational structure, decompose employee duties and especially pay attention to income, incentives and bonuses for employees.

Agropreneurship for Sustainable Development – College Students’ Perspective

Education for Sustainable Development is essential for transforming attitudes, raising consciousness and giving people the information regarding the importance of embracing sustainable behaviours. This induces the research team to identify the perception of the college students’ towards agropreneurship for sustainable development. The research team has analysed the relationship between the demographic profile and the students’ level of Perception towards agropreneurship for Sustainable Development. Besides, the research team had made an attempt to identify the impetus “P” among the 5P’s of Sustainable development goals. Both the primary and secondary data were used for this study. The primary data were collected using Google forms from 160 respondents. The collected data were analysed using statistical tools such as Percentage analysis with Graph, Chi Square Test and Weighted Average Method. The study found that, the demographic profiles like gender and academic domain influenced the perception of student community towards agropreneurship for Sustainable Development. It was identified that, among the 5P’s framework of Sustainable development goals, the student community gave prime priority to the framework “People” followed by the other frameworks Planet, Partnership, Prosperity and Peace. The study revealed that, the student community have a positive Perception towards agropreneurship for Sustainable Development. The student community believes that, their Career as an agropreneur will make a balance between Economy, Ecology and Equity dimension of Sustainability.

ECP-IEM: Enhancing seasonal crop productivity with deep integrated models.

Accurate crop yield forecasting is vital for ensuring food security and making informed decisions. With the increasing population and global warming, addressing food security has become a priority, so accurate yield forecasting is very important. Artificial Intelligence (AI) has increased the yield accuracy significantly. The existing Machine Learning (ML) methods are using statistical measures as regression, correlation and chi square test for predicting crop yield, all such model's leads to low accuracy when the number of factors (variables) such as the weather and soil conditions, the wind, fertilizer quantity, and the seed quality and climate are increased. The proposed methodology consists of different stages, like Data Collection, Preprocessing, Feature Extraction with Support Vector Machine (SVM), correlation with Normalized Google Distance (NGD), feature ranking with rising star. This study combines Bidirectional Gated Recurrent Unit (Bi-GRU) and Time Series CNN to predict crop yield and then recommendation for further improvement. The proposed model showed very good results in all datasets and showed significant improvement compared to baseline models. The ECP-IEM achieved an accuracy 96.34%, precision 94.56% and recall 95.23% on different datasets. Moreover, the proposed model was also evaluated based on MAE, MSE, and RMSE, which produced values of 0.191, 0.0674, and 0.238, respectively. This will help in improving production of crops by giving an early look about the yield of crops which will than help the farmer in improving the crops yield.

Association between stroke and fracture and the mediating role of depression: a cross-sectional study from NHANES 2017 to 2020

BackgroundStroke is a significant health threat, and its complex interplay with fractures warrants further investigation. Depression, a critical psychological mediator in various health conditions, may also play a role. This study aims to clarify the intricate relationships among stroke, depressive symptoms, and fracture risk, potentially informing more holistic clinical strategies.MethodsUtilizing the most recent data from the National Health and Nutrition Examination Survey (NHANES, 2017 to 2020), this study encompassed 4,979 valid samples. T-test and chi square test are conducted to compare the differences between fracture and non fracture subgroups. Subsequently, regression models were applied to assess the mediating impact of depression, with Sobel’s test and the bootstrap method deployed to substantiate the mediation pathways.ResultsIn this study, we conducted subgroup and regression analyses to investigate factors influencing fractures in stroke patients using NHANES data. Subgroup analysis revealed significant associations with gender, race, osteoporosis, and depression. Female stroke patients had a higher fracture rate (73.86% vs. 47.78%, p &amp;lt; 0.001), and those with post-stroke depression (29.67% vs. 13.16%, p &amp;lt; 0.001) or osteoporosis (33.33% vs. 15.81%, p &amp;lt; 0.05) were at increased risk of fractures. Logistic regression models showed a positive association between stroke and fractures in the unadjusted (OR = 1.862, 95% CI: 1.348–2.573, p &amp;lt; 0.001) and adjusted I models (OR = 1.789, 95% CI: 1.240–2.581, p &amp;lt; 0.01), but not in the adjusted II model. Depression was significantly correlated with fractures in all models (unadjusted OR = 2.785, 95% CI: 1.271–6.101, p &amp;lt; 0.05; Model 1 OR = 3.737, 95% CI: 1.470–9.498, p &amp;lt; 0.01; Model 2 OR = 3.068, 95% CI: 1.026–9.175, p &amp;lt; 0.05). Mediation analysis using Sobel and bootstrap tests indicated that depression mediates 7.657% of the relationship between stroke and fractures (Z = 2.31, p &amp;lt; 0.05), with significant indirect (Z = 2.80, p &amp;lt; 0.01), direct (Z = 3.61, p &amp;lt; 0.001), and total effects (Z = 3.92, p &amp;lt; 0.01). The direct effect of stroke on fracture was 0.079 (95% CI: 0.036–0.121), the total effect was 0.085 (95% CI: 0.043–0.128), and the indirect effect mediated by depressive symptoms was 0.007 (95% CI: 0.002–0.011). These results suggest that depressive symptoms following stroke may contribute to an increased risk of fractures.ConclusionDepressive symptoms serve as a critical mediator in the link between stroke and fracture risk. Consequently, our study concludes that holistic prevention strategies for fractures in stroke patients must incorporate a focus on mental health to effectively address this complex clinical challenge.

Prevalence and determinants of intimate partner violence in pregnancy: a multicentre, binational study

BackgroundGlobally, intimate partners are the most common perpetrators of violence against women. Sub-Saharan Africa (SSA) contributes significantly to the burden of intimate partner violence (IPV) in Africa, with four of every 10 women in SSA having experienced IPV. When IPV occurs in pregnancy, it is significantly associated with adverse outcomes. This study sought to assess the prevalence, determinants and complications of IPV in pregnancy in Nigeria and Ghana, two SSA countries.MethodsA descriptive, cross-sectional study, conducted between February-July 2022, amongst pregnant women attending antenatal care clinics in 17 health facilities across the six geopolitical zones in Nigeria, and three hospitals in three regions in Ghana. The women were screened for IPV using an adaptation of the ‘HARK’ (Humiliation, Afraid, Rape, Kick) questions. Data obtained were analysed using the IBM SPSS Statistics for Windows, version 25. Associations between IPV and sociodemographic characteristics of the women and their spouses/partners were tested using Pearson’s Chi square. Factors found to be statistically significant were subjected to binary logistic regression modelling to determine the predictors of IPV. The level of statistical significance was set at a p-value of < 0.05.ResultsThe prevalence of IPV was 26.2%. Predictors of IPV included the women’s marital status (p = 0.001), educational status (p = 0.040), rural residence (p = 0.034), occupation (p = 0.040), spouse’s/partner’s occupation (p = 0.021), use of illicit drugs by spouse/partner (p = 0.014), history of psychiatric illness in spouse/partner (p = 0.030), experience of IPV in previous relationship(s) by spouse/partner (p = 0.011), and witness of parental IPV by spouse/partner (p < 0.001). The most common complication of IPV in pregnancy were the mental health complications of anxiety (54.7%) and depression (46.9%). Miscarriages (15.6%) and preterm birth (9.5%) were the most common pregnancy complications.ConclusionsOne in every four pregnant women in Nigeria and Ghana experience IPV, with significant mental health and pregnancy complications. Routine IPV screening in pregnancy and prompt referral of screen-positive women to support services is recommended. Policies and interventions that promote gender equality and women’s economic and educational empowerment are beneficial.

The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer

BackgroundIn cancer cachexia the relationship between the tumour, its environment and the systemic inflammatory response is not clear. This study aims to examine this relationship in greater detail.MethodsHost characteristics included the presence of a Systemic Inflammatory Response (SIR) as measured by Systemic Inflammatory Grade (SIG), sarcopenia (SMI) and myosteatosis (SMD) were measured. Categorical variables were analysed using χ2 test for linear-by-linear association, or χ2 test for 2 by 2 tables. Survival analysis was carried out using univariate and multivariate Cox regression.ResultsA total of 473 patients were included. Of these, 70.4% were over 65 years of age, 54.8% were male and 49.8% had an ASA grade of 1 or 2. Pathological examination showed that the majority of patients had a T3 (53.7%) or a T4 (34.0%) cancer and 73.0% had evidence of necrosis. A SIG score of 0 or 1 was present in 57.7% of patients. Tumour necrosis was associated with age (p < 0.01), tumour location (p < 0.01), T-stage (p < 0.001), margin involvement (p < 0.05), SIG (p < 0.001), SMI (p < 0.01), SMD (p < 0.05) and 5-year survival (p < 0.001). On multivariate survival analysis in patients with T3 cancers age (HR: 1.45 95% CI 1.13–1.86 p < 0.01), ASA grade (HR: 1.50 95% CI 1.15–1.95 p < 0.01) and SIG (HR: 1.28 95% CI 1.11–1.48 p < 0.001) remained independently associated with survival.ConclusionThese results suggest that tumour necrosis and the subsequent SIR could result in profound changes in body composition and survival. Further pre-clinical and clinical work is required to prove causation.

Prevalence, influencing factors, and prediction model construction of anemia in ankylosing spondylitis based on real-world data: An exploratory study.

This study aimed to explore the prevalence and influencing factors of anemia in patients with ankylosing spondylitis (AS) using real-world data and to construct a predictive model for anemia in AS. In November 2023, we accessed the database from China Rheumatoid Arthritis Registry of Patients with Chinese Medicine (CERTAIN). Clinical data of AS collected from the CERTAIN between March 2022 and September 2023 were analyzed. Demographic information, clinical assessment scales, and laboratory test results of the patients were collected. According to the anemia diagnostic criteria established by the World Health Organization (WHO) in 2018, patients were divided into anemia group and non-anemia group. Statistical analyses were performed using SPSS 25.0 software, including χ2 tests, independent sample t-tests to compare differences between the two groups, and multivariate stepwise logistic regression analysis to explore the influencing factors of anemia in AS. The predictive efficacy of the model was evaluated by plotting receiver operating characteristic (ROC) curves. Calibration was assessed through the Hosmer-Lemeshow goodness-of-fit test, and a calibration curve was plotted to comprehensively evaluate the predictive capability of the model. A total of 251 patients were included in this study, among which 58 cases had anemia (23.1%). There were significant differences in gender, ossification, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) indicators, and clinical assessment scale results between the two groups (P < 0.05). The results of multivariate stepwise logistic regression analysis showed that female gender, underweight, ossification, abnormal CRP and ESR were independent risk factors for anemia in AS (P < 0.05). Based on the results of multivariate stepwise logistic regression analysis, a predictive model for anemia in AS was established as Logit(P) = -5.02 + 2.041 × gender -1.11 × BMI(body mass index) category + 1.103 × ossification category + 0.942 × CRP category + 1.476 × ESR category. The ROC curve analysis showed that the area under the curve of the model for predicting anemia in AS was 0.857 (95% CI: 0.808 ~ 0.906). The Omnibus test of model coefficients yielded χ2 = 85.265, P < 0.001. The Hosmer-Lemeshow test showed χ2 = 7.005, P = 0.536 (P > 0.05). Analysis of real-world AS diagnosis and treatment data showed that the prevalence of anemia in Chinese AS was 23.1%. The occurrence of anemia was closely related to female gender, underweight, ossification, and abnormal CRP and ESR. The logistic model constructed based on these indicators for predicting the risk of anemia in AS demonstrated good efficacy.

Towards the definition of disease phenotypes in pediatric SAPHO syndrome: a national multicentric study.

To confirm the presence of different disease phenotypes of pediatric SAPHO syndrome (pSAPHO) based on their skin manifestations in a large cohort of Italian patients. pSAPHO were enrolled in the Eurofever Registry and the data retrospectively analysed. Patients were divided depending on their skin manifestations into an Acne-Hidradenitis suppurativa (HS) group and a Palmoplantar Pustulosis-Psoriasis Vulgaris (PPP-PV) group and were compared with patients without skin manifestations (chronic non-bacterial osteomyelitis, CNO). Comparison of frequencies between groups was performed by the means of χ2 test or by Fischer's Exact test. 54 pSAPHO with skin manifestations (35 acne-HS, 19 PPP-PV) were enrolled and compared with 167 CRMO. In the Acne-HS, 82.9% were males, in the PPP-PV, 84.2% were females, while in the CNO group there were no gender differences (p< 0.0001). The 3 groups differed significantly for age at disease onset: acne-HS median 13.3 years, PPP-PV median 10.2 years, CNO median 9.5 years (p= 0.0001). An axial pattern was more frequent in acne-HS (91.4%) and PPP-PV group (89.4%) compared with CNO (46%) (p< 0.0001). Both acne-HS (82.9%), and PPP-PV (63.2%) required more frequently a biologic therapy than CNO (36.8%), but acne-HS presented a refractory skin disease requiring steroids and different lines of treatment, while PPP-PV responded well to biologics. Our data have identified two different phenotypes of pSAPHO based on skin manifestations, with different sex, age and response to treatments. These two groups have peculiar clinical features different from the CNO group. A new classification encompassing these phenotypes is warranted.

Comparison of Transoral and Transcutaneous Approaches for Gender-Affirming Thyroid Cartilage Reduction: A Case Series of 246 Patients.

Thyroid cartilage reduction (TCR) for gender-affirming neck surgery can reduce prominent thyroid notches and improve dysphoria. TCR can be performed with a transoral or transcutaneous approach. This study aims to review TCR approaches and outcomes. A retrospective chart review of all TCRs at a multi-institutional, integrated healthcare system from May 2016 to July 2024 was performed. Patient demographics, operative details, and post-operative complications were reviewed. Major complications included invasive interventions (corticosteroid injections for scars, fluid drainage, etc) or intraoperative complications. Minor complications included infections, hypertrophic scarring, and temporary voice changes. Chi square tests and Mann-Whitney U tests were performed to evaluate differences in postoperative outcomes by surgical approach. A total of 246 patients underwent TCR with 207 patients (84.1%) in the transcutaneous group and 39 patients (15.9%) in the transoral group. The median patient age was 30.7 years (interquartile range, IQR 24.9-39.0). Median BMI was 22.7 kg/m2 (IQR 20.6-25.5). There were no significant differences between transcutaneous and transoral groups, for median age (30.1 years vs 33.4 years, p=0.08) or median BMI (22.6 kg/m2 vs 23.7 kg/m2, p=0.28). Total major complication was 9.3% and minor complication was 10.6%. There were no significant differences between transcutaneous and transoral groups in rates of major (9.2% vs 10.3%, p=0.83) or minor (12.1% vs 2.6%, p=0.08) complications. TCR can be an effective treatment for neck dysphoria. Transoral approach avoids visible neck scars and is not associated with increased peri-operative complications. Further research is needed to determine the long-term outcomes of TCR.

Covid-19 Vaccine Acceptance and its Influencing Factors Through a Cross-Sectional Study

Background: The rise in Covid-19 related deaths has led to the implementation of vaccination. Despite this effort, some of the population remains reluctant to get vaccinated, citing various reasons for their hesitation. The objective of this research was to examine the various factors affecting covid-19 vaccination acceptance. Methods: This study adopted a cross-sectional design and was conducted between October and December 2022. This study looked at various independent variables such as sex, education, occupation, family income, health insurance, social assistance, history of Covid-19 infection, and information from the health worker. The main variable of interest was vaccination acceptance. The research involved a group of 133 people. Research data is collected by sending surveys to participants while adhering to Covid-19 health guidelines. The research data was examined using chi square test and logistic regression. This study received ethical approval from the Ethics Committee at Palu Health Polytechnic, Ministry of Health in Indonesia number: 0089/KEPK-KPK/VI/2022. Results: Most of the individuals were involved in favor of accepting the Covid-19 vaccine, with a percentage of 83.5%, whereas only 16.5% declined it. Among the different factors considered, age was found to be the most significant in determining vaccine acceptance compared to having social assistance and information from health workers. Conclusion: Vaccine acceptance varied by age, prioritizing older individuals due to their heightened vulnerability to the Covid-19 virus. It is crucial to further investigate how different factors such as socio-demographic characteristics, vaccine’ knowledge, and trust in the healthcare system interact with each other.