Multicenter Cross-sectional Study Research Articles

Post-COVID syndrome in children: the results of a retrospective multicenter cross-sectional study

Post-COVID syndrome in children: the results of a retrospective multicenter cross-sectional study

Exploring the Role of Self-Efficacy in Maintaining Healthy Lifestyle Habits among Patients with Cardiometabolic Diseases; Findings from the Multi-Center IACT Cross-Sectional Study.

(1) Background: Cardiometabolic disease progression can be delayed if patients engage in healthy lifestyle behaviors, adherence to which is highly influenced by psychosocial factors. The present study aimed at investigating the association of self-efficacy with the adherence level to healthy lifestyle behaviors among patients with cardiometabolic diseases in Greece. (2) Methods: 1988 patients (1180 females) with cardiometabolic diseases participated. Anthropometric, demographic, socioeconomic, clinical, and lifestyle characteristics were recorded. Patients were also asked to evaluate their efficacy to comply with healthy lifestyle behaviors. (3) Results: The majority exhibited unhealthy lifestyle behaviors. A subgroup demonstrated elevated self-efficacy in maintaining healthy habits despite facing diverse psychosocial challenges. Individuals with higher educational attainment, socioeconomic status, and rural/semi-urban residency had significantly elevated self-efficacy. Those with heightened self-efficacy exhibited significantly lower BMI and reduced prevalence of certain health conditions. Self-efficacy significantly influenced adherence to the Mediterranean diet, physical activity engagement, and smoking cessation, even in challenging circumstances. (4) Conclusions: This study represented an innovative approach in examining the role of self-efficacy in shaping health behaviors and outcomes within a Greek population. By integrating specific psychosocial circumstances into the analysis, valuable insights were provided into the contextual factors influencing self-efficacy and adherence to healthy lifestyle behaviors.

Association of Constipation with Modes of Delivery: A Retrospective Questionnaire-based Study

Introduction and HypothesisPelvic floor damage can contribute to pelvic floor dysfunction, including constipation. Most studies focus on constipation during pregnancy, whereas information regarding the mode of delivery in relation to constipation is limited. We hypothesise that women with a history of vaginal delivery report constipation more often than women with a history of caesarean section.MethodsThis was a retrospective cross-sectional multicentre study conducted in the Netherlands. All included patients (n = 2,643) completed the Groningen Defecation and Fecal Continence questionnaire to assess bowel problems of the last 6 months. Parametric tests, Chi-squared, univariable and multivariable regression analyses were performed.ResultsAmong 2,643 parous women, 2,248 delivered vaginally (85.1%) and 395 (14.9%) by caesarean section. Altogether, 649 women (24.6%) suffered from constipation. Women in the vaginal delivery group were constipated more often than women in the caesarean section group (25.5% versus 19.0%, p = 0.005). For women who had delivered vaginally, multivariable regression analysis showed an odds ratio for constipation of 1.47 (95% confidence interval, 1.109–1.938, p = 0.007). The odds ratio for constipation in women with a spontaneous perineal tear was 1.4 times higher than in women with an intact perineum (p = 0.030). Furthermore, the vaginal delivery group reported difficulties regarding bowel emptying (p = 0.048), straining (p = 0.027), incomplete defecation (p = 0.043), not able to defecate daily (p = 0.018), manually assisted defecation (p = 0.015) and had higher Renzi scores (p = 0.043) more often.ConclusionsWomen in the vaginal delivery group have higher prevalences and odds ratios for constipation. Furthermore, a perineal tear during vaginal delivery increases the odds ratio for constipation.

Validation of the Indian (Hindi) version of the life-space assessment scale among community-dwelling older adults: a multicentric cross-sectional study

BackgroundThe Life-Space Assessment (LSA) is an instrument that measures mobility in older adults as they reach different areas, defined as life-spaces extending from home to beyond towns or regions. The purpose of the study was to develop the Hindi version of the LSA (LSA- H) and to investigate the validity and reliability of the Hindi version as well as its cultural adaptation.MethodsA cross-sectional study of two hundred forty-five older adults participated in the study from four different study practice areas. Following forward backwards translation, the LSA-H was developed, and the scores were correlated with those of the Activities-Specific Balance Confidence Scale Hindi (ABC- H), the Physical Health Subscale of the WHO-BREF Questionnaire and the Geriatric Depression Scale: Short Form Hindi (GDS-SFH) to test the criterion and concurrent validity.ResultsThe mean score and standard deviation of the LSA-H questionnaire were 56.53 ± 35.99, those of the Physical Health Subscale of the WHO-BREF instrument were 18.54 ± 7.87, those of the GDS-SFH questionnaire were 6.95 ± 4.21 and those of the ABC- H questionnaire were 54.40 ± 28.96. The Pearson correlation coefficient (r) between the LSA-H score and ABC-H score was 0.707 (p value < 0.0001), that between the LSA-H score and the Physical Health Subscale of the WHO-BREF was 0.766 (p value < 0.0001), and that between the LSA-H score and GDS-SFG score was − 0.674 (p value < 0.0001).ConclusionThis study demonstrated that the Hindi version of the LSA is a valid and reliable instrument for assessing living space among older adults in the Hindi language in an Indian population. Furthermore, the LSA-H was significantly correlated with other health assessment tools in terms of functional mobility, general health status and mental well-being.

Empathy in undergraduate medical students: a multi-center cross-sectional study in China

BackgroundFostering empathy has been continuously emphasized in the global medical education. Empathy is crucial to enhance patient-physician relationships, and is associated with medical students’ academic and clinical performance. However, empathy level of medical students in China and related influencing factors are not clear.MethodsThis was a cross-sectional study among medical students in 11 universities. We used the Jefferson Scale of Empathy Student-version of Chinese version to measure empathy level of medical students. Factors associated with empathy were identified by the univariate and multivariate logistic regression analyses. Based on the variables identified above, the nomogram was established to predict high empathy probability of medical students. Receiver operating characteristic curve, calibration plot and decision curve analysis were used to evaluate the discrimination, calibration and educational utility of the model.ResultsWe received 10,901 samples, but a total of 10,576 samples could be used for further analysis (effective response rate of 97.02%). The mean empathy score of undergraduate medical students was 67.38 (standard deviation = 9.39). Six variables including gender, university category, only child or not, self-perception doctor-patient relationship in hospitals, interest of medicine, Kolb learning style showed statistical significance with empathy of medical students (P < 0.05). Then, the nomogram was established based on six variables. The validation suggested the nomogram model was well calibrated and had good utility in education, as well as area under the curve of model prediction was 0.65.ConclusionsWe identify factors influencing empathy of undergraduate medical students. Moreover, increasing manifest and hidden curriculums on cultivating empathy of medical students may be needed among medical universities or schools in China.

Adherence to medication, dietary and physical activity recommendations: Findings from a multicenter cross-sectional study among adults with diabetes in rural South Africa.

Diabetes is a complex health condition requiring medical therapy and lifestyle modifications to attain treatment targets. Previous studies have not fully explored factors associated with adherence to medication, diets and physical activity recommendations among individuals living with diabetes in rural South Africa. We examined the association between knowledge, health belief and adherence to medication, dietary, and physical activity recommendations and explored self-reported reasons for non-adherence. This cross-sectional study was conducted among 399 individuals living with diabetes recruited over 12 weeks from six randomly selected primary healthcare centres in rural South Africa. Sociodemographic and clinical data were obtained by self-report. Health beliefs, knowledge, and adherence were assessed using validated measures. Descriptive and inferential statistics were carried out. The majority (81.7%) of the participants were females, with a mean age of 62 ± 11 years. Only 39% reported adhering to their prescribed medication regimen, 25% reported adhering to dietary recommendations, and 32% reported adhering to physical activity recommendations. The most cited reasons for non-adherence were lack of access to (n = 64) and cost of drugs (n = 50), perceived high costs of healthy diets (n = 243), and lack of time (n = 181) for physical activity. Level of education was an independent predictor of medication adherence [odds ratio, OR = 2.02 (95% confidence interval, CI: 1.20-3.40)] while diabetes knowledge was independently associated with both medications [OR = 3.04 (95% CI: 1.78-45.12)]; and physical activity adherence [OR = 2.92 (95% CI: 1.04-2.96). Positive health belief was independently associated with adherence to medications [OR = 1.72 (95% CI: 1.15-2.57) and dietary recommendations [OR = 1.75 (95% CI: 1.04-2.96)]. Adherence to three important self-care practices, medication, diet, and physical activity, was suboptimal in this study setting. Socioeconomic reasons and access barriers were significant drivers of non-adherence, while increased knowledge and positive health beliefs were potential facilitators. Efforts to improve medication adherence and foster engagement in healthy lifestyle behaviours must consider patients' knowledge and health beliefs. Primary healthcare providers should create awareness on the importance of adherence on health outcomes for people with diabetes. Likewise, efforts to increase the availability and affordability of medications for socioeconomically disadvantaged populations should be prioritised by the key health stakeholders.

523P Investigation and analysis of nutritional risks on oral nutrition supplementation during the peri-radiotherapy period in patients in Shandong province, China: A multicenter cross-sectional study

523P Investigation and analysis of nutritional risks on oral nutrition supplementation during the peri-radiotherapy period in patients in Shandong province, China: A multicenter cross-sectional study

Worldwide Prevalence of Single-rooted with a Single Root Canal and Four-rooted Configurations in Maxillary Molars: A Multi-center Cross-sectional Study with Meta-analysis

IntroductionTo evaluate the prevalence of single root with a single root canal and four-root configurations in the maxillary first and second molars, and analyze how geographic region, ethnicity, sex, and age impact these outcomes. MethodsResearchers from 44 nations examined 26,400 maxillary molars using cone-beam computed tomography scans to gather data on the proportions of single roots with single canals and four-root configurations. All observers underwent prior calibration regarding the step-by-step assessment protocol and anatomical concepts to ensure consistent evaluations across all assessed locations. Tests were conducted to evaluate the intraobserver and interobserver reliability. Demographic data including ethnicity, gender, and age were collected for each participant. The potential impact of imaging voxel size and field-of-view on bias was also assessed. The primary results were depicted as odds ratios and untransformed proportion forest plots with 95% confidence intervals. Additionally, a meta-analysis was performed to compare various subgroups and identify sources of variation among them. Statistical significance was set at 5%. ResultsThe prevalence of single-rooted with a single canal and four-rooted configurations in the maxillary first molar was 0.16% and 0.28%, respectively, while in the maxillary second molar, it was 2.56% and 0.83%. Males tended to exhibit lower percentages of single roots with a single canal (P < .05) and higher percentages of four-rooted configurations (P > .05) in the second molar, whereas the African subgroup displayed lower proportions for both configurations. Additionally, in both teeth, single roots with a single canal were more prevalent among older patients. Voxel size and field-of-view did not significantly influence the results (P > .05). ConclusionsThe proportions of single-rooted with a single canal and four-rooted configurations were low, and demographic factors such as geographic region, ethnicity, sex, and age may have influenced the outcomes for the maxillary second molar.

Exploring help-seeking pathways and disparities in substance use disorder care in India: A multicenter cross-sectional study.

Substance use disorders (SUDs) are among the leading causes of morbidity in the population. In low- and medium-income countries like India, there is a wide treatment gap for SUD. A multicentric study on the care pathways for SUD in India can help to understand service provision, service utilization, and challenges to improve existing SUD care in India. We aimed to map pathways to care in SUD. We compared the clinical and demographic characteristics of patients who first consulted specialized services versus other medical services. This was a cross-sectional study of consecutive, consenting adults (18-65 years) with SUD registered to each of the nine participating addiction treatment services distributed across five Indian regions. We adapted the World Health Organization's pathway encounter form. Of the 998 participants, 98% were males, 49.4% were rural, and 20% were indigenous population. Addiction services dominated initial (50%) and subsequent (60%) healthcare contacts. One in five contacted private for-profit healthcare. Primary care contact was rare (5/998). Diverse approaches included traditional healers (4-6%) and self-medication (2-8%). There was a 3-year delay in first contact; younger, educated individuals with opioid dependence preferred specialized services. There is a need to strengthen public healthcare infrastructure and delivery systems and integrate SUD treatment into public healthcare.

Perceived Family Functioning of Adolescents with Affective Disorders: A Multicentric Cross-Sectional Study.

This study aims to investigate the status of family functioning and dissatisfaction of family function from the perception of adolescents with affective disorders and explore associated factors. This was a multicentric cross-sectional study conducted from April 2022 to February 2023. Adolescents with affective disorders were surveyed in representative samples drawn from three hospitals in Sichuan province, China. Data were obtained from 235 participants regarding their demographic characteristics, family characteristics, disease-related characteristics, and family functioning. The study found family functioning and its' dissatisfaction both lower than national norms from the perspectives of adolescents. Younger age, single-parent family, and reconstituted family were predictors of not close of cohesion. Younger age, lower educational level of father, and reconstituted family were associated with less change of flexibility. Less times of hospitalizations, higher educational level of father, stem family were more satisfy with cohesion. Higher educational level of father, and stem family were also associated with greater satisfaction with flexibility. The study demonstrated that the family function of adolescents of affective disorders was poor, more attention should be paid to it. Age, family structure, number of hospitalizations and the educational level of father were influencing factors of family functioning. Therefore, it is important for medical worker to assess demographic and family characteristics of adolescents with affective disorders. Younger children, children of reconstituted family and single-parent family, children with repeated hospitalizations and fathers of lower level of education should be given emphasized in implementation of interventions. Based on the evaluation results, personalized family therapy has been proved to be an affective measure and could be used in clinical work.

Correlation of ADC values of adult brain tumors with the diagnosis and pathological grade: A cross-sectional multicenter study.

Brain tumors are common, requiring physicians to have a precise understanding of them for accurate diagnosis and treatment. Considering that various histological tumor types present different cellularity, we conducted this research to examine the role of apparent diffusion coefficient (ADC) values in the differential diagnosis and pathologic grading of brain tumor types. In this cross-sectional study, we gathered pathology reports of histological samples of adult brain tumors. The tissue sample of brain tumors were examined histologically by a pathologist. The magnetic resonance imaging data of these patients were interpreted by a neuroradiologist. The measured ADC values and ADC ratios were calculated. Standard mean ADC values were expressed as 10- 6 mm2/s. The findings were compared according to the histological diagnosis of each tumor. Sixty-eight patients were included in the study: 34 (50%) were male, and 34 (50%) were female. The average age of the patients was 51.69 + 16.40 years. In the examination of tumor type, 16 (23.5%) were astrocytoma, 9 (13.2%) were oligodendroglioma, 20 (29.4%) were glioblastoma, 4 (5.9%) were medulloblastoma, and 19 (27.9%) were metastatic tumors. the average value of ADC was statistically significantly different according to the pathological type of tumor (p < 0.001). The two-by-two comparison of average ADC among tumor types revealed significant differences, except for oligodendroglioma and glioblastoma (p-value = 0.87) and glioblastoma and medulloblastoma (p-value = 0.347). The average value of ADC and ADC ratio was statistically significantly different according to the pathological grade of the tumor (p < 0.001). In the two-by-two comparison of average ADC between all pathological grades of the tumor showed a significance difference except for Grade I and Grade II (p-value = 0.355). The mean value of ADC and ADC ratio for glioblastoma and metastatic tumors showed no significant difference. The assessment of brain tumor grade through ADC examination will help to estimate prognosis and devising suitable therapeutic strategies.

Association of physical performance with cognitive impairment in middle-aged to older haemodialysis patients: a multicentre cross-sectional observational study.

To determine the prevalence of cognitive impairment (CI) among middle-aged to older patients receiving maintenance haemodialysis (MHD) and to investigate the potential association between CI and physical performance. This cross-sectional observational study enrolled participants aged 55-85 years who received MHD. Cognitive status was assessed using the Mini Mental State Examination (MMSE). Physical performance was measured by hand grip strength, the Timed Up and Go Test (TUGT) and the 4-m walking speed. Sociodemographic, clinical and laboratory parameters were recorded for each patient. The study included 592 patients (363 males); and of these, 126 (21.3%) were diagnosed with CI. Compared with patients with normal cognitive function, those with CI were significantly older and had significantly longer dialysis duration, lower educational level, higher Malnutrition Inflammation Score, higher depression and higher Charlson Comorbidity Index score. After adjustment for covariates, multiple regression analysis suggested that grip strength (odds ratio [OR] = 0.959, 95% confidence interval [CI] = 0.924, 0.996) and 4-m walking speed (OR = 0.161, 95% CI = 0.070, 0.368) were protective factors. TUGT (OR = 1.037, 95%CI = 1.003, 1.071) was a risk factor. Physical performance was correlated with CI and might be a significant indicator for the early identification of CI in middle-aged to older MHD patients.

Comparison of baseline clinical characteristics among people with type 2 diabetes on second-line therapy previously added with dapagliflozin or another oral glucose-lowering drug: AGORA study

IntroductionType 2 diabetes mellitus (T2D) has acquired epidemic proportions worldwide. In recent years, new oral glucose-lowering drugs (OGLD) have emerged that improve the cardiovascular–kidney–metabolic control in T2D people. ObjectivesTo compare the baseline clinical–biological characteristics among T2D people to whom had added-on dapagliflozin (DAPA group) or another OGLD (SOC group) second-line hypoglycaemic therapies among the AGORA study population. MethodsThis is a multicentre cross-sectional observational study of the baseline characteristics of T2D people recruited through competitive sampling among 46 primary care health centres in Spain for the AGORA study. The inclusion and exclusion criteria of participants, and justification of the sample size are reported. After verifying the data necessary to be evaluated and informed consent, 317 subjects were included to the DAPA group and 288 to the SOC group. Both categorical and continuous variables were analysed and compared with the usual statistics. Cohen's d was used to assess the standardised difference in means. ResultsSix hundred and five patients with T2D were assessed (mean age 63.5 [SD±8.1] years, 61.8% men), whom 17.4% were smokers, 47.6% had obesity, 74.8% hypertension, 87.3% dyslipidaemia, and 41.7% reported physical inactivity, with no significant differences between both comparison groups. The mean (SD) evolution time of T2D was 10.1 (5.6) years. Most baseline clinical–biological characteristics at recruitment were similar in both groups. However, DAPA group was younger (2.9 years), and had lower systolic blood pressure (SBP) (2.8mmHg), higher body weight (BW) (3.7kg), and higher glycated haemoglobin A1c (HbA1c) (0.3%) than SOC group. Only 11.5% of participants had poor glycaemic control (HbA1c>8%) at recruitment, 54.9% had good glycaemic control (HbA1c<7%), being significantly lower in the DAPA group (47.3%) than in the SOC group (63.4%). The percentage of T2D patients with high vascular risk (VR) was 46.3%, and 53.7% with very high VR, being significantly higher in the DAPA group (57.4%) than in the SOC group (49.6%). ConclusionsMost baseline cardiovascular–kidney–metabolic characteristics were similar in T2D patients whom had added dapagliflozin on second-line hypoglycaemic therapy as those whom had added-on another OGLD. However, patients whom had added-on dapagliflozin had higher VR, lower SBP, higher BW, and slightly worse HbA1c control. Future research is necessary to explain the causes of these differences in cardiometabolic control.

Predictors of Urinary and Fecal Incontinence in Prefrail and Frail Older Adults: A Cross-Sectional Study of the FRAGSALUD Project.

Frailty is associated with urinary and fecal incontinence, which are common geriatric syndromes. This study aims to identify health factors associated with incontinence in prefrail or frail older adults living in the community. This multicenter cross-sectional study included 225 older adults (75.0 ± 6.4 years) with prefrailty or frailty based on the 5-component Fried phenotype. Physical function was assessed using the Short Physical Performance Battery (SPPB). Physical activity, inactivity, and sleep were estimated using a wrist-worn accelerometer. Urinary or fecal incontinence was registered using the Barthel scale (urine and bowel items). Multivariable logistic regression analyses, with age as a covariate, were conducted to identify associations of incontinence. In our participants, 27% presented urinary or fecal incontinence with no sex differences (p = .266). Our results showed that age, daily medication count, and number of falls in the previous year independently predicted incontinence in frail and prefrail older adults (p < .05). Some Fried's criteria, including self-reported exhaustion, gait speed, and handgrip strength, were associated with the presence of incontinence (p < .05), but not Fried's classification. The SPPB total score and its isolated variables were significantly associated with the urinary and fecal incontinence (p < .05). However, none of the accelerometer outcomes showed significant associations with incontinence status. According to this study, age, number of medications, and falls (but not sex) are linked to urinary and fecal incontinence in frail or prefrail older adults living in the community, recommending the assessment of physical function using the SPPB rather than estimating daily physical activity, inactivity, or sleep.

A Multi-center Cross-Sectional Assessment of Healthcare Professionals' Knowledge, Attitudes, and Practices Toward Thromboprophylaxis.

Background Venous thromboembolism (VTE) is a potentially avoidable condition that affects hospitalized patients. Risk stratification and preventative strategies have substantial evidence supporting their use, but reasons hinder widespread adoption, compliance, and success, explaining the continuation of VTE. Thromboprophylaxis consists of several measures that are frequently adopted to avoid the complications of VTE. The study evaluated knowledge, attitude, and practice towardusing thromboprophylaxis by health professionals. Methods This multi-center cross-sectional study was carried out on health professionals involved in patient care working in various secondary and tertiary hospitals in the study region between October 2023 and February 2024. A previously published questionnaire was sent in the form of an online survey to the study participants. Fifteen, ten, and ninequestions evaluated the participants' knowledge, attitude, and practice of thromboprophylaxis, respectively. The study followed the checklist for reporting results of the Internet E-survey (CHERRIES) guidelines. Frequency and percentages were calculated. Bi-variable and multi-variable logistic regression were carried out and presented as crude and adjusted odds ratios with corresponding 95% confidence intervals. AP-value of <0.05 was considered significant. Results Of the 219 participants, 115 (52.5%) and 104 (47.5%) were males and females. More than 50.7%were in the age group of >30 years, and the majority of the participants possessed a bachelor's (104 (47.5%)) degree. One hundred seventy-six (80.4%)of the study participants were working in government hospitals, and the majority (112 (51.1%)) were nurses. One hundred sixty-two (74% (67.63-79.65)), 175 (79.9% (73.98-85.01)) and 211 (96.3% (92.93)) had satisfactory knowledge, a positive attitude, and good practice regarding thromboprophylaxis, respectively. Regarding the facility characteristics, 196 (89.5%), 150 (68.5%), and 164 (74.9%) respondents agreed with the availability of a VTE prevention policy, VTE prevention consultants, and the availability of anticoagulants. Eighty (36.5%)participants responded with a 'not availability' of pneumatic compression devices. Of the 15 knowledge questions, the majority (124 (56.6%)) participants faulted the false statements regarding 'patients of DVT being symptomatic' and 119 (54.3%) on the statement that helping patients 'out of bed activity does not prevent VTE'. On multi-variable analysis, participants who were aware of having a VTE prevention policy and availability of anticoagulants were more knowledgeable with adjusted odds ratios of 5.39 (1.88-15.39) and 2.52 (1.12-5.63) respectively. Every practice domain received >90% approval ratings. Conclusions The study concludes that an overall satisfactory knowledge and positive attitude regarding thromboprophylaxis exists among the participants. The study proposes more training sessions on VTE prevention and orientation of health professionals on the availability of VTE policy guidelines and facility availability of resources for thromboprophylaxis.

Establishing optimized staining protocol and cutoff values of pan-TRK immunohistochemistry for detecting NTRK fusions in solid tumors: A Chinese multicenter cross-sectional study.

e15160 Background: Using IHC to screen NTRK+ patients, followed by NGS confirmation, is a strategy recommended by ESMO guidelines. However, the current IHC staining protocol (Protocol) and cutoff value (CV) are suboptimal, resulting in limited screening performance. This study aims to optimize the Protocol and redefine the CV to improve the efficacy of pan-TRK IHC in screening NTRK fusions. Methods: 126 NTRK+ and 162 NTRK- solid tumor samples (spls), previously confirmed by NGS and/or FISH, were collected retrospectively from 12 hospitals across China in 2023. All spls were stained with VENTANA pan-TRK IHC assay by using two different Protocols: 1) the conventional one recommended by the manufacturer's instruction and 2) an amplification one that included additional amplification steps to enhance the staining. The IHC stained spls were interpreted based on the manufacturer's instruction, and the results were analyzed to calculate the CVs. The sensitivity, specificity, accuracy, PPV, and NPV based on these CVs and the CV reported in the literature were calculated. Results: 126 NTRK+ spls involve 25 fusion-partner types and 23 tumor types. IHC showed 35 NTRK- spls without staining, and 253 spls (126NTRK+/127NTRK-) stained. The staining predominantly localized to the cytoplasm and nucleus (132 cytoplasmic positive, 105 cytoplasmic and nuclear positive). Due to the limited samples with membrane staining, only CVs for cytoplasmic and nuclear staining were defined. In order to enhance the sensitivity and feasibility of the pan-TRK IHC assay in NTRK+ screening, the statistically calculated CVs were adjusted, and we recommended using the following CVs in clinical practice: 1) ≥1 intensity of cytoplasmic staining in ≥50% of tumor cells and/or 2) ≥1 intensity of nuclear staining in any percentage of tumor cells. Compared with the statistically calculated CVs, although the accuracy of the recommended CVs was slightly reduced (87.5% vs 93.75%), the sensitivity was improved (94.44% vs 89.68%). The sensitivity and specificity of the recommended CVs were higher than that of the previously reported CV (≥1%): sensitivity (94.44% vs. 87.9%) and specificity (82.1% vs. 81.1%). Conclusions: The pan-TRK IHC assay demonstrated high sensitivity while maintaining good specificity and accuracy, improving screening and enrichment efficacy for identifying NTRK fusions in solid tumors by utilizing the amplification protocol and the recommended CVs. Clinical trial information: ChiCTR2200066850 . [Table: see text]

Red Cell Alloimmunisation Among Sickle Cell Disease and Thalassemia Patients Following Rh- and K-Matched Red Cell Transfusion in Southwestern Saudi Arabia: A Multicenter Study.

Alloimmunisation remains a major consequence of blood transfusion among sickle cell disease (SCD) and thalassemia patients due to the exposure to non-self-red blood cell (RBC) antigen. The complication is associated with transfusion reactions and delayed transfusion procedure because of the difficulty of finding compatible blood. This study aims to determine the prevalence of alloimmunisation to RBC and alloantibody specificities among SCD and thalassemia patients in, an endemic area of SCD and thalassemia, Jazan province of Saudi Arabia, from three major hospitals. This is a retrospective, multicenter cross-sectional study conducted on 1027 patients with SCD and thalassemia, which received Rh/K matched transfusions in 2019 in the three centers. Demographic data and medical records of participants from three transfusion institutions were collected and analysed. A total of 1027 were enrolled in the cohort; 906 (88.2%) and 121 (11.8%) patients with SCD and thalassemia, respectively. There were 483 (47%) males and 544 (53%) females with median age of 15 (range 1-48). Among the studied population, 78 were alloimmunised with an overall alloimmunisation rate of 7.6%. These patients developed a total of 108 alloantibodies, and anti-E was the most detected antibody (25.9%) followed by anti-K (24.1%). The overall rate of alloimmunisation to RBC antigen among the studied population in Jazan was low compared to other areas in the country. Most alloantibodies detected were against E and K antigens. The knowledge of most encountered alloantibodies in our population will aid in selecting the most appropriate antigen-negative red cells. Further research, however, is needed to explore factors associated with residual risk of alloimmunisation in these patients.

Paths to improve voluntary blood donation in mixed public/private blood donation systems such as in Lebanon?

BackgroundThe World Health Organization advocates for the achievement of 100% voluntary non-remunerated blood donation (VNRD) globally by the year 2020. However, until today, little was known in Lebanon regarding its actual rate or influencing factors, particularly donor motivations and behaviors. Therefore, the aim of this study was to assess the knowledge, attitudes, and practices of blood donors in Lebanon. The ultimate goals were to retain first-time donors, encourage them to become regular ones, and facilitate the transition from replacement donation to VNRD. Materials and MethodsA multi-centric cross-sectional study was carried across the five governorates in Lebanon. A self-administered and structured questionnaire was used in this survey. Results were presented in terms of odds ratios, with statistical significance defined at a P value of 0.05 and a 95% confidence interval. Additionally, a benchmarking analysis of the situation of blood donation in Lebanon was also conducted, identifying several areas for improvement. ResultsA total of 620 blood donors participated in this study, with 21.3% being first-time donors and 78.7% repeat donors. While the latter were primarily motivated by self-esteem, solidarity or returning a favor (89%, 77.9% and 78.1%), the main obstacle for becoming regular donors was a lack of initiative (34.6%). Female donors (9.9% of the total) exhibited better knowledge (OR = 2.20, p = 0.011) and were more inclined to donate voluntarily (OR = 1.52, p = 0.048). Conversely, male donors were more likely to be repeat donors, often through replacement donation (OR = 2.95, p = 0.001). ConclusionThere is a significant disparity between the low rate of voluntary donation in Lebanon (22.2%) and the relatively high proportion of donors with adequate knowledge of the donation process (60.5%). Therefore, urgent action by public authorities, based on the evidence based strategies outlined in this article, is crucial to enhancing the voluntary donation rate in Lebanon.

Variation in care and outcome for fragile hip fracture patients: a European multicentre study benchmarking fulfilment of established quality indicators.

Despite the availability of clinical guidelines for hip fracture patients, adherence to these guidelines is challenging, potentially resulting in suboptimal patient care. The goal of this study was (1) to evaluate and benchmark the adherence to recently established quality indicators (QIs), and (2) to study clinical outcomes, in fragile hip fracture patients from different European countries. This observational, cross-sectional multicenter study was performed in 10 hospitals from 9 European countries including data of 298 consecutive patients. A large variation both within and between hospitals were seen regarding adherence to the individual QIs. QIs with the lowest overall adherence rates were the administration of systemic steroids (5.4%) and tranexamic acid (20.1%). Indicators with the highest adherence rates (above 95%) were pre-operative (99.3%) and post-operative haemoglobin level assessment (100%). The overall median time to surgery was 22.6h (range 15.7-42.5h). The median LOS was 9.0 days (range 5.0-19.0 days). The most common complications were delirium (23.2%) and postsurgical constipation (25.2%). The present study shows large variation in the care for fragile patients with hip fractures indicating room for improvement. Therefore, hospitals should invest in benchmarking and knowledge-sharing. Large quality improvement initiatives with longitudinal follow up of both process and outcome indicators should be initiated.

Prevalence and Impact of Psychiatric Co-Morbidity in Patients with Spinal Pathology in Basrah, Iraq

Background and objective: to minimize complications by proper selection of patients for surgery and to evaluate what is the impact of psychiatric co-morbidity in patients admitted to a spinal surgical unit in Basrah, Iraq. Patients and Methods: A multi-center cross-sectional prospective cohort study was conducted on 247 patients. In Basrah province. During admission complete history was taken in form of identity, complaint, past medical and surgical history, drug history, type of previous and the coming surgery and lastly special emphasis on the questioner to assess patient psychological status using the Patient Health Questioner. Somatic Anxiety Depressive Symptoms (PHQ.SADS) After one week and one-month the same questions were addressed to the patient to check the general condition,and any complications or readmission. Results: Out of the 247 patients: Eight patients refuse to be part of this study, thirty-one patients lost follow up, three patients excluded from the study due to exclusion criteria, five patients their surgery postponded because they were psychologically unstable and advised for psychiatrist consultation. 111 patients (55.5%) of the sample size were male patients. A 90 (45%) patients were at age of 38-57 years, 111 (55.5%) of the sample were male 82 patients (41%) were of moderate degree using the PHQ.SADS. 62 patients (31%) were within the severe scale PHQ.SADS.132 patients (66%) complained from radiculopathy with or without backache,192 (96%) patients discharged safely postoperatively. 41(39.4%) patients were diagnosed with lumber canal stenosis belongs to the severe group. Psychological break down occurs in 10 (5%) patients, 9 (90%) of those patients belong to severe grade category of PHQ.SADS. Conclusion: There was a strong association between pre-operative psychological conditions and post-operative complications in form of repeated visit after surgery and persistence of pain and disability.