Chi-square Test Research Articles

Integrated nomogram to predict HER2 expression in breast tumor: Clinical, Ultrasound, and Photoacoustic imaging approaches

BackgroundHER2 is a key biomarker for breast cancer treatment and prognosis. Traditional assessment methods like immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) are effective but costly and time-consuming. Our model incorporates these methods alongside photoacoustic imaging to enhance diagnostic accuracy and provide more comprehensive clinical insights. Materials and methodsA total of 301 breast tumors were included in this study, divided into HER2-positive (3+ or 2+ with gene amplification) and HER2-negative (below 3+ and 2+ without gene amplification) groups. Samples were split into training and validation sets in a 7:3 ratio. Statistical analyses involved t-tests, chi-square tests, and rank-sum tests. Predictive factors were identified using univariate and multivariate logistic regression, leading to the creation of three models: ModA (clinical factors only), ModB (clinical plus ultrasound factors), and ModC (clinical, ultrasound, and photoacoustic imaging-derived oxygen saturation (SO2)). ResultsThe area under the curve (AUC) for ModA was 0.756 (95 % CI: 0.69–0.82), ModB increased to 0.866 (95 % CI: 0.82–0.91), and ModC showed the highest performance with an AUC of 0.877 (95 % CI: 0.83–0.92). These results indicate that the comprehensive model combining clinical, ultrasound, and photoacoustic imaging data (ModC) performed best in predicting HER2 expression. ConclusionThe findings suggest that integrating clinical, ultrasound, and photoacoustic imaging data significantly enhances the accuracy of predicting HER2 expression. For personalised breast cancer treatment, the integrated model could provide a comprehensive and reproducible decision support tool.

Assessment of Behaviour among Households towards Solid Waste Management in GHMC

Background: Rapid urbanization has made domestic waste management a crucial environmental challenge in Hyderabad, which generates 5,500 to 6,000 metric tons of waste daily. Despite regulations, improper disposal practices persist, posing risks to public health and sustainability. Research Methodology: This mixed-methods study used surveys of 404 households and secondary data to assess household waste management behavior in GHMC. Statistical tools like Chi-square tests and ANOVA were used to analyze the influence of demographic factors. Results: Significant variations in waste management practices were found across demographics. Improper disposal methods, such as roadside dumping (mean = 3.43, p-value = 0.13) and burning (mean = 3.17, p-value = 0.572), are prevalent among older adults and higher-income households (mean = 3.44, p-value = 0.002). Conversely, younger individuals (<20 years, mean = 3.36, p-value = 0.084) and lower-income groups (<₹10,000, mean = 3.13, p-value = 0.805) show better adherence to sustainable practices like the 3R's and composting (mean = 3.32, p-value = 0.013). Education level also influences waste management behavior, with primary education correlating with better practices (mean = 3.41, p-value = 0.315). Conclusion: Targeted interventions are needed to address improper disposal practices among older and higher- income groups. Positive trends in waste facility utilization and e-waste disposal are noted, but burning and burying waste remain common. Enhanced educational campaigns and infrastructure improvements are essential for sustainable waste management. Keywords: Solid Waste Management, Household Behavior, Urbanization, Environmental Sustainability, Waste Segregation, Greater Hyderabad Municipal Corporation (GHMC), Recycling, Waste Reduction, Education, Public Health.

Evaluating Retention of Onlay Versus Complete Coverage Using E.Max-Restoration

This study compared the retention of different types of indirect restorations (only or full coverage) utilized on endodontically treated molars. Fourteen patients requiring restoration of endodontically treated molars were randomly allocated into two groups (n = 7) according to the type of restoration used. lithium disilicate ceramic crowns were given to the control group. While lithium disilicate ceramic onlays were given to the intervention group. The heat pressing technique was used for the fabrication of both restorations. Following the final cementation with adhesive resin cement, the restoration was assessed at three, six, twelve, and twenty-four months using the modified USPHS criteria. Statistical analysis was performed using the chi-square test. Results: At all intervals, there was no statistically significant difference in retention (P > 0.05) between the two tested groups. Both groups showed comparable results, with full coverage showing somewhat higher retention after 2 years. Regardless of the type of restoration, the emax-press produced high clinical performance in terms of retention. Compared to full coverage, onlay has proven to be a trustworthy substitute.

Pediatric and Adolescent Gynecology Experience in OBGYN Residency Training across the United States

Study ObjectiveThe purpose of this study is to better understand the pediatric and adolescent gynecology (PAG) experience from the obstetrics and gynecology (OBGYN) resident perspective and its impact on physician comfort with caring for younger patients. MethodsThis is a cross-sectional survey study of physicians enrolled in OBGYN residency programs in the United States. For each program, an internet search was also performed to identify the closest PAG providers. Chi-square and Fisher's exact tests were performed to compare categorical variables. This study was IRB approved. Results74 resident responses from 42 unique OBGYN training programs were included. The majority (62%) of programs offered no PAG clinical experience. Of programs with no PAG clinical experience, 45% had unaffiliated self-identified PAG providers within 30 miles of their institution. Only 26% of residents reported having a dedicated PAG rotation. 68% of residents felt they did not have enough PAG exposure in training. Residents who had a dedicated PAG rotation were more comfortable caring for patients <7 years old (p=0.016) and patients 8-14 years old (p=0.019) than residents without a rotation. The majority (88%) of residents believe that PAG experience will be useful for their future practice. ConclusionResidents with PAG training are more comfortable in caring for patients <14 years than those in programs who lack this training. Residencies without PAG-trained staff physicians could consider partnering with PAG-practicing community physicians with the aim of broadening clinical experience. Improvement in PAG education helps provide graduating obstetrician-gynecologists with the necessary knowledge to provide needed care to younger patients.

Associations Between CYP3A5 (c.6986A>G) Gene Polymorphism and Kidney Impairment in Hypertensive Adults Without Cystatin C Elevation.

This study aimed to explore the potential role of CYP3A5 (c. 6986A>G) gene polymorphism in predicting kidney function impairment in patients with hypertension who did not have elevated serum cystatin C. We recruited a group of patients with hypertension who did not have elevated cystatin C and analyzed the CYP3A5 (c. 6986A>G) gene polymorphism. Chi-square tests were used to compare the clinical characteristics and genotypic distribution between the two groups. Logistic regression analysis was used to explore the association between CYP3A5 (c.6986A>G) gene polymorphism and renal function impairment in hypertension with non-elevated cystatin. In patients with hypertension who participated in the study, there was a significant association between CYP3A5 (c. 6986A>G) gene polymorphism and kidney function impairment (p < 0.05). Patients with the CYP3A5 (c. 6986A>G) mutation display a greater risk of kidney function impairment. CYP3A5 (c. 6986A>G) gene AA homozygote polymorphism significantly increases risk of kidney function impairment in patients with hypertension with normal cystatin C. However, further studies are needed to validate this association and to further understand the mechanism of CYP3A5 (c. 6986A>G) gene polymorphism in kidney function impairment in patients with hypertension.

Incremental prognostic value of cardiovascular magnetic resonance imaging in patients with severe LV dysfunction undergoing coronary artery bypass grafting.

Coronary artery disease (CAD) remains a significant global health issue, particularly when complicated by left ventricular ejection fraction (LVEF) < 35%. Although coronary artery bypass grafting (CABG) is recommended for such cases, the unclear prognosis necessitates further investigation. This retrospective study aimed to determine whether cardiovascular magnetic resonance (CMR) imaging provides additional prognostic value in guiding effective clinical management. The study included patients with CAD and LVEF < 35% who underwent CABG surgery after enhanced CMR between March 2016 and March 2023. CMR was performed using a 3.0T scanner with steady-state free precession and phase-sensitive inversion recovery sequences. Prognostic analysis of clinical and CMR data was conducted, with the endpoint defined as cardiovascular death, revascularization, hospitalization for heart failure, or stroke. Statistical analysis included Student's t-test, chi-squared test, univariate and multivariate Cox regression analysis, receiver operating characteristic analysis, Harrell C statistical analysis, integrated discrimination improvement (IDI), and net reclassification improvement (NRI) analysis. The study included 152 patients (mean age 58.6 ± 9.7 years; 138 men). During a mean follow-up of 2.0 years, 8 patients experienced cardiovascular death, while 1 case had revascularization, 13 had hospitalization for heart failure, and 11 had a stroke. Left atrial diameter index (LADi) (hazard ratio [HR], 1.08 [95% confidence interval (CI): 1.02-1.15]; P = 0.04) and late gadolinium enhancement (LGE) mass (HR, 1.03 [95% CI: 1.01-1.06]; P < 0.001) were associated with the endpoint, even after adjusting for multiple clinical variables. Adding LADi and LGE mass improved risk prediction for adverse events, as indicated by the C-index (0.738, p < 0.01), IDI (0.36), and NRI (0.13). Left atrial diameter index (LADi) and scar burden are valuable prognostic indicators in patients with LVEF < 35% undergoing CABG. They offer enhanced risk stratification beyond traditional clinical factors, highlighting their importance in guiding clinical management.

A difference in application time between two direct orthodontic bonding methods: A prospective randomized clinical trial.

This clinical study aimed to evaluate the difference in the time of application phase, employing the conventional and modified direct orthodontic bonding method. Thirty patients who needed orthodontic therapy with fixed appliances were randomly divided into two equal groups (n = 15): the control and experimental group, according to the bonding method applied. A total of 600 metal brackets inch slot 0.022 (Mini Sprint®, Forestadent, Germany) were bonded to incisors, canines, and premolars using the light-cured adhesive Transbond XT (3M Unitek, Monrovia, CA, USA). The failure rates of the brackets were evaluated within 12 months. The independent samples t-test was applied. The Chi-square test and Fisher exact test were used for statistical analysis. The initial bonding time using the modified method was significantly shorter (3.27 min or 17.1% per patient) compared with the conventional bonding method (p < 0.001). Number of failed brackets between the two methods did not differ significantly (p = 0.226). The time of the application phase in initial bonding using the modified method (experimental group) was shorter than in control group. There was no statistically significant difference in the number of bond failures between the two methods. The modified application phase of direct orthodontic bracket placement shortens the total bonding time and facilitates the manual work of orthodontists.

Enhancing patient informed consent in elective skin cancer surgeries: a comparative study of traditional and digital approaches in a German public hospital

BackgroundThis study aims to investigate the integration of modern sources of patient information, such as videos, internet-based resources, and scientific abstracts, into the traditional patient informed consent process in outpatient elective surgeries. The goal is to optimize the informed consent experience, enhance patient satisfaction, and promote shared decision making (SDM) between patients and surgeons. By exploring different patient informed consent formats and their impact on patient satisfaction, this research seeks to improve healthcare practices and ultimately enhance patient outcomes. The findings of this study will contribute to the ongoing efforts to improve the informed consent process in public hospitals and advance patient-centred care.MethodsData collection occurred at the day care clinic of a prominent German public hospital, forming an integral component of a prospective clinical investigation. The study exclusively focused on individuals who had undergone surgical intervention for skin cancer. For the purpose of meticulous data examination, the statistical software SPSS version 21 was harnessed. In the course of this study, a chi-square test was aptly employed. Its purpose was to scrutinize the nuances in patient experiences pertaining to informed consent across four distinct categories, viz., oral informed consent discussion (Oral ICD), written informed consent discussion (Written ICD), video-assisted informed consent discussion (video-assisted ICD), and digitally assisted informed consent discussion (digital-assisted ICD). The primary dataset of this inquiry was diligently gathered via a structured questionnaire administered to a targeted cohort of 160 patients. Within this sample, a balanced representation of genders was observed, encompassing 82 males and 78 females. Their collective age span ranged from 18 to 92 years, with an average age of 71 years. A randomized selection methodology was employed to include participants in this study during the period spanning from July 2017 to August 2018.ResultsSignificant differences were observed across the groups for all research questions, highlighting variations in patient responses. Video-assisted and digital-assisted IC were rated as superior in patient satisfaction with information compared to written and oral IC. Demographic profiles of the four study groups were found to be comparable.ConclusionThe findings of this study indicate that the incorporation of digital technologies in the informed consent process can enhance patient understanding during outpatient elective skin cancer surgeries. These results have important implications for increasing patient satisfaction and improving the SDM process within the hospital environment.

Impact of a simulator-based training program on the success rate of external cephalic version

ObjectiveTo compare the success and complication rates of external cephalic version before and after the implementation of a simulator-based training program at a tertiary care university centre with a dedicated external cephalic version team. Study designIn this single-center intervention study, the success rate and the complication rates of external cephalic version in the two years before the implementation of a simulation-based training program for all specialists and residents, were compared with the two years following the event. T- student, Mann-Whitney, and Chi-square tests were used. All data were extracted from the hospital’s electronic patient records. ResultsA total of 96 external cephalic versions were performed in the 2 years before the training program, and 74 after the training program. The overall success rates were similar between the two groups: 44.8 % before training and 43.2 % after training (p = 0.824). No major complications occurred, and no emergency cesarean deliveries were performed in either period. ConclusionIn a tertiary care university training center with a dedicated team in external cephalic version, a structured simulation-based training program did not impact the success rate or the complication rates of the procedure.

Clinical profiles of community-acquired Pseudomonas aeruginosa infections in children

Objectives: To investigate clinical characteristics, outcomes and antimicrobial resistance of community-acquired Pseudomonas aeruginosa (CAPA) infections in Chinese pediatric patients. Methods: This retrospective study was conducted at 6 tertiary hospitals in China during January 2016 to December 2018. The clinical and microbiological data of CAPA infected hospitalized children in Hainan and in other regions were collected and compared, and the antimicrobial resistance patterns, clinical characteristics and antibiotic therapy were analyzed. Between different groups were compared using the Chi-square test and Mann-Whitney U test. Results: Among 91 patients, 63 cases were males, 28 cases were females, and 74 cases were from Hainan province, 17 cases were from other regians. The age of consultation was 22.5 (5.4, 44.0) months. Twenty-four cases (26%) had underlying diseases. Fever (79 cases (87%)) and cough (64 cases (70%)) were common initial symptoms. Other concomitant symptoms included wheezing 8 cases (9%), diarrhea 3 cases (3%) and vomiting 4 cases (4%). Twenty-eight cases (31%) had organ infections, including pneumonia 22 cases (24%), skin infection 5 cases (5%), meningitis, intra-abdominal infection and upper urinary tract infection each 1 case (1%). The resistance rate of CAPA isolates to cefepime (4% (4/90)), amikacin (1% (1/90)), ciprofloxacin (2% (2/90)) and levofloxacin (1% (1/89)) was low, and to ceftazidime, piperacillin, piperacillin-azobactam, carbapenem was 12% (11/90), 3/16, 18% (10/56) and 6% (5/90), respectively. Antimicrobial combination therapy accounted for 52% (47/91) of empirical therapy and 59% (52/88) of definite therapy. Two cases (2%) were hopeless discharged, and 3 cases (3%) died during hospitalization. The worse prognosis of CAPA infection is significantly different among children in other regions and in Hainan (4/17 vs. 1% (1/74), χ²=9.74, P<0.05). Conclusions: The invasive CAPA-infection has regional difference in incidence and prognosis in China. Clinical symptoms and signs are non-specific. CAPA strains isolated from pediatric patients display low level of resistance to most of the common antipseudomonal antibiotics. The proportion of poor prognostic outcome is lower in Hainan than in other regions.

Primary observational study of tocilizumab in children with severe acute necrotizing encephalopathy

Objective: To investigate the efficacy and safety of tocilizumab in the treatment of critically ill children with acute necrotizing encephalopathy (ANE). Methods: It is a retrospective cohort study. The children with ANE admitted to the pediatric intensive care unit of 4 Chinese tertiary hospitals from December 2022 to November 2023 were divided into conventional treatment group and tocilizumab group, and the comparison between groups was performed by using Mann - Whitney U test or Chi-square test. Results: Among 21 cases of severe ANE, there were 11 males with the onset age of 65 (27, 113) months. The duration from onset to PICU admission was 2 (1, 2) days. There were 13 cases of ultra-high fever (greater than 40 ℃), including 18 cases of convulsions, and 19 cases with a GCS score of less than 8 points. The causative agent was novel coronavirus Omicron in 7 cases and influenza A in 14 cases. All cases had central respiratory failure requiring mechanical ventilation. Of the 21 cases, 18 were shock, 15 were coagulopathy, 10 were kidney injury and 13 were liver dysfunction. Of these hospitalized patients, 8 children with ANE were treated with tocilizumab. Eight cases received continuous blood purification (CBP) treatment, 5 of them were combined with plasmapheresis. Serum cytokine levels were elevated in 21 children with ANE, including (interleukin, IL)-6 and IL-8 (61 (22, 1 513) and 68 (5, 296) ng/L). There were 14 cases (67%) deaths, including 11 cases in the conventional treatment group and 3 cases in the tocilizumab group. There was no significant difference in the mortality rate between the two groups (P=0.056). Tocilizumab-related rash or other adverse events were not observed. Conclusions: The motality of critically ill ANE patients was high. The combination of Tocilizumab with conventional treatment did not reduce the motality of severe ANE patients, and no adverse reactions of tocilizumab were observed.

Analysis of genetic etiology of 234 deaths in the pediatric intensive care unit with suspected genetic diseases

Objective: To explore the genetic etiology of pediatric intensive care unit (PICU) mortality cases and summarize their clinical characteristics. Methods: This was a retrospective cohort study. The study population consisted of 234 children who died within 7 d after admitted to the PICU of Children's Hospital of Fudan University from January 2017 to December 2021. The clinical diagnoses, laboratory test results, and genetic testing results were collected. These patients were divided into the pathogenic gene variation positive (PGVP) group and the pathogenic gene variation negative (PGVN) group according to the results of genetic testing. The Mann-Whitney U test and Pearson's chi-square test or Fisher's exact probability method were used to compare the clinical characteristics between the groups. Results: A total of 234 cases were enrolled, including 139 (59.4%) males and 95 (40.6%) females. The age at death was 1.0 (0.4, 3.7) years old and the length of PICU stay was 16 (6, 33) days. There were 62 cases (26.5%) PGVP, and the mutated pathogenic genes included immune genes (23 cases (37.1%)), metabolic genes (11 cases (17.7%)), neuromuscular genes (11 cases (17.7%)), cardiovascular genes (4 cases (6.5%)), and genes of other systems (13 cases (21.0%)). The age at death in PGVP cases was significantly lower than in PGVN cases (0.6 (0.3, 1.4) vs. 1.3(0.5, 4.3) years old, Z=3.85, P<0.001). Compared with the PGVN group, the PGVP group had a higher incidence of family history and chronic complex conditions (CCC) than the PGVN group (6.5% (4/62) vs. 0.6% (1/172) and 93.5% (58/62) vs. 76.2% (131/172), χ2=8.87, P=0.018 and 0.003, respectively). Children in the PGVP group were admitted with higher incidence of severe infection, decreased consciousness or coma, moderate-to-severe anemia, thrombocytopenia, protracted diarrhea, and abnormalities in muscle strength or tone than those in the PGVN group (74.2%(46/62) vs. 45.9%(79/172), 50.0%(31/62) vs. 35.5%(61/172), 32.3%(20/62) vs. 18.0%(31/172), 21.0%(13/62) vs. 10.5%(18/172), 25.8%(16/62) vs. 4.1%(7/172), 16.1%(10/62) vs. 5.2%(9/172), χ2=14.63, 4.04, 5.41, 4.37, 24.30, 7.25, all P<0.05). Pathogenic genes that occurred more than twice included IL2RG (5 cases), SMN1 (4 cases), and SH2D1A (3 cases, including 2 single gene varients and 1 copy number varient). Conclusions: Among the deceased cases in the PICU, the main genetic causes are immune-related, metabolic, and neuromuscular genetic disorders. Critically ill children with a family history, CCC, and early features such as severe infections, decreased consciousness or coma, moderate to severe anemia, thrombocytopenia, protracted diarrhea, or abnormalities in muscle strength or tone should be closely monitored and undergo early genetic testing.

Risk of immediate postoperative fever in PFAPA patients undergoing tonsillectomy

ObjectivePeriodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is the most common periodic fever syndrome in children. Tonsillectomy is considered a potential treatment option.A common concept is that patients with PFAPA are more likely to have postoperative fever, which might be hard to distinguish from other etiologies such as malignant hyperthermia or drug adverse effects. For this reason, many institutions require these patients to be cared for at their main center and not at satellite centers.Our objective was to evaluate the rate of immediate postoperative fever in PFAPA patients undergoing tonsillectomy. Material and methodsFollowing IRB approval (STUDY20060029), a retrospective chart review of all PFAPA patients who underwent tonsillectomy at a tertiary children's hospital between January 1st, 2013, and September 30th, 2022.The PHIS database was queried from January 1st, 2013, to June 30th, 2022, for pediatric tonsillectomy and PFAPA. ResultsSixty-one patients underwent tonsillectomy for PFAPA during the study period at our institution. Only one (1.6 %) had immediate postoperative fever. Fever episode resolution was seen in 90.25 % of patients, 41/41 (100 %) of the patients reported fever episodes pre-op, compared with 4/41 (9.75 %) post-op (McNemar's Chi-squared test, Chi2 = 37.0, p < 0.001).481,118 pediatric tonsillectomies were recorded in the PHIS database during this period, 1197 (0.25 %) were also diagnosed with PFAPA. None of the PFAPA patients had an immediate post-operative fever. ConclusionsOur results suggest there is no increased risk of immediate postoperative fever in PFAPA patients undergoing tonsillectomy.

Nutritional Deficiencies, Vitamin D Levels, and other Risk Factors in Pediatric Tuberculosis Patients

Background: Tuberculosis (TB) is a major world health challenge affecting more than 9 million people every year of which more than 1 million are children. It presents non-specific symptoms and for this reason has been described as a silent epidemic, especially in the diagnosis of childhood TB, especially in bacteriological confirmation. Understanding the risk factors of TB in children is therefore important. Objectives: to describe socio-economic, environmental, and health related characteristics of childhood TB patients in Nowshera, Pakistan, and their risk factors in order to propose public health interventions. Study design: A Cross-Sectional-Study Place and duration of study : This research study is proposed to be conducted in Nowshera Medical College / Nowshera Medical College / Qazi Hussain Ahmed Medical Complex situated in Nowshera, Khyber Pakhtunkhwa province of Pakistan over a period of eight months starting from the first of 03 March 2022 to 03 December 2022 Materials and Methods: A cross-sectional study was carried out at the DOTS-center of Nowshera Medical College / Qazi Hussain Ahmed Medical Complex Nowshera from 1st March to 31st October 2022 and comprised of 130 patients. In this study, Convenience sampling (Non probability) was used. The data was collected by a structured questionnaire and analyzed by statistical package for the social sciences (SPSS version 24). Quantitative data were described by measures of central tendencies; mean and standard deviation and qualitative data were described by frequencies and percentages. Chi-square test was used to test the relationship between variables where the level of statistical significant was set at P ≤ 0. 05. Results: Participants included mainly the study population of children aged 0-15 years, and the gender was equally split throughout boy 50% and girls 50%. A large percentage (69. 2%) were from low income earners’ homes, and 66. 9% of the respondents were from rural areas. Subjects’ Body Mass Index (BMI) varied from less than 18 to more than 25. Of special interest, 43. 8% of the children with TB had not been administered BCG vaccination. The source of infection, that is, contact with an adult TB patient, was reported in 43. 8% while the rest were in the 56. 2 % who had no such history. Conclusion: childhood TB in the population under study is significantly related with some factors namely; direct contact with TB patients, low economic status, crowded housing, poor ventilation and malnutrition

Effectiveness of caring behaviours course on decision-making and caring behaviours in undergraduate nursing students: An experimental study.

Although caring is a core principle of the nursing profession, students often lack the knowledge, comprehension and ability to integrate care into all aspects of nursing practice. Students may have few opportunities to practise caring behaviours on patients who create the impression of providing care and elicit a feeling of receiving care. Studies of strategies to enhance caring behaviours in nursing education are limited. This experimental study aimed to examine the effect of nursing caring behaviours course based on interactive learning strategies on the caring behaviours and decision-making abilities of nursing students. A purposive sample of 50 undergraduate students was recruited from a faculty of nursing. Students in the intervention group (n = 24) received 2 h of training per week for 14 weeks in accordance with caring behaviours course based on interactive learning strategies including discussion, brainstorming, concept mapping, reflection and simulation training. Nursing students in the control group (n = 26) received training according to other elective courses in the curriculum. Data were measured at the baseline time point, 7th week and 14th week with the Caring Behaviours Inventory and Nursing Decision-Making Instrument. Chi-square test, Mann-Whitney U-test, Friedman test and mixed repeated measures ANOVA were used to assess the data. No significant difference was determined in terms of baseline caring behaviours and decision-making scores between the intervention and control groups (p > 0.05). A significant difference in caring behaviours between the two groups and time effect was not found (p > 0.05). However, there was a significant interaction between time and groups (F = 3.484, p = 0.047). There was a significant increase in the decision-making in intervention groups over time (F = 9.372, p < 0.001) and interaction between time and groups (F = 4.160, p = 0.019). A deliberate strategy to raise students' awareness of caring behaviours and incorporate interactive learning methods into education enhances both caring behaviours and clinical decision-making.

Health literacy and its associated factors among the population in two schistosomiasis-endemic villages in Jiangxi Province, China.

This cross-sectional study aimed to assess the levels of health literacy and the associated factors among the general population living in 2 schistosomiasis-endemic villages in Jiangxi Province, China. Multistage stratified random sampling was used to select participants, and a face-to-face survey was conducted from July to August 2021 to collect participants' socio-demographic characteristics and levels of overall health literacy (HL) and its 3 subscales: health literacy of basic knowledge and concepts (HL-BKC), health literacy of behavior and lifestyle (HL-BAL), and health literacy of health-related skills (HL-HRS). The Chi-square test and logistic regression models were used to assess the association between socio-demographic characteristics and low HL levels. The prevalence rates of low overall HL, HL-BKC, HL-BAL, and HL-HRS were 84.3%, 61.8%, 82.6%, and 86%, respectively. In addition, no significant differences (P > .05) were noted between the 2 villages regarding overall HL scores and the 3 subscales of health literacy scores. Older age (P < .001), occupation (P < .001), lower educational level (P < .001), and lower annual household income (P < .05) were associated with an increased risk of low HL. Multivariate logistic regression revealed that occupation as a student (OR = 32.289, 95% CI:1.965-530.462, P < .05) and fishermen (OR = 27.902, 95%CI:1.91-407.642, P < .05), lower education level (OR = 0.384, 95%CI:0.149-0.99, P < .05), older age (OR = 5.228, 95%CI:1.458-18.75, P < .001), and lower annual household income (OR = 0.452, 95%CI:0.24-0.851, P < .05) were independently associated with low HL. The prevalence of low HL is high among the population in the schistosomiasis-endemic villages of Jiangxi Province, China. Age, education level, occupation, and annual household income were all independent factors associated with HL levels. Health educational interventions to improve HL should be simultaneously conducted in health promotion work to reduce risky habits.

Intentional physical self-injury in Auckland: patterns, associations and clinical implications in a single-centre cross-sectional study

introduction: Intentional physical self-injury (IPSI) is a pressing health challenge and there is little awareness of injury patterns, management and outcomes. This study examines IPSI’s epidemiological and clinical aspects in one major Auckland hospital, highlighting demography, injury patterns and implications for clinical practice and prevention. methods: Using Auckland City Hospital Trauma Registry data, a retrospective, descriptive study was conducted covering adult patients admitted from January 2015 to December 2019. It assessed demographic characteristics, injury patterns and outcomes, using Mann–Whitney U tests, Fisher’s exact tests and Chi-squared tests. results: Among 137 IPSI admissions, 92 (67%) required surgery, and 24% experienced post-operative complications. Major trauma was identified in 39 (28.5%) admissions. Discharge destinations varied, with only 64 (47%) patients returning home unassisted. Injury severity did not significantly vary across sex, age or injury event location. Major injuries often resulted from falls (19 of 39) and minor injuries from lacerations/stabs (73 of 98). conclusions: IPSI represents a significant challenge to Auckland health services, with a notable burden of care. The study highlights the need for targeted interventions to reduce the incidence of IPSI and improve outcomes. It underscores the importance of multidisciplinary approaches to care, integrating surgical, mental health and rehabilitative services.

Factors associated with low back pain in ready-made garments workers in Bangladesh

ObjectivesLow back pain (LBP) is an increasingly prevalent work-related condition that affects workers in manufacturing in Dhaka, Bangladesh, which often causes disability or additional problems when doing demanding physical duties. This study focused on the risk factors for LBP in the context of workers with LBP who work in the ready-made garment (RMG) factories.Methods and materialsA cross-sectional study involved 385 RMG workers, all of whom were adults with ≥ 1 year of work job experience and who typically worked in a sitting position. We use surveys method for collecting data, and a standardized questionnaire covering sociodemographic, pain, work, associated effects, and activities, as well as risk factor-related variables, was used. To evaluate the associations among categorical variables and LBP, we used the chi-square test. To identify the variables that showed strong relationships with LBP, multivariable logistic regression analysis was also carried out.ResultsThe participant’s age (mean ± SD) is 31.27 ± 6.94. One-hundred ninety-four of the 385 participants between the ages of 30–39 years (23.9%) suffered from LBP and statistically strongly significant (χ2 = 15.187, p < 0.05). BMI, employment pattern, and specific work experience are also strongly significant. Out of all risk factors, age 40 and above (OR 1.65, 95% CI 1.53–17.78), overweight (BMI > = 25 kg/m2) (OR 10.72, 95% CI 2.16–53.5), work in an awkward position, stationary position for ling time, working beyond physical ability, incorrectly using body mechanics, repeated twisting and bending, continuously longtime sitting, and using ergonomically improper tools were found to be significantly associated with LBP.ConclusionThe point prevalence of LBP among RMG workers is 41.6%. Only male gender is associated with the presence of LBP. This study showed that working in an awkward position, stationary position for a long time, incorrectly using body mechanics, repeated twisting, and bending had significant associations with LBP. Training programs that instruct proper weight-bearing skills should be encouraged by factories. The occurrence of LBP must also be reduced by regularly performing screening activities to detect it, with a special focus on married people, overweight or obese, and older-aged people.

Development of a dry eye index as a new biomarker of dry eye disease.

To evaluate signs and symptoms in patients diagnosed with dry eye disease (DED), divided into dry eye (DE) groups, in order to find a new biomarker that allows an accurate diagnosis, management and classification of DED. This cross-sectional, observational study included 71 DED subjects. Subjective symptoms, visual quality and DE signs were assessed using the Ocular Surface Disease Index (OSDI), the Quality of Vision (QoV) questionnaire, best corrected distance visual acuity (VA), functional visual acuity (FVA), contrast sensitivity (CS), high- and low-order corneal aberrations (HOA and LOA, respectively), tear break-up time (TBUT), Meibomian Gland Dysfunction (MGD), Schirmer test, corneal staining, lid wiper epitheliopathy (LWE) and meibography. Participants were classified into three groups based on dryness severity using a cluster analysis, i.e., mild (N = 17, 55.8 ± 15.4 years), moderate (N = 41, 63.5 ± 10.6 years) and severe (N = 13, 65.0 ± 12.0). A new Dry Eye Severity Index (DESI) based on ocular surface signs has been developed and its association with symptoms, visual quality and signs was assessed. Comparisons between groups were made using Kruskal-Wallis and Chi-squared tests. Spearman correlation analysis was also performed. The DESI was based on three tests for DE signs: TBUT, Schirmer test and MGD. The DESI showed significant differences between different pairs of groups: Mild Dryness versus Moderate Dryness (p < 0.001), Mild Dryness versus Severe Dryness (p < 0.001) and Moderate Dryness versus Severe Dryness (p < 0.001). The DESI was significantly correlated with age (rho = -0.30; p = 0.01), OSDI score (rho = -0.32; p = 0.007), QoV score (rho = -0.35; p = 0.003), VA (rho = -0.34; p = 0.003), FVA (rho = -0.38; p = 0.001) and CS (rho = 0.42; p < 0.001) Also, significant differences between the severity groups were found for OSDI and QoV scores, VA, FVA, CS and MGD (p < 0.05). The DESI has good performance as a biomarker for the diagnosis, classification and management of DED.

Effects of world stroke campaign on stroke literacy and knowledge in Taiwan

ABSTRACT Objectives Stroke is a leading cause of death in Taiwan. Poor public knowledge of stroke may lead to delays in prehospital arrival, resulting in unfavorable prognoses. Studies have investigated public knowledge of stroke and highlighted the importance of stroke education, however, few such studies have been conducted in Taiwan. This study assessed the changes in public knowledge of stroke between 2012 and 2020 by conducting a survey during two World Stroke Day events. Furthermore, this study identified areas where educational efforts may have been insufficient. Materials & Methods Questionnaires were distributed to the participants of 2012 and 2020 World Stroke Day events in Taiwan. In total, 328 and 336 questionnaires were completed, respectively. Stroke literacy and knowledge were analyzed between 2012 and 2020. Data were analyzed using the chi-square test or independent t-test. p < 0.05 indicates statistical significance. Results Hypertension was the most recognized risk factor for stroke in both years (p < 0.001), and recognition of most of the given risk factors significantly increased. In addition, recognition of more than half of the stroke warning signs significantly increased, awareness of the correct acute stroke response also increased (p < 0.001), and overall stroke literacy in Taiwan increased (p = 0.001). Conclusion Stroke literacy and knowledge in Taiwan have improved significantly between 2012 and 2020, but many people still lack adequate stroke knowledge and awareness. Government health department must take this sort of intervention continually (campaigns) and novel approaches (e.g. board game…) to improve stroke literacy and knowledge in public health. Registration ID N202109072, approved by the Joint Institutional Review Board of Taipei Medical University on 2021/11/02