Chi-square Test Research Articles

Low-dose, standard, and high-resolution cone beam computed tomography for alveolar bone measurements related to implant planning: An exvivo study in human specimens.

To evaluate the performance of low-dose cone beam computed tomography (CBCT) protocols with regard to linear bone measurements in the posterior mandible for implant planning compared with higher dose protocols. Forty-two edentulous posterior sites in human cadaveric mandibles were imaged in three CBCT scanners using three or four protocols with varying exposure parameters to achieve lower dose. Co-registration was performed to generate sagittal and cross-sectional image sections representative of the implant site. Three observers measured bone height, from the alveolar crest to the mandibular canal, and width, three mm from the top of the alveolar crest. Intra- and interobserver reproducibility were assessed for the cases rated as nonmeasurable as well as for completed measurements. The measurements were analyzed using paired t-tests for differences among the CBCT protocols and the frequency distribution of nonmeasurable cases with a Pearson Chi-square test. Reproducibility for registering nonmeasurable cases varied among observers; however, no consistent significant differences were found in the frequency distribution of these cases among observers, units, and protocols. Intraclass correlation coefficients (ICC) were >0.9 for all measurements of bone height and width. Mean differences of <0.5 mm were found regardless of protocol; however, one observer did in some cases produce larger differences. Linear bone measurements did not differ significantly and could be performed with excellent reliability, using low-dose CBCT protocols compared with standard and high-resolution ones. Varying approaches for rating nonmeasurable cases were found, indicating differences in diagnostic strategies related to implant planning among observers.

Analysis of Risk Factors and Predictors of Success in Controlling Drop Out Pulmonary Tuberculosis: An Observational Study in Batang Regency, Indonesia

Introduction: Pulmonary tuberculosis (TB) remains a significant public health problem in Batang Regency, Indonesia. The high drop out (DO) rate of treatment is one of the main obstacles in controlling TB. This study aims to identify risk factors and predictors of DO for pulmonary TB treatment in Batang Regency. Methods: An analytical observational study with a cross-sectional design was conducted in 2023 involving 150 pulmonary TB patients who were recorded as having DO in the 2021-2022 period. Primary data was collected through interviews and secondary data from medical records. Bivariate analysis using the Chi-square test or Fisher's exact test, and multivariate analysis using logistic regression were performed to identify risk factors and predictors of DO. Results: Bivariate analysis showed that young age (&lt;25 years) (OR = 3.21; 95% CI: 1.54-6.69), long distance of residence from health facilities (OR = 4.12; 95% CI: 1.98-8.57), and a history of adverse drug reactions (ESO) (OR = 5.63; 95% CI: 2.65-11.94) were significant risk factors for DO. Multivariate analysis confirmed that young age (aOR = 2.95; 95% CI: 1.35-6.43), long distance of residence (aOR = 3.88; 95% CI: 1.79-8.41), and history of ESO (aOR = 5.12; 95% CI: 2.38-11.01) were independent predictors of DO. Conclusion: Young age, long distance of residence from health facilities, and history of ESO are risk factors and independent predictors of DO for pulmonary TB treatment in Batang Regency. Interventions that target these factors, such as intensive education and counseling for young patients, increased access to health services, and optimal management of ESO, are needed to increase the success of TB control.

Prevalence of osteoporosis and associated factors among people aged 50 years and older in the Madhesh province of Nepal: a community-based cross-sectional study

BackgroundThe high prevalence of osteoporosis has increased the economic burden on the health system globally. The burden of osteoporosis and its associated factors have not been adequately assessed in community settings in the Nepalese context thus far. Therefore, this study aimed to assess the prevalence of osteoporosis and its associated factors, lifestyle behaviors, and dietary calcium intake.MethodsA community-based cross-sectional study was conducted among 395 people aged 50 years and older in the Madhesh Province of Nepal between July 2022 and August 2023. The Osteoporosis Self-assessment Tools for Asians (OSTA) index was used to measure osteoporosis. A structured questionnaire was used to collect sociodemographic information, anthropometric data, lifestyle behavior, daily dietary calcium intake, and frequency of calcium-rich food consumption. A food frequency questionnaire and 24-hour recall methods were used to assess dietary intake. The chi-square test, binary logistic regression and Mann‒Whitney U test were applied to measure the association between predictors and the outcome of interest.ResultsThe prevalence of no risk, moderate risk and high risk of osteoporosis were 38.7%, 39%, and 22.3% respectively. The risk of osteoporosis was higher in females (aOR = 5.18, CI: 2.10-12.75, p < 0.001) and increased risk with advancing age (aOR = 32.49, CI: 14.02–75.28, p < 0.001). Similarly, underweight was associated with increased odds of having osteoporosis (aOR = 13.42, CI = 4.58–39.30, p < 0.001). The incidence of osteoporosis was strongly associated with daily calcium intake of 225 mg (100, 386).ConclusionThis study revealed a high prevalence of osteoporosis among people aged 50 years and older due to the combined effect of being underweight and having inadequate calcium intake. Nutritional counselling services encourage people to consume sufficient calcium-rich food and adopt an appropriate lifestyle behaviours to maintain healthy body weight so that osteoporosis and osteoporotic fractures could be prevented. Further research can explore the impact of socioeconomic status and medical comorbidities on a large scale.

The effect of birth weight on tooth development by Demirjian's method.

The aim of this study was to investigate the impact of birth weight on tooth development in children aged 7-8 years. This retrospective cohort study comprised 75 children born at Bint Al-Huda Hospital, Bojnurd, in 2013-2014. The children were categorized into three groups based on their birth weight: Normal Birth Weight (NBW), Low Birth Weight (LBW), and Very Low Birth Weight (VLBW). Panoramic radiographs were taken for orthodontic examination, and Demirjian's 8-teeth method was employed to determine dental age. The study compared dental and chronological age within each group. Data analysis utilized SPSS software version 26, employing One-way ANOVA and chi-square tests. Statistical significance was set at P ≤ 0.05. The mean difference in dental and chronological age for Very Low Birth Weight (VLBW) children was 0.22 ± 0.44 years, for Low Birth Weight (LBW) children it was 0.19 ± 0.45 years, and for Normal Birth Weight (NBW) children, it was 0.08 ± 0.46 years. Although the mean difference decreased with increasing birth weight, this trend did not achieve statistical significance (P = 0.55). Furthermore, no significant differences were observed between the weight groups (P = 0.529) or genders (P = 0.191).

The Effect of Education Performed Using Mobile Application on Supportive Care Needs and Quality of Life in Women with Breast Cancer: Randomized Controlled Trial

ObjectivesAimed to determine the effect of education provided with a mobile application on the supportive care needs and quality of life of women undergoing breast-conserving surgery. MethodsThe study was conducted in 81 patients. The experimental group received mobile application and the control group received standard education. Fisher's Exact Test, Chi-Square test, Student's t Test, Mann-Whitney U test, mixed design analysis of variance and Bonferroni-Dunn test were used to analyze the data. ResultsWhile the pre-study supportive care needs scores of the women were similar in the experimental (85.37 ± 23.58) and control (83.13 ± 23.03) groups, they decreased significantly in the experimental group at the 4th and 8th-week measurements (54.34 ± 27.28; 58.78 ± 16.51) (p < .05). In the 4th and 8th week measurements, the quality of life of the experimental group (72.26 ± 14.12; 71.04 ± 8.12) increased significantly, while no significant change was found in the control group (42.50 ± 14.38; 45.63 ± 8.28). ConclusionsIt was found that the supportive care needs of the decreased and their quality of life increased after the education given to women with a mobile application. Implications for Nursing PracticeThis study ensured that women who had a sufficiently intense and exhausting process during the cancer treatment process could comfortably receive care support and education with the mobile application at any time and place they wanted. It also revealed that nurses can provide care and education support to their patients at any time and place they want with the mobile application in their busy work tempo.

Medical costs of Swedish nursing home residents at the end of life: a retrospective observational registry study

BackgroundThere are many studies of medical costs in late life in general, but nursing home residents’ needs and the costs of external medical services and interventions outside of nursing home services are less well described.MethodsWe examined the direct medical costs of nursing home residents in their last year of life, as well as limited to the period of stay in the nursing home, adjusted for age, sex, Hospital Frailty Risk Score (HFRS), and diagnosis of dementia or advanced cancer. This was an observational retrospective study of registry data from all diseased nursing home residents during the years 2015–2021 using healthcare consumption data from the Stockholm Regional Council, Sweden. T tests, Wilcoxon rank sum tests and chi-square tests were used for comparisons of groups, and generalized linear models (GLMs) were constructed for univariable and multivariable linear regressions of health cost expenditures to calculate risk ratios (RRs) with 95% confidence intervals (95% CIs).ResultsAccording to the adjusted (multivariable) models for the 38,805 studied nursing home decedents, when studying the actual period of stay in nursing homes, we found significantly greater medical costs associated with male sex (RR 1.29 (1.25–1.33), p < 0.0001) and younger age (65–79 years vs. ≥90 years: RR 1.92 (1.85–2.01), p < 0.0001). Costs were also greater for those at risk of frailty according to the Hospital Frailty Risk Score (HFRS) (intermediate risk: RR 3.63 (3.52–3.75), p < 0.0001; high risk: RR 7.84 (7.53–8.16), p < 0.0001); or with advanced cancer (RR 2.41 (2.26–2.57), p < 0.0001), while dementia was associated with lower medical costs (RR 0.54 (0.52–0.55), p < 0.0001). The figures were similar when calculating the costs for the entire last year of life (regardless of whether they were nursing home residents throughout the year).ConclusionsDespite any obvious explanatory factors, male and younger residents had higher medical costs at the end of life than women. Having a risk of frailty or a diagnosis of advanced cancer was strongly associated with higher costs, whereas a dementia diagnosis was associated with lower external, medical costs. These findings could lead us to consider reimbursement models that could be differentiated based on the observed differences.

Effectiveness of a hybrid emergency room system in the management of acute ischemic stroke: a single-center experience

IntroductionHybrid emergency room systems (HERSs) have shown promise for the management of severe trauma by reducing mortality. However, the effectiveness of HERSs in the treatment of acute ischemic stroke (AIS) remains unclear. This study aimed to evaluate the impact of HERSs on treatment duration and neurological outcomes in patients with AIS undergoing endovascular therapy.Materials and methodsThis single-center retrospective study included 83 patients with AIS who were directly transported to our emergency department and underwent endovascular treatment between June 2017 and December 2023. Patients were divided into the HERS and conventional groups based on the utilization of HERSs. The primary outcome was the proportion of patients achieving a favorable neurological outcome (modified Rankin Scale score 0–2) at 30 days. The secondary outcomes included door-to-puncture and door-to-recanalization times. Univariate analysis was performed using the Mann–Whitney U test for continuous variables and the chi-squared test or Fisher’s exact test for categorical variables, as appropriate.ResultsOf the 83 eligible patients, 50 (60.2%) were assigned to the HERS group and 33 (39.8%) to the conventional group. The median door-to-puncture time was significantly shorter in the HERS group than in the conventional group (99.5 vs. 131 min; p = 0.001). Similarly, the median door-to-recanalization time was significantly shorter in the HERS group (162.5 vs. 201.5 min, p = 0.018). Favorable neurological outcomes were achieved in 16/50 (32.0%) patients in the HERS group and 6/33 (18.2%) in the conventional group. The HERS and conventional groups showed no significant difference in the proportion of patients achieving favorable neurological outcomes (p = 0.21).ConclusionImplementation of the HERS significantly reduced the door-to-puncture and door-to-recanalization times in patients with AIS undergoing endovascular therapy. Despite these reductions in treatment duration, no significant improvement in neurological outcomes was observed. Further research is required to optimize patient selection and treatment strategies to maximize the benefits of the HERS in AIS management.

The clinical impact of estimating low-density lipoprotein cholesterol (LDL-C) using different equations in the general population

BackgroundLow-density lipoprotein cholesterol (LDL-C) is associated with atherosclerotic cardiovascular disease (ASCVD). Friedewald, Sampson, and Martin-Hopkins equations are used to calculate LDL-C. This study compares the impact of switching between these equations in a large geographically defined population.Materials and methodsData for individuals who had a lipid panel ordered clinically between 2010 and 2019 were included. Comparisons were made across groups using the two-sample t-test or chi-square test as appropriate. Discordances between LDL measures based on clinically actionable thresholds were summarized using contingency tables.ResultsThe cohort included 198,166 patients (mean age 54 years, 54% female). The equations perform similarly at the lower range of triglycerides but began to diverge at a triglyceride level of 125 mg/dL. However, at triglycerides of 175 mg/dL and higher, the Martin-Hopkins equation estimated higher LDL-C values than the Samson equation. This discordance was further exasperated at triglyceride values of 400 to 800 mg/dL. When comparing the Sampson and Friedewald equations, at triglycerides are below 175 mg/dL, 9% of patients were discordant at the 70 mg/dL cutpoint, whereas 42.4% were discordant when triglycerides are between 175 and 400 mg/dL. Discordance was observed at the clinically actionable LDL-C cutpoint of 190 mg/dL with the Friedewald equation estimating lower LDL-C than the other equations. In a high-risk subgroup (ASCVD risk score > 20%), 16.3% of patients were discordant at the clinical cutpoint of LDL-C < 70 mg/dL between the Sampson and Friedewald equations.ConclusionsDiscordance at clinically significant LDL-C cutpoints in both the general population and high-risk subgroups were observed across the three equations. These results show that using different methods of LDL-C calculation or switching between different methods could have clinical implications for many patients.

Job satisfaction and turnover of the first group of rural-oriented tuition-waived medical students in Guangxi, China: a mixed-method study

BackgroundIn 2010, China launched a rural-oriented tuition-waived medical education (RTME) programme to train more general practitioners (GPs) to meet the needs of the rural health workforce. Motivating and maintaining GPs is an important consideration for the shortage in the rural health workforce. This study aimed to investigate job satisfaction and turnover among the first group of rural-oriented tuition-waived medical students (RTMSs) who had completed a three-year compulsory service in Guangxi, as well as the factors affecting RTMSs turnover.MethodsThis study adopted a mixed-method approach. A quantitative survey of 129 RTMSs was analysed (81.6% response rate), and qualitative interviews were conducted with 30 stakeholders, including 18 RTMSs, six administrators of the County Health Bureau, and six administrators of township health centers (THCs). A t-test, chi-square test, Fisher’s exact test, and logistic regression analysis were used to examine the quantitative data, and thematic analysis was used to analyse the qualitative data.ResultsAmong the 129 participants, the turnover rate was high, with 103 RTMSs reporting turnover (79.84%). Interpersonal relationships scored the highest in job satisfaction (3.63 ± 0.64) among RTMSs, while working conditions were rated the lowest (2.61 ± 0.85). Marital status (odds ratio [OR] = 0.236, 95% confidence interval [95%CI] = 0.059–0.953, P = 0.043), only child status (OR = 8.660, 95%CI = 1.714–43.762, P = 0.009), and job return satisfaction (OR = 0.290, 95%CI = 0.090–0.942, P = 0.039) were significantly associated with turnover. Univariate analyses showed that income had a significant influence on turnover, but the relationship gone by multivariable; however it was deemed important in the qualitative study. Qualitative analysis revealed that turnover was influenced by the working atmosphere, effort-reward imbalance, professional competence, and opportunities for training and promotion.ConclusionsThis study provides insights for the policymakers about the priority areas for retaining GPs in rural locations and provides reference values for the retention of GPs in other regions with a shortage of rural health workers. For RTMSs to continue providing services to rural areas, the government should improve their salaries, balance their income and workload, provide more opportunities for training and career promotion, and managers should recognise their efforts and create an optimistic working atmosphere.

A 10-year mono-center study on patients with burns ≥70% TBSA: prediction model construction and multi-center validation: retrospective cohort.

Burn injuries with ≥70% total body surface area (TBSA) are especially acute and life-threatening, leading to severe complications and terrible prognosis, while a powerful model for prediction of overall survival (OS) is lacked. The objective of this study is to identify prognostic factors for the OS of patients with burn injury ≥70% TBSA, construct and validate a feasible predictive model. Patients diagnosed with burns ≥70% TBSA admitted and treated between 2010 and 2020 in our hospital were included. A cohort of the patients from the Kunshan explosion were assigned as the validation set. The Chi-square test and K-M survival analysis were conducted to identify potential predictors for OS. Then, multi-variate Cox regression analysis was performed to identify the independent factors. Afterwards, we constructed a nomogram to predict OS probability. Finally, the Kunshan cohort was applied as an external validation set. Gender, the percentage of third- and fourth-degree burn as well as organ dysfunction were identified as significant independent factors. A nomogram only based on the factors of the individuals was built and evidenced to have promising predictive accuracy, accordance, and discrimination by both internal and external validation. This study recognized significant influencing factors for the OS of patients with burns ≥70% TBSA. Furthermore, our nomogram proved to be an effective tool for doctors to quickly evaluate patients' outcomes and make appropriate clinical decisions at an early stage of treatment.

Factors Associated with Having Uncontrolled Asthma in Rural Appalachia

ABSTRACT BACKGROUND: Chronic respiratory disease disproportionately affects residents of Appalachia, particularly those residing in Central Appalachia. Asthma is particularly burdensome to Central Appalachian residents regarding cost and disability. Improving our understanding of how to mitigate these burdens requires understanding the factors influencing asthma control among individuals with asthma living in Central Appalachia, specifically rural Kentucky. METHODS: This community-based, cross-sectional epidemiologic study used survey data to identify characteristics associated with uncontrolled and controlled asthma. The designation of “uncontrolled asthma” was based on self-report of ≥ 2 asthma exacerbations in the past year. Individuals with ≤ 1 or no exacerbations were considered to have controlled asthma. Chi-square or Fisher exact tests assessed the association between categorical variables and asthma control categories. Logistic regression was conducted to determine the impact of factors on the likelihood of uncontrolled asthma. RESULTS: In a sample of 211 individuals with self-reported asthma, 29% (n = 61, 46 females) had uncontrolled asthma. Predictors of uncontrolled asthma included depression (odds ratio 2.61, 95% CI 1.22-5.61, P = .014) and living in multi-unit housing (odds ratio 4.99, 95% CI 1.47-16.96, P = .010) when controlling for age, sex, financial status, and occupation. Being overweight or obese was not a predictor of uncontrolled asthma. Physical activity and BMI did not predict the likelihood of uncontrolled asthma. CONCLUSION: This study highlights significant challenges rural communities in Appalachian Kentucky face in managing asthma. Factors like depression, housing conditions, and a lack of self-management strategies play pivotal roles in asthma control in this population.

Do Precipitation and Temperature Influence Perceptions of Urban Cleanliness?

Abstract This study explores the correlation between weather and the perception of urban cleanliness across the 47 largest cities in Spain. Utilizing survey data conducted by the national Consumers and Users Organization (OCU) in 2015, 2019, and 2023 to assess cleanliness perceptions, we analyze potential associations with precipitation and temperature recorded by weather stations of the Spanish Meteorological Agency. Additionally, we consider computed values of the De Martonne aridity index. The OCU data reveal regional disparities in perceived cleanliness quality. Higher cleanliness scores are obtained in cities located in the northern and north-central regions of Spain, characterized by humid and super-humid climates according to the De Martonne index. Conversely, lower cleanliness ratings are given to cities in the southern and eastern regions of Spain, where a Mediterranean climate and lower aridity index values prevail. In conducting a statistical analysis on the perception of cleanliness and variables related to precipitation and temperature, the results of the chi-square and linear correlation tests found no strong statistical correlation, although a tendency is observed. Cities with higher annual precipitation and lower values of average annual temperature tend to receive better cleanliness ratings, while drier and warmer cities exhibit the worst values of perceived urban cleanliness. Furthermore, our findings indicate that the Gompertz model effectively captures a strong statistical correlation in the relationship between cleanliness perception and the De Martonne index: As aridity increases, cleanliness perception decreases. These results are relevant for the development of future cleaning methods and systems, particularly in light of the climate change scenarios that are anticipated in the Mediterranean region due to warmer and drier conditions and, consequently, an increase in aridity.

Associations between Preschool Teachers' Food-Based Learning Frequency, Level of Personal Priority and Identified Resources and Challenges: A Needs Assessment.

Food-based learning (FBL) is the use of food as a teaching tool in the classroom, which can expose children to healthy foods to improve preference and consumption. However, more research is needed on the use and perception of FBL in the Head Start (HS) preschool classroom. In an online survey, we explored associations between North Carolina HS teachers' (n = 168) experiences (e.g., resources, challenges, needs, and preferences) with FBL, how frequently teachers implemented it, and how much they prioritized it. We used frequencies and chi-square tests of independence to assess associations between study variables. Teachers reported using FBL regularly with access to FBL resources (e.g., books and center play materials) and experiencing challenges (e.g., lack of funding and material resources). Teachers partnered with parents and farmers markets and expressed a need for additional FBL professional development. Our needs assessment findings revealed specific resources, challenges, and perceptions significantly associated with how often teachers used FBL and their priority level. Additional research should investigate how to alleviate FBL challenges and strategies to create policy and environmental changes that facilitate early FBL.

Examining the Association between Discussion Strategies and Learners’ Critical Thinking in Asynchronous Online Discussion

A well-designed asynchronous online discussion (AOD) has the potential to encourage learners’ critical thinking (CT). Previous studies have shown that the discussion strategies selected by instructors when designing AOD questions can influence learners’ CT. However, the associations between different discussion strategies and learners’ CT have not been fully explored, and clear guidance for instructors on how to promote learners’ CT by selecting appropriate discussion strategies is limited. In this study, a coupling deep learning model named CritiNet was developed to classify and identify learners’ CT automatically based on Murphy's CT analysis model as a coding scheme (recognize, understand, analyze, evaluate, and create) in 15,483 Chinese text discussion posts. These discussion posts were generated by 505 learners in four different discussion strategies: case-based discussion, debate, open-ended discussion, and role play. Then, the associations of the discussion strategies with learners’ CT were examined. Results indicated CritiNet had excellent performance in classifying Chinese text discussion posts and identifying learners’ CT. Pearson's chi-squared test reported a strong association between the four discussion strategies and learners’ CT. Cross-analysis revealed differences among the four discussion strategies in encouraging CT. Specifically, the case-based discussion strategy developed evaluate of CT more effectively, whereas the three other strategies promoted analyze to a greater extent. By contrast, the open-ended strategy encouraged the least development of CT in create, and the role play strategy generated the smallest proportion in evaluate. The implications of these findings for instructors to encourage learners’ CT effectively in AOD were discussed.

The bidirectional relationship between benign/malicious envy and subjective well-being in adolescents: The mediating effect of self-esteem.

Subjective well-being, an important index for measuring mental health, is presently declining among junior high school students. Envy, one of their common emotions, is inextricably linked to subjective well-being. Based on the Dual Envy Theory, our research explores the bidirectional relationship between benign-malicious envy and subjective well-being. The mediating role of self-esteem, as well as the related gender differences, is examined. Chinese middle school students (n = 1566, boys 50.3%, age = 13.96 ± 0.88 years old) were assessed at two time points over a 3-month interval. Structural equation modeling was used to examine the longitudinal relationships among the variables. (1) Cross-lagged analysis showed a positive bidirectional relationship between benign envy and subjective well-being and a negative bidirectional relationship between malicious envy and subjective well-being in the total sample. However, the path from T1 subjective well-being to T2 malicious envy in boys was not significant. (2) Self-esteem mediated the relationship between both benign and malicious envy and subjective well-being among both boys and girls. A Wald chi-square test showed that T2 self-esteem was a stronger predictor of T2 benign envy in boys than in girls. The results reveal a virtuous cycle of benign envy and subjective well-being, and a vicious cycle of malicious envy and subjective well-being, while emphasizing the role of self-esteem in this process. Gender differences were also noted. These findings have important implications for improving the subjective well-being of secondary school students and exploring the positive effects of envy.

Continental scale comparison of mycobiomes in Parmelia and Peltigera lichens from Turkey and South Korea

BackgroundLichens, traditionally considered as a simple partnership primarily between mycobiont and photobiont, are, in reality, complex holobionts comprised of a multitude of microorganisms. Lichen mycobiome represents fungal community residing within lichen thalli. While it is acknowledged that factors like the host lichen species and environmental conditions influence the structure of the lichen mycobiome, the existing research remains insufficient. To investigate which factor, host genus or location, has a greater impact on the lichen mycobiome, we conducted a comparative analysis of mycobiomes within Parmelia and Peltigera collected from both Turkey and South Korea, using high-throughput sequencing based on internal transcribed spacer region amplification.ResultsOverall, the lichen mycobiome was dominated by Capnodiales (Dothideomycetes), regardless of host or location. At the order level, the taxonomic composition was not significantly different according to lichen genus host or geographical distance. Hierarchical clustering of the top 100 abundant ASVs did not clearly indicate whether the lichen mycobiome was more influenced by host genus or location. Analyses of community similarity and partitioning variables revealed that the structure of the lichen mycobiome is more significantly influenced by location than by host genus. When analyzing the core mycobiome by host genus, the Peltigera mycobiome contained more ASV members than the Parmelia mycobiome. These two core mycobiomes also share common fungal strains, including basidiomycete yeast. Additionally, we used chi-squared tests to identify host genus-specialists and location-specialists.ConclusionsBy comparing lichen mycobiomes of the same genera across different countries, our study advances our comprehension of these microbial communities. Our study elucidates that, although host species play a contributory role, geographic distance exerts a more pronounced impact on the structure of lichen mycobiome. We have made foundational contributions to understanding the lichen mycobiome occupying ecologically crucial niches. We anticipate that broader global-scale investigations into the fungal community structures will provide more detailed insights into fungal residents within lichens.

Urban-Rural Disparities in Food Insecurity and Weight Status among Children in the United States.

Place of residence (urban versus rural) is a contextual determinant of health that has received less attention in the food insecurity literature. The purpose of this study was to assess the urban-rural disparity in the prevalence of food insecurity and weight status among US children. Using data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 with three age groups of children (2-5, 6-11, and 12-17 years old), the associations of weight status and child and household food security status by urban-rural residence were examined using Rao-Scott Chi-square tests. Statistical significance was set at p < 0.05. Children living in urban areas were significantly more likely to experience household food insecurity (29.15%) compared to their rural counterparts (19.10%), among those aged 6-11 years. The associations between children's weight status and child and household food security status were significant for children living in urban areas overall and different age groups but not for children living in rural areas. These trends were more pronounced in older age groups. Given the link between food insecurity and higher obesity rates, particularly among urban children, this study highlights the importance of incorporating food security interventions into future obesity prevention programs.

Perceptions and experiences of community pharmacists with off-label prescribing in the pediatric population.

This study aimed to investigate and provide insight into the prevalence and patterns of off-label drug use in the pediatric population from the perspective of community pharmacists, addressing the existing data gap in a developing setting. A questionnaire-based cross-sectional study was conducted on Albanian community pharmacists in June 2021. The online administered survey explored the participants' demographic details, perceptions, and experiences with off-label prescriptions in pediatric patients. The statistical analysis conducted on the survey data comprised the construction of frequency tables and the application of the chi-square test for independence. Three hundred and thirty-six community pharmacists nationwide completed the survey, out of which 186 (55.3%) were practiced in Tirana, the capital of Albania. Over 80% of surveyed pharmacists (n = 275) had encountered off-label drug prescriptions in pediatric patients, yet only 40% of participants reported dispensing medicines for off-label use. Community pharmacists reported that general pediatricians tended to prescribe off-label medications more frequently than pediatric subspecialists or general practitioners. It was found that off-label prescriptions were more frequently observed among children aged between 2 and 11 years. Antibiotics were the most reported medicines for off-label use in this study mentioned in almost all off-label categories. Prescribing medicines for unapproved uses for the treatment of pediatric patients is present in community settings in Albania. This indicates the need for further data collection and analysis to understand off-label practices in our country's pediatric population comprehensively.

A four-year assessment of the characteristics of Rwandan FDA drug recalls

BackgroundA drug recall is an act of removing products from the market and/or returning them to the manufacturer for disposal or correction when they violate safety laws. Action can be initiated by the manufacturing company or by the order of a regulatory body. This study aimed to assess the characteristics of Rwanda FDA drug recall and determine the association between classes of recall and recall characteristics.MethodologyThis was a retrospective descriptive cross-sectional study. Data about recalled drugs were collected from the official website of the Rwanda FDA in the section assigned to “Safety alerts”. The search included data reported between February 2019 and February 2023 covering four years. Data cleaning was conducted in Microsoft Excel to address missing data and inconsistencies, followed by importation into STATA/SE software version 17.0 for further cleaning and subsequent analysis. Descriptive statistics were computed for independent variables. Categorical variables were described in terms of counts and relative frequencies. Bivariate analyses used Pearson’s chi-square test to illustrate the associations between categorical independent variables and recall classes.ResultsThe study revealed that a large proportion (33.0%) of the recalled products belonged to Class I. Antibiotics constituted 35.8% of the recalled products, with contamination emerging as a leading cause and responsible for 26.4% of the recalls. India was the leading manufacturing country for the recalled products (29.2%), followed by France (17.9%), China (17.0%), Kenya (13.2%), and Russia (6.6%). An association was found between the class of recall and several recall characteristics, including the year of recall, drug category, safety issues, reporter, and manufacturing country.ConclusionThis study provides a comprehensive overview of the characteristics of drug recalls in Rwanda. The insights gained contribute to a nuanced understanding of recall dynamics and provide evidence-based strategies to enhance drug quality, safety, efficacy, regulatory compliance, and patient welfare.

P-626 Progesterone rescue is effective for clinical pregnancy outcome in women presenting low circulating progesterone levels at frozen embryo transfer day

Abstract Study question Is subcutaneous progesterone (prolutex® 25mg daily) addition effective for clinical pregnancy outcome in women presenting low progesterone(P4) levels at frozen embryo transfer(FET) day? Summary answer Subcutaneous progesterone rescue improved ongoing pregnancy rate and clinical pregnancy rate in women with low P4 results at FET day. What is known already FET has been increased, because preimplantation genetic testing for aneuploidies is performed widely, and FET presents a significantly low risk of ovarian hyperstimulation syndrome.In FET, there is no established optimal protocol for preparing endometrium, but hormonal replacement therapy (HRT) is widely used due to its convenient schedule adjustment. HRT protocol induce anovulation, functioning corpus luteum is lacking and exogenous progesterone administration is very important. Therefore, women showing low P4 levels around FET day have lower pregnancy rate. However, there are currently no data on the effectiveness of progesterone rescue. Study design, size, duration Primary outcomes from a randomized cohort retrospective study investigating subcutaneous progesterone (prolutex® 25mg) daily addition for whom had low P4 levels (&amp;lt;12ng/mL) at FET day. The study was conducted at one infertility center in Korea from January 2022 to December 2023 and pregnancy outcomes of FET transfers registered until Oct. 2023,. 194 patients fulfilled the inclusion criteria. Participants/materials, setting, methods One hundred ninety four women divided into two groups based on progesterone levels, with 12ng/ml as the threshold. Under 12ng/mL group were randomized to subgroup with and without addition of subcutaneous progesterone. In total 278 FET cycles, the effect of progesterone rescue on cumulative clinical pregnancy rate (CPR), Ongoing pregnancy rate (OPR) was reported as primary outcomes. Main results and the role of chance In total 278 cycles, there were 137 cycles with adequate serum P4 levels, while 141 cycles presented with low P4 levels in which randomly rescue subcutaneous progesterone administration added from next day of embryo transfer. When comparing the groups, there was no statistical difference in maternal age, BMI, smokers, duration of infertility, type of infertility, indication of in vitro fertilization(IVF), endometrial preparation method. In low P4 group, with and without subcutaneous progesterone addition subgroups included 51 and 90 cycles, retrospectively. CPR were 52.9% versus 35.6% (P = 0.044; chi-squared test) with a statistically significant higher rate of OPR in progesterone rescue group (45.1% versus 28.9%, p = 0.052). When comparing the group with adequate P4 levels and the group with low P4 levels without progesterone rescue, OPR were 18.2% versus 28.9% (p = 0.06, chi-squared test), CPR was significantly higher in low P4 levels group (23.4% versus 35.6%,p=0.046, chi-squared test). Adequate P4 level group had more IVF attempts (4.6 versus 2.2, p &amp;lt; 0.001, chi-squared test). There is tendency to use more luteal phase support medication with repeated attempt (serum P4 concentration on ET day 39.3 ng/mL versus 8.7 ng/mL, p &amp;lt; 0.001, t-test) Limitations, reasons for caution The main limitation of the study was retrospective, and had small sample size. A control group without progesterone rescue in low P4 levels did not receive any intervention. Wider implications of the findings The progesterone rescue for women presenting low P4 on FET day improved clinical outcome and excessively raising progesterone medication may have adverse effects. Therefore rather than using excessive progesterone administration from luteal support start day, progesterone rescue might be effective when low P4 levels presenting at FET day. Trial registration number not applicable