Evaluation Of Outcomes Research Articles

Arthroscopic Reconstruction of an Anterior Cruciate Ligament Tear Using the Anatomic Single-Bundle Technique: A Clinical and Functional Outcome Evaluation.

The anterior cruciate ligament (ACL) consists of an anteromedial bundle and a posterolateral bundle giving anteroposterior and rotational stability to the knee. An ACL tear might lead to secondary changes in the knee joint if not operated in time. The aim of the study was to evaluate the clinical and functional results in patients with ACL tears treated by arthroscopic reconstruction using the anatomic single-bundle technique. This was a prospective study conducted between June 2015 and December2017 at a teaching institute in Kolkata, India, on patients who underwent single-bundle arthroscopic reconstruction of an ACL tear. A minimum follow-up of nine months was considered for all patients. The functional outcome was assessed via the Lysholm knee score. A total of 45 patients were included in this study, of which 34 (75.56%) and eight (17.78%) patients showed excellent and good results, respectively, at the final follow-up. The mean age in this study was 29.88±9.02 years. No complication was seen in 95.6% of patients. The mean Lysholm score by the end of nine months was 95.31±6.55. At the time of the final follow-up, all the patients returned to their same activity status prior to injury. Arthroscopic anatomic single-bundle ACL reconstruction using hamstring autograft is an effective treatment modality for ACL injuries. It restores the stability of the knee and is associated with good recovery of joint function with an early return to active lifestyle and sports activities. This procedure achieves excellent clinical and functional outcomes without any long-term disability.

WP7.9 - Evaluation of outcomes of early laparoscopic cholecystectomy for acute gallstone disease using Traffic Light Booking system

Abstract Introduction Delayed cholecystectomy leads to recurrent admissions with potential increased preoperative, operative, and postoperative complications. Aim To evaluate the outcomes of early laparoscopic cholecystectomy using traffic light booking system. Methods A quality improvement early gallbladder service was designed using the weighted scores of patients’ demographics, BMI, comorbidities, LFTs, imaging findings, confirmed diagnosis and associated gallstone complications. The scores were stratified into traffic light system colours of green (0-3), amber (4-6) and red (>7) to predict the operative difficulty and allocated operative time. Early cholecystectomy was performed within 6 weeks of the onset of symptoms. Operative difficulty grading use was by Nassar et al. Prospectively data was analysed using SPSS to present the outcomes. Results 207 patients had early cholecystectomy from February 2022 to January 2024. Median age was 50.5 years and 71.5% were females. Diagnoses were 60 biliary colic, 102 acute cholecystitis, 41 pancreatitis and 4 cholecystitis with biliary obstruction. Traffic light scores were 114 green, 76 amber and 17 red while operative difficulty grading was 44 mild, 73 moderate, 54 severe and 36 extreme difficulties. Median time to surgery was 21 (21-42) days and median operative time was 75 (25-205) minutes. 13.5% of the patients were operated at the index admission, 67.1% as day cases, 20.3% stayed overnight and 12.6% as inpatient stays. None were converted to open but four procedures were abandoned. Complication and readmission rates were 4.8% and 5.3% respectively with one patient returning to theatre. Conclusion Early laparoscopic cholecystectomy service can be safely delivered with the majority done as day cases.

Results from a retrospective case finding and re-engagement exercise for people previously diagnosed with hepatitis C virus to increase uptake of directly acting antiviral treatment

BackgroundDirect acting antivirals (DAAs) for the Hepatitis C virus (HCV) have shifted the World Health Organisation global strategic focus to the elimination of HCV by 2030. In England, the UK Health Security Agency (UKHSA) led a national ‘patient re-engagement exercise’, using routine surveillance data, which was delivered through the HCV Operational Delivery Networks (ODNs) with support from National Health Service England (NHSE), to help find and support people with a positive HCV PCR test result to access treatment. We report a quantitative evaluation of outcomes of this exercise.MethodsIndividuals with a recorded positive HCV antibody or PCR result between 1996 and 2017 were identified using UKHSA’s records of HCV laboratory diagnosis. Linkage with established health-care datasets helped to enhance patient identification and minimise attempts to contact deceased or previously treated individuals. From September to November 2018 each ODN was provided with a local list of diagnosed individuals. ODNs were asked to perform further data quality checks through local systems and then write to each individual’s GP to inform them that the individual would be contacted by the ODN to offer confirmatory HCV PCR testing, assessment and treatment unless the GP advised otherwise. Outcomes of interest were receipt of treatment, a negative PCR result, and death. Data were collected in 2022.ResultsOf 176,555 individuals with a positive HCV laboratory report, 55,329 individuals were included in the exercise following linkage to healthcare datasets and data reconciliation. Participants in the study had a median age of 51 years (IQR: 43, 59), 36,779 (66.5%) were males, 47,668 (86.2%) were diagnosed before 2016 and 11,148 (20.2%) lived in London. Of the study population, 7,442 (13.4%) had evidence of treatment after the re-engagement exercise commenced, 6,435 (11.6%) were reported as PCR negative (96% had no previous treatment records), 4,195 (7.6%) had prescription data indicating treatment before the exercise commenced or were reported to have been treated previously by their ODN, and 2,990 (5.4%) had died. The status of 32,802 (59.3%) people remains unknown.ConclusionsA substantial number of those included had treatment recorded after the exercise commenced, however, many more remain unengaged. Evaluation of the exercise highlighted areas that could be streamlined to improve future exercises.

Evaluation of the Oncological Outcomes According to Different Organ-Sparing Techniques in Penile Cancer

Evaluation of the Oncological Outcomes According to Different Organ-Sparing Techniques in Penile Cancer

Evaluation of the Clinical Outcome of Laparoscopic Myomectomy in the Management of Patients with Uterine Fibroids

Objective: This paper aims to evaluate the effectiveness of laparoscopic myomectomy in managing patients with uterine fibroids. Methods: This time, 78 patients with uterine fibroids were randomly selected from the hospital from January 2023 to December 2023 for analysis and study. The 78 patients were divided into two groups, the control group contained 39 patients who were treated with traditional open myomectomy, while the study group also contained 39 patients who were treated with laparoscopic myomectomy. The two groups were analyzed and studied in terms of treatment effect, surgery-related indexes and complications. Results: The therapeutic effect of the patients in the study group was remarkable, and the incidence of complications in the treatment process was lower. The study group also performed better than the control group in terms of surgical-related indexes, with P < 0.05, which is of research value. Conclusion: For patients with uterine fibroids, treatment with laparoscopic myomectomy is an effective means of intervention. This treatment method can achieve precise clinical results and shows significant advantages in reducing patient trauma, which is worth utilizing.

Interprofessional education in cardiothoracic surgery: a narrative review.

Interprofessional education, an approach where healthcare professionals from various disciplines learn with, from, and about each other, is widely recognized as an important strategy for improving collaborative practice and patient outcomes. This narrative review explores the current state and future directions of interprofessional education in cardiothoracic surgery. We conducted a literature search using the PubMed, Scopus, and Web of Science databases, focusing on English-language articles published after 2000. Our qualitative synthesis identified key themes related to interprofessional education interventions, outcomes, and challenges. The integration of interprofessional education in cardiothoracic surgery training programs varies across regions, with a common focus on teamwork and interpersonal communication. Simulation-based training has emerged as a leading modality for cultivating these skills in multidisciplinary settings, with studies showing improvements in team performance, crisis management, and patient safety. However, significant hurdles remain, including professional socialization, hierarchies, stereotypes, resistance to role expansion, and logistical constraints. Future efforts in this field should prioritize deeper curricular integration, continuous faculty development, strong leadership support, robust outcome evaluation, and sustained political and financial commitment. The integration of interprofessional education in cardiothoracic surgery offers considerable potential for enhancing patient care quality, but realizing this vision requires a multifaceted approach. This approach must address individual, organizational, and systemic factors to build an evidence-based framework for implementation.

Implant-based Breast Reconstruction Salvage with Negative Pressure Wound Therapy with Instillation: An Evaluation of Outcomes.

Implant infection is problematic in breast reconstruction. Traditionally, infected tissue expanders (TE)/implants are removed for several months before replacement, resulting in breast reconstruction delay. Salvage involving device removal, negative pressure wound therapy with instillation and dwell (NPWTi-d) placement, and early staged TE/implant replacement within a few days has been described. The purpose of this study was to compare outcomes of the NPWTi-d salvage pathway with traditional implant removal. A retrospective review was performed on patients who underwent implant-based reconstruction and developed TE/implant infection/exposure requiring removal. Patients were divided into two groups. Group 1 had TE/implant removal, NPWTi-d placement, and TE/implant replacement 1-4 days later. Group 2 (control) underwent standard TE/implant removal and no NPWTi-d. Reinfection after TE/implant salvage, TE/implant-free days, and time to final reconstruction were assessed. The study included 47 patients (76 TE/implants) in group 1 (13 patients, 16 TE/implants) and group 2 (34 patients, 60 TE/implants). The success rate (no surgical-site infection within 90 days) of implant salvage was 81.3% in group 1. No group 1 patients abandoned completing reconstruction after TE/implant loss versus 38.2% (13 of 34) in group 2 (P = 0.0094). Mean implant-free days was 2.5 ± 1.2 in group 1 versus 134.6 ± 78.5 in group 2 (P = 0.0001). The interval to final implant-based reconstruction was 69.0 ± 69.7 days in group 1 versus 225.6 ± 93.6 days in group 2 (P = 0.0001). A breast implant salvage pathway with infected device removal, NPWTi-d placement, and early TE/implant replacement was successful in 81.3%. Patients experienced 132 less implant-free days and faster time to final reconstruction.

Evidence Map of Non-Pharmacological Dementia Care Partner Interventions Implemented in the US: Gaps and Impact Opportunities.

There are 200+ tested interventions for care partners (family, friends, and fictive kin) of people living with dementia (PLWD). But these interventions do not systematically cover relevant settings. Nor do these interventions affect all relevant outcomes that matter to people and healthcare systems. We present an evidence map of settings and outcomes from translated interventions to identify gaps. Of 190 studies identified, 31 unique interventions were retained in the evidence map. Identified setting gaps included studies set solely in hospitals/medical centers or set in multiple settings. Identified outcome gaps included interventions that improved care partner beliefs about providing care, care partner negative coping strategies, PLWD resources (e.g., social support), and PLWD coping strategies. Armed with an understanding of present gaps, we call on researchers to fill the identified gaps to ensure systematic coverage of settings and evaluation of outcomes that matter to people and healthcare systems.

An 'alcohol health champions' intervention to reduce alcohol harm in local communities: a mixed-methods evaluation of a natural experiment.

Globally alcohol consumption is a leading risk factor for premature death and disability and is associated with crime, social and economic consequences. Local communities may be able to play a role in addressing alcohol-related issues in their area. To evaluate the effectiveness and cost-benefit of an asset-based community development approach to reducing alcohol-related harm and understand the context and factors that enable or hinder its implementation. A mixed-methods evaluation. Area-level quasi-experimental trial analysed using four different evaluation methods (a stepped-wedge design where each area was a control until it entered the intervention, comparison to matched local/national controls and comparison to synthetic controls), alongside process and economic evaluations. Ten local authorities in Greater Manchester, England. The outcomes evaluation was analysed at an area level. Ninety-three lay persons representing nineareas completed questionnaires, with 12 follow-up interviews in five areas; 20 stakeholders representing ten areas were interviewed at baseline, with 17 follow-up interviews in eight areas and 26 members of the public from two areas attended focus groups. Professionals in a co-ordinator role recruited and supported lay volunteers who were trained to become alcohol health champions. The champion's role was to provide informal, brief alcohol advice to the local population and take action to strengthen restrictions on alcohol availability. Numbers of alcohol-related hospital admissions, accident and emergency attendances, ambulance call-outs, street-level crime and antisocial behaviour in the intervention areas (area size: 1600-5500 residents). Set-up and running costs were collected alongside process evaluation data exploring barriers and facilitators. Routinely collected quantitative data on outcome measures aggregated at the intervention area and matched control and synthetic control areas. Data from policy documents, licensing registers, meeting notes, invoices, time/cost diaries, training registers, questionnaires, interviews, reflective diaries and focus groups. The intervention rolled out in nine out of ten areas, seven of which ran for a full 12 months. Areas with better-established infrastructure at baseline were able to train more champions. In total, 123 alcohol health champions were trained (95 lay volunteers and 28 professionals): lay volunteers self-reported positive impact. Champions engaged in brief advice conversations more readily than taking action on alcohol availability. There were no consistent differences in the health and crime area-level indicators between intervention areas and controls, as confirmed by using three different analysis methods for evaluating natural experiments. The intervention was not found to be cost-beneficial. Although the sequential roll-out order of the intervention was randomised, the selection of the intervention areas was not. Self-reported impact may have been subject to social desirability bias due to the project's high profile. There was no measurable impact on health and crime outcomes. Possible explanations include too few volunteers trained, volunteers being unwilling to get involved in licensing decisions, or that the intervention has no direct impact on the selected outcomes. Future similar interventions should use a coproduced community outcomes framework. Other natural experiment evaluations should use methodological triangulation to strengthen inferences about effectiveness. This trial is registered as ISRCTN81942890. This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 15/129/03) and is published in full in Public Health Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information.

Clinical impact of sex differences and procedural setting in transcatheter aortic valve implantation

BackgroundTranscatheter aortic valve implantation (TAVI) is a well-established treatment for symptomatic patients with aortic stenosis. Yet, the impact of sex differences and public vs. private procedural setting on TAVI outcomes remain uncertain. MethodsThe RIBAC-NT (Brazilian Registry for Evaluation of Transcatheter Aortic Valve Replacement Outcomes) dataset included 3194 TAVI patients from 2009 to 2021. This retrospective analysis explored disparities in baseline characteristics, procedural and in-hospital outcomes stratifying patients by sex and procedural setting. Temporal trends were also investigated. ResultsWe included 1551 (49 %) female and 1643 (51 %) male patients. Women were older (83 [78–87] vs. 81 [75–85] years; p < 0.01) but had a lower prevalence of diabetes mellitus (30.2 % vs. 36.3 %, p < 0.01) and coronary artery disease (39.0 % vs. 52.2 %, p < 0.01). However, women had a 3-fold higher higher risk of life-threatening bleeding (6.1 % vs. 2.4 %, p < 0.01). Women presented higher procedural and in-hospital mortality rates (4.4 % vs. 2.5 % and 7.7 % vs. 4.5 %, all p < 0.01, respectively). Although public hospitals presented ~2-fold higher procedural mortality rate compared with private settings (5.0 % vs. 2.7 %, p < 0.01), after multivariable analysis procedural setting was not independently associated with in-hospital mortality. ConclusionsWomen had higher procedural and in-hospital mortality rates after TAVI as compared with men, while facing higher life-threatening bleeding and adverse events rates. Although public hospitals exhibited higher mortality rates than private centers, procedural setting was not independently associated with in-hospital mortality.

Real-World Evaluation of Treatment Patterns and Clinical Outcomes among Patients With Chronic Myeloid Leukemia in Chronic Phase Treated With Asciminib in Clinical Practice in the United States: Real-world asciminib treatment outcomes in CML-CP

BackgroundTyrosine kinase inhibitors (TKIs) are the mainstay treatment for chronic myeloid leukemia in chronic phase (CML-CP). Asciminib, an ABL/BCR::ABL1 inhibitor which binds to the myristoyl pocket, was recently approved in the US for patients with CML-CP previously treated with ≥2 TKIs or with the T315I mutation. This study described treatment patterns and real-world clinical outcomes among patients with CML-CP treated with asciminib in US clinical practice. MethodsElectronic health record data from adult patients with CML-CP who initiated asciminib after ≥2 prior TKIs, without the T315I mutation, were obtained from the Flatiron Health database. Time-to-treatment discontinuation and molecular response (MR; time-to-BCR::ABL ≤0.1% and time-to-BCR::ABL1 ≤1%, separately) were evaluated from asciminib initiation (index date) using Kaplan–Meier analyses. ResultsOverall, 97 patients initiated asciminib (median age: 63 years, 50.5% female, 64.9% White) after either 2 (47.4%) or 3 (24.7%), or ≥4 (27.8%) prior TKIs. In total, 85.7% and 78.1% of patients remained on asciminib by 12- and 24-weeks postindex, respectively. Among patients with ≥1 MR assessment postindex, 31.3% (95% confidence interval [CI]: 21.6%, 43.9%) and 49.7% (95% CI: 38.1%, 62.6%) achieved or maintained BCR::ABL1 ≤0.1%, while 51.3% (95% CI: 40.1%, 63.6%) and 64.2% (95% CI: 52.6%, 75.6%) achieved or maintained BCR::ABL1 ≤1%, by 12- and 24-weeks, respectively. ConclusionsResults of this real-world study describing clinical outcomes among patients with CML-CP treated with asciminib after ≥2 prior TKIs in the US demonstrated that asciminib was well-tolerated and effective. These findings were consistent with results from the ASCEMBL trial.

MAIN STAGES OF THE LANGUAGE TEST DEVELOPMENT PROCESS AND VALIDATION ANALYSIS METHODS: THE CASE OF GAZI TÖMER

Testing is the most widely used assessment tool in measuring the development process of students' languagecompetence. Therefore, the existence of valid and reliable language tests appropriate to student achievements in education is of great importance. Research on language test development in foreign language teaching in Kazakhstan is insufficient. The aim ofthis study is to practically demonstrate the basic stages of the test development process and how to conduct content validity analysis with the example of the proficiency test of foreign language (Turkish) prepared by Gazi TÖMER. The research method was based on a quantitative research design. The sample of the research for validation was consisted of 7 experts with experience in Gazi TÖMER. For reliability, there were a total of 66 students studying at Abai KazNPU. The first part of the study was examinedfor the content validity of the relevant test. For this purpose, based on the criteria determined by Webb for the evaluation of learning outcomes, the opinions received from field experts were evaluated using the Lawshe technique. The CVR value of the 45-question test was .96, and the CVI was “significant”. The second part of the study was about reliability. For this purpose, the difficulty level of each item was examined based on the data obtained from the pilot application of the test. Data were analyzedusing Excel and SPSS programs. Additionally, the KR-20 value was calculated and found to be .80, and the test was considered reliable. It is believed that the steps and results included in the study will guide the process of creating valid and reliable tests in various fields.

296. CLINICAL T1B-SM2-3N0M0 ESOPHAGEAL SQUAMOUS CELL CARCINOMA

Abstract Background With advancements in endoscopic techniques, safer and more reliable endoscopic resection of submucosal invasive lesions has become feasible. The evaluation of treatment outcomes for superficial esophageal carcinoma has typically been predicated on the depth of pathological diagnosis; however, there have been limited studies based on preoperative diagnosis. Given that treatment decisions in clinical practice are primarily guided by preoperative diagnosis, there is a heightened emphasis on studies grounded in preoperative assessments. This study aims to analyze the accuracy of preoperative diagnosis of T1b-SM2-3 N0M0, evaluate the accuracy of treatment selection and depth diagnosis, and assess long-term outcomes based on these determinations. Methods Thirty-eight patients diagnosed with T1b-SM2-3 N0M0 between April 2010 and December 2020 were included in the study. Depth diagnosis was determined through endoscopic evaluation utilizing white light, NBI, NBI magnification plus EUS, with lymph node metastasis diagnosis performed via CT imaging. Treatment decisions were made following patient consent, and long-term prognosis was assessed for each treatment modality. Results Initial treatment involved ESD in 14 patients, with an additional 5 patients undergoing additional treatment (ESD + AD) based on histological evaluation (surgery: 1, CRT: 4). Surgery or neoadjuvant chemotherapy (NAC) followed by surgery was performed in 15 patients, with CRT administered in 7. Among the 22 patients who did not receive NAC and whose histologic depth was evaluable, the accuracy rate of depth diagnosis was 64%, primarily attributable to overdiagnosis. In the 14 patients who underwent ESD excluding piecemeal resection, the negative rate of vertical margins was 93%. Five-year overall survival rates were as follows: ESD: 64.8%, ESD+AD: 75%, surgery: 86.2%, and CRT: 45.7%, with no statistically significant differences observed. The majority of deaths (83%) were attributed to other diseases or cancers, with only 2 deaths attributed to the primary disease. Conclusion ESD or surgery emerged as the preferred treatment modalities in the majority of cases, with relatively favorable long-term prognoses. Treatment decisions were influenced by comorbidities and other factors, potentially impacting long-term outcomes.

CML-317 Asciminib After Two or More Prior Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia: Real-World Evaluation of Treatment Patterns and Clinical Outcomes in US Clinical Practice

CML-317 Asciminib After Two or More Prior Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia: Real-World Evaluation of Treatment Patterns and Clinical Outcomes in US Clinical Practice

A Review of the ECO415 Course Learning Outcome (CLO) Based on the UiTM Melaka Exit Entrance Survey (EES)

The evaluation of program learning outcomes for continuous quality improvement and assessment has garnered global interest in higher academic institution. This is because, student evaluations have the potential to improve the quality of education and the results of learning in a particular course. This article examines the Course Learning Outcomes (CLO) of the Economics course for degree students in UiTM Melaka. This research utilizes data from 328 students who registered ECO415 course for Semester March - August 2023. To evaluate the achievement, Exit Entrance Survey used to compare student responses towards similar questions in the beginning and end of the semester. The question was form in a Likert scale to gauge achievement gaps. Findings demonstrated strong achievement in all three CLOs, with over 70% of students performing at the "excellent" or "very good".

473 Evaluation of hematology outcomes as indicators of liver abscess formation in beef × dairy cross steers

473 Evaluation of hematology outcomes as indicators of liver abscess formation in beef × dairy cross steers

Comparative evaluation of postoperative functional and esthetic outcomes for lip reconstruction with Fujimori gate flap versus Abbe-Estlander flap in patients being operated for oral squamous cell carcinoma

Background: Lip carcinomas account for 23.6% to 30% of tumors affecting the oral cavity. Lip reconstruction aims to achieve a competent oral sphincter with a good cosmetic appearance while avoiding microstomia. There are various techniques for lip reconstruction like Fujimori gate flap, Abbe-Estlander Flap, Gillies fan flap, Nasolabial flap, Karapandzic flap, bilateral advancement flap, perialar crescentic advancement flap, Bernard-Burow flap, and free flap. Aims and Objectives: To compare the Fujimori gate flap and Abbe-Estlander flap in terms of functional and esthetic outcomes when used for reconstruction of the lip. Materials and Method: Ten patients diagnosed with oral squamous cell carcinoma requiring resection and reconstruction of lip were included in the study. Functionally, maximal interincisal opening, lip competence, speech intelligibility and esthetically, scar, symmetry of lip during mouth opening, and symmetry of lip at rest were evaluated at the end of 1 week and 1 month. Results: On evaluation of functional and esthetic parameters, the Fujimori gate flap provides superior results in terms of mouth opening, speech intelligibility, and symmetry of lip at rest. However, results were comparable in both groups in terms of lip competence, scar, and symmetry of lip during mouth opening. Conclusion: The results of this study suggest that the Fujimori gate flap provides superior results with respect to function and esthetics when used for the reconstruction of lower lip defects with minimal or less complications.

PE086 Perioperative outcome and urodynamic evaluation at three months in patients undergoing robot-assisted radical cistectomy with intracorporeal Y-modified neobladder ("Bordeaux neobladder") reconstruction

PE086 Perioperative outcome and urodynamic evaluation at three months in patients undergoing robot-assisted radical cistectomy with intracorporeal Y-modified neobladder ("Bordeaux neobladder") reconstruction

Outcome Evaluation of an Integrated, Combined-care Perinatal Addiction Medicine- Primary Care Obstetrics Model for Urban, Inner-city Pregnant Patients With Severe Substance Use Disorders

ABSTRACT Objective: Programs for pregnant individuals with severe substance use disorders that combine addiction, obstetrical, and psychosocial care contribute to better neonatal and maternal outcomes. This research aims to describe patient demographics, retention in care, and maternal and neonatal outcomes associated with an integrated perinatal addiction program. Methods: Retrospective chart review of patients who received care in the Substance Use in Pregnancy (SUP) program at St Michael’s Hospital, Toronto, ON, Canada, between July 1, 2013, and December 31, 2019. Demographic information, as well as outcome measures, were collected for each mother-infant dyad. Descriptive statistics were used to describe study participants and maternal and neonatal outcomes. Results: A total of 121 pregnancies were included in the study. Most of the cohort was unemployed, single, and with unstable housing. Pregnant patients attended, on average, 10 prenatal visits (SD=7.8), and 77% of the cohort had a visit after delivery. Ninety-seven percent of the pregnant individuals completed prenatal screening. Sixty-one percent of infants required admission to the neonatal intensive care unit with an average length of stay of 14 days (SD=14.9). Nicotine (71%) and cannabis (50%) were the most used drugs at program enrolment, followed by opioids (41%), cocaine (34%) and alcohol (32%). The proportion of pregnant patients using substances was lower at delivery, compared with the first visit, except for fentanyl users. Conclusions: The SUP program yields positive maternal and neonatal outcomes associated with high rates of prenatal appointment attendance. Participation in this integrated, combined care program is associated with sustained retention in care for a highly marginalized patient population. Objectif: Les programmes destinés aux personnes enceintes souffrant de troubles sévères liés à l’utilisation de substances psychoactives qui combinent les soins en toxicomanie, obstétricaux et psychosociaux contribuent à de meilleurs résultats néonataux et maternels. Cette recherche vise à décrire les caractéristiques démographiques des patients la rétention dans les soins et les résultats maternels et néonataux associés à un programme intégré en toxicomanie périnatale. Méthodes: Examen rétrospectif des dossiers des patientes ayant reçu des soins dans le cadre du programme Substance Use in Pregnancy (SUP) à l’hôpital St Michael, Toronto, ON, Canada entre le 1er juillet 2013 et le 31 décembre 2019. Des données démographiques ainsi que des mesures de résultats ont été collectées pour chaque dyade mère-enfant. Des statistiques descriptives ont été utilisées pour décrire les participants à l'étude et les résultats maternels et néonataux. Résultats: Au total, 121 grossesses ont été incluses dans l'étude. La plupart des membres de la cohorte étaient sans emploi, célibataires et avaient un logement instable. Les patientes enceintes ont assisté en moyenne à 10 visites prénatales (écart-type=7,8) et 77% de la cohorte ont eu une visite après l’accouchement. 97% des femmes enceintes ont effectué un dépistage prénatal. 61% des nourrissons ont dû être admis dans une unité de soins intensifs néonataux, avec une durée moyenne de séjour de 14 jours (écart-type=14,9). La nicotine (71%) et le cannabis (50%) étaient les drogues les plus consommées au moment de l’inscription au programme, suivies des opioïdes (41%), de la cocaïne (34%) et de l’alcool (32%). La proportion de patientes enceintes consommant des substances était plus faible à l’accouchement qu'à la première visite, sauf pour les consommatrices de fentanyl. Conclusions: Le programme SUP produit des résultats maternels et néonataux positifs associés à des taux élevés d’assiduité aux rendez-vous prénataux. La participation à ce programme de soins intégrés et combinés est associée à une rétention durable des soins pour une population de patients très marginalisés.

Comprehensive analysis of cuproptosis-related genes involved in prognosis and tumor microenvironment infiltration of colorectal cancer.

Colorectal cancer (CRC) is a common malignancy, with high incidence and high mortality rates. Cuproptosis, a novel form of copper-induced programmed cell death, contributes to tumor progression. However, whether cuproptosis-related genes (CRGs) play a role in CRC remains unclear. This study aims to elucidate the role of CRGs in CRC development, patient prognosis, and immune response. We performed bioinformatics analysis of the differential expression of CRGs between CRC and normal tissues. Least absolute shrinkage and selection operator (LASSO), and univariate and multivariate Cox analyses were employed to identify risk factors, which were used to construct a risk score model. Patients with CRC were categorized into high- and low-risk groups based on their median risk scores. Receiver operating characteristic curve analysis was used to verify the predictive accuracy of the risk model. A nomogram was developed for CRC through univariate and multivariate Cox regression analyses. The chemotherapeutic drug sensitivity was compared between patients with high and low CDKN2A/DLAT expression using the Wilcoxon rank-sum test. Spearman's correlation and TISIDB database analyses were conducted to determine relationships between CDKN2A or DLAT and immune cell infiltration. Eight of ten identified CRGs exhibited significant differential expression between CRC and normal tissues. Among the eight significant differential expression CRGs, CDKN2A and DLAT were identified as independent risk factors for predicting overall survival (OS) in CRC. Patients with CRC in the low-risk group had longer OS than those in the high-risk group. The risk score model had good predictive accuracy for OS. Based on CDKN2A, DLAT and some clinical characteristics, a prognostic nomogram was developed to predict OS for CRC patients and showed good predictive ability. CDKN2A and DLAT expressions were significantly associated with chemotherapeutic drug sensitivity and immune cell infiltration in CRC, and the molecular subtypes and immune subtypes differed between CDKN2A and DLAT. Our research revealed the prognostic value of CRGs, particularly CDKN2A and DLAT, in CRC and demonstrated the relationship between CDKN2A/DLAT and immune infiltration in CRC, thereby contributing to the outcome evaluation of patients with CRC and identifying novel targets for CRC immunotherapy.