Edition Of Code Research Articles

Association between hydroxychloroquine use and risk of diabetes mellitus in systemic lupus erythematosus and rheumatoid arthritis: a UK Biobank-based study

Context/ObjectivesHydroxychoroquine has hypoglycemic effects and may reduce the risk of diabetes mellitus (DM). We determined the association between hydroxychoroquine use and the incidence of DM in a population-based cohort of pations with Rheumatic diseaseMethodsA prospective cohort study among 502392 Potentially eligible participants in the context of UK Biobank, recruitment to the database began between 2006 and 2010. Patients diagnosed with diabetes and fasting glucose greater than or equal to 7 mmol/L at baseline (n=619) were excluded and patients diagnosed with either RA or SLE at baseline (n=6793) were followed up until 2022. Diagnosis was recorded using the International Classification of Diseases, tenth edition (ICD-10) code. The mean follow-up was 13.78 years and the primary outcome was newly recorded type 2 diabetes mellitus (T2DM), with the time of onset of diabetes as the follow-up endpoint date.ResultsDuring a median follow-up period of 13.78 (12.93, 14.49) years, diabetes developed in 537 participants, with an incidence of 7.9%. New diabetes cases not taking hydroxychloroquine and taking hydroxychloroquine was 504 (8.03%) and 33 (6.36%), respectively. In univariate models, the hazard ratio for diabetes was 0.89 (95% confidence interval, 0.81-0.98, P=0.014) for hydroxychloroquine users compared with those not taking hydroxychloroquine. After adjusting for age, sex, race, education level, and BMI the hazard ratio for incident diabetes among hydroxychloroquine users was 0.88 (95% confidence interval, 0.80-0.97, P=0.008). In complete multivariate model hazard ratio for hydroxychloroquine was 0.87 (95% confidence interval, 0.79- 0.96, P=0.005).ConclusionHydroxychloroquine was associated with decreased risk of DM among rheumatoid arthritis patients, our data taken together with correlational studies, warrant further investigation of the potential preventive effect of hydroxychloroquine against T2DM.

Comparative Analysis of Seismic Design Standards for Structures and Safety Standards for High-rise Concrete Building Structures

The core of this study is the comparative analysis of I S. 1893 (Part One): 2016 Edition (Code for Seismic Design of Structures) and I S. 16700:2017 (Code for Safety of High rise Concrete Building Structures). In addition, the study aims to uncover the key factors that contribute to poor performance of buildings in earthquakes, with the aim of improving the safety performance of structures in earthquakes in the future. As a research case, we selected a specific reinforced concrete moment shelving frame (SMRF) building at Jabalpur Airport. The building structure was modeled and analyzed using SAPpro V20i software. According to software calculations, we obtained the time history analysis results of the structure in two directions and ensured that they comply with the two Indian standards mentioned above. Subsequently, by comparing the structural responses under the two standards, we evaluated the significant differences in foundation shear force, displacement, and mass participation. The research results indicate that compared to I S. 1893 (Part One): 2016, following I S. The performance of the 16700:2017 structure in earthquakes is relatively poor.

Vitamin D Levels and Temporomandibular Disorders: A Bidirectional Two-Sample Mendelian Randomization Analysis.

Growing researches explore vitamin D's role in temporomandibular disorders (TMDs), but the link between vitamin D and TMDs remains debated. To clarify the causal relationship, we conducted a Mendelian randomization (MR) analysis using data from genome-wide association studies (GWAS). The GWAS dataset of vitamin D (GWAS ID: ukb-d-30890_irnt; sample size: 329247) was obtained from the IEU Open GWAS project. And that of TMDs (GWAS ID: finn-b-TEMPORO; sample size: 134280), initiated on August 25th, 2017 and publicly released on December 18th, 2023, was extracted from the FinnGen dataset, whose cases were diagnosed based on the revised International Classification of Diseases, 10th Edition (ICD-10) code K07.6. Both datasets were obtained from the European population. According to three assumptions of MR analysis, a bi-directional MR analysis was performed to measure the causal relationship, with Inverse variance weighted (IVW) as the primary method and MR Egger and Weighted median as supplement. Moreover, diverse sensitivity analyses, including Cochran's Q test, MR Egger intercept, Mendelian randomized polymorphism RESidual Sum and Outlier (MR-PRESSO), and leave-one-out analysis, were used to verify the stability of the findings. The MR analysis supported causal effects of vitamin D levels on TMDs risks within the European population using IVW method [odds ratio = 1.316; 95% confidence interval = 1.086 to 1.595; P = 0.005], supported by MR Egger and Weighted median. While there was no indication that TMDs have a direct impact on vitamin D levels [β: -0.00738, standard error = 0.00665; P = 0.568]. The study revealed that within the European population higher levels of vitamin D led to higher risks of developing temporomandibular disorders, but found no obvious evidence that TMDs are causally associated with vitamin D. The conclusion should be cautiously interpreted, given the selection bias of TMDs patients sample.

Risk of postoperative pneumonia after extubation with the positive pressure versus normal pressure technique: a single-center retrospective observational study.

A normal pressure extubation technique (no lung inflation before extubation), proposed by the Japanese Society of Anesthesiologists to prevent droplet infection during the coronavirus disease 2019 (COVID-19) pandemic, could theoretically increase postoperative pneumonia incidence compared with a positive pressure extubation technique (lung inflation before extubation). However, the normal pressure extubation technique has not been adequately evaluated. This study compared postoperative pneumonia incidence between positive and normal pressure extubation techniques using a dataset from the University of Tsukuba Hospital. In our hospital, the extubation methods changed from positive to normal pressure extubation techniques on March 3, 2020 due to the COVID-19 pandemic. Thus, we compared the risk of postoperative pneumonia between the positive (April 1, 2017 to December 31, 2019) and normal pressure extubation techniques (March 3, 2020 to March 31, 2022) using propensity score analyses. Postoperative pneumonia was defined using the International Classification of Diseases, 10th Edition (ICD-10) codes (J13-J18), and we reviewed the medical records of patients flagged with these ICD-10 codes (preoperative pneumonia and ICD-10 codes for prophylactic antibiotic prescriptions for pneumonia). We identified 20,011 surgeries, including 11,920 in the positive pressure extubation group (mean age 48.2years, standard deviation [SD] 25.2years) and 8,091 in the normal pressure extubation group (mean age 47.8years, SD 25.8years). The postoperative pneumonia incidences were 0.19% (23/11,920) and 0.17% (14/8,091) in the positive and normal pressure extubation groups, respectively. The propensity score analysis using inverse probability weighting revealed no significant difference in postoperative pneumonia incidence between the two groups (adjusted odds ratio 0.98, 95% confidence interval 0.50 to 1.91, P = 0.94). These results indicated no increased risk of postoperative pneumonia associated with the normal pressure extubation technique compared with the positive pressure extubation technique. Clinical trial number: UMIN000048589 https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000055364.

Learnable and Expressive Visualization Authoring through Blended Interfaces.

A wide range of visualization authoring interfaces enable the creation of highly customized visualizations. However, prioritizing expressiveness often impedes the learnability of the authoring interface. The diversity of users, such as varying computational skills and prior experiences in user interfaces, makes it even more challenging for a single authoring interface to satisfy the needs of a broad audience. In this paper, we introduce a framework to balance learnability and expressivity in a visualization authoring system. Adopting insights from learnability studies, such as multimodal interaction and visualization literacy, we explore the design space of blending multiple visualization authoring interfaces for supporting authoring tasks in a complementary and fexible manner. To evaluate the effectiveness of blending interfaces, we implemented a proof-of-concept system, Blace, that combines four common visualization authoring interfaces-template-based, shelf confguration, natural language, and code editor-that are tightly linked to one another to help users easily relate unfamiliar interfaces to more familiar ones. Using the system, we conducted a user study with 12 domain experts who regularly visualize genomics data as part of their analysis workfow. Participants with varied visualization and programming backgrounds were able to successfully reproduce unfamiliar visualization examples without a guided tutorial in the study. Feedback from a post-study qualitative questionnaire further suggests that blending interfaces enabled participants to learn the system easily and assisted them in confdently editing unfamiliar visualization grammar in the code editor, enabling expressive customization. Refecting on our study results and the design of our system, we discuss the different interaction patterns that we identifed and design implications for blending visualization authoring interfaces.

Principles of criminal law of Ukraine and principles of criminal law protection of professional activity of law enforcement officers

The article analyzes the links between the basic principles of criminal law of Ukraine and the principles governing criminal law protection of professional activities of law enforcement agencies. Special attention is paid to the study of interaction and impact of these principles on law enforcement. The author refers to the contributions of national scholars who have studied the nature of certain principles of criminal law and offers a systematic analysis for further improvement of the regulatory framework. The author emphasizes that modern changes in criminal law should reflect not only historical experience, but also modern challenges that require a deeper understanding and application of the principles of justice, legality, humanism and democracy. The author also emphasizes the need to enshrine the principles in the new edition of the Criminal Code of Ukraine in order to comply with international standards and ensure legal certainty and objectivity of law enforcement. According to the author, there is a need for greater clarity and systematization of the principles of criminal law, and their inclusion in the Criminal Code will help ensure greater transparency and efficiency in their application. The author of the article emphasizes the importance of the principles of criminal law proposed by P. L. Fries, which form the basis for criminal law protection of professional activities of law enforcement agencies, but also emphasizes the possibility of their expansion. In particular, the author proposes new articles for the Criminal Code of Ukraine which include the principles of legality, equality before the law, guilt, justice, individualization of punishment, personal nature of responsibility, humanism, and inevitability of responsibility. The author comes to the conclusion that the principles of criminal law protection of the professional activities of law enforcement agencies are based on constitutional and criminal law principles. The basic principles such as the rule of law, justice, equality before the law, individualization of punishment, and inevitability of liability form the structure of protection of law enforcement officers’ rights. An analysis of the principles which are repeated in constitutional and special criminal provisions shows that it is inappropriate to allocate separate principles for law enforcement officers. The author proposes a two-tier system of principles for effective criminal law protection which avoids duplication of categories and ensures systematic and rational law application.

Rheumatoid arthritis is associated with higher 90-day systemic complications compared to osteoarthritis after total shoulder arthroplasty: a cohort study.

Total shoulder arthroplasty (TSA) in patients with rheumatoid arthritis (RA) can present unique challenges. The aim of this study was to compare both systemic and joint-related postoperative complications in patients undergoing primary TSA with RA versus those with primary osteoarthritis (OA). Using the TriNetX database, Current Procedural Terminology and International Classification of Diseases, 10th edition codes were used to identify patients who underwent primary TSA. Patients were categorized into two cohorts: RA and OA. After 1:1 propensity score matching, postoperative systemic complications within 90 days following primary TSA and joint-related complications within 5 years following anatomic TSA (aTSA) and reverse shoulder arthroplasty (RSA) were compared. After propensity score matching, the RA and OA cohorts each consisted of 8,523 patients. Within 90 days postoperation, RA patients had a significantly higher risk of total complications, deep surgical site infection, wound dehiscence, pneumonia, myocardial infarction, acute renal failure, urinary tract infection, mortality, and readmission compared to the OA cohort. RA patients had a significantly greater risk of periprosthetic joint infection and prosthetic dislocation within 5 years following aTSA and RSA, and a greater risk of scapular fractures following RSA. Among RA patients, RSA had a significantly higher risk of prosthetic dislocation, scapular fractures, and revision compared to aTSA. Following TSA, RA patients should be considered at higher risk of systemic and joint-related complications compared to patients with primary OA. Knowledge of the risk profile of RA patients undergoing TSA is essential for appropriate patient counseling and education. Level of evidence: III.

Real Time Collaborative Code Editor

Abstract: The main goal of our project is to provide an online platform especially for group coding interviews. This platform provides a comprehensive environment for seamless communication between interviewers and candidates, with the goal of addressing the challenges faced during remote technical assessments. The creation ofa feature-rich web platform is the goal of our project. Thisincludes an adaptable rich text editor that enables coding in real time, a mechanism for instantaneous code evaluation via execution and compilation, integrated video conferencing for efficient communication, and the abilityto set up interview rooms to hold several interviews at once. We're designing a user intuitive interface using technology and strong programming frameworks. The main objectives of the platform are to ensure real time code execution and a seamless interview process. This is achieved by incorporating code compilation engines implementing editing tools and utilizing WebRTC for video conferencing. By creating a user-friendly and productive environment that benefits both interviewers and candidates, our platform seeks to expedite the remote technical interview process. This means reducing logistical obstacles, making thorough coding evaluations possible, and creating a positive interview environment.

Implementing an Agile-Driven Centralized System: A Key Strategy for Optimizing Stock Administration Efficiency

The stock administration program architecture involves user roles, such as managers, administrators, and staff, interacting with the system's components to access and process data. The system's development relies on hardware and application elements, including databases, front-end and back-end systems, code editing tools, and local servers. A use-case approach organizes stock administration, with diagrams showing users' interactions with the system. Administrators can manage stock by adding, modifying, or deleting items, while the system provides reports for analysis and decision-making. Staff members can view inventory, adjust stock levels, and receive alerts for low stock. Managers oversee stock requests, analyze reports, and manage staff accounts. A SUS questionnaire was administered to assess usability, revealing user perceptions based on ease of use, efficiency, and satisfaction. Comparing SUS scores across user roles helps identify usability challenges. High scores indicate that the system is user-friendly and effective, while lower scores suggest areas for improvement through training, redesign, or feature enhancements. Users reported high usability for ease of use, with support requirements scoring second highest. Staff ratings highlighted areas for improvement, such as stock level notifications, which can be addressed through redesign or training to enhance system usability.

Mortality from pulmonary hypertension in Europe 2001-2019

BackgroundThe incidence of Pulmonary Hypertension (PH) and Pulmonary Arterial Hypertension (PAH) is believed to be on the rise and is associated with poor outcomes.MethodsWe extracted age-standardized mortality rates (ASMRs) for decedents ≥ 18 years of age from the World Health Organization Mortality Database, using International Classification of Diseases 10th edition codes for PH and PAH, covering the period from 2001 to 2019. The UK and European Union countries with at least 1,000,000 inhabitants and at least 75% of available data points over the study period were included.ResultsBetween 2001 and 2019, in countries with available data, the median ASMR for PH increased by + 1.19 per 1,000,000 (+ 22.51%) in females and + 0.36 per 1,000,000 (+ 6.06%) in males. Out of 19 countries, 13 demonstrate an increase in female PH ASMR, and 12 reported an increase in male PH ASMR. In contrast, median PAH ASMR decreased by -0.29 per 1,000,000 (-28.74%) in females and remained relatively unchanged in males, with a minor increase of + 0.01 per 1,000,000 (+ 1.07%). Notably, there was significant inter-country heterogeneity, with countries such as Hungary, Romania, and Poland displaying results incongruous with the rest of Europe.ConclusionsWhile publicly available mortality statistics for PH may be unreliable, these data suggest an overall increase in mortality across Europe from 2001 to 2019. However, mortality from PAH has shown a decrease in females and a modest increase in males. This underscores the urgent need for robust and high-quality mortality reporting, including international registries, for both PH and PAH.

Predictors of Outcomes and a Weighted Mortality Score for Moderate to Severe Subdural Hematoma.

As the incidence of subdural hematoma is increasing, it is important to understand symptomatology and clinical variables associated with treatment outcomes and mortality in this population; patients with subdural hematoma were selected from the National Inpatient Sample (NIS) Database between 2016 and 2020 using International Classification of Disease 10th Edition (ICD10) codes. Moderate-to-severe subdural hematoma patients were identified using the Glasgow Coma Scale (GCS). Multivariate regression was first used to identify predictors of in-hospital mortality and then beta coefficients were used to create a weighted mortality score. Of 29,915 patients admitted with moderate-to-severe subdural hematomas, 12,135 (40.6%) died within the same hospital admission. In a multivariate model of relevant demographic and clinical covariates, age greater than 70, diabetes mellitus, mechanical ventilation, hydrocephalus, and herniation were independent predictors of mortality (p < 0.001 for all). Age greater than 70, diabetes mellitus, mechanical ventilation, hydrocephalus, and herniation were assigned a "1" in a weighted mortality score. The ROC curve for our model showed an area under the curve of 0.64. Age greater than 70, diabetes mellitus, mechanical ventilation, hydrocephalus, and herniation were predictive of mortality. We created the first clinically relevant weighted mortality score that can be used to stratify risk, guide prognosis, and inform family discussions.

Healthcare Use and Expenditures in Rural Survivors of Hospitalization for Sepsis.

Sepsis survivors have greater healthcare use than those surviving hospitalizations for other reasons, yet factors associated with greater healthcare use in this population remain ill-defined. Rural Americans are older, have more chronic illnesses, and face unique barriers to healthcare access, which could affect postsepsis healthcare use. Therefore, we compared healthcare use and expenditures among rural and urban sepsis survivors. We hypothesized that rural survivors would have greater healthcare use and expenditures. To test this hypothesis, we used data from 106,189 adult survivors of a sepsis hospitalization included in the IBM MarketScan Commercial Claims and Encounters database and Medicare Supplemental database between 2013 and 2018. None. We identified hospitalizations for severe sepsis and septic shock using the International Classification of Diseases , 9th Edition (ICD-9) or 1CD-10 codes. We used Metropolitan Statistical Area classifications to categorize rurality. We measured emergency department (ED) visits, inpatient hospitalizations, skilled nursing facility admissions, primary care visits, physical therapy visits, occupational therapy visits, and home healthcare visits for the year following sepsis hospitalizations. We calculated the total expenditures for each of these categories. We compared outcomes between rural and urban patients using multivariable regression and adjusted for covariates. After adjusting for age, sex, comorbidities, admission type, insurance type, U.S. Census Bureau region, employment status, and sepsis severity, those living in rural areas had 17% greater odds of having an ED visit (odds ratio [OR] 1.17; 95% CI, 1.13-1.22; p < 0.001), 9% lower odds of having a primary care visit (OR 0.91; 95% CI, 0.87-0.94; p < 0.001), and 12% lower odds of receiving home healthcare (OR 0.88; 95% CI, 0.84-0.93; p < 0.001). Despite higher levels of ED use and equivalent levels of hospital readmissions, expenditures in these areas were 14% (OR 0.86; 95% CI, 0.80-0.91; p < 0.001) and 9% (OR 0.91; 95% CI, 0.87-0.96; p < 0.001) lower among rural survivors, respectively, suggesting these services may be used for lower-acuity conditions. In this large cohort study, we report important differences in healthcare use and expenditures between rural and urban sepsis survivors. Future research and policy work is needed to understand how best to optimize sepsis survivorship across the urban-rural continuum.

A 3-year retrospective review of hospital admissions involving opioid toxicity in South Australia.

This article aims to characterise hospital admissions involving opioid toxicity across South Australia to guide future implementation and evaluation of risk mitigation strategies. International Classification of Diseases, 10th Edition codes (T40.0-T40.4) were used to identify admissions involving pre-hospital opioid toxicity in public hospitals across South Australia from 1 June 2017 to 30 August 2020. Demographic and episode of care data were extracted and summarised using descriptive statistics. Admission cost estimates were calculated using Independent Hospital Pricing Authority data. A total of 2046 cases met the criteria for inclusion; over half (56%) were female and median age on admission was 44 years (interquartile range 27 years). Where opioid toxicity was the primary diagnosis, 70% of admissions did not specify the responsible opioid and 23% were related to heroin use. One-fifth of admissions occurred outside of metropolitan Adelaide. Individuals living in an area of relative socio-economic disadvantage were over-represented. Over half of admissions required a stay >24 h; 19% were admitted for ≥5 days, 22% required intensive care and ~10% required mechanical ventilation. The total estimated cost of admissions involving opioid toxicity in South Australia over the 3-year period was $18,230,546.50, equating to $5.6 million per annum. These findings highlight the significant personal, fiscal, and systemic impacts of opioid toxicity-related hospital admissions in South Australia and provide a baseline to evaluate the effectiveness of initiatives to reduce opioid-related harm, including real-time prescription monitoring and take-home naloxone supply.

Research and implementation of three-dimensional modeling techniques for Chinese dragon

This paper delves into a new trend in the field of computer science, which involves a shift from complex code editing techniques of the past towards more intuitive visual software applications. Under this trend, modeling and rendering techniques have undergone long-term development and continuous iteration, becoming indispensable tools across various domains. Using the construction of a Chinese dragon model as a case study, this paper showcases the application and development of this new trend through a detailed description of the selected software tools' characteristics, classification of production steps, and the modeling process. Special emphasis was placed on shaping key details such as the dragon's body contour, scales, eyes, etc., during the dragon model construction process, as well as how these details are manifested in software applications. Software selection and utilization were carefully aligned with practical needs and technical features to ensure the efficiency and accuracy of the modeling process. In-depth research into the modeling process revealed the potential and advantages of this new technology, receiving widespread acclaim and recognition.

Research and implementation of three-dimensional modeling techniques for Chinese dragon

This paper delves into a new trend in the field of computer science, which involves a shift from complex code editing techniques of the past towards more intuitive visual software applications. Under this trend, modeling and rendering techniques have undergone long-term development and continuous iteration, becoming indispensable tools across various domains. Using the construction of a Chinese dragon model as a case study, this paper showcases the application and development of this new trend through a detailed description of the selected software tools' characteristics, classification of production steps, and the modeling process. Special emphasis was placed on shaping key details such as the dragon's body contour, scales, eyes, etc., during the dragon model construction process, as well as how these details are manifested in software applications. Software selection and utilization were carefully aligned with practical needs and technical features to ensure the efficiency and accuracy of the modeling process. In-depth research into the modeling process revealed the potential and advantages of this new technology, receiving widespread acclaim and recognition.

The validity of pathology codes for biopsy-confirmed kidney disease in the Danish National Patobank.

This study validates the application of Systematized Nomenclature of Medicine second edition (SNOMED II) codes used to describe medical kidney biopsies in Denmark in encoded form, aiming to support robust epidemiological research on the causes, treatments and prognosis of kidney diseases. Kidney biopsy reports from 1 January 1998 to 31 December 2018 were randomly extracted from the Danish National Patobank, using SNOMED codes. A 5% sample was selected, and nephrologists assessed the corresponding medical records, assigning each case the applied clinical diagnoses. Sensitivity, specificity, positive predictive values (PPV), negative predictive values and Cohen's kappa coefficient for the retrieved SNOMED codes were calculated. A total of 613 kidney biopsies were included. The primary clinical disease groups were glomerular disease (n=368), tubulointerstitial disease (n=67), renal vascular disease (n=51), diabetic nephropathy (n=51) and various renal disorders (n=40). Several SNOMED codes were used to describe each clinical disease group and PPV for the combined SNOMED codes were high for glomerular disease (94%), diabetic nephropathy (85%) and systemic diseases affecting the kidney (96%). Conversely, tubulointerstitial disease (62%), renal vascular disease (60%) and other renal disorders (17%) showed lower PPV. SNOMED codes have a high PPV for glomerular diseases, diabetic nephropathy and systemic diseases affecting the kidney, in which they could be applied for future epidemiological research.

Soft-tissue sarcoma in Japan: National Cancer Registry-based analysis from 2016 to 2019.

No previous reports have characterized national profiles of soft-tissue sarcoma overall. We examined the nationwide statistics for soft-tissue sarcoma in Japan using data from the population-based National Cancer Registry. We identified 23 522 soft-tissue-sarcoma patients who were entered in the National Cancer Registry during 2016-19 using International Classification of Diseases-Oncology, Third Edition codes for cancer topography and morphology. We extracted data on patient demographics, tumor details (reason for diagnosis, tumor location, histology, extent of disease), hospital volume/type, treatment, and prognosis for each patient. Soft-tissue sarcoma showed a slight male preponderance. Approximately 5500-6000 new cases were diagnosed as soft-tissue sarcoma per year, with the age-adjusted incidence of soft-tissue sarcoma being 3.22/100000/year. The age distribution showed a single peak in the 70-79 age range, and sex-stratified data showed it was higher in men. The most common histologic subtype was liposarcoma. The most frequent tumor locations were the soft tissue and skin, followed by the retroperitoneum. Extent of disease was categorized as: "localized" (31.3%), "regional" (38.9%), or "distant" (10.5%). We found significant associations between overall survival and sex, age, tumor location, facility type, hospital volume, reason for diagnosis, extent of disease, and surgical treatment. This is the first study to outline the epidemiology, clinical features, treatment, prognosis, and significant factors affecting prognosis of soft-tissue sarcoma in Japan using the National Cancer Registry. Documenting our data regarding elderly patients' outcomes is essential so other countries showing similar population-aging trends can learn from our experiences. Prognostic studies, Level III.

Adoption of network and plan-do-check-action in the international classification of disease 10 coding.

with the widespread application of computer network systems in the medical field, the plan-do-check-action (PDCA) and the international classification of diseases tenth edition (ICD-10) coding system have also achieved favorable results in clinical medical record management. However, research on their combined application is relatively lacking. Objective: it was to explore the impact of network systems and PDCA management mode on ICD-10 encoding. Material and Method: a retrospective collection of 768 discharged medical records from the Medical Record Management Department of Meishan People's Hospital was conducted. They were divided into a control group (n = 232) and an observation group (n = 536) based on whether the PDCA management mode was implemented. The two sets of coding accuracy, time spent, case completion rate, satisfaction, and other indicators were compared. To study the adoption of network and PDCA in the ICD-10. A retrospective collection of 768 discharged medical records from the Medical Record Management Department of Meishan People's Hospital was conducted. They were divided into a control group (n = 232) and an observation group (n = 536) based on whether the PDCA management mode was implemented. The two sets of coding accuracy, time spent, case completion rate, satisfaction, and other indicators were compared. In the 3, 6, 12, 18, and 24 months of PDCA cycle management mode, the coding accuracy and medical record completion rate were higher, and the coding time was lower in the observation group as against the controls (P < 0.05). The satisfaction of coders (80.22% vs 53.45%) and patients (84.89% vs 51.72%) in the observation group was markedly higher as against the controls (P < 0.05). The combination of computer networks and PDCA can improve the accuracy, efficiency, completion rate, and satisfaction of ICD-10 coding.

P-330 The impact of adenomyosis on pregnancy outcomes, from conception to birth- a systematic review and meta-analysis

Abstract Study question What is the impact of adenomyosis and its phenotypes on spectrum of outcomes ranging from conception to birth? Summary answer Adenomyosis has a negative impact on implantation with reduced clinical pregnancy and live birth rate and increased risk of miscarriage and perinatal morbidity. What is known already Current evidence, including meta-analyses, on the impact of adenomyosis on reproductive outcomes is conflicting. There are data suggesting that adenomyosis has a negative impact on pregnancy outcomes whereas some studies have suggested that adenomyosis appears inert, with no impact on reproductive functions. A wide variation has been observed in the baseline population, type of Assisted Reproductive Technology (ART) stimulation protocol, number, order and type of ART cycles across the pooled observational studies. Alongside, there may be a spectrum of adenomyosis characteristics like the disease type, location, severity, and presence of coexisting endometriosis, resulting in heterogeneity and our interpretation of evidence. Study design, size, duration For this systematic review and meta-analysis, a comprehensive search was conducted in MEDLINE, EMBASE, CINAHL Plus, Web of Science Core Collection, Clinicaltrials.gov and WHO ICTRP from inception until January 2024 with no language restriction. Observational studies were included with participants as women with natural and/or medically assisted reproduction (MAR) conception, exposure as adenomyosis diagnosed on imaging, histology or using WHO International Classification of Disease 10th edition (ICD-10) code (N80.0) and comparator as women without adenomyosis. Participants/materials, setting, methods Data was included from 51 observational studies for the meta-analysis of pregnancy and obstetric outcomes. ROBINS-E tool (Risk Of Bias In Non-randomized Studies-of Exposure) was be used to assess the risk of bias. Odds ratio (OR) from individual studies were pooled using random-effects model to summarise the estimate for dichotomous outcomes with 95% confidence interval (CI) and mean differences for continuous outcomes. This was supplemented by sensitivity analyses. Clinical heterogeneity was assessed with I² statistics. Main results and the role of chance Women with adenomyosis had reduced odds of implantation (OR = 0.78; CI: 0.72-0.86), lower clinical pregnancy (OR = 0.87; CI: 0.82-0.92), higher miscarriage (OR = 1.51; CI: 1.44-1.58), and lower live birth (OR = 0.56; CI: 0.50-0.63) compared to those without. Both, diffuse and focal adenomyosis were associated with lower live birth (OR = 0.56; CI: 0.45-0.72; diffuse and OR = 0.56; CI: 0.45-0.70; focal). The miscarriage risk was higher in junctional zone adenomyosis (OR = 4.04; CI: 1.17-13.94) compared to outer myometrium adenomyosis. The negative impact of adenomyosis was evident in subgroups of women undergoing donor oocyte cycles (OR = 0.62; CI: 0.50-0.76; live birth and OR = 1.83; CI: 1.26-2.66; miscarriage) and first ART cycle (OR = 0.55; CI: 0.48-0.65; live birth and OR = 2.16 CI: 1.72-2.71; miscarriage). Conversely, those with euploid embryo transfer, had a higher odds of miscarriage (OR = 1.90; CI:1.05-3.43) with no significant impact on live birth (OR = 0.78; CI: 0.52-1.19). The impact continued perinatally, including pre-eclampsia (OR = 1.32; CI: 1.23-1.41), small for gestational age (OR = 1.323; CI:1.25-1.40), placenta previa (OR = 3.99, CI: 3.53-4.51), caesarean section (OR = 1.97; CI:1.89-2.05), and low Apgar scores (OR = 0.911; CI:0.88-0.96). Limitations, reasons for caution The inherent heterogeneity among the included observational studies was high; however, subgroup analyses for type of ART cycle, number, and order of ART cycle and by phenotype of adenomyosis had low heterogeneity. This warrants caution when interpreting pooled outcome estimates for pregnancy and obstetric outcomes across general population of women. Wider implications of the findings Adenomyosis has a direct and negative impact on fertility and pregnancy outcomes by virtue of impaired implantation and trophoblastic function. Hence, adenomyosis needs to be factored in when counselling women about the success of MAR cycles and requires closer monitoring in pregnancy as a high-risk pregnancy. Trial registration number not applicable

Code Verse

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