Independent Samples Kruskal-Wallis Test Research Articles

Mildly elevated serum prolactin level may be a protective factor for preventing thickening of the carotid intima-media in patients with type 2 diabetes mellitus.

To evaluate the correlation between the serum prolactin (PRL) level and carotid intimate-media thickness (CIMT) in patients with type 2 diabetes mellitus (T2DM). In this study, 1500 participants were divided into three groups based on the serum PRL levels: hypoprolactinemia group (PRL ≤ 7 μg/L); normal PRL level group (7 μg/L < PRL ≤ 25 μg/L); and homeostatic functionally increased transient PRL group (25 μg/L < PRL ≤ 100 μg/L). The independent-sample Kruskal-Wallis test was used to compare the CIMT among the three groups. The Spearman correlation test was used to examine the relationship between the CIMT, serum PRL level, and clinical data. Multivariate linear regression analysis was used to determine the independent factors that influence the CIMT. Individuals in the homeostatic functionally increased transient PRL group had a significantly lower CIMT compared to the hypoprolactinemia and normal PRL level groups (P < 0.001). The CIMT was positively correlated with age, systolic blood pressure, body mass index, duration of T2DM, luteinizing hormone and follicle-stimulating hormone levels, and negatively correlated with alanine transaminase and aspartate transaminase activities, the estimated glomerular filtration rate, and PRL. Multivariate linear regression analysis revealed that only PRL was negatively associated with the CIMT, while age and the systolic blood pressure were positively associated with the CIMT. In patients with T2DM, a PRL level within the mildly elevated range is negatively correlated with the CIMT. A mildly elevated serum PRL level may be a protective factor for preventing thickening of the CIMT.

Experiences of psychological, social and organisational work environments in occupational health service in Sweden: a cross-sectional survey

BackgroundThe aim of this study was to compare and describe different professionals’ experiences of workplace psychological and social factors in occupational health (OH) organizations in Sweden.MethodsThis cross-sectional study with a descriptive and comparative design included 472 respondents with common professions in the occupational health service (OHS) in Sweden. Data were collected with “The General Nordic Questionnaire for Psychological and Social Factors at Work” (QPSNordic). The professions have been compared pairwise using the Independent Samples Kruskal-Wallis test, adjusted by Bonferroni correction for multiple tests on subscales and single items and these are presented descriptively.ResultsThe experience of the psychological and social work environment on job task measurement level differed between the professionals. Experiences on social and organizational as well as on individual measurement levels are similar between the professionals who perceive them as satisfactory. Out of the 472 respondents, 7% reported that they had seen someone being subjected to harassment and bullying at the workplace during the last six months.ConclusionsThe experience among the professionals differs most in the Job task measurement level. The results indicate that although different OH professionals experience psychological and social factors at work in different ways, their experiences are generally satisfactory even though harassment and bullying do exist. The research about occupational health professionals and their work environment is sparse. Further applied research is needed for the planning and development of occupational health services in Sweden.

DAPK-1 as a Potential Early Marker for Malignant Transformation Risk of Oral Lichen Planus.

Introduction Oral lichen planus (OLP) comprises a chronic inflammatory autoimmune disease observed in the oral cavity. It most commonly manifests as white papules arranged confluently, drawing a picture of white lines in the form of a network (reticular form). It may emerge in other forms as well. In our study, the erosive form presents the most clinical interest. Among the biomarkers that participate in the tumorigenesis process, DAPK-1 seems promising, rendering its study necessary. This study focuses on the investigation of the presence of the DAPK-1 using immunohistochemistry in OLP compared to oral squamous cell carcinoma (OSCC), oral leukoplakia (OL), a well-established oral potentially malignant disorder, and normal oral epithelium to evaluate its possible role as an early predictor of the possibility of malignant transformation risk of OLP lesions. Methods To monitor the expression profile of the tumor suppressor protein DAPK-1, an immunohistochemical detection took place in 18 samples of OLP (reticular and erosive type), in 22 OSCC samples of all degrees of differentiation, in 30 OL samples of all degrees of dysplasia, and five normal tissue samples used as the control group. To complete the above procedure, immunohistochemistry was used in a semiquantative manner. The paraffin-embedded tissue samples were selected from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, from biopsies performed in this department as well as from St. Lukas Hospital of Thessaloniki, Greece, between 2014 and 2019. The study was conducted per the Research and Ethics Committee guidelines of Aristotle University, School of Dentistry, and the Helsinki II declaration (protocol number 29/21.11.2018). Results The statistical analysis showed that there was no statistically significant difference in DAPK-1 staining between normal tissues and OLP (p=0.588, independent-samples Kruskal-Wallis test). On the other hand, there was a statistically significant difference between OSCCs and OLPs (p<0,001, independent-samples Kruskal-Wallis test), with the extent of expression of DAPK-1 being greater in OLP than in OSCC. In addition, there was a statistical difference in DAPK-1 expression between OLPs and OLs (p=0,001, independent-samples Kruskal-Wallis test), with DAPK-1 being expressed more in OLP than in OL. Conclusion The DAPK-1, as a pro-inflammatory with its role as a tumor suppressor factor, was highly expressed in OLP, both reticular and erosive. The relatively milder expression of DAPK-1 in OL means that, between the two disorders, OLP is less likely to progress to oral cancer. On the other hand, OLP could also offer the background for further investigation of a possible correlation between methylation (immunohistochemical expression of proteins, deriving from potentially DNA-methylated genes) and the development of inflammation. It appears that DNA methylation is important in the regulation of inflammatory genes. Conversely, inflammation may regulate the DNA methylation of many genes involved in carcinogenesis and thus should be taken into account when studying the methylation behavior of genes such as DAPK-1 in pathologies characterized by a sparse inflammatory infiltrate.

Female sexual dysfunctions in multiple sclerosis patients with lower urinary tract symptoms: an Italian case-control study.

Multiple sclerosis (MS) is a recurrent, autoimmune, and inflammatory demyelinating chronic disease that typically manifests in young adulthood and exerts adverse effects on sexual functions. The study evaluated the prevalence of sexual dysfunctions (SDs) and the relationship with neurological disability, depression, and lower urinary tract symptoms (LUTS) in a cohort of MS female patients, comparing these results with those of healthy women. From January 2023 to January 2024, consecutive premenopausal female patients with MS, were recruited and the examination included urinalysis, ultrasonography and a urodynamic test according to the International Continence Society standard. Descriptive statistics were reported as mean and standard deviation for continuous variables (analyzed by independent samples Mann-Whitney U test and independent samples Kruskal-Wallis test) while categorical variables were reported as frequency and percentage (analyzed by chi-square test with Fisher's exact test). Female Sexual Function Index (FSFI) total score and all FSFI subscales scores were significantly lower in patients with MS vs healthy control subjects (P < .001); FSFI total scores and all FSFI subscale scores were statistically significantly lower in patients with MS with an International Prostate Symptom Score ≥20 (P < .001) and considering a cutoff for Beck Depression Inventory-II score ≥17, depression was present in 61% (n = 47 of 77) of patients with MS and completely absent in the control group. The knowledge that SDs are a common problem in MS and in other chronic illnesses can alleviate the feeling of stigma and talking openly of sexual problems can be helpful for the patients and so the doctor-patient relationship can be reinforced. The sample was drawn from a single center, and larger multicenter studies that include both genders are needed to obtain strong results. Our findings confirm the idea of a polygenic and multifactorial etiology of female SDs in MS. Therefore, women with MS should be evaluated in terms of SDs during follow-ups.

Quantyfing the impact of the water security index on socio-economic development in EU27

The issue of environmental security in the context of sustainable development is a highly topical one, being intensively studied by specialists both in terms of its impact on biodiversity and on the protection of non-renewable resources, and in terms of its economic and social impact. The authors aim to quantify the impact of water security on economic and social development based on a new structural equation model and identify changes in the latent variable Water Security Index. (WSI), economic development (ED) and social development (SD) dynamics over the period 2000–2022 for the 27 EU Member States. The methodology is based on the use of structural equation systems and the use of the Independent-Samples Kruskal-Wallis Test to identify the influences of water security measures on economic and social indicators and to assess regional disparities of environmental policy development in relation to economic and social development. The research results will highlight the level of homogeneity of regional water security clusters in Europe and the influence of this approach on economic and social disparities. The results of the study highlight the significant correlation between population density, pollution levels and the costs associated with maintaining water quality. The study shows that high population density and high pollution levels disproportionately increase the financial burden of water quality management. In addition, the analysis highlights the social ramifications of neglecting the sustainability of water sources, particularly in regions experiencing low economic growth. In such scenarios, the negative social impact intensifies, highlighting the importance of sustainable practices. The results allow the formulation of the following public policies: Standardization of the national water quality management framework in line with the European framework; Establishment of organizations to monitor the safety of water sources and the health of the local population; Continuation of innovations in the field of water environment protection; Promotion of social responsibility towards the aquatic environment; Continuation of the process of improving water management governance. The results are useful for economic, environmental and social policy makers to optimise European sustainable development strategies.

Assessment of the prevalence and risk factors for dry eye symptoms among Romanian medical students using the ocular surface disease index – a cross-sectional study

BackgroundThis study aims to assess how Romanian medical students suffer from dry eye disease symptoms, establish the prevalence and severity of dry eye (DE) symptoms and identify potential risk factors.MethodsAn analytical, cross-sectional study was conducted on students from “Carol Davila” University of Medicine, Romania, after the final examination period of July 2022. The OSDI score (Ocular Surface Disease Index©) was applied in an online survey. The study adopted the standards used by other authors, who defined symptomatic DED as an OSDI score greater than 12. The chi-square test was used to establish statistical significance at a cutoff value of p < 0.05. The predictive model was created using linear logistic regression analysis. The goodness of fit of the logistic regression model was assessed using the Hosmer-Lemeshow test. When the severity outcome had a nominal categorical form, multinomial regression analysis with normal subjects as a reference was performed. The distribution of the severe type of symptomatology across sex categories and years of study was analyzed using a nonparametric test (Independent-Samples Kruskal-Wallis Test).ResultsA total of 274 answers were received from 81.4% females and 18.6% males with a response rate of 35.58%. The mean age was 22.7 years ± 1.66 with an age range between 20 and 25 years old. Using the OSDI score, we established that the overall prevalence of DE symptoms was 83.6% (95%CI: 79.6%, 88%), with an 85.2% (95%CI: 80.5%, 89.8%) prevalence in females and 76.5% (95%CI: 65%,88%) in males. The severe form of DE was the most prevalent, regardless of the study year or sex. Increased screen time (p-value < 0.05) and non-smokers (p-value < 0.05) were proven risk factors. The predictive model which includes the explanatory variables (sex, contact lens wearers, smoking, oral contraceptives, screen time) proved an 84.7% predictability for symptomatic DE and was able to better predict the dependent variable than the intercept model only (p-value < 0.05). Smoking (p = 0.002) and screen time (p = 0.009) preserved their significance in the multinominal regression as well.ConclusionsThis is the first study to report the epidemiology of DE symptoms among Romanian medical students. OSDI revealed a high prevalence of symptomatic DE in medical students. Screen time, although not the only factor, likely plays a role in exacerbating the disease. This information can be used to inform healthcare policies, establish occupational health guidelines, and implement preventive measures for individuals in similar high-stress academic or professional environments.

Measuring Digital Financial Literacy: A Comparative Analysis

In today’s digital landscape, digital financial literacy (DFL) has become a critical skill due to the widespread adoption of digital financial services. However, there remains a dearth of research on how demographic factors influence DFL, especially in developing countries like India. Understanding the influence of demographic variables on DFL is critical for evaluating and refining existing policies aimed at promoting digital financial inclusion. This study examines the influence of various demographic factors such as age, gender, marital status, employment class, employment sector, income level and education level on DFL among residents of the National Capital Territory (NCT) of India. The study, which surveyed 499 residents of the NCT, used the Kruskal-Wallis test for independent samples to analyse the data. The results reveal differences in DFL levels depending on age, gender, marital status, employment sector, income level and education. In particular, men, unmarried people, high earners, young adults and employees with a high level of education show a higher DFL level. These findings offer valuable insights for policy makers, financial institutions, and educators to develop interventions tailored to the specific needs of demographic groups to promote digital financial literacy and inclusion across India.

Growth Response of Long Beans (Vigna unguiculata) and Mung Beans (Vigna radiata) to the Application of Different Types of Water

Germination begins with imbibition or the entry of water that will activate various physiological components of the seed. So it is known that water has an important role in initiating the early stages of plant growth and development. The process of growth and development can be influenced by the type of water around it. This study aims to determine the growth response in Long Beans (Vigna unguiculata) and Mung Beans (Vigna radiata) to the application of various types of water, namely river water, peat water, rainwater and tap water. The seeds were soaked for 3 hours before planting. Then transferred to the planting media. Furthermore, for 7 days, observations were made along with watering the seeds using the treatment water. The parameters observed were the number of germinated seeds, sprout length, and root length on the seventh day. The data obtained were analyzed and processed using IBM SPSS software through parametric test (One-way ANOVA) and non-parametric test (Independent-Samples Kruskal-Wallis Test). Based on statistical tests, it is known that there is no significant difference, where in Long Beans the significance value is 0.795 (&gt; 0.05). While in Mung Beans the significance value is 0.602 (&gt; 0.05). The conclusion of this study is that there is no significant difference between each treatment, so that the various types of water in the treatment only as an initiator in the process of germination.

Plasma Alpha Synuclein as a Potent Biomarker of Diseases with Synucleinopathies

Objective: We explored whether plasma α-syn be used as a potential biomarker for synucleinopathies. Materials and Methods: α-syn levels in plasma from 54 Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB) patents, 31 Alzheimer’s disease dementia (AD), and 29 controls were measured by enzymelinked immunosorbent assay (ELISA). Results: The mean age of the synucleinopathies group, the AD group, and the normal controls was 72.70, 74.26, and 62 years old. The median plasma α-syn levels in the synucleinopathies group, AD group and controls were 9.72 (4.41-25.30), 16.78 (7.68-51.41) and 16.65 (10.37-32.72) ng/ml, respectively (Independent-Samples Kruskal-Wallis test, p = 0.026). The α-syn levels in the synucleinopathies group were lower than those of AD and controls. There was a fair correlation between plasma α-syn levels and the sum of the Unified Parkinson’s Disease Rating Scale (UPDRS) part 3 (spearman correlation coefficient r = -0.261, p = 0.021) but not with cognition measured by Thai Mental Status Examination (TMSE). The area under the receiver operating characteristic curve (ROC) was 0.710 between the PDD and DLB vs non synucleinopathies group (AD and normal controls) (SE = 0.052, p ≤ 0.001). At the cut-off levels of 11.4 ng/ml indicated a sensitivity of 58% (95% CI 43.21-71.81%), specificity of 84.78% (95% CI 71.13-93.66%), positive predictive value (PPV) of 80.56%, a negative predictive value (NPV) of 65% and a precision of 70.83%. Conclusion: The present results suggest that plasma α-syn could be a potential biomarker to differentiate synucleinopathies from Alzheimer’s disease and the elderly with normal cognition.

Changes in needle maneuver space and optimal insertion site for midline neuraxial puncture with progressive age: an analysis in computed tomography scans

IntroductionWe systematically describe the morphology and accessibility of interspinous spaces across age groups of patients. Our primary goal was to objectively estimate if the maneuver space for a virtual spinal...

Influence of Perceived Family Functioning on Depression among Postmenopausal Women in Nigeria

This was a cross-sectional descriptive survey, designed to determine the influence of perceived family functioning on depression among of post-menopausal women attending the family medicine clinic of a tertiary hospital in Southern Nigeria. An interviewer-administered questionnaire was used to get the respondents’ socio-demographic and clinical parameters. Data were analysed to determine: the rate and severity of depression; how some socio-demographic factors related to depression in postmenopausal women, (PMW); whether there was an association between family function and depression among the women. Our survey revealed that 66.7% of PMW had some degree of depression and their sociodemographic factors were important markers for depression. One third of the women had no form of mood disturbance but 5.7% had severe depression necessitating referral to Neuropsychiatry clinic.The participants’ family function had statistically significant association with depression (χ2 =117, p-value = &lt;.001). Women in dysfunctional milieu were more likely to have depressive illnesses than those in functional families. There was also statistically significant strong negative correlation between respondents’ family function scores and their depression scores (Spearman’s rho = -0.622; sig. (2-tailed = &lt;.001). Using Independent-samples Kruskal-Wallis test, the relationship between family function scores and depression categories was such that women with depression had significantly lower functional scores, when compared with those without depression.

167-OR: Significant Differences in DKA Outcomes across Hospitals Despite Same Guidelines Highlights the Need for Better Implementation Strategies—Results from DEKODE Initiative

Aim: To measure differences in DKA care and outcomes between hospitals having same guidelines. Method: The data was gathered as part of the DEKODE (Digital Evaluation of Ketosis and Other Diabetes-related Emergencies) initiative from October 2021 to September 2022 in six hospitals (anonymised as A to F) in the UK which has guidelines based on Joint British Diabetes Societies-Inpatient (JBDS-IP) recommendations. We collected data on adherence to Fixed Rate Intravenous Insulin Infusion (FRIII), fluids administration, glucose monitoring, and ketones monitoring. Pseudonymised data on dates and times of admission, discharge, DKA diagnosis and resolution was collected. Independent-Samples Kruskal-Wallis test was performed to assess differences in various parameters of DKA care and outcomes. Results: A total of 442 DKA episodes were analysed. There were differences between hospitals in fluids administration (median: A-92.1%, B-101.3%, C-89.7%, D-76.0%, E-98.3%, F-115.5%; p&amp;lt;0.001), glucose monitoring (median: A-103.1%, B-86.1%, C-88.9%, D-106.4%, E-99.2%, F-95.7%; p&amp;lt;0.001), and ketone monitoring (median: A-71.5%, B-85.1%, C-70.0%, D-59.3%, E-65.0%, F-85.7%; p&amp;lt;0.001). There was no significant difference in FRIII (median: A- 99.5%, B- 100.0%, C- 100.0%, D- 100.0%, E- 93.9%, F- 99.8%; p=0.064). We found inter-hospital differences in DKA duration (median in hours; A-13.3, B-13.4, C-18.5, D-15.1, E-17.1, F-16.3; p=0.002), and length of stay (median in days; A-2.1, B-2.5, C-3.5, D-3.6, E-2.5, F-3.0; p&amp;lt;0.001). Conclusion: Despite similar guidelines, significant variations in DKA outcomes exist between hospitals. Variations in various components of DKA highlight there may be differences in guidelines implementation. A centralised data collection system can identify and share best practices between centres, which may help minimise inter-hospital variations and facilitate uniform patient care. Disclosure P.Kempegowda: None. L.Rengarajan: None. P.Narendran: Advisory Panel; Omnipod, Speaker's Bureau; Abbott Diabetes, Lilly Diabetes. Dekode team: n/a.

Immobilization effects of co-pyrolyzed neem seed mixed with poultry manure on potentially toxic elements in soil and the phytoremediation potentials of native Manihot esculenta and Jatropha curcas in ensuring sustainable land use

This study evaluated the effects of neem seed biochar, poultry manure, and their combinations at varying rates of 15 and 25% (w/w) on potentially toxic elements (PTEs) in soils. Afterward, the suitability of Manihot esculenta and Jatropha curcas in removing Cd, As, Zn, Pb, and Hg from mine spoils were appraised in a 270-day outdoor pot experiment. Using ICP–Mass Spectrometry, the elemental contents of target PTE in the shoot, root, and soil specimens were determined for each treatment. The obtained average values were further subjected to a nonparametric test of samples using IBM SPSS Statistic 29. The applied organic amendments resulted in significant differences p < 0.05 in PTE availability for plant uptake after the Independent-Samples Kruskal–Wallis Test was made. Nonetheless, applying a 25% (w/w) mixture of neem seed biochar and poultry manure was efficient in immobilizing more PTEs in soils which caused lower PTEs presence in plants. Organic amendments further significantly enhanced the fertility of the mine soils leading to about a 6– 25.00% increase in the biomass yield (p < 0.05) of both plants. No significant difference (p > 0.05) was however observed between the phytoremediation potentials of both plants after the Independent-Sample Mann–Whitney U test. Even that, Manihot esculenta was averagely more efficient in PTE uptake than Jatropha curcas. Larger portions of the bioaccumulated PTEs were stored in the roots of both plants leading to high bioconcentration factors of 1.94– 2.47 mg/kg and 1.27– 4.70 mg/kg, respectively, for Jatropha curcas and Manihot esculenta. A transfer factor < 1 was achieved for all PTEs uptake by both plants and indicated their suitability for phytostabilization. Techniques for easy cultivation of root-storing PTEs are required to enhance their large-scale use as their biomass could further be used in clean energy production.

Influence of buccal and palatal bone thickness on post-surgical marginal bone changes around implants placed in posterior maxilla: a multi-centre prospective study

BackgroundNumerous clinical variables may influence early marginal bone loss (EMBL), including surgical, prosthetic and host-related factors. Among them, bone crest width plays a crucial role: an adequate peri-implant bone envelope has a protective effect against the influence of the aforementioned factors on marginal bone stability. The aim of the present study was to investigate the influence of buccal and palatal bone thickness at the time of implant placement on EMBL during the submerged healing period.MethodsPatients presenting a single edentulism in the upper premolar area and requiring implant-supported rehabilitation were enrolled following inclusion and exclusion criteria. Internal connection implants (Twinfit, Dentaurum, Ispringen, Germany) were inserted after piezoelectric implant site preparation. Mid-facial and mid-palatal thickness and height of the peri-implant bone were measured immediately after implant placement (T0) with a periodontal probe and recorded to the nearest 0.5 mm. After 3 months of submerged healing (T1), implants were uncovered and measurements were repeated with the same protocol. Kruskal-Wallis test for independent samples was used to compare bone changes from T0 to T1. Multivariate linear regression models were built to assess the influence of different variables on buccal and palatal EMBL.ResultsNinety patients (50 females, 40 males, mean age 42.9 ± 15.1 years), treated with the insertion of 90 implants in maxillary premolar area, were included in the final analysis. Mean buccal and palatal bone thickness at T0 were 2.42 ± 0.64 mm and 1.31 ± 0.38 mm, respectively. Mean buccal and palatal bone thickness at T1 were 1.92 ± 0.71 mm and 0.87 ± 0.49 mm, respectively. Changes in both buccal and palatal thickness from T0 to T1 resulted statistically significant (p = 0.000). Changes in vertical bone levels from T0 to T1 resulted not significant both on buccal (mean vertical resorption 0.04 ± 0.14 mm; p = 0.479) and palatal side (mean vertical resorption 0.03 ± 0.11 mm; p = 0.737). Multivariate linear regression analysis showed a significant negative correlation between vertical bone resorption and bone thickness at T0 on both buccal and palatal side.ConclusionThe present findings suggest that a bone envelope > 2 mm on the buccal side and > 1 mm on the palatal side may effectively prevent peri-implant vertical bone resorption following surgical trauma.Trial RegistrationThe present study was retrospectively recorded in a public register of clinical trials (www.clinicaltrials.gov - NCT05632172) on 30/11/2022.

Micro-relief characterization of benign and malignant skin lesions by polarization speckle analysis in vivo.

A recent direction in skin disease classification is to develop quantitative diagnostic techniques. Skin relief, colloquially known as roughness, is an important clinical feature. The aim of this study is to demonstrate a novel polarization speckle technique to quantitatively measure roughness on skin lesions in vivo. We then calculate the average roughness of different types of skin lesions to determine the extent to which polarization speckle roughness measurements can be used to identify skin cancer. The experimental conditions were set to target the fine relief structure on the order of ten microns within a small field of view of 3 mm. The device was tested in a clinical study on patients with malignant and benign skin lesions that resemble cancer. The cancer group includes 37 malignant melanomas (MM), 43 basal cell carcinomas (BCC), and 26 squamous cell carcinomas (SCC), all categories confirmed by gold standard biopsy. The benign group includes 109 seborrheic keratoses (SK), 79 nevi, and 11 actinic keratoses (AK). Normal skin roughness was obtained for the same patients (301 different body sites proximal to the lesion). The average root mean squared (rms) roughness ± standard error of the mean for MM and nevus was equal to 19 ± 5 μm and 21 ± 3 μm, respectively. Normal skin has rms roughness of 31 ± 3 μm, other lesions have roughness of 35 ± 10 μm (AK), 35 ± 7 μm (SCC), 31 ± 4 μm (SK), and 30 ± 5 μm (BCC). An independent-samples Kruskal-Wallis test indicates that MM and nevus can be separated from each of the tested types of lesions, except each other. These results quantify clinical knowledge of lesion roughness and could be useful for optical cancer detection.

Workflow in Simultaneous acute code Stroke activations in the emergency department (P6-5.021)

<h3>Objective:</h3> To assess the effect of simultaneous acute code stroke activation (ACSA) in the emergency department on the door-to-needle (DTN) time of patients with acute ischemic stroke eligible for reperfusion therapies. <h3>Background:</h3> Simultaneous emergency call activations carry increased workload that could possibly compromise quality parameters and patient outcomes. <h3>Design/Methods:</h3> All ACSA from March 2021 to August 2022 from the QuICR (Quality Improvement and Clinical Research Alberta Stroke Program) Registry were assessed. We defined Simultaneity based on the Canadian Triage and Acuity Scale, average local DTN and door-to-puncture (DTP) times: ACSA 30 min prior to any patient receiving intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT); ACSA within 60 min of any patient receiving IVT and ACSA within 120 min of any patient receiving EVT. The simultaneity grade 1 was 2 patients care overlap as per simultaneous ACSA definition, grade 2 was 3 patients care overlap and grade 3 was &gt;3 patients care overlap. Independent sample Kruskal-Wallis test was applied to assess the between-group differences in median treatment times. <h3>Results:</h3> 496 patients (20.9%, n=2364) underwent acute reperfusion therapy with a mean±SD age of 70.4±14.6 years, 45%(n=224) were female and a median (IQR) NIHSS of 12 (10) during the study period. Simultaneous ACSA was 163 (32.9%). The median (IQR) DTN time in the non-simultaneous group(n=205), grades 1 (n=76), 2 (n=13) and 3 (n=4) simultaneities was 38 (22)min, 39.5 (21)min, 45 (26)min, 58.5 (19.5)min respectively (p=0.27). The median (IQR) DTP time in the non-simultaneous group (n=187), in grades 1 (n=69), 2 (n=27) and 3 (n=6) simultaneities was 99 (42)min, 93 (48)min, 98 (39)min and 153 (112.75)min respectively (p=0.6). <h3>Conclusions:</h3> Simultaneous ACSA occurs in one-third of patients receiving reperfusion therapies. No differences were noted in treatment times between the study groups. Novel strategies are required to understand the effect of simultaneous ACSA on the acute stroke team and emergency department. <b>Disclosure:</b> Dr. Sarmiento has nothing to disclose. Miss Bhangoo has nothing to disclose. The institution of Dr. Jeerakathil has received research support from University Hospital Foundation. Dr. Shuaib has nothing to disclose. Dr. Buck has nothing to disclose. Ms. Taralson has nothing to disclose. Ms. Moniz has nothing to disclose. Dr. Kate has nothing to disclose.

In vitro effect of beer, red and white wine on the morphology and surface roughness of human enamel.

Beer, red and white wine are acidic drinks whose frequent consumption can increase the risk of dental erosion. To establish the effect of beer, red and white wine on the morphology and surface roughness (SR) of human enamel using different exposure times in a cyclic deand remineralization model in vitro. The experiment included 33 surgically extracted impacted human third molars from patients aged 18-25 years. Enamel samples obtained by cutting crowns (n = 132) were submitted to alternate cycles of demineralization in (1) beer, (2) red wine, (3) white wine, (PC) positive control (orange juice), and remineralization in artificial saliva, which also represented a medium for negative control (NC). The experiment included cycles with different exposure times in alcoholic beverages and orange juice of 15, 30 and 60 min. Thus, 12 groups were formed (for each drink and each exposure time) containing 10 samples each, while the NC group consisted of 12 samples. Experiments were repeated 3x/day for 10 days. Enamel surface alterations were determined by stylus profilometry (average surface roughness (Ra)) and scanning electron microscopy (SEM). The Shapiro-Wilk test, independent samples Kruskal-Wallis test and multiple comparisons (all pairwise) were performed. With increasing exposure time, there was a positive correlation with Ra for white wineand orange juice-immersed samples (60 min compared to 15 min), which was also observed using SEM. There was no significant difference in the Ra between the other experimental samples for the same exposure time. This study confirms a certain erosive potential of beer, red and white wine, and a significant relationship with pH, titratable acidity (TA) and SR, but not with the exposure time for all tested alcoholic beverages. Moreover, differences among the ultrastructural patterns caused by alcoholic beverages over the enamel surface were observed.

The transition journey of EU vs. NON-EU countries for waste management.

This study aims to identify macroeconomic indicators that can be used as predictors of waste management on the European continent. The study was conducted taking in account the intensification of urbanizations, the increase of standard of leaving that fuels to consumerism phenomenon, and imposed challenges for waste management. The research focuses on the interval from 2010 to 2020 for 37 European countries grouped according to EU15/EU28/non-EU and EU/non-EU members. As macroeconomic indicators, human development index (HDI), GDP/capita. GNI/capita, general government expenditure with environment protection, people at risk of poverty or social exclusion, population by educational attainment level, sex, and age (%)-less than primary, primary and lower secondary education (levels 0-2) were used. A multilinear regression model with collinearity diagnosis was applied to find out the direction and intensity of the contribution of independent variables and to hierarchy the predictors of waste management.. For multiple comparison between and inside of each grouping of countries, statistical inference methods were used: one-way ANOVA with Bonferroni post hoc test multiple comparisons and independent samples Kruskal-Wallis test with Dunn's post hoc test. The main conclusions of the study are that EU15 countries have the highest average values for most indicators of waste management, comparative with EU28 and with non-EU countries, followed by a group of EU28 countries. For indicators of recycling rate of packaging waste by type of packaging-metallic and recycling rate of e-waste, the non-EU countries have the highest values of mean compared with the EU15 and EU28 groups of countries. This can be explained by the high level of development of the some non-euro area countries (Iceland, Norway, Switzerland, Liechtenstein) that have intense concerns about waste recycling and have the necessary financial strength to carry out complex environmental protection programs.

MP77-08 PROSTATE CANCER PRESENTATION IN A COMMUNITY SETTING A DECADE SINCE THE USPSTF GRADE D RECOMMENDATION

You have accessJournal of UrologyCME1 Apr 2023MP77-08 PROSTATE CANCER PRESENTATION IN A COMMUNITY SETTING A DECADE SINCE THE USPSTF GRADE D RECOMMENDATION Franklin Gaylis, Edward Cohen, Paul Dato, Rose Prime, Julie Cramer, Katayune Golshan, Sonia Romo, Sepi Mahooti, Michael Leapman, Robert Topp, and William Catalona Franklin GaylisFranklin Gaylis More articles by this author , Edward CohenEdward Cohen More articles by this author , Paul DatoPaul Dato More articles by this author , Rose PrimeRose Prime More articles by this author , Julie CramerJulie Cramer More articles by this author , Katayune GolshanKatayune Golshan More articles by this author , Sonia RomoSonia Romo More articles by this author , Sepi MahootiSepi Mahooti More articles by this author , Michael LeapmanMichael Leapman More articles by this author , Robert ToppRobert Topp More articles by this author , and William CatalonaWilliam Catalona More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003351.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The United States Preventative Services Task Force (USPSTF) issued a grade “D” recommendation against PSA-based prostate cancer (PCa) screening in 2012. We present an analysis of a prospectively collected data repository including PCa tumor burden, Gleason score group, PSA and prostate biopsy positivity rates in a community setting a decade since the Task Force recommendation METHODS: We identified 7,914 patients undergoing prostate biopsy between April 2011 and December 2021 from the Genesis Healthcare Partner’s (large urology group practice) electronic medical record (EMR). For 2011, we annualized the number of biopsies performed based on an imputed estimate from April through December of 2011. We compiled the number of prostate biopsies and proportions of biopsies demonstrating cancer, Gleason score (6, 7, 8-10), and the maximum positive biopsy core percentage involvement with cancer. Statistical analysis included Chi Square and a one-way ANOVA. RESULTS: The annual biopsy rate was significantly higher in 2011 (997 cases [748 actual cases plus 249 estimated cases] than for all other years. Chi Square analysis indicated a significant consistent increase (p<0.001) in the percentage of positive biopsies between 2011 (44.25%) and 2021 (65.91%). The proportion of low grade disease significantly decreased (p<0.001) between 2011 and 2021 from 49.12% to 33.33%, while the proportion high grade disease significantly increased (p<0.001) from 16.47% to 27.59%. The proportion of intermediate grade disease significantly increased (p<0.001) from 34.41% in 2011 to 39.08% in 2021. The mean maximum positive biopsy core percentage was lower in 2011 (48.00+.33%) versus 2021 (55.00+.29%) (p<0.001). A non-parametric independent samples Kruskal-Wallis test with Bonferroni post hoc comparisons indicated that the median PSA levels were similar during 2011-2012 (6.7 – 6.9 ng/ml) and were significantly lower (p<.05) than the median PSA values measured during 2020-2021 (8.5 – 9 ng/ml). Study limitations include uncertainty about the extent of adoption of USPSTF guidelines in the practices, possible inaccurate attribution of causality (versus imaging and biomarker effects). Its strengths include prospective acquisition of granular data and findings that align with studies showing increases in metastatic disease and PCa-specific mortality during this interval. CONCLUSIONS: We identified a temporal association between the USPSTF 2012 recommendation against screening and increasing volume and proportion of high-grade prostate cancer. This trend was not reversed following the 2018 ‘Grade C’ revision to the USPSTF guideline. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1104 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Franklin Gaylis More articles by this author Edward Cohen More articles by this author Paul Dato More articles by this author Rose Prime More articles by this author Julie Cramer More articles by this author Katayune Golshan More articles by this author Sonia Romo More articles by this author Sepi Mahooti More articles by this author Michael Leapman More articles by this author Robert Topp More articles by this author William Catalona More articles by this author Expand All Advertisement PDF downloadLoading ...

Three-Dimensional Accuracy of Virtual Casts Obtained from Intra Oral Scanners and Scannable Impression for Three Units Bridge

Aims: For evaluation and comparison of the accuracy of different methods for virtual models obtaining techniques. Materials and methods: The reference cast was prepared for 3-unit fixed bridge. Four Groups with 8 samples in each group. Stone models were poured from conventional impressions. Digital impressions of the reference cast were created using two types of intraoral scanner defers in scanning technology and direct impression digitization. Reference cast, stone casts and scannable impressions were subsequently scanned using a laboratory optical scanner; files were exported in a stereolithography file format. All datasets were superimposed using 3D analysis software to evaluate the accuracy (trueness and precession). An independent-samples median test summary was performed to compare trueness among the four impression groups. The independent-samples Kruskal-Wallis test was performed to evaluate the precession of each group of impression techniques. Results: with regard to trueness, the Trios Group and Medit i500 Group had the highest trueness of all groups, with no significant differences between them, followed by the conventional impression group, then the scannable impression group which had the largest deviation from the reference model. None of the groups showed significant differences in precession. Conclusions: Intraoral scanners have a high accuracy level for both trueness and precession. Scannable impression direct digitization showed significantly higher deviation than conventional impression stone casts with clinically acceptable levels of accuracy.