Significant Gender Differences Research Articles

Response to prone positioning in COVID-19 patients with acute respiratory distress syndrome: a retrospective observational study

BackgroundCOVID-19 pneumonia and respiratory failure are the leading causes of death in COVID-19 patients. Prone positioning was hypothesized to improve oxygenation in ARDS patients and is being studied in COVID-19, but the current evidence is still unclear regarding survival and hospitalization. We aimed to investigate the effect of prone positioning on oxygenation in patients with COVID-19 pneumonia and ARDS and to examine the factors associated with better/worse outcomes.MethodsA retrospective record-based cohort study included all confirmed COVID-19 patients with pneumonia and ARDS who underwent prone positioning admitted to King Fahad Hospital, Medina, Saudi Arabia, during 2020–2021.ResultsThis study included 75 cases (mean age 60.3 ± 15.7 year, 50 (66.7%) males), and all fulfilled the definition of ARDS. There was a significant improvement in oxygenation (PaO2 and PaO2/FIO2) following prone positioning (53.5 ± 6.8 vs. 60.4 ± 8.2 mmHg, p < 0.001 for PaO2 supine and prone and 120.3 ± 35 vs. 138 ± 40.2, p < 0.001 for PaO2/FIO2 supine and prone respectively). There was no significant difference in age, gender, smoking, or number of comorbidities between survivors and non-survivors. Survivors had significantly higher baseline PaO2 (p 0.018) and PF ratio (p 0.001) compared to non-survivors. They had also less severe inflammation and organ damage observed as significantly lower ferritin (p 0.001), D-dimer (p 0.026), aspartate aminotransferase (p 0.02), urea (p 0.032), creatinine (p 0.001), and higher platelet counts (p 0.001). Intubation and high-moderate comorbidity risk categories were associated with non-survival (p 0.001 and p 0.014, respectively).ConclusionProne positioning is useful in the improvement of oxygenation in intubated and awake patients with COVID-19 pneumonia and ARDS. Intubation and high comorbidity risk categories were associated with non-survival.

Assessing the assessment: exploring Norwegian primary education teachers’ perceptions of national accountability testing

ABSTRACT Since the beginning of the new millennium, the Norwegian education system has shown a growing inclination towards performance-based management. This mixed-methods study aims to gain a deeper understanding of Norwegian primary school teachers’ perceptions of the implementation and application of the National Quality Assessment System. The results revealed that teachers’ professional agency is influenced by the changes in structure and content driven by performance-based management. The teachers perceived that the national testing process offers valuable insights into students’ performance, but it falls short in providing novel information that could enhance individualized instruction. Significant gender differences were discovered concerning the perceived importance, motivation, and influence of national testing on pupils in the primary school setting. This was evident in both the quantitative and qualitative findings of this study. The findings are discussed in light of current educational practices, existing research, and implications for future directions.

Academic Performance and Academic Self-Efficacy among Pre-University Students in Malaysia

This research investigated the relationship between academic performance and self-efficacy among pre-university students in Malaysia using cross-sectional survey data. The sample comprised 171 pre-university undergraduates, aged between 18 and 20, studying at a public university in Kuala Lumpur. They were derived from the population to form the sample using stratified random sampling. Two separate scales measuring academic self-efficacy and academic performance (i.e., the CEVEAPEU) were used to collect the survey data. The study used descriptive statistics, independent sample t-test, Pearson correlation, and multiple regression to analyze the data. The results indicate that a majority of the students reported a high level of academic self-efficacy and established a strong positive relationship between self-efficacy and academic performance. No statistically significant gender differences were found in the respondents’ academic self-efficacy, but academic performance was significantly influenced by academic self-efficacy. The findings suggest the potential involvement of additional variables, such as CGPA, in shaping students’ academic performance, highlighting the need for further exploration of these variables in future studies.

Promoting young learners’ computational thinking with AI-based robots and the ICAP model in blended learning contexts

ABSTRACT Fostering young learners’ computational thinking in AI-based robots is a crucial issue in educational settings. However, there was the complexity of technology in supporting learning activities and the gender gap issue, so an appropriate strategy is needed to guide students to achieve the learning goals. In this study, an AI (Artificial Intelligence)-based robot with the ICAP model was proposed to investigate students’ learning motivation, learning satisfaction, computational thinking, and gender issues while creating AI-based robots in a blended learning environment. To evaluate the effectiveness of the proposed approach, this study employed the quasi-experiment. The experimental group students learned with the AI-based robot learning approach with the ICAP model, while the control group students learned with the conventional AI-based robot learning approach. The results showed that the proposed learning approach significantly improved students’ intrinsic and extrinsic motivation, learning satisfaction, and computational thinking. However, there was no significant interaction between group and gender across all variables. It showed that the ICAP model successfully promoted female students to improve their intrinsic and extrinsic motivation, learning satisfaction, and computational thinking in AI-based robots. So, there was no significant difference in gender in the experimental group which employed AI-based robots with the ICAP model.

Asthma Prevalence Among Adults in Qassim Region, Saudi Arabia.

Asthma is a major non-communicable disease affecting both children and adultsand is the most common chronic disease among children. It has a significant effect on patient's daily lives, as well as a big economic impact on society, as it affects 262 million people of the population globally. According to the previous research conducted in the Aseer region in southwestern Saudi Arabia, the prevalence rate of bronchial asthma was found to be 19.2%. Also, a number of studies revealed a significant prevalence of asthma in Saudi Arabia. Therefore, it is simple and effective to measure specific asthma symptoms among the adult population by utilizing the European Community Respiratory Health Survey(ECRHS) criteria. To investigate asthma prevalence and measure asthma symptoms among Saudi adults in Qassim, Saudi Arabia using the ECRHS. This cross-sectional study targets the males and females living in the Qassim regionof Saudi Arabia. The study was conducted by handing out a validated, self-administered questionnaire among adultmale and female patients in the Qassim region of Saudi Arabia. Both descriptive and inferential statistics analyses were conducted. To test the association, both chi-square and Fisher's exact tests were carried out. For the test, a p-value less than 0.05 was considered statistically significant. The study involved 461 participants who met the inclusion criteria. The study found that 137 (29.9%) participants reported having tightness in their chests when they woke up. Among the respondents who reported these symptoms were 83 (60.1%) female and 55 (39.9%) male respondents. This shows a statistically significant difference between the gender and severity of chest tightness upon waking up (p = 0.008) with more females experiencing it than the male gender. More so, there was a statistically significant difference between the gender and severity of shortness of breath (p = 0.008), with more females (81, 60.4%) having the symptoms than the male gender (53, 39.6%). In addition, the study results reveal statistically significant gender differences among the patients who were diagnosed with asthma by the physician (p = 0.003), with more males (51, 65.4%) having been diagnosed than the female gender (27, 34.6%). Asthmaattacks inthe12months (p = 0.047) and the use of tobacco products(p = 0.001) were also found to have a statistically significant difference across the genders. This was shown by most males (26, 65.0%)who hadasthmaattacks inthe12months and 70 (98.6%) who smoked any tobacco products than the few females (14, 35.0%) who reported to have had asthmaattacks inthe12months and one (1.4%) who reported smoking any tobacco products. This study noted that the prevalence of asthma symptoms varied based on the gender of the participants. Therefore, the study suggests that gender should be taken as an important factor while evaluating the severity and how asthma-related symptoms manifest.

The use of social media networks for healthy nutritional practices by deaf and hearing students.

Background: Social media networks such as Facebook, Twitter, WhatsApp, and YouTube are among the most commonly used social networks among people. If used properly, they can contribute to enhancing individual knowledge and scientific values. Aim: The study aimed to investigate the use of social media networks for healthy nutritional practices among deaf and hearing students. Methods: The sample of the study consisted of 103 students (50 deaf and 53 hearing). The researchers used a descriptive approach and adopted a questionnaire for data collection. Results: The findings of the study showed that the use of social media networks for healthy nutritional practices among deaf and hearing students was at a moderate level. However, there were statistically significant gender differences in the average responses of deaf and hearing students in the use of social media networks for healthy nutritional practices. For the status of students (deaf and hearing students), there were statistically significant differences in the average responses to the use of social media networks for healthy nutritional practices. Conclusion: Social media networks play an important role in raising awareness and promoting healthy nutrition practices for both deaf and hearing students.

Prevalence, Clinical and Imaging Characteristics of Superior Ophthalmic Vein Periphlebitis in Thyroid Eye Disease.

To determine the prevalence, clinical features, and radiographic findings of superior ophthalmic vein periphlebitis (SOVP) in thyroid eye disease (TED). Patients with a clinical diagnosis of thyroid eye disease and contrast-enhanced imaging were included. Imaging was reviewed for the presence of SOVP, and patients with SOVP were compared to those without. A random eye was determined to be the affected eye in patients without SOVP. A total of 212 patients met the inclusion criteria. Unilateral SOVP was identified in 4.7% of cases. There was no significant difference in age (p = 0.22), gender (p = 0.09), or disease duration (p = 0.14) between patients with and without SOVP. There was a significant (p < 0.05) difference in stage classification and clinical activity core between the groups. The affected eye in patients with SOVP had significantly (p < 0.05) greater margin reflex distance 1, degree of relative proptosis, horizontal motility restriction, and vertical motility restriction than in patients without SOVP. There was no significant difference in horizontal strabismus (p = 1.0), vertical strabismus (p = 0.87), or relative intraocular pressure (p = 0.77). On imaging, the maximal diameter of the SR and IR were found to be significantly (p < 0.05) larger in the affected eye of patients with periphlebitis; however, there was no difference in measured diameter of the medial rectus and (p = 0.30) or lateral rectus (p = 0.78). SOVP is an under-reported imaging finding of thyroid eye disease. It is associated with significantly greater margin reflex distance 1, relative proptosis, and motility restriction on exam as well as larger superior rectus and inferior rectus diameter on imaging. These patients tend to present in the active stage of disease with greater clinical activity score.

P730 Edema index as a more sensitive indicator of nutritional status with Crohn’s disease

Abstract Background Crohn's disease (CD) often presents with malnutrition due to the impaired mucosal barrier accelerating the loss of protein. The edema index can indicate protein consumption. This study aims to confirm whether the edema index could be a nutritional assessment for CD patients. Methods The study was conducted at Xiangya Hospital Central South University between May 2023 and July 2023, including CD patients and the control group. In both groups, bioelectrical impedance analysis was performed, and the edema index defined as extracelluar water/total body water (ECW/TBW) was calculated. The demographic data and body composition parameters were collected through the medical system. The control group consisted of healthy adults, strictly matched for gender, age, and BMI in a 1:1 case-control manner. Univariate analysis and multivariate analysis were used to compare the differences in nutrition-related indicators between both groups. Results A total of 128 subjects were included in the final cohort with 50% each of CD patients and healthy individuals. There were no significant differences in gender, age, BMI. Fat free mass, muscle mass, basal metabolic rate (BMR), and visceral fat rating were similar in both groups (P &amp;gt; 0.05). Compared to the control group, CD patients had significantly lower fat mass (9.26 ± 5.38 vs.16.63 ± 10.67, P = 0.006), bone mass (2.16 ± 0.41 vs. 2.52 ± 0.57, P = 0.019), but a higher level of edema index (41.07 ± 2.38 vs. 38.53 ± 5.62, P = 0.015). Multivariate logistic regression analysis revealed that edema index was an independent factor to malnutrition in CD patients (OR: 1.665, 95% CI: 1.158-2.395, P = 0.006). Conclusion A higher edema index in CD patients demonstrates their worse nutritional status compared to healthy subjects. The edema index may serve as a more sensitive and noninvasive indicator to assess nutritional status in CD patients.

Utilising electrodermal activity sensor signals to quantify nociceptive response during movement activities

ObjectiveWith an increasingly ageing population and osteoarthritis prevalence, the quantification of nociceptive signals responsible for painful movements and individual responses could lead to better treatment and monitoring solutions. Changes in electrodermal activity (EDA) can be detected via changes in skin conductance (SC) and measured using finger electrodes on a wearable sensor, providing objective information for increased physiological stress response.ResultsTo provide EDA response preliminary data, this was recorded with healthy volunteers on an array of activities while receiving a noxious stimulus. This provides a defined scenario that can be utilised as protocol feasibility testing. Raw signal extraction, processing and statistical analysis was performed using mean SC values on all participant data. The application of the stimuli resulted in a significant average increase (p < 0.05) in mean SC in four out of five activities with significant gender differences (p < 0.05) in SC and self-reported pain scores and large effect sizes. Though EDA parameters are a promising tool for nociceptive response indicators, limitations including motion artifact sensitivities and lack of previous movement-based EDA published data result in restricted analysis understanding. Refined processing pipelines with signal decomposition tools could be utilised in a protocol that quantifies nociceptive response clinically meaningfully.

Is there a difference in surgical accuracy following bimaxillary surgery between cleft and non-cleft patients?

To assess the surgical accuracy of 3D virtually planned orthognathic surgery among patients with and without cleft. This retrospective cohort study included cleft and non-cleft patients with class III malocclusion who underwent bimaxillary surgery. CBCT scans were acquired before and immediately after surgery. 3D virtual surgical planning (VSP) was performed using CBCT and digitalized dentition data. All orthognathic surgeries were performed by the same surgeons using interocclusal splints. The primary outcome variable was surgical accuracy, defined as the difference between the planned and surgically achieved maxillary movements, quantified in six degrees of freedom. Analysis of covariance was used to test for intergroup differences in surgical accuracy after correcting for differences in the magnitude of planned surgical maxillary movements. Twenty-eight cleft and 33 non-cleft patients were enrolled, with mean ages of 18.5 and 25.4 years, respectively (P=0.01). No significant gender difference was present between the groups (P=0.10). After adjustment for small differences in surgical movements, no significant differences in surgical accuracy were observed between cleft and non-cleft patients. The present study demonstrates that high surgical accuracy in maxillary movements can be achieved in both cleft and non-cleft patients using VSP and interocclusal splints. Orthognathic cases with cleft can be performed with 3D VSP to obtain a satisfactory surgical accuracy.

Emotional Dimorphism in Pedagogy: Assessing Gender Response to Active Methodologies

This study investigated the interplay between gender, emotions, and active methodologies in education. It was found that women had a higher average of affective responses before activities (2.874 compared to 2.607 in men). Subsequently, men experienced an increase in their affect average, while it remained stable for women. The analysis showed an increase in positive emotions such as "Interested" and "Excited" across both genders. The Wilcoxon tests indicated significant differences in specific emotions before and after the activities. The Mann-Whitney Test revealed significant gender differences in emotional responses. The hypothesis analysis demonstrated notable gender-based differences in affective changes, particularly more pronounced in women. This underscores the importance of considering gender-specific emotional differences in teaching. From a pedagogical perspective, the findings highlight the necessity of tailoring teaching to these emotional differences and emphasize the effectiveness of active methodologies and critical pedagogy in enhancing engagement and participation. Educator training in gender emotional differences is crucial, along with ongoing reflection on teaching practices to effectively meet students' emotional needs and prioritize their emotional well-being and mental health

Child rearing or childbearing? Risk of cardiovascular diseases associated to parity and number of children

BackgroundAn increased risk of cardiovascular diseases (CVD) has been associated with women’s parity, but whether or not this association reflects a direct pregnancy effect, or exposure to factors related to childrearing, still appears unclear. We assessed the CVD risk associated with number of children separately by gender and tested effect modification by socioeconomic position (SEP) and employment status, in order to elucidate the possible mechanisms underlying this association.MethodsThe study population was composed of 20,904 men and 25,246 women who were interviewed in one of two National Health Surveys conducted in 2000 and 2005 in Italy. These subjects were followed for CVD incidence up to 2014 through record-linkage with national archives of mortality and hospitalisations. CVD risk was estimated by Cox regression models that were adjusted for socio-demographics, perceived health, lifestyles, biological CVD risk factors and for other potential confounders.ResultsCVD incidence was significantly increased among men with 3 or more children (HR = 1.26, 95% CI: 1.02–1.56) and among women with 2 and with 3 or more children (HR = 1.42, 95% CI: 1.10–1.83; and HR = 1.39, 95% CI: 1.03–1.87, respectively) compared to subjects without children and no significant gender differences were observed. Subjects with lower SEP displayed stronger associations with parity and a higher number of children for both genders; by contrast, no modifying effect of employment status was observed.ConclusionsTaken together, the significant association between higher parity and CVD risk in both genders, and the higher risk of CVD associated with higher parity among lower SEP parents, suggests that childrearing has a potential effect on the development of CVD that is more pronounced among disadvantaged families, although a concurrent effect of childbearing cannot be completely excluded.

Medical students’ career preferences in Bangladesh

AimThis study aimed to investigate the career preferences among Bangladeshi medical students, identify the factors that influence their present choices, and additionally report the role of gender and academic year behind their decisions.MethodsThis cross-sectional study conducted in Bangladesh from August 2022 to April 2023 included 801 medical students conveniently selected from medical colleges in eight divisions. Data were collected using a web-based survey and analysed using STATA version 16.0. Statistical tests included the Kolmogorov-Smirnov test, arithmetic mean, standard deviation, frequency, and Kruskal-Wallis H test. The response rate was 94.6%, and the CHERRIES guideline was followed for reporting the results.ResultThe majority of the participants were female (64.42%) and under the age of 23 years (58.8%). The study revealed that medicine was the preferred career choice for the majority of students (65%), with surgery being the most popular first choice (30.21%) among them. Female medical students showed a significantly higher preference for gynaecology & obstetrics (p < 0.001), while male students had a significantly higher tendency to choose general practice (p = 0.002). There is a significant gender difference (p < 0.05) in the career preference factors, including professional prestige, role model influence, easy money, family time, promotion opportunities, income for lifestyle, and research opportunities. Academic year differences were also observed, with increasing interest in medicine and public health (p < 0.001), a decrease in interest in surgery (p < 0.001), and a decline in preference for non-medical careers as students progressed through their MBBS life (p < 0.05).ConclusionOverall, medicine was the most popular speciality choice, however, male students preferred general practice and female students preferred gynaecology and obstetrics more. Personal passion, opportunities for contribution to society, professional prestige, having a direct dealing with patients, and income will allow an enjoyable lifestyle were the most important factors in the choice of their career.

Advantages of robotic surgery for advanced gastric cancer in short-term outcomes: A single-center retrospective study using propensity score matching.

343 Background: The advantages of robotic gastrectomy (RG) for gastric cancer are being demonstrated. However, there are few reports that have focused on advanced gastric cancer and examined the advantages of RG for laparoscopic gastrectomy (LG). We conducted the following study to clarify the advantages of RG for advanced gastric cancer. Methods: This single-center retrospective study reviewed the clinical data of 1531 patients who underwent either RG or LG from 2014 to 2023. 473 patients were with clinically diagnoses as having advanced gastric cancer. They were divided into the RG group (n = 143) and the LG group (n = 330). Propensity score matching was employed to adjust the background of the two groups, as covariates of age, gender, BMI, surgical method (distal gastrectomy/total gastrectomy), stage (early cancer/advanced cancer), and presence or absence of preoperative chemotherapy. Then, the treatment results were compared and examined. Results: 130 patients in each group were extracted by propensity score matching. There were no significant differences in age, gender, and ECOG-PS between the two groups. Compared to the LG group, the RG group had more cases with deeper invasion depth ≥T3 (93.1 vs 84.6%, P = 0.04), more D2 dissection (96.9 vs 88.5%, P = 0.01), and longer operative time (339.5 vs 294.5min, P &lt;0.01). The number of retrieved lymph nodes was larger (49.5 vs. 44, P &lt;0.01) in the RG group. Importantly, in the RG group, there were fewer complications with Clavien-Dindo (CD) classification ≥Grade II (11.5 vs 21.5%, P = 0.04) and CD classification ≥Grade III (0.8% vs 6.9%, P = 0.01). Postoperative hospital stay was shorter (8 vs 9 days, P = 0.01) in the RG group. Conclusions: RG for advanced gastric cancer has the potential to reduce complications compared to LG. Long-term survival outcomes should be investigated.

Socio-demographic characteristics of children and young people with primary brain tumours: comparison between a public and private sector tertiary hospital in Karachi, Pakistan.

Primary brain tumours (PBTs) are the commonest solid tumours in children and young people (CYP). A study was conducted at a private and a public sector hospital in Karachi, Pakistan, to determine the socio-demographic and tumour-related characteristics of CYP with PBTs between those presenting to the public and private hospitals. A total of 49 patients were included. The commonest PBT was pilocytic astrocytoma (29%). There were no differences in tumour-related characteristics between the two groups. However, parents of CYP with PBTs presenting to the public sector hospital were significantly less educated and had lower household incomes. No significant differences in age, gender, educational status, and ethnicity of CYP with PBTs were observed. Since CYP with PBTs presenting at the public sector hospital were from significantly lower socioeconomic backgrounds and their parents were less educated, it suggests socio-economic disparities in PBT care for CYPs in Karachi, Pakistan.

Presence and correlates of autistic traits among patients with social anxiety disorder.

Due to their similar behavioral presentation, it can sometimes be challenging to distinguish between a social anxiety disorder (SAD) and the social avoidance that is frequently described in autism spectrum disorder (ASD). Moreover, a growing body of evidences is reporting that a significant proportion of subjects with ASD also meet the requirements for SAD and, vice versa, subjects with SAD tend to exhibit a higher prevalence of autistic traits. In this framework, the current study aims to evaluate prevalence and correlates of autistic traits in a sample of adult subjects diagnosed with SAD and healthy controls (HC), also evaluating which autism spectrum dimensions may statistically predict higher SAD symptoms. 56 subjects with a clinical diagnosis of SAD and 56 gender and age matched HC were recruited from the Psychiatric Clinic of the University of Pisa. Subjects were assessed with the SCID-5, the Social Anxiety Spectrum - Short Version (SHY- SV) and the Adult Autism Subthreshold Spectrum (AdAS Spectrum). SAD group scored significantly higher in all AdAS Spectrum and SHY-SV domains and total score compared to the HC group with no significant gender difference. SHY-SV total and domain scores, were strongly and positively and strongly correlated with all AdAS Spectrum domains and total score. AdAS Spectrum total score and Childhood/Adolescence, Non-Verbal Communication, Empathy and Restricted interests and Rumination domain scores score were significant predictors of higher SHY-SV score. Our results confirm the link between SAD and autistic traits also in adult population, describing not only high levels of autistic traits in SAD adults, but also significant correlations between many core features of the two disorders and a predictive role of autistic traits on higher SAD symptoms.

Internal Rotation Measurement of the Knee with Polymer-Based Capacitive Strain Gauges versus Mechanical Rotation Measurement Taking Gender Differences into Account: A Comparative Analysis.

With the conventional mechanical rotation measurement of joints, only static measurements are possible with the patient at rest. In the future, it would be interesting to carry out dynamic rotation measurements, for example, when walking or participating in sports. Therefore, a measurement method with an elastic polymer-based capacitive measuring system was developed and validated. In our system, the measurement setup was comprised of a capacitive strain gauge made from a polymer, which was connected to a flexible printed circuit board. The electronics integrated into the printed circuit board allowed data acquisition and transmission. As the sensor strip was elongated, it caused a change in the spacing between the strain gauge's electrodes, leading to a modification in capacitance. Consequently, this alteration in capacitance enabled the measurement of strain. The measurement system was affixed to the knee by adhering the sensor to the skin in alignment with the anterolateral ligament (ALL), allowing the lower part of the sensor (made of silicone) and the circuit board to be in direct contact with the knee's surface. It is important to note that the sensor should be attached without any prior stretching. To validate the system, an in vivo test was conducted on 10 healthy volunteers. The dorsiflexion of the ankle was set at 2 Nm using a torque meter to eliminate any rotational laxity in the ankle. A strain gauge sensor was affixed to the Gerdii's tubercle along the course of the anterolateral ligament, just beneath the lateral epicondyle of the thigh. In three successive measurements, the internal rotation of the foot and, consequently, the lower leg was quantified with a 2 Nm torque. The alteration in the stretch mark's length was then compared to the measured internal rotation angle using the static measuring device. A statistically significant difference between genders emerged in the internal rotation range of the knee (p = 0.003), with female participants displaying a greater range of rotation compared to their male counterparts. The polymer-based capacitive strain gauge exhibited consistent linearity across all measurements, remaining within the sensor's initial 20% strain range. The comparison between length change and the knee's internal rotation angle revealed a positive correlation (r = 1, p < 0.01). The current study shows that elastic polymer-based capacitive strain gauges are a reliable instrument for the internal rotation measurement of the knee. This will allow dynamic measurements in the future under many different settings. In addition, significant gender differences in the internal rotation angle were seen.

Influence of Body Mass Index, Physical Fitness, and Physical Activity on Energy Expenditure during Recess.

This study aims to investigate the potential relationship between energy expenditure, physical fitness level, physical activity, and body mass index among children taking part in a 30 min school recess. A total of 259 participants from three schools were included in this study. Data on energy expenditure during recess, age, gender, anthropometric measurements, global physical fitness, and physical activity index were recorded. The evaluation sessions occurred twice a week on alternate days over two weeks. A significant gender difference was observed in energy expenditure during recess, favoring boys (p < 0.01). The participants classified as very active exhibited significantly higher scores compared to those categorized as sedentary and moderately active, respectively (p < 0.01), with a poor but significant correlation (rho: 0.208; p < 0.001). There were significant differences between energy expenditure and cardiorespiratory fitness and energy expenditure and global physical fitness (p < 0.01) with fair (rho: 0.289; p < 0.001) and poor (rho: 0.196, p = 0.001) correlation, respectively. In contrast, there were no significant differences by body mass index categories (p = 0.571). These results suggest that gender, physical activity index, and global physical fitness were found to influence energy expenditure during a 30 min recess. However, no significant relationships were found with the body mass index.

Use of a Novel Artificial Intelligence System Leads to the Detection of Significantly Higher Number of Adenomas During Screening and Surveillance Colonoscopy: Results From a Large, Prospective, US Multicenter, Randomized Clinical Trial.

Adenoma per colonoscopy (APC) has recently been proposed as a quality measure for colonoscopy. We evaluated the impact of a novel artificial intelligence (AI) system, compared with standard high-definition colonoscopy, for APC measurement. This was a US-based, multicenter, prospective randomized trial examining a novel AI detection system (EW10-EC02) that enables a real-time colorectal polyp detection enabled with the colonoscope (CAD-EYE). Eligible average-risk subjects (45 years or older) undergoing screening or surveillance colonoscopy were randomized to undergo either CAD-EYE-assisted colonoscopy (CAC) or conventional colonoscopy (CC). Modified intention-to-treat analysis was performed for all patients who completed colonoscopy with the primary outcome of APC. Secondary outcomes included positive predictive value (total number of adenomas divided by total polyps removed) and adenoma detection rate. In modified intention-to-treat analysis, of 1,031 subjects (age: 59.1 ± 9.8 years; 49.9% male), 510 underwent CAC vs 523 underwent CC with no significant differences in age, gender, ethnicity, or colonoscopy indication between the 2 groups. CAC led to a significantly higher APC compared with CC: 0.99 ± 1.6 vs 0.85 ± 1.5, P = 0.02, incidence rate ratio 1.17 (1.03-1.33, P = 0.02) with no significant difference in the withdrawal time: 11.28 ± 4.59 minutes vs 10.8 ± 4.81 minutes; P = 0.11 between the 2 groups. Difference in positive predictive value of a polyp being an adenoma among CAC and CC was less than 10% threshold established: 48.6% vs 54%, 95% CI -9.56% to -1.48%. There were no significant differences in adenoma detection rate (46.9% vs 42.8%), advanced adenoma (6.5% vs 6.3%), sessile serrated lesion detection rate (12.9% vs 10.1%), and polyp detection rate (63.9% vs 59.3%) between the 2 groups. There was a higher polyp per colonoscopy with CAC compared with CC: 1.68 ± 2.1 vs 1.33 ± 1.8 (incidence rate ratio 1.27; 1.15-1.4; P < 0.01). Use of a novel AI detection system showed to a significantly higher number of adenomas per colonoscopy compared with conventional high-definition colonoscopy without any increase in colonoscopy withdrawal time, thus supporting the use of AI-assisted colonoscopy to improve colonoscopy quality ( ClinicalTrials.gov NCT04979962).

Epidemiology of home enteral and parenteral nutrition in adults: Comprehensive national data

Background and AimsAlthough HEN and HPN are important parts of home healthcare, lack of information about the number of patients concerned is surprising. This educational paper presents a review of literature concerning published national data on epidemiology of both HEN and HPN, for different countries. It compares these publications with an exhaustive retrospective observational study on our national adult population for the year 2019. MethodsOur presented retrospective observational national study was carried out on patients aged 20 and over, divided by sex and into three age groups: 20-39, 40-59, 60 years old and over. Open data from the National Health Insurance obtained the number of patients who started a HEN or HPN during 2019 (incidence), as well as those followed in HEN or HPN during this year (prevalence). Results are compared with a literature review compiling all available publications presenting national data on epidemiology of both HEN and HPN for a same country. ResultsThis work covered an entire national population of 50.881 948 adults. The incidence and prevalence of HEN were respectively 37.4/100 000 inhab/year and 74.0/100 000 inhab, with significant gender and age differences. The incidence and overall prevalence of HPN were respectively 22.0/100 000 inhab/year and 25.3/100 000 inhab. The prevalence of HPN during over 12 weeks was 6.2/100 000 inhab. The HEN/HPN ratio was 3:1. A total of 37 657 and 12 859 adults respectively required HEN and HPN among 50 881 948 people aged 20 and over. Published papers to compare, aggregating national data for both HEN and HPN, are only few. They do not have exhaustive data, they are often carried out on limited populations and often indiscriminately affect adults and children. ConclusionsEpidemiology of HEN and HPN remains poorly described in the literature. We present here the first results to accurately assess the incidence and prevalence of HAN on a complete national adult population and for a same year. The completeness of our data may explain these results of incidence and prevalence significantly higher than almost all available information in the existing literature, but as close as possible to real data.