Ordinal Scale Research Articles

The Relationship Between Family Support And The Attitudes Of Partworld Mothers In Exclusive Breastfeeding At The Hj Clinic. Tarpianie Amd. Keb Prambon Sidoarjo

Mother's Milk (ASI) is the best and most suitable food for babies to ensure the growth of babies into human quality. The substances contained in breast milk contain almost all the nutrients needed by babies with concentrations that suit the needs of the baby. (MOH RI, 2014). Based on preliminary studies conducted by researchers at Clinic Hj. Tapianie Prambon Sidoarjo in January 2020 from 15 respondents showed that the attitude of the mother in giving exclusive breast milk is very good this is because of the large amount of family support in motivating mothers to want to breastfeed exclusively. The purpose of this study was to determine the Relationship Between Family Support and Attitude of Postpartum Mother in Giving Exclusive Asi at Clinic Hj. Tarpianie Prambon Sidoarjo Year 2020. The design of this study included a cross sectional analytic study with a survey approach. The population in this study were all postpartum mothers in Clinic Hj. Tarpianie Amd.Keb Prambon Sidoarjo Year 2020, the sample in this study was taken with a non-probability sampling technique by means of accidental sampling, amounting to 31 respondents. The independent variable in this study is family support with an ordinal scale and the dependent variable is the attitude in exclusive breastfeeding with an ordinal data scale. This research was conducted from January to July 2020 in the Class of Pregnant Women at Clinic Hj. Tarpianie, Amd. Keb Prambon Sidoarjo using a questionnaire measuring instrument that was tested with a validity and reliability test. In collecting data from respondents the next step taken by researchers is data processing by editing, coding, scoring, tabulating, data entry, and cleaning. Data analysis in this study used the Spearman rank test. From the Spearman rank test results following the normal distribution with a significant level (α = 0.05), it was found that p value <α or 0.001 <0.05 which means that H0 is rejected and H1 is accepted. The conclusion is that there is a relationship between family support and mother's attitude in exclusive breastfeeding. The form of husband's support can be shown by the husband through daily activities, for example giving information to the mother about the importance of exclusive breastfeeding to the baby or taking the mother to a health service to find information. If a mother benefits from all her husband's support, then a mother has received a positive stimulus to change her attitude to be positive.

Pengaruh Motivasi Intrinsik dan Kompensasi terhadap Kinerja Karyawan PT. Kereta Api Indonesia Logistik Kota Madiun

The purpose of this research is to determine the influence of intrinsic motivation and compensation on the employees performance at PT. Kereta Api Indonesia Logistics in Madiun City. The population of employees at PT. Kereta Api Indonesia Logistics in Madiun City is 35 employees, and the sampling method used is a saturated sampling technique, making all employees participants in the research. The research method employed is quantitative with a measurement scale using the ordinal scale with the Likert scale weighting technique ranging from 1 to 5. To achieve the research objectives, the hypotheses are tested using the Partial Least Square (PLS) software. The entire testing process using PLS demonstrates results that surpass the required values for the reliability of the testing. Based on the research findings, it is established that both intrinsic motivation and compensation have a significant positive effect on the employees performance at PT. Kereta Api Indonesia Logistics in Madiun City.

Is it safe to give birth with an activated implantable cardioverter-defibrillator: A multicentre observational study.

Data and guidelines are lacking, so implantable cardioverter-defibrillators (ICDs) are often deactivated during labour to prevent inappropriate shocks. This study aimed to ascertain the safety of an activated ICD during labour. An observational study was performed. Dutch hospitals. A total of 41 childbirths were included of 26 patients who gave birth between February 2009 and November 2018 after receiving an ICD in our tertiary hospital. Five of these childbirths were attended by the research team between December 2018 and August 2020, during which the ICD remained active. Groups were made based on ICD status during labour. Patients who gave birth with an activated ICD at least once were stratified to the activated ICD group. Patients' files were checked and patients received a questionnaire about childbirth perceptions and treatment preferences. The differences in ordinal data resulting from the questionnaire were calculated using a chi-square or Fisher's exact test. Primary outcome was inappropriate ICD therapy and occurrence of ventricular arrhythmias requiring treatment. During the 41 childbirths, no inappropriate shocks or ventricular arrhythmias occurred during labour. All patients in the activated ICD group (n = 13) preferred this setting, while 8 of the 13 patients in the deactivated ICD group preferred activation (p = 0.002). Reasons included avoiding hemodynamic monitoring, magnet placement, or labour induction to facilitate technician availability. This study shows no evidence that labour and birth in women with an activated ICD are unsafe, as there were no ventricular arrhythmias or inappropriate therapy. In addition, most patients prefer an activated ICD during labour.

Load and recovery monitoring in Swiss top-level youth soccer players: Exploring the associations of a new web application-based score with recognised load measures

Load and recovery monitoring in Swiss top-level youth soccer players: Exploring the associations of a new web application-based score with recognised load measures

Comparison of Masimo Total Hemoglobin SpHb® continuous non-invasive hemoglobin monitoring device with laboratory complete blood count measurement using venous sample: Protocol for an observational substudy of the Pregnancy Risk and Infant Surveillance and Measurement Alliance Maternal and Newborn Health (PRISMA MNH) study

Background The Masimo Total Hemoglobin SpHb® is a continuous and non-invasive handheld device to measure hemoglobin levels. Previous research has found that SpHb is able to accurately detect hemoglobin levels in adult patients with a similar degree of bias and standard deviation to point-of-care invasive method measurements. Generally, limited clinical evidence, lack of validation of Masimo at higher than and lower than hemoglobin threshold values, and scientific consensus supporting the use of Masimo for accurate hemoglobin testing for the diagnosis of anemia during pregnancy calls for further research. Methods and analysis The proposed prospective cohort will be nested within the ongoing Pregnancy Risk and Infant Surveillance and Measurement Alliance (PRISMA) Maternal and Newborn Health (MNH) study. Three study sites (located in Zambia, Kenya, and Pakistan) will participate and collect hemoglobin data at five time points (<20 weeks, 20 weeks, 28 weeks, 36 weeks’ gestation, and six weeks postpartum). We will measure hemoglobin using a venous blood sample via hematology auto-analyzer complete blood count (gold standard) and the non-invasive device. The primary objective is to assess agreement between Masimo total hemoglobin and complete blood count and on a continuous scale using Intraclass Correlation Coefficient and Bland-Altman Analysis. The second objective is to assess agreement between the two measures on a binary scale using Positive Percentage Agreement and Negative Percentage Agreement, Cohen’s Kappa, and McNemar Test. On an ordinal scale, agreement will be measured using Weighted Cohen’s Kappa and Harrel’s Concordance Index. Lastly, we will assess factors that might affect the accuracy of Masimo total hemoglobin using linear mixed models. Conclusions The primary aim of this study is to assess the validity of the non-invasive Masimo device compared to the gold standard method of invasive hemoglobin measurements during pregnancy and postpartum periods for the diagnosis of anemia.

Inter-tester reliability and agreement of the Cumulated Ambulation Score in acute stroke: The InTRO-CAS-stroke study

TitleInter-Tester Reliability and Agreement of the Cumulated Ambulation Score in Stroke patients: The InTRO-CAS-stroke study ObjectiveTo examine the inter-tester reliability of the total Cumulated Ambulation Score (CAS) and the three activities of the CAS, and to define limits for the smallest change in basic mobility that indicates a real change in patients with stroke. MethodsAn intertester reliability study. Setting: Participants: 60 participants from a specialized stroke unit with a mean age of 69.10 ± 13.23 years. The CAS describes a patient's independency in three activities – (1) getting in and out of bed, (2) sit to stand from a chair, and (3) walking ability and was assessed by two independent physiotherapists at median day 3 poststroke. Each activity was assessed on a three-point ordinal scale from 0 (not able to) to 2 (independent). The cumulated score for each activity provides a total CAS from 0 to 6, with 6 indicating independent basic mobility. Relative and absolute reliability was evaluated using weighted kappa, the standard error of measurement (SEM) and minimal detectable change (MDC). ResultsThe weighted kappa for the total CAS score was 0.816 and ranged from 0.733 to 0.904 for the 3 CAS activities. The SEM and the MDC of the total CAS was 0.37 and 1.03 respectively. ConclusionsThe intertester reliability of the CAS is almost perfect, and a change of 1 CAS point for the total CAS indicates a real change in basic mobility, at group level and for an individual patient with stroke Clinicaltrials.gov identifierNCT05601089

Safety and efficacy of onradivir in adults with acute uncomplicated influenza A infection: a multicentre, double-blind, randomised, placebo-controlled, phase 2 trial

Onradivir (ZSP1273) is a novel anti-influenza A virus inhibitor. Preclinical studies show that onradivir can inhibit influenza A H1N1 and H3N2 replication and increase the survival rate of infected animals. In this study, we aimed to evaluate the safety and efficacy of three onradivir dosing regimens versus placebo in outpatients with acute uncomplicated influenza A virus infection. We did a multicentre, double-blind, randomised, placebo-controlled, phase 2 trial at 20 clinical sites in China. Eligible participants were adults (18-65 years) with an influenza-like illness screened by rapid antigen testing at the first clinical visit, had the presence of a fever (axillary temperature ≥38·0°C), and had the presence of at least one moderate systemic and one respiratory symptom within 48 h of symptom onset. Patients were excluded if they were pregnant, allergic to onradivir, or had received any influenza antiviral medication within 7 days before enrolment. Participants were randomly assigned (1:1:1:1) into four groups by an interactive web response system: onradivir 200 mg twice per day group, onradivir 400 mg twice per day group, onradivir 600 mg once per day group, and a matching placebo group. A 5-day oral treatment course was initiated within 48 h after symptoms onset. The primary outcome was the time to alleviate influenza symptoms in the modified intention-to-treat population. Safety was a secondary outcome. We evaluated the patients' self-assessed severity of seven influenza symptoms on a 4-point ordinal scale, and the treatment-emergent adverse events in all patients. This trial is registered with ClinicalTrials.gov, number NCT04024137. Between Dec 7, 2019, and May 18, 2020, a total of 205 patients were screened; of whom, 172 (84%) were randomly assigned to receive onradivir (n=43 in the 200 mg twice per day group; n=43 in the 400 mg twice per day group; and n=43 in the 600 mg once per day group), or placebo (n=42). Median age was 22 years (IQR 20-26). All three onradivir groups showed decreased median time to alleviate influenza symptoms (46·92 h [IQR 24·00-81·38] in the 200 mg twice per day group, 54·87 h [23·67-110·62] in the 400 mg twice per day group, and 40·05 h [17·70-65·82] in the 600 mg once per day) compared with the placebo group (62·87 h [36·40-113·25]). The median difference between the onradivir 600 mg once per day group and the placebo group was -22·82 h (p=0·0330). The most frequently reported treatment-emergent adverse event was diarrhoea (71 [42%] of 171), ranging from 33-65% of the patients in onradivir-treated groups compared with 10% in the placebo group; no serious adverse events were observed. Onradivir showed a safety profile comparable to placebo, as well as higher efficacy than placebo in ameliorating influenza symptoms and lowering the viral load in adult patients with uncomplicated influenza infection, especially the onradivir 600 mg once per day regimen. National Multidisciplinary Innovation Team Project of Traditional Chinese Medicine, National Natural Science Foundation of China, Guangdong Science and Technology Foundation, Guangzhou Science and Technology Planning Project, Emergency Key Program of Guangzhou Laboratory, Macao Science and Technology Development Fund, and Guangdong Raynovent Biotech.

Identification of Factors Associated with Mortality in the Elderly Population with SARS-CoV-2 Infection: Results from a Longitudinal Observational Study from Romania.

The progression of SARS-CoV-2 infection has been linked to a hospitalization rate of 20%. The susceptibility of SARS-CoV-2 infection increases with age, resulting in severe and atypical clinical forms of the disease. The severity of SARS-CoV-2 infection in the elderly population can be attributed to several factors, including the overexpression of angiotensin-converting enzyme 2 (ACE2) receptors, immunosenescence, and alterations in the intestinal microbiota that facilitate the cytokine storm. In light of these observations, we conducted a retrospective analysis based on prospectively collected data between 23 December 2021 and 30 April 2022 (the fourth wave of SARS-CoV-2 infection). We analyzed patients aged over 60 years who were hospitalized in a county hospital in Romania. The primary objective of our study was to assess the risk factors for an unfavorable outcome, while the secondary objective was to assess the clinical and baseline characteristics of the enrolled patients. We included 287 cases with a complete electronic medical record from this available cohort of patients. We aimed to retrospectively evaluate a group of 127 patients that progressed, unfortunately, toward an unfavorable outcome versus 160 patients with a favorable outcome. We used the Combined Ordinal Scale of Severity that combines the WHO ordinal scale and the degrees of inflammation to assess the severity of the patients at the time of the initial assessment. The age group between 70 and 79 years had the highest percentage, accounting for 48.0%-61 patients, of the deceased patients. We noted statistically significant differences between groups related to other cardiovascular diseases, nutritional status, hematological diseases, other neurological/mental or digestive disorders, and other comorbidities. Regarding the nutritional status of the patients, there was a statistically significant unfavorable outcome for all the age groups and the patients with a BMI > 30 kg/m2, p = 0.004. The presence of these factors was associated with an unfavorable outcome. Our results indicate that with the presence of cough, there was a statistically significant favorable outcome in the age group over 80 years, p ≤ 0.049. In terms of the presence of dyspnea in all groups of patients, it was associated with an unfavorable outcome, p ≤ 0.001. In our study, we analyzed laboratory test results to assess the level of inflammation across various WHO categories, focusing on the outcome groups determined by the average values of specific biomarkers. Our findings show that, with the exception of IL-6, all other biomarkers tend to rise progressively with the severity of the disease. Moreover, these biomarkers are significantly higher in patients experiencing adverse outcomes. The differences among severity categories and the outcome group are highly significant (p-values < 0.001). CART algorithm revealed a specific cut-off point for the WHO ordinal scale of 4 to stand out as an important reference value for patients at a high risk of developing critical forms of COVID-19. The high death rate can be attributed to proinflammatory status, hormonal changes, nutritional and vitamin D deficiencies, comorbidities, and atypical clinical pictures.

Evaluating a novel accelerated free-breathing late gadolinium enhancement imaging sequence for assessment of myocardial injury

IntroductionCardiac magnetic resonance imaging (MRI), including late gadolinium enhancement (LGE), plays an important role in the diagnosis and prognostication of ischemic and non-ischemic myocardial injury. Conventional LGE sequences require patients to perform multiple breath-holds and require long acquisition times. In this study, we compare image quality and assessment of myocardial LGE using an accelerated free-breathing sequence to the conventional standard-of-care sequence. MethodsIn this prospective cohort study, a total of 41 patients post Coronavirus 2019 (COVID-19) infection were included. Studies were performed on a 1.5 Tesla scanner with LGE imaging acquired using a conventional inversion recovery rapid gradient echo (conventional LGE) sequence followed by the novel accelerated free-breathing (FB-LGE) sequence. Image quality was visually scored (ordinal scale from 1 to 5) and compared between conventional and free-breathing sequences using the Wilcoxon rank sum test. Presence of per-segment LGE was identified according to the American Heart Association 16-segment myocardial model and compared across both conventional LGE and FB-LGE sequences using a two-sided chi-square test. The perpatient LGE extent was also evaluated using both sequences and compared using the Wilcoxon rank sum test. Interobserver variability in detection of per-segment LGE and per-patient LGE extent was evaluated using Cohen's kappa statistic and interclass correlation (ICC), respectively. ResultsThe mean acquisition time for the FB-LGE sequence was 17 s compared to 413 s for the conventional LGE sequence (P < 0.001). Assessment of image quality was similar between both sequences (P = 0.19). There were no statistically significant differences in LGE assessed using the FB-LGE versus conventional LGE on a per-segment (P = 0.42) and per-patient (P = 0.06) basis. Interobserver variability in LGE assessment for FB-LGE was good for per-segment (= 0.71) and per-patient extent (ICC = 0.92) analyses. ConclusionsThe accelerated FB-LGE sequence performed comparably to the conventional standard-of-care LGE sequence in a cohort of patients post COVID-19 infection in a fraction of the time and without the need for breath-holding. Such a sequence could impact clinical practice by increasing cardiac MRI throughput and accessibility for frail or acutely ill patients unable to perform breath-holding.

Cervical spondylotic myelopathy and driving abilities: defining the prevalence and long-term postoperative outcomes using the Quality Outcomes Database.

Cervical spondylotic myelopathy (CSM) can cause significant difficulty with driving and a subsequent reduction in an individual's quality of life due to neurological deterioration. The positive impact of surgery on postoperative patient-reported driving capabilities has been seldom explored. The CSM module of the Quality Outcomes Database was utilized. Patient-reported driving ability was assessed via the driving section of the Neck Disability Index (NDI) questionnaire. This is an ordinal scale in which 0 represents the absence of symptoms while driving and 5 represents a complete inability to drive due to symptoms. Patients were considered to have an impairment in their driving ability if they reported an NDI driving score of 3 or higher (signifying impairment in driving duration due to symptoms). Multivariable logistic regression models were fitted to evaluate mediators of baseline impairment and improvement at 24 months after surgery, which was defined as an NDI driving score < 3. A total of 1128 patients who underwent surgical intervention for CSM were included, of whom 354 (31.4%) had baseline driving impairment due to CSM. Moderate (OR 2.3) and severe (OR 6.3) neck pain, severe arm pain (OR 1.6), mild-moderate (OR 2.1) and severe (OR 2.5) impairment in hand/arm dexterity, severe impairment in leg use/walking (OR 1.9), and severe impairment of urinary function (OR 1.8) were associated with impaired driving ability at baseline. Of the 291 patients with baseline impairment and available 24-month follow-up data, 209 (71.8%) reported postoperative improvement in their driving ability. This improvement seemed to be mediated particularly through the achievement of the minimal clinically important difference (MCID) in neck pain and improvement in leg function/walking. Patients with improved driving at 24 months noted higher postoperative satisfaction (88.5% vs 62.2%, p < 0.01) and were more likely to achieve a clinically significant improvement in their quality of life (50.7% vs 37.8%, p < 0.01). Nearly one-third of patients with CSM report impaired driving ability at presentation. Seventy-two percent of these patients reported improvements in their driving ability within 24 months of surgery. Surgical management of CSM can significantly improve patients' driving abilities at 24 months and hence patients' quality of life.

Factor analyzing ordinal items requires substantive knowledge of response marginals.

In the social sciences, measurement scales often consist of ordinal items and are commonly analyzed using factor analysis. Either data are treated as continuous, or a discretization framework is imposed in order to take the ordinal scale properly into account. Correlational analysis is central in both approaches, and we review recent theory on correlations obtained from ordinal data. To ensure appropriate estimation, the item distributions prior to discretization should be (approximately) known, or the thresholds should be known to be equally spaced. We refer to such knowledge as substantive because it may not be extracted from the data, but must be rooted in expert knowledge about the data-generating process. An illustrative case is presented where absence of substantive knowledge of the item distributions inevitably leads the analyst to conclude that a truly two-dimensional case is perfectly one-dimensional. Additional studies probe the extent to which violation of the standard assumption of underlying normality leads to bias in correlations and factor models. As a remedy, we propose an adjusted polychoric estimator for ordinal factor analysis that takes substantive knowledge into account. Also, we demonstrate how to use the adjusted estimator in sensitivity analysis when the continuous item distributions are known only approximately. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Abstract TP211: TICI Scoring Reliability in Proximal vs Distal Vessel Thrombectomy: A Comparative Analysis

Introduction: The extended Thrombolysis in Cerebral Infarction (eTICI) scale has been demonstrated to correlate strongly with clinical outcomes. Thrombectomy has evolved into the pursuit of not only proximal but distal vessel occlusions, however the reliability of eTICI grading for distal occlusions has not been well studied. We aim to study the interrater agreement of proximal as compared to distal occlusions. Methods: A fellowship trained Neurointerventionalist retrospectively scored the Digital Subtraction Angiography(DSA) images of consecutive patients with only isolated proximal (MCA-M1 or ICA-T) or distal occlusions (MCA-M3, ACA, or PCA) that underwent MT at a single comprehensive stroke center (2022 for proximal occlusions and 2015-2022 for distals). We assessed the agreement between the Neurointerventionalist and original report for the ordinal eTICI scale using Fleiss-Cohen’s Weighted Kappa with quadratic weights. TICI distributions were compared using Wilcoxon’s rank sum test. Results: 187 patients were included in the analysis (124 Proximal and 60 patients distal: 32-M3, 20 -ACA, 8-PCA). The distribution of eTICI 0, 2a, 2b50, 2b67, 2c and 3 were comparable between proximal(MCA-M1 or ICA-T) vs distal occlusions (MCA-M3, ACA, or PCA). The Fleiss-Cohen weighted kappa coefficients were assessed. The proximal eTICI score assessment demonstrated moderate reliability with a kappa value of 0.77 (95%CI: 0.67-0.88)(Table 1A), while the distal eTICI score assessment exhibited almost perfect agreement with kappa value of 0.87 (95%CI: 0.71-1.00)(Table 1B). Conclusion: This study underscores comparable reliability of eTICI scores in assessing reperfusion post MT for distal as compared to proximal occlusions.

Survival Analysis as a Basis for Testing Hypotheses when Using Quantitative Ordinal Scale Disease Severity Data.

Disease severity in plant pathology is often measured by the amount of a plant or plant part that exhibits disease symptoms. This is typically assessed using a numerical scale, which allows a standardized, convenient, and quick method of rating. These scales, known as quantitative ordinal scales (QOS), divide the percentage scale into a predetermined number of intervals. There are various ways to analyze these ordinal data, with traditional methods involving the use of midpoint conversion to represent the interval. However, this may not be precise enough, as it is only an estimate of the true value. In this case, the data may be considered interval-censored, meaning that we have some knowledge of the value but not an exact measurement. This type of uncertainty is known as censoring, and techniques that address censoring, such as survival analysis (SA), use all available information and account for this uncertainty. To investigate the pros and cons of using SA with QOS measurements, we conducted a simulation based on three pathosystems. The results showed that SA almost always outperformed midpoint conversion with data analyzed using a t test, particularly when data were not normally distributed. Midpoint conversion is currently a standard procedure. In certain cases, the midpoint approach required a 400% increase in sample size to achieve the same power as the SA method. However, as the mean severity increases, fewer additional samples are needed (approximately an additional 100%), regardless of the assessment method used. Based on these findings, we conclude that SA is a valuable method for enhancing the power of hypothesis testing when analyzing QOS severity data. Future research should investigate the wider use of survival analysis techniques in plant pathology and their potential applications in the discipline.

Sine Spin flat detector CT can improve cerebral soft tissue imaging: a retrospective in vivo study

BackgroundFlat detector computed tomography (FDCT) is frequently applied for periinterventional brain imaging within the angiography suite. Novel technical developments such as the Sine Spin FDCT (S-FDCT) may provide an improved cerebral soft tissue contrast. This study investigates the effect of S-FDCT on the differentiation between gray and white matter compared to conventional FDCT (C-FDCT) and multidetector computed tomography (MDCT).MethodsA retrospective analysis of a prospectively maintained patient database was performed, including patients who underwent mechanical thrombectomy in our institution and received S-FDCT or C-FDCT as well as MDCT. Differentiation between gray and white matter on the contralateral hemisphere to the ischemic stroke was analyzed quantitatively by contrast-to-noise ratio (CNR) and qualitatively (5-point ordinal scale).ResultsIn a cohort of 109 patients, MDCT demonstrated the best differentiation between gray and white matter compared to both FDCT techniques (p ≤ 0.001). Comparing both generations of FDCT, S-FDCT provided better visibility of the basal ganglia (p = 0.045) and the supratentorial cortex (p = 0.044) compared to C-FDCT both in quantitative and qualitative analyses. Median CNR were as follows: S-FDCT 2.41 (interquartile range [IQR] 1.66–3.21), C-FDCT 0.96 (0.46–1.70), MDCT 3.43 (2.83–4.17). For basal ganglia, median score and IQR were as follows: S-FDCT 2.00 (2.00–3.00), C-FDCT 1.50 (1.00–2.00), MDCT 5.00 (4.00–5.00).ConclusionsThe novel S-FDCT improves the periinterventional imaging quality of cerebral soft tissue compared to C-FDCT. Thus, it may improve the diagnosis of complications within the angiography suite. MDCT provides the best option for x-ray-based imaging of the brain tissue.Relevance statementFlat detector computed tomography is a promising technique for cerebral soft tissue imaging, while the novel Sine Spin flat detector computed tomography technique improves imaging quality compared to conventional flat detector computed tomography and thus may facilitate periinterventional diagnosis of gray and white matter.Key points• Flat detector computed tomography (FDCT) is frequently applied for periinterventional brain imaging.• The potential of novel Sine Spin FDCT (S-FDCT) is unknown so far.• S-FDCT improves the visibility of cerebral soft tissue compared to conventional FDCT.• Multidetector computed tomography is superior to both FDCT techniques.• S-FDCT may facilitate the evaluation of brain parenchyma within the angiography suite.Graphical

Leading beyond the Script: A Cross-Sectional Study Exploring Preparedness of Pharmacy Academic Administrators.

Limited research exists on the preparedness of pharmacy academic administrators for their roles. This cross-sectional survey aimed to explore the self-perceptions of pharmacy academic administrators, including deans, associate deans, assistant deans, department chairs, and directors, within United States-based Colleges or Schools of Pharmacy. Participants answered questions regarding their demographics, self-perceived readiness for administrative roles, self-perceived leadership skills, and strategies used to develop these skills. Data were analyzed using descriptive statistics, and subgroup comparisons were made using Student's t-test for normally distributed continuous variables, Mann-Whitney tests for ordinal variables or non-normally distributed continuous variables, and Chi-squared tests for nominal variables. A total of 193 responses were analyzed. Respondents reported feeling least prepared in two areas: entrepreneurial revenue and handling grievances and appeals. There were gender differences noted in preparedness to conduct performance reviews, manage unit finances, and develop entrepreneurial revenue, with men rating themselves significantly higher than women in all three areas. Despite high self-ratings of leadership skills in the overall cohort, significant gender differences were noted in micromanagement with men rating themselves lower than women. Seeking advice from senior colleagues was the most used development strategy, and women showed a significantly higher preference for programs facilitated by professional organizations. This study contributes valuable insights into the preparedness of pharmacy academic administrators to inform future strategies that better support individuals to be successful in their roles.

Is the learning curve of the urology resident for conventional radical prostatectomy similar to that of staff initiating robot-assisted radical prostatectomy?

The superiority of the functional results of robot-assisted radical prostatectomyis still controversial. Despite this, it is known that minimally invasive surgery obtains better results when analyzing blood loss, blood transfusion and length of stay, for example. Several studies have analyzed the impact of the resident physician's involvement on the results of urological surgeries. The simple learning curve for robot-assisted radical prostate surgery is estimated to be around 10 to 12 cases. Learning curve data for robotic surgeons is heterogeneous, making it difficult to analyze. Rare studies compare the results of a radical prostatectomy of an inexperienced surgeon starting his training in open surgery, with the results of the same surgeon, a few years later, starting training in robotic surgery. to analyze the results of open radical prostatectomy surgeries (ORP) performed by urology residents, comparing them to the results of robot-assisted radical prostatectomy (RARP), performed by these same surgeons, after completing their training in urology. a retrospective analysis of the cases of only 3 surgeons was performed. 50 patients underwent ORP (group A). The surgeons who operated on the ORP patients were in the 3rd and final year of the urology residency program and beginners in ORP surgery, but with at least 4 years of experience in open surgery. The same surgeons, already trained urologists, began their training in robotic surgery and performed 56 RARP surgeries (group B). For the comparative analysis, data were collected on age, number of lymph nodes removed, surgery time, hospitalization time, drain volume, drain permanence time, indwelling bladdercateter (IBC) permanence time, positive surgical margin, biochemical recurrence, risk classification (ISUP), intra and postoperative complications, urinary incontinence (UI) and erectile dysfunction (ED). The console used was the Da Vinci Si, from Intuitive®. For statistical analysis, the Shapiro-Wilk test verified that the data did not follow normality, the Levene test guaranteed homogeneity, and the Mann-Whitney test performed the comparative analysis of the quantitative data. For the analysis of qualitative data, the Chi-square test was used for nominal variables and the Mann-Whitney U test for ordinal variables. Additionally, the Friedman test analyzed whether there was an improvement in the perception of UI or ED over the months, for each group individually (without comparing them), and the post-hoc Durbin-Conover test, for the results with statistically significant difference. We used a p-value < 0.05, and the Jamovi® program (Version 2.0). there was no statistically significant difference between the groups for age, number of lymph nodes removed, positive surgical margin, biochemical recurrence, risk classification and urinary incontinence. Additionally, we observed that the surgical time was longer in group B. On the other hand, the length of stay, drain volume, drain time, IBC time, complication rate and levels of erectile dysfunction in the third and sixth months were higher in group A, when compared to group B. We also observed that there was no evolutionary improvement in ED over the months in both groups, and that there was a perception of improvement in UI from the 1st to the 3rd month in group A, and from the 1st to the 6th month, and from the 3rd to the 12th month, in group B. the learning curve of RARP is equivalent to the curve of ORP. In general, the results for the robotic group were better, however, the functional results were similar between the groups, with a slight tendency of advantage for the robotic arm.

Association of body-mass index (BMI) with age, PSA, and survival in metastatic prostate cancer.

96 Background: Increased body-mass index (BMI) is associated with increased prostate cancer incidence and death. However, an ‘obesity paradox’ exists where patients with BMI have longer survival once diagnosed with cancer. We investigated the influence of BMI on overall survival of veterans with metastatic hormone-sensitive prostate cancer (mHSPC) and metastatic castration-resistant prostate cancer (mCRPC). Methods: Two cohorts were identified in the US Veterans Health Affairs. The mHSPC cohort included patients diagnosed with de-novo mHSPC from 2011-2021. The mCRPC cohort was treated with abiraterone or enzalutamide from May 2011 to June 2017. We determined BMI at time of treatment and weight loss during the one year prior. BMI was categorized as ≤20, &gt;20-25, &gt;25-30 or &gt;30 kg/m2. We used Kruskal-Wallis testing for ordinal variables and Cox hazard models to assess the association between BMI, age, Charlson comorbidity index, PSA level at diagnosis, Black race, weight loss, and survival. Results: We identified 5019 veterans with mHSPC and 8159 with mCRPC. Mean BMI was 27.2 (SD 5.9) in mHSPC and 28.2 (SD 5.8) in mCRPC. Mean age was 75.7 years (SD 9.8) in mHSPC and mean age of 74.6 (SD 9.3) in mCRPC. Median overall survival was 25.6 months (95% CI 24.6-26.6) in mHSPC and 20.5 months (95% CI 19.9-21.1) in mCRPC. There were significant differences in age, Black race, and PSA at diagnosis across BMI strata with BMI&gt;30 having the youngest age, lowest percentage of Black race, lowest PSA, and longest survival in mHSPC and mCRPC (see Table). In unadjusted analyses, veterans with BMI&gt;30 had lowest risk of death with Hazard Ratio (HR) 0.66 (95% CI 0.60-0.71) in mHSPC and 0.60 (95% CI 0.56-0.64) in mCRPC compared to BMI&gt;20-25. In adjusted analyses, veterans with BMI&gt;30 had lowest risk of death with adjusted hazard ratio (HR) 0.89 (95% CI 0.81-0.97) in mHSPC and HR 0.77 (95% CI 0.72-0.83) in mCRPC compared to BMI&gt;20-25. Conclusions: Increased BMI is associated with younger age at diagnosis, lower PSA, and longer survival in both mHSPC and mCRPC. Further studies between BMI and prostate cancer are warranted to understand these complex interactions. [Table: see text]

Abstract TP264: Does Cerebral White Matter Disease Predict Post-Stroke Fatigue or Depression in an Afro-Caribbean Cohort?

Background and Purpose: Fatigue and depression frequently occur after ischemic stroke and are associated with worse Health-Related Quality of Life. While there has been research on the correlation between the burden of white matter disease (WMD) and the onset of depressive symptoms, this relationship has yet to be validated in patients with stroke from minority groups. Methods: An IRB-approved retrospective, cross-sectional study. The study sampled a cohort of patients aged ≥18 years old who had stroke within the last 3 years and were assessed with standardized questionnaires for fatigue (Fatigue Assessment Scale [FAS], score range 10-50) and depression (Beck’s Depression Inventory, score range 0-63). Exclusion criteria included patients with prior depression or severely disabling pre-existing conditions that would confound assessment. Patients with available MRI were evaluated using the Fazekas scale (score range 0-3), a validated visual scale (correlates significantly with automated software), to grade WMD. Grading was conducted blinded to patient's fatigue and depression scores. The collected ordinal data presented a non-parametric distribution thus was analyzed using the Spearman correlation coefficient. Results: Of 72 patients with available MRI, 96% identified as African or Caribbean; mean age = 66, median FAS score = 19 (IQR 14-26), and median BDI score = 6 (IQR 2-11). The prevalence of stroke-related disability (modified ranking scale ≥ 2) was 38%. Within the Fazekas grading, the score was 0 in 12.4%, 1 in 41.4%, 2 in 31.7%, and 3 in 13.8%. Spearman correlation coefficients showed non significant associations between WMD severity and either depression ( R s =0.058, p=0.62, 95%CI -0.17,0.29) or fatigue ( R s =0.059, p=0.62, 95% CI -0.18,0.30). Conclusion: Our results suggest no association between WMD severity and the development of post-stroke fatigue or depression in an Afro-Caribbean population. However, the lack of statistical significance might be due to limited sample size and patient heterogeneity, since few patients exhibited high scores for fatigue and depression. Additional studies are needed to validate the absence of correlation.

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome.

Supporting Screening of New Plant Protection Products through a Multispectral Photogrammetric Approach Integrated with AI

This work was aimed at developing a prototype system based on multispectral digital photogrammetry to support tests required by international regulations for new Plant Protection Products (PPPs). In particular, the goal was to provide a system addressing the challenges of a new PPP evaluation with a higher degree of objectivity with respect to the current one, which relies on expert evaluations. The system uses Digital Photogrammetry, which is applied to multispectral acquisitions and Artificial Intelligence (AI). The goal of this paper is also to simplify the present screening process, moving it towards more objective and quantitative scores about phytotoxicity. The implementation of an opportunely trained AI model for phytotoxicity prediction aims to convert ordinary human visual observations, which are presently provided with a discrete scale (forbidding a variance analysis), into a continuous variable. The technical design addresses the need for a reduced dataset for training the AI model and relating discrete observations, as usually performed, to some proxy variables derived from the photogrammetric multispectral 3D model. To achieve this task, an appropriate photogrammetric multispectral system was designed. The system operates in multi-nadiral-view mode over a bench within a greenhouse exploiting an active system for lighting providing uniform and diffuse illumination. The whole system is intended to reduce the environmental variability of acquisitions tending to a standard situation. The methodology combines advanced image processing, image radiometric calibration, and machine learning techniques to predict the General Phytotoxicity percentage index (PHYGEN), a crucial measure of phytotoxicity. Results show that the system can generate reliable estimates of PHYGEN, compliant with existing accuracy standards (even from previous PPPs symptom severity models), using limited training datasets. The proposed solution addressing this challenge is the adoption of the Logistic Function with LASSO model regularization that has been shown to overcome the limitations of a small sample size (typical of new PPP trials). Additionally, it provides the estimate of a numerical continuous index (a percentage), which makes it possible to tackle the objectivity problem related to human visual evaluation that is presently based on an ordinal discrete scale. In our opinion, the proposed prototype system could have significant potential in improving the screening process for new PPPs. In fact, it works specifically for new PPPs screening and, despite this, it has an accuracy consistent with the one ordinarily accepted for human visual approaches. Additionally, it provides a higher degree of objectivity and repeatability.