Independent Sample T-test Research Articles

Inappropriate medication prescribing, polypharmacy, potential drug-drug interactions and medication regimen complexity in older adults attending three referral hospitals in Asmara, Eritrea: a cross-sectional study

BackgroundOlder adults often face several chronic illnesses that require them to take multiple medications. The increased number of prescribed medications has led to more complex medication regimens, putting older adults at a higher risk of potential drug-drug interactions, inappropriate medication prescribing, and adverse events. This study aimed to assess inappropriate prescribing practices, polypharmacy, medication regimen complexity, and their determinants in older adults.MethodsA cross-sectional study was conducted among older adults (aged 65 years and above) who visited three referral hospitals in Asmara, Eritrea, between June and August, 2023. A stratified random sampling technique was used, and data were collected from patient prescriptions, medical cards, and through interviews with a questionnaire. Inappropriate medication prescribing was evaluated using STOPP (Screening Tool of Older Person's Prescriptions)/ START (Screening Tool to Alert to Right Treatment) criteria version 3. Potential drug-drug interactions (pDDIs) and medication regimen complexity (MRC) were assessed using Lexi-comp drug interaction checker and MRC index, respectively. Descriptive statistics, logistic regression, Pearson’s correlation coefficient, independent samples t-test, one-way Analysis of Variance, and paired t-test were employed using IBM SPSS (version-26.0).ResultsA total of 430 respondents, with a similar male to female ratio, were included. The prevalence of polypharmacy was 5.3% (95%CI: 3.2, 7.5). Moreover, the prevalence of clinically significant pDDI was 51% (95%CI: 46, 56). The most common medicines involved in clinically significant pDDIs were enalapril (n = 179) and acetylsalicylic acid (n = 124). The presence of chronic illness (AOR = 7.58, 95%CI: 3.73, 15.39) and the number of drugs prescribed (AOR = 2.80, 95%CI: 1.91, 4.10) were predictors of clinically significant pDDIs. The prevalence of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) were 27.4% (95% CI: 23.4, 31.8) and 13.3% (95% CI: 10.3, 16.7), respectively. The most common PIMs were long-acting sulfonylureas (n = 63) and aldosterone antagonists (n = 19). Besides, proton pump inhibitors (PPIs) (n = 41) and cardio-selective beta-blockers (n = 14) were the most common PPOs identified. Age (AOR: 0.95, 95% CI: 0.92, 0.98), presence of chronic illness (AOR: 1.51, 95% CI: 0.81, 2.80), and number of drugs prescribed (AOR: 2.01, 95% CI: 1.51, 2.69) were significant factors associated with PIM. MRCI score was a significant determinant of PPO (AOR: 1.25, 95% CI: 1.14, 1.38). The mean (SD) of the overall MRCI score was 9.1 (3.7), with dose frequency being the major contributor. The number of drugs prescribed was a determinant of MRCI score (r = 0.625, p < 0.001).ConclusionInappropriate medication prescribing and clinically significant drug-drug interactions were common among older adults, highlighting the need for immediate attention from policymakers, program managers, and healthcare professionals.

Patient-reported outcomes after immediate and delayed DIEP-flap breast reconstruction in the setting of post-mastectomy radiation therapy-results of the multicenter UMBRELLA breast cancer cohort.

Timing of Deep Inferior Epigastric artery Perforator (DIEP)-flap breast reconstruction in the context of post-mastectomy radiotherapy for breast cancer patients is topic of debate. We compared the impact of immediate (before radiotherapy) versus delayed (after radiotherapy) DIEP-flap breast reconstruction (IBR versus DBR) on short- and long-term patient-reported outcomes (PROs). Within the prospective, multicenter breast cancer cohort (UMBRELLA), we identified 88 women who underwent immediate or delayed DIEP-flap breast reconstruction and received PMRT. At 6 and 12months post-mastectomy, as well as on long-term (≥ 12months post-reconstruction) body image, breast symptoms, physical functioning, and pain were measured by EORTC-QLQ-30/BR23. Additionally, long-term evaluation included satisfaction with breast(s), physical well-being and self-reported adverse effects of radiation as measured by BREAST-Q, and late treatment toxicity. PROs were compared between groups using independent sample T-test. IBR was performed in 56 patients (64%) and DBR in 32 patients (36%), with 15 months of median time to reconstruction. At 6 and 12months post-mastectomy, better body image and physical functioning were observed after IBR. No statistically nor clinically relevant differences were observed in long-term EORTC and BREAST-Q outcomes (median follow-up 37-41months for IBR vs. 42-46months for DBR). Patients with IBR reported more fibrosis and movement restriction (median follow-up 29 vs. 61months, resp.). Long-term PROs were comparable for patients with IBR and DBR, despite more patient-reported fibrosis and movement restriction after IBR. Therefore, both treatment pathways can be considered when opting for autologous breast reconstruction in the setting of PMRT.

Role of Self-Efficacy and Life Satisfaction among Adolescents

The purpose of the present study was to measure the relationship between life-satisfaction and Self-efficacy among adolescents. To examine the correlation between Life-satisfaction and self-efficacy. There was a significant correlation between Life-Satisfaction and Self-Efficacy in adolescents. The study involved 200 students, equally divided by gender, from various government and private College in Gojra, Pakistan. The research utilized two key psychological measures: Life-Satisfaction Scale, and Generalized Self-Efficacy Scale. The data was analyzed using SPSS version 25, regression analysis, independent sample t-tests, and Pearson correlation were applied to the data to interpret the results. The findings reveal Life-Satisfaction and Self-Efficacy are significantly correlate. An independent sample T-test shows that female students have a higher Self-efficacy than male students. Male students have a higher Life-Satisfaction level than female students. It provides insights into the unique challenges faced by these student populations, helps in developing targeted interventions, Self-Efficacy and Life-Satisfaction related to study promotes, and contributes to the creation of adolescent’s life. The study highlights the low level of Self-Efficacy to improve the problem of students' Life-Satisfaction. These findings underscore the need for targeted interventions to alleviate Life-Satisfaction and self-efficacy level among adolescents, ultimately contributing to adolescent’s life.

The Roles of Higher Education Institutions (HEIs) in Supporting Entrepreneurship and Innovation in Developing Countries: Evidence from Oman

Purpose: The purpose of this study is to determine whether innovation and entrepreneurship activities are being adopted by higher education institutions (HEIs) in developing countries and specifically in Oman. It aims to explore the entrepreneurial ecosystem at HEIs and understand the support and challenges facing those institutions in order to promote entrepreneurship, innovation, and to spill-over of knowledge from universities’ campus to the market. Design/Methodology/Approach: A combination of semi-structured and in-depth interviews was used to gather the data, and one-sample and independent-sample t-tests were used to analyse the data. The study’s results confirmed that all variables contributed to enhancing entrepreneurship and innovation activities in HEIs. Findings: This study’s results confirmed that all variables contributed to enhancing entrepreneurship and innovation activities in HEIs. However, the findings reveal that HEIs failed to support some activities regarding access to finance, programmes and support activities, and policies and guidelines for promoting entrepreneurship and innovation in their education system. Research Limitations/Implications: The findings of this study can be used as a map plan for universities in developing countries to provide the necessary actions to support innovation and entrepreneurship activities. HEIs can utilise the findings of this research to collaborate with external parties to facilitate students’ commercialisation to the market. Originality/Value: This study fills the knowledge gap by exploring the entrepreneurial ecosystem components in developing countries and enabling a better understanding of the challenges faced by innovation and entrepreneurial activities. Keywords: Entrepreneurship; Innovation; Higher Educational Institutions; Entrepreneurial Ecosystem; Oman. Citation: Al Shukaili, A., Mohd Kassim, N., Al Alawi, A., Al Kindi, K.S.A., Khairnnas, R. and Al-Riyami, S. (2025): The Roles of Higher Education Institutions (HEIs) in Supporting Entrepreneurship and Innovation in Developing Countries: Evidence from Oman. World Journal of Entrepreneurship, Management and Sustainable Development, Vol. 21, No. 1, pp.19-45.

Optimal Portfolio Analysis Using Markowitz and Single Index Model

This study aims to determine the composition of the optimal portfolio formation results of the Markowitz Model and Single Index Model. This study also aims to compare the results of optimal portfolio formation and performance of the Markowitz Model and Single Index Model. The population in this study are all stocks included in the LQ45 index listed on the Indonesia Stock Exchange for the period 2018-2022. The research sample is stocks that are consistently listed in the LQ-45 index during the 2018-2022 period. The number of research samples based on these conditions was 27 stocks. The results of this study are: In the Markowitz Model, 5 optimal portfolio-forming stocks are obtained, namely ADRO (49%), ANTM (22%), BBCA (7%), ICBP (5%), and KLBF (16%). With a portfolio return rate of 0.025382 (2.54%) and a portfolio risk of 0.081342 (8.13%). In the Single Index Model, 9 optimal portfolio-forming stocks are obtained, namely UNTR (15.18%), PTBA (3.38%), MNCN (4.15%), ICBP (35.59%), EXCL (6.62%), BBTN (0.92%), BBCA (32.55%), ANTM (0.04%) and ADRO (1.56%). With a portfolio return rate of 0.02066 (2.1%) and a portfolio risk of 0.04005 (4%). The results of the independent sample t-test processing of the return show that there is no difference between the Markowitz Model return and the Single Index Model return.

Effect of Ultrasound Combined with Dry Needling on Myofascial Pain in the Upper Trapezius : a Controlled Randomised Study

INTRODUCTION. Myofacscial Pain Syndrome (MPS) Upper trapezius is a condition of tightness in the upper trapezius characterized by the appearance of myofascial trigger points in the upper trapezius muscle fibers. This causes pain and decreased elastitrapezius muscle fibers, resulting in cervical motion limitations. AIM. To determine the effect of the addition of ultrasound to Dry needling intervention on reducing pain and increasing cervical range in the condition of upper trapezius MPS. MATERIALS AND METHODS. This type of research is a quasi-experiment with a randomized pre-test-post-test control group design that uses 2 sample groups, where the treatment group is given Ultrasound Therapy and Dry needling intervention, and the control group is given Dry needling intervention only. The sample obtained was 30 people according to the inclusion criteria, then randomized into 2 groups, namely 15 people in the treatment group and 15 people in the control group. Data collection was obtained through measurement of tenderness using Visual Analog Scale (VAS) and measurement of Range of Motion (ROM) using a goniometer. RESULTS AND DISCUSSION. Based on the independent sample t-test for the VAS scale, the value of p = 0.619 (mean difference of 3.767 control 3.553 treatment), and based on the Mann-Whitney test, the value of p = 0.074 for flexion ROM (mean difference of 17.00 control 12.33 treatment), p = 0.311 for lateral flexion ROM (mean difference of 9.33 treatment 8.00 control), and p = 0.494 for rotation ROM (mean difference of 13.33 treatment 11.67 control), which means that there is no significant difference in effect between the treatment and control groups. CONCLUSION. The addition of ultrasound to the dry needling intervention resulted in an increase of 9.33 in lateral flexion and 13.33 in rotation which means this number is greater when compared to dry needling alone with an increase of 8.00 in lateral flexion and 11.67 in rotation. However, the addition of ultrasound did not result in a decrease in tenderness and a greater improvement in cervical flexion where the value of 3.767 in dry needling alone compared to the value of 3.553 in the addition of ultrasound and 17.00 12.33.

Bridging the Digital Gap: A Quantitative Study on ICT Integration in Antiguan Secondary Schools

In this article, specific quantitative findings from a mixed-methods study that examined the leadership strategies Antiguan school principals employed to integrate technology into the curriculum are examined. The goal was to provide a critical analysis of the impact of ICT integration in Antiguan Secondary Schools from the perspectives of teachers and students. This study was anchored by the International Standards for Technology in Education (ISTE), as well as the TPACK theoretical frameworks. In order to gather data about participants perceptions of the impact of integrating technology into the curriculum, online questionnaires were administered via Google Forms to educators (N=163) from nine secondary schools, as well as to students (N=256) in Forms 4 and 5. The quantitative data were then subjected to descriptive analyses, independent Samples T-Tests, and One-Way ANOVAs using SPSS 26. The quantitative data analyses highlighted findings that included significant T-Tests related to ICT training and perception of the value of technology among teachers, as well as positive correlations related to higher levels of principal’s involvement and support of ICT integration. To make ICT integration smoother, schools should invest in both pre-service and in-service training for teachers and principals. Additionally, having an up-to-date technology use policy can provide clear guidance for everyone.

Environment Disaster: A Cross-Sectional Study of the Determinants for the Preparation of Azorean Nurses

Background/Objectives: Climate change increases the vulnerability of regions, communities, and individuals, stressing the urgent requirement to prepare health professionals in alignment with the Sustainable Development Goals. To foster sustainable and resilient communities, it is essential to integrate disaster preparedness into health education and practice. By equipping nurses with essential knowledge and skills, healthcare systems can be better prepared to respond to the challenges of climate change and disasters, contributing to safer and more resilient urban environments. This study aims to identify the factors that determine nurses’ preparedness for disaster situations. Methods: A cross-sectional online survey was conducted through digital platforms among 230 nurses across the Azores to assess their preparedness for disaster management. A structured questionnaire, adapted from the validated Disaster Preparedness Evaluation Tool (DPET©), was administered to registered nurses affiliated with the Nursing Council. The sample was chosen for convenience, and data were analyzed using IBM® SPSS Statistics, employing descriptive statistics, Cronbach’s alpha for measuring internal consistency, independent samples t-tests, and one-way ANOVA for comparative analysis. Ethical oversight was obtained from the Ethics Committee of the Azores, ensuring confidentiality and the voluntary nature of participation. Results: The findings revealed concerns about nurses’ disaster response, with 70% of participants indicating low ability. While knowledge was relatively strong (M = 5.50, SD = 1.07), practical competence showed a moderate score (3.51, SD = 1.797). Additional education is necessary in areas such as family preparation (M = 2.58, SD = 1.569), patient management during responses (M = 3.43, SD = 1.312), disaster-specific knowledge (M = 2.95, SD = 1.45), and recovery management (M = 2.53, SD = 1.363). Conclusions: Despite increased knowledge and awareness of climate change and its global impact, there is a need for more meaningful nursing interventions to minimize the impact of climate change on the community. This study highlights that nurses have an in-depth knowledge of communities’ needs, which puts them in a unique position to influence disaster preparation and response. By developing these strategies, nurses contribute significantly to communities’ resilience in climate change, improving society’s ability to respond and adapt to these challenges.

Comparing outcomes for early and late drainage of malignant ascites.

842 Background: Malignant ascites (MA) is a common sequela of peritoneal carcinomatosis resulting in significant morbidity and poses substantial management challenges for clinicians. Large volume paracentesis remains the gold standard treatment. The impact of time to drainage of MA is poorly studied. The purpose of this study was to compare clinical outcomes of hospitalized patients with MA that had drainage performed within 48 hours of admission and after 48 hours of admission. Methods: The NIS was queried between the years 2016 and 2020 to identify all adult patients hospitalized with malignant ascites (ICD-10 code R18.0) and had a drainage procedure performed (ICD-10 Procedure code 0W9Gx). These patients were then stratified into an early cohort (&lt;48 hours after admission) and late cohort (&gt;48 hours after admission). Baseline characteristics and clinical outcomes were collected and analyzed using chi squared tests, independent sample t-tests, and binary logistic regression (adjusted for age, gender, and Charlson comorbidity index or CCI). Adjusted Odds ratios (aOR) are presented with 95% Confidence intervals (CI). Results: A total of 129,040 patients were analyzed, with 89,905 (69.7%) hospitalizations in the early cohort and 39,135 (30.3%) in the late cohort. Baseline characteristics were similar between the groups, with no significant differences in age (63.8 vs 63.6, p = .06) or gender distribution (63.6% vs 63.1%, p = .09). However, patients in the early paracentesis group exhibited a lower CCI (9.8 vs 10.2, p&lt;.001). Notably, early paracentesis was associated with significantly improved outcomes, including lower mortality (aOR 0.67, 95% CI 0.64–0.69), reduced incidence of sepsis (aOR 0.67, 95% CI 0.65–0.69), decreased need for transfusions (aOR 0.69, 95% CI 0.66–0.71), lower rates of mechanical ventilation (aOR 0.44, 95% CI 0.42–0.47) and vasopressor use (aOR 0.79, 95% CI 0.73–0.87). Conclusions: Early paracentesis in patients with malignant ascites was found to be associated with significantly improved clinical outcomes, independent of comorbidity burden. These findings underscore the importance of timely intervention to mitigate complications and enhance quality of life. Late ParacentesisN=39,135 EarlyN=89,905 p-value Age (years) 63.6 ± 13.1 63.8 ± 13.0 .06 Gender (% female) 24665 (63.1%) 57120 (63.6%) .09 CCI 10.2 ± 3.1 9.8 ± 3.2 &lt;.001 Mortality 5720 (14.6%) 9030 (10.0%)aOR .67 (.64 - .69) &lt;.001 Sepsis 7675 (19.6%) 12525 (13.9%)aOR .67 (.65 - .69) &lt;.001 Transfusion 5275 (13.5%) 8605 (9.6%)aOR .69 (.66 - .71) &lt;.001 Ventilation 2130 (5.4%) 2190 (2.4%)aOR .44 (.42 - .47) &lt;.001 Vasopressor 770 (2.0%) 1385 (1.5%)aOR .79 (.73 - .87) &lt;.001

Investigating survival outcomes in patients with early- vs late-onset colorectal cancer with liver metastases.

282 Background: Approximately 50% of patients with colorectal cancer develop liver metastases (CRLM). The incidence of early onset colorectal cancer (EOCRC), defined as &lt;50 years of age at time of diagnosis, is increasing. In this study, we aim to explore the prognosis of early vs late onset colorectal cancer patients with CRLM who receive curative-intent treatment. Methods: A retrospective study was conducted to assess clinical outcomes in patients with CRLM presenting with EOCRC compared to those with late onset colorectal cancer (LOCRC). All patients underwent surgical resection and/or ablation between 2009 and 2024 at a tertiary care center. Groups were defined by patient age at the time of diagnosis of the primary tumor &lt; 50 years versus ≥ 50 years. Demographics, tumor characteristics, and treatment modalities were compared between groups using Chi-square, independent samples t-test, and median test. Survival outcomes were assessed using Kaplan-Meier. Results: 342 patients met inclusion criteria. There were 85 (24.9%) EOCRC patients, with a median age at diagnosis of 44 years versus 63 years in the LOCRC group. EOCRC patients had fewer major medical comorbidities. EOCRC patients had a smaller proportion of right-sided (15.9% vs 29.6%, P=0.049) tumors. Rates of synchronous metastases (74.1% in EOCRC vs 72.4%, P=0.781), median size (28cm in EOCRC vs 25cm, P=0.421) median number of metastases (2 in EOCRC vs 2, P=0.385), and initial CEA levels (339.18 + 1276.48 ng/ml vs 328.87 + 2520.59 ng/ml, P=0.482) were similar between groups. However, EOCRC patients had higher rates of node-positive disease (75.6% vs 58.8%, P=0.010) and Fong Clinical Risk Scores 3-5 (57.0% vs 39.7%, P=0.009). Both groups underwent similar operative management with no differences in morbidity, but more EOCRC patients received neoadjuvant therapy (82.4% vs 66.1%, P=0.017). There were no significant differences in RAS/RAF (37.6% in EOCRC vs 34.2%, P=0.669) or TP53 (25.9% vs 34.6%, P=0.98) mutational status or microsatellite instability (stable in 74.1% in EOCRC vs 69.3%, P=0.523). Both intra- (46.5% in EOCRC vs 50.6%, P=0.535) and extra-hepatic (47.7% in EOCRC vs 38.1%, P=0.129) recurrences occurred at similar rates, with no significant differences in post-recurrence treatments received. Patients with CRLM and EOCRC had significantly worse overall survival, with a median time of 80 months versus 116 months (P=0.042). Conclusions: Despite similar clinical, pathologic, and genetic features, fewer medical comorbidities, and receiving similar medical and surgical treatments, EOCRC patients had worse median overall survival than LOCRC patients. High risk Fong Clinical Risk Scores were more common in the EOCRC group, who also received neoadjuvant therapy at higher rates. Additional research is needed to understand the differences in survival.

Exploring the link between liver cirrhosis and liver metastasis in colorectal cancer.

301 Background: Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer mortality in the world. Although it is now associated with improved outcomes due to advancements in treatment modalities, CRC continues to be the most common source of liver metastasis. Previous studies have shown cirrhotic livers to be at reduced risk of metastatic disease. Our study aims to investigate the association between colorectal cancer and liver metastasis in the presence of concomitant liver cirrhosis. Methods: The National Inpatient Sample (NIS) was queried to identify all hospitalizations with colorectal cancer utilizing ICD-10 codes C18.x, C19.x, and C20.x from 2016 to 2020 and were further classified based on the presence or absence of cirrhosis. Demographic and clinical data were analyzed using chi-squared tests, independent sample t-tests, and binary logistic regression (adjusted for age, gender, and Charlson comorbidity index or CCI). The primary outcome studied was liver metastasis. Secondary outcomes were hepatic encephalopathy, portal hypertension, and spontaneous bacterial peritonitis. Statistical significance is indicated by a p-value less than 0.05. Results: A total of 255,599 hospitalizations with colorectal cancer were identified. Out of these, 5,370 (2.1%) had liver cirrhosis and 250,229 (97.9%) did not. Hospitalizations with CRC and concomitant cirrhosis had higher comorbidities as per the Charlson Comorbidity Index (10.5 vs 8.1, p-value&lt;0.001) and higher mortality rates (8.5% vs 4.2%, p-value&lt;0.001). Higher rates of liver metastasis (26.5 vs 23.4, p &lt;0.001) and portal hypertension (26.1% vs 0.3%, p&lt;0.001) were observed in the cirrhosis subgroup. This subgroup also has a significantly higher risk of SBP (2.8% vs 0.2%, p &lt;0.001). Conclusions: This is a large retrospective study analyzing the impact of cirrhosis on liver metastasis in patients with colorectal cancer. Patients with concomitant cirrhosis consistently have increased liver metastasis and worse outcomes. The results of this study imply that diligent CRC screening is of utmost importance in patients with cirrhosis. Patients with CRC and coexisting cirrhosis would benefit from routine surveillance such as carcinoembryonic antigen (CEA) screening or CT scans to allow early detection of liver metastases which could potentially improve outcomes. Colorectal Cancer Patients No Cirrhosis (N=250,229) Cirrhosis (N=5,370) p-value Age (in years) 65.79 ± 13.8 65.04 ± 10.9 &lt;.001 Sex (Female) 47.3% 36.8% &lt;.001 Charlson Comorbidity Index 8.1 ± 3.6 10.5 ± 3.7 &lt;.001 Mortality 4.2% 8.5% &lt;.001 Length of Stay 6.6 ± 7.2 7.4 ± 7.2 &lt;.001 Liver Metastasis 23.4% 26.5% &lt;.001 Hepatic Encephalopathy 0.0% 0.2% &lt;.001 Portal hypertension 0.3% 26.1% &lt;.001 Spontaneous Bacterial Peritonitis (SBP) 0.2% 2.8% &lt;.001

Correlation of Platelet Indices with Severity of Gastroesophageal Varices in Patients of Liver Cirrhosis: A Research Protocol

Introduction: In India, liver cirrhosis is a significant public health concern, contributing to 2.95% of total deaths. Cirrhosis is the advanced stage of ongoing liver fibrosis, which poses substantial global health challenges due to its fatal consequences, such as gastroesophageal varices. Need of the study: Gastroesophageal varices are a potentially lethal complication of liver cirrhosis. The severity of these varices directly impacts the prognosis of the patient. Gastroesophageal varices are major contributors to both mortality and morbidity on a global scale. While various parameters have been explored to predict the progression and severity of these varices, platelet indices have not been extensively studied in cirrhosis patients with gastroesophageal varices in India. Aim: To study the association and correlation of platelet indices with the severity of gastroesophageal varices in patients with liver cirrhosis. Materials and Methods: A cross-sectional study will be conducted in the Medicine OPD/IPD of Acharya Vinoba Bhave Rural Hospital (AVBRH), Wardha, Maharashtra, India from May 2023 to May 2025, involving 64 patients who meet the inclusion and exclusion criteria. Patients fulfilling the selection criteria will be informed about the study procedure in their native language. The diagnosis of liver cirrhosis will be established based on the patient’s detailed history, physical examination, laboratory tests, and ultrasound scan. Upon enrollment, a detailed history will be taken, and parameters will be recorded in a specifically designed proforma. Initial parameters will include age, gender, weight, co-morbidities (such as Diabetes Mellitus (DM), Hypertension (HTN), Heart Failure (HF), Cardiovascular Disease (CVS), Chronic Obstructive Pulmonary Disease (COPD), kidney failure, liver failure, and malignant conditions), and the aetiology of cirrhosis. Platelet count and indices-Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), and Plateletcrit (PCT)- will be assessed. The categorical and continuous variables will be represented as frequency (percentage) and mean (standard deviation, SD). The Chi-square test and Independent sample t-test will be used to evaluate the association between various categorical variables and continuous variables. The Pearson correlation test will be used to assess any correlation between platelet indices and oesophageal varices, with a significance level set at &lt;0.05.

Prevalence and determinants of lower urinary tract symptoms in pregnant women.

The management of lower urinary tract symptoms (LUTS) is crucial for providing quality pregnancy care. This study aims to determine the prevalence and predictors of LUTS in pregnant women. This cross-sectional study was conducted between November 2023 and February 2024 with a total of 1703 pregnant women who attended routine pregnancy care at four state hospital obstetrics outpatient clinics. Data were collected using a pregnant woman information form and the "Bristol Female Lower Urinary Tract Symptoms-Short Form (BFLUTS-SF)". Descriptive statistics, the independent sample t-test, analysis of variance (ANOVA) test, Tukey or Tamhane's T2 post-hoc tests, and multiple linear regression (Stepwise) analysis were carried out. All analyses were conducted with a 95% confidence interval and a significance level of p<0.05. The prevalence of LUTS among pregnant women was found to be 99.2%. High prevalence rates were obtained for storage symptoms, voiding symptoms, and urinary incontinence symptoms (respectively, 99.2%, 48.8%, and 61.2%). Multiple linear regression analysis indicated that previous pregnancy stress urinary incontinence (SUI), history of curettage and urinary tract infection (UTI), absence of episiotomy, presence of SUI in the mother and/or sister, smoking, being employed, and being in the third trimester are significant predictors of LUTS during pregnancy (p<0.05). The findings of this study indicate that LUTS is commonly in pregnant women. For quality pregnancy care, it is recommended to organize community-based, repeated educational programs and counseling services aimed at preventing and reducing LUTS in women.

Impact of race on end-of-life care among patients with esophageal cancer.

337 Background: Esophageal cancer is an aggressive malignancy with rising incidence globally. Patients with advanced esophageal cancer suffer from a heavy burden of a wide array of symptoms including dysphagia and cachexia/anorexia, necessitating the need for focused symptom management and palliative care. Studies focused on other cancer types have shown that Black patients are more likely to receive aggressive care at end-of-life (EOL) and suffer from a decline in quality of life. We sought to investigate racial differences in EOL care among patients with advanced esophageal cancer in the US. Methods: The National Inpatient Sample (NIS) was queried to identify all hospitalizations with esophageal cancer utilizing ICD-10 codes C15x from 2016 to 2020. Hospitalizations of White and Black patients with documented inpatient mortality events were then extracted. Demographic and clinical data were analyzed using chi squared tests, independent sample t-tests, and binary logistic regression (adjusted for age, gender, and Charlson comorbidity index or CCI). Adjusted Odds ratios (aOR) are presented with 95% Confidence intervals (CI). Results: A total of 15,130 patients with esophageal cancer were included, of which 13,345 (88.2%) were White and 1785 (11.8%) were Black. Hospitalizations with White patients recorded higher age, more males, and higher comorbidities per CCI. Hospitalizations with Black patients had longer lengths of stay on average, higher total hospital charges, and significantly less likely to have a Do Not Resuscitate (DNR) code status (aOR 0.81, 0.74-0.9 95% CI). Rates of inpatient palliative care consultation at EOL were significantly lower among Black patients (aOR=0.53, 0.48-0.58 95% CI). Black patients were more likely to receive aggressive intervention at EOL demonstrated by rates of blood transfusion (aOR 1.9, 1.6-2.1 95% CI), mechanical ventilation (aOR 1.7, 1.5-1.8 95% CI), and vasopressor usage (aOR 1.4, 1.2-1.6 95% CI). Conclusions: We present a large retrospective analysis demonstrating significant racial disparities in EOL care amongst hospitalized patients with esophageal cancer. Black patients had longer lengths of stay, lower rates of palliative care consultation and DNR code status, and higher rates of aggressive interventions at EOL. These findings may have implications for improving health care decision making for EOL care amongst minority patients with esophageal cancer. WhiteN=13345 BlackN=1785 p-value Age (in years) 68.24±10.67 65.12±10.36 &lt;.001 CCI 9.4±3.3 8.6±3.9 &lt;.001 Mean length of stay (days) 7.5±11.3 10.4±22.8 &lt;.001 Total Cost (In thousands of dollars) 108.6±231.0 141.9±388.5 &lt;.001 Palliative Adjusted OR 60.9% 45.1% .53 (.48 - .58) &lt;.001 DNR Adjusted OR 63.8% 58.0% .81 (.74 - .90) &lt;.001 Blood transfusion Adjusted OR 13.0% 23.0% 1.9 (1.6-2.1) &lt;.001 Mechanical ventilation Adjusted OR 31.4% 45.9% 1.7 (1.5-1.8) &lt;.001 Vasopressor Adjusted OR 7.8% 10.6% 1.4 (1.2-1.6) &lt;.001

Sickness presenteeism, job burnout, social support and health-related productivity loss among nurses in the Chinese nurses' health cohort study (TARGET): A cross-sectional survey

BackgroundSickness presenteeism has potential negative impacts on job burnout and health-related productivity loss among clinical nurses, whereas social support has been identified as a potential mitigating factor for such impacts. However, there is limited evidence regarding the relationships and mechanisms between sickness presenteeism, job burnout, social support, and health-related productivity loss. ObjectiveTo explore the role of job burnout and social support in the association between sickness presenteeism and health-related productivity loss among female nurses. DesignA cross-sectional study. Setting(s)105 hospitals conveniently selected from 36 cities in 15 provinces in China. Participants50,653 registered female nurses. MethodsThis study utilizes the cross-sectional data from the baseline survey of the Chinese Nurses' Health Cohort Study (Towards A Revolution in GETting nurses' health ticked, TARGET), conducted from December 2020 to 21st February 2024. Variables were measured using the Sickness Presenteeism Questionnaire, Stanford Presenteeism Scale, Maslach Burnout Inventory, and Perceived Social Support Scale. Data analyses were performed using independent sample t-tests, Pearson correlation analysis, one-way analysis of variance, multivariate linear regression analysis, and the Process 4.0 macro plug-in method. ResultsA total of 42,843 valid questionnaires were collected with an 85 % response rate. The incidence of sickness presenteeism among female nurses was 62 %. Sickness presenteeism was positively correlated with job burnout and health-related productivity loss, and job burnout was also positively correlated with health-related productivity loss. Conversely, social support was negatively associated with sickness presenteeism, job burnout and health-related productivity loss. The findings showed that the association between sickness presenteeism and health-related productivity loss was partially mediated by job burnout. Moreover, the direct and indirect effects within the mediation model were moderated by social support. When levels of social support were high, the impact of sickness presenteeism on job burnout and health-related productivity loss was weaker, as was the impact of job burnout on health-related productivity loss. ConclusionsHospital administrators and nurses themselves can mitigate the adverse effects of sickness presenteeism on health-related productivity loss by alleviating job burnout and increasing levels of social support. By addressing these significant challenges, they can more effectively manage the consequences of sickness presenteeism and job burnout among nurses. RegistrationThe protocol of TARGET was registered in the China Clinical Trial Registry (ChiCTR2100043202). Tweetable abstractThe study based on TARGET analyzes the mechanisms between sickness presenteeism and health-related productivity loss.

Effect of Weight-Loss Diet Combined with Taurine Supplementation on Fasting Levels of Fibroblast Growth Factors19, 21, and β -klothoCo-Receptor in Obese Women: A Randomized Clinical Trial

Background: Taurine (Tau) is naturally synthesized in the body from cysteine. It plays a crucial role in lipid and carbohydrate metabolism, increasing energy consumption, reducing inflammation, and controlling appetite. Some research suggests that obesity may be associated with decreased serum Tau levels. This study is the first randomized controlled trial to assess the effectiveness of a Tau supplement in combination with a weight loss intervention on fibroblast growth factors (FGF) 19, 21, and β-Klotho co-receptor in obese women. Methods: Participants were randomly assigned to two groups: a standard weight-loss group receiving 3 g/day of Tau capsules for 8 weeks (n=20) and a standard weight-loss group receiving placebo capsules for 8 weeks (n=18). The weight loss intervention aimed to reduce 30% of the total energy consumed by the participants.A paired t-test and an independent sample t-test were employed to assess parametric continuous data within and between the groups. Analysis of covariance was utilized to control for confounding variables. Results: At post-intervention, there was a significant reduction in mean changes of β-Klotho (P=0.01) in Tau group, compared to the control group. However, there were no significant differences in mean changes of FGF 19 and FGF 21 between the two groups (P&gt;0.05). Conclusion:This study suggests that Tau supplementation alongside a weight loss diet may lead to a reduction in serum levels ofβ-Klothoco-receptor, which could serve as an alternative marker of obesity.

Impact of inpatient palliative care consultation on end-of-life care among patients with esophageal cancer.

502 Background: Esophageal cancer is an aggressive malignancy with a high global prevalence. Patients often suffer from various debilitating symptoms like dysphagia and cachexia, particularly with more advanced stage disease. Most patients continue to receive aggressive interventions until terminal stages of disease without timely initiation of formal palliative care (PC). We sought to investigate the impact of formal inpatient palliative care consultation on end-of-life (EOL) care among patients with esophageal cancer. Methods: The National Inpatient Sample (NIS) was queried to identify all hospitalizations with esophageal cancer utilizing ICD-10 codes C15.x from 2016 to 2020. Hospitalizations with documented inpatient mortality events were extracted and stratified based on reception of PC consultation (ICD-10 code Z51.5). Demographic and clinical data were analyzed using chi-squared tests and independent sample t-tests. A threshold of p-value less than 0.05 was set to determine statistical significance. Results: A total of 17,745 patients with esophageal cancer were included, of which 10,370 (58.4%) received PC consultation. Patients that received PC consultation at EOL were more likely to have higher comorbidities per CCI. No significant difference between age and sex was observed between the two cohorts. Patients who received PC consultations at EOL had higher rates of Do Not Resuscitate (DNR) code status (78.1% vs 43.2%, p &lt;0.001) and lower rates of aggressive interventions such as chemotherapy (0.9% vs 1.6%, p&lt;.001), blood transfusions (12.3% vs 18%, p&lt;.001), and mechanical ventilation (28.5% vs 41%, p&lt;0.001). No significant difference was observed in the rates of vasopressor use between the two groups (p=0.83). Hospitalizations with PC consultations were associated with significantly lower total hospitalization cost ($97,879 vs $146,128, p&lt;.001). Conclusions: Inpatient PC consultations among patients with esophageal cancer were associated with lower rates of aggressive interventions and higher rates of DNR code status in addition to significantly lower total hospitalization costs. These findings underscore the importance of inpatient PC consultation at the EOL in helping minimize aggressive interpretation and facilitate a greater focus on comfort and quality of life. No PalliativeN=7375 PalliativeN=10370 p-value Age (in years) 67.58 ± 10.9 67.58 ± 10.9 .98 CCI 9.1 ± 3.5 9.4 ± 3.3 &lt;.001 Mean length of stay (days) 8.9 ± 14.9 7.5 ± 11.3 &lt;.001 Total Charges 146128 ± 321830 97879 ± 195868 &lt;.001 DNR 3170 (43.2%) 8100 (78.1%) &lt;.001 Blood transfusion 1320 (18.0%) 1280 (12.3%) &lt;.001 Mechanical ventilation 3015 (41.0%) 2960 (28.5%) &lt;.001 Vasopressor 585 (8.0%) 835 (8.1%) 0.83 Chemotherapy 115 (1.6%) 95 (0.9%) &lt;.001

Characteristics and violence risk factors of criminal offenses committed by patients with depression: An eight -year retrospective study in China.

Accumulating evidence indicates a relationship between depression and violence; however, little is known about the characteristics of criminal offenses and the risk factors of violent offenses for patients with depression. This article analyzed the sociodemographic, criminological, and clinical characteristics of criminal offenses committed by patients with depression and the risk factors for violent offenses. Criminal cases committed by patients with depression between January 2016 and December 2023 were collected in a national database named China Judgements Online and a forensic center. The sociodemographic, criminological and clinical characteristics of the cases and offenders were analyzed. Chi-squared test and independent sample t-test were used to compare the differences between violent and non-violent subgroups. A binary logistic regression analysis was used to determine the risk factors of violent offenses. A total of 1781 criminal cases were enrolled, among which 1086 (61.0%) cases were violent offenses, and 695 (39.0%) cases were non-violent offenses. Significant differences were found between the violent group and the non-violent group in education level (p<0.001), employment status (p<0.001), disease stage (p<0.001), and treatment history (p<0.001). Male (OR=2.336, 95% CI=1.134-4.484), irritability (OR=1.861, 95% CI=1.063-3.596), and diagnosis of bipolar disorder (OR=3.146, 95% CI=1.053-9.399) were risk factors for violent offenses, while treatment and medication were protective factors. Early identification, regular treatment, and dynamic risk management were critical for violence prevention in patients with depression, particularly in those exhibiting irritable symptoms. It is essential to educate many people, including family members, about the signs and symptoms of depression and effective communication strategies with patients.

Investigating the Influence of Residential Location and Religious Affiliation on College Students' Attitudes toward Love, Sex, and Marriage

Comprehending the interaction of variables such as residential location and religious affiliation in shaping students' perspectives is crucial for educators, legislators, and counsellors seeking to facilitate students' social and emotional growth. This study explicitly investigates the variation of these views according to residential arrangements and religious affiliations, which are evaluated by null hypotheses. A descriptive survey methodology was employed, utilising questionnaires and semi-structured interviews to collect comprehensive data from college students. The study sample consists of 350 respondents chosen from five tertiary educational institutions in the Tamale city of Ghana. Respondents were acquired by stratified, purposive, and random sampling methods. Independent-sample t-tests and one-way ANOVA were utilised to assess the hypotheses using the SPSS 16.0 software. The findings indicated statistically significant variations in students' beliefs towards romantic relationships, sexual activities, and marriage, influenced by residential location and religious affiliations. The study contributes to understanding the sociocultural and environmental factors shaping college students' perspectives on relationships and marriage. Educational policymakers ought to execute location-specific measures to rectify geographical disparities in students' social and emotional development, including seminars and counselling services. Institutions ought to foster open dialogue around relationships, sexuality, and marriage, thereby enhancing comprehension and respect for varied viewpoints.

Abstract TP100: Predictors of Skilled Nursing Facility Length of Stay and Discharge after Aneurysmal Subarachnoid Hemorrhage

Introduction: Aneurysmal subarachnoid hemorrhage (aSAH) carries high morbidity and mortality. Survivors often require extended care at skilled nursing facilities (SNF) or long-term acute care centers (LTAC). The need for long-term institutional care and distribution of patients returning to independence is unclear. We sought to identify predictors of discharge from extended care facilities to home in aSAH patients. Methods: We conducted a retrospective review of a prospectively maintained database of aSAH patients treated at a single center from June 2016 to March 2024. Included patients were discharged from the hospital to an extended care facility. Patients were grouped by whether they were discharged from extended care to home and the estimated facility length of stay (LOS) was determined. Demographics, aSAH characteristics, hospital complications, and post-aSAH neurological status were analyzed. Predictors of extended care facility discharge to home were determined using independent-sample t-tests, Fisher analyses, and multivariable logistic regression. Facility LOS predictors were identified using cumulative link modeling. Results: Of 450 aSAH patients, 61 (13.5%) were discharged to a SNF. No patients discharged to LTAC returned home and were not reviewed further. Among SNF patients, 49 (80.3%) were discharged home ( Figure 1) . Discharged patients were younger (mean 63.3±11.5 years vs. 70.2±9.3, p=0.040; Figure 2 ) and had lower modified Fisher scores (3 [IQR 3-4] vs. 4 [IQR 4-4], p=0.046; Figure 3 ). Intraventricular hemorrhage (OR 0, 95% CI 0-1.12, p=0.043), tracheostomy (OR=0.14, 95% CI 0.14-1.01, p=0.048), and gastrostomy tube (PEG) placement (OR=0.13, 95% CI 0.03-0.51, p=0.003) were associated with lower odds of SNF discharge. Patients discharged home had shorter hospital LOS (26±10 vs. 39±15 days, p&lt;0.001) and lower mRS scores at discharge (4 [IQR 4-5] vs. 5 [IQR 4-5], p=0.028) and 90-days post-discharge (4 [IQR 3-5] vs. 6 [IQR 5-6], p=0.001). Multivariable regression identified old age, PEG and hospital LOS as independent predictors of SNF discharge. Tracheostomy, PEG, and symptomatic vasospasm predicted SNF LOS. Conclusions: A majority of aSAH patients were discharged from SNF to home. Those not discharged were more medically complex with neurological deficits. These results may guide goals of care discussions, suggesting that patients unfit for home discharge may benefit from SNF placement to bridge hospitalization and independence.