Probability Test Research Articles

Health status and living conditions of fathers of multiple babies: Analysis of the Comprehensive Survey of Living Conditions

Objective This study explored the physical and mental health status and living conditions of fathers raising 0-year-old multiples in Japan compared with those raising singletons to gain insight into fathers' health issues and the need for support.Methods Household and health data from the Comprehensive Survey of Living Conditions (2016, 2019, and 2022) were used. Because of the small number of fathers with multiples in each dataset, three datasets were combined. The t-test and Fisher's exact probability test were used to compare fathers with multiples and singletons for various factors.Results Fathers with multiples were significantly more likely to sleep for < 5 h than those of singletons. There was no significant difference between both groups in the percentage of fathers with a K6 score of ≥ 10. However, the percentage of fathers with multiples exceeded the target set by the government. There were no differences in the counseling status regarding worries and stress. The proportion of consultations with public institutions was extremely low in both groups.Conclusion The analysis of representative data from Japan highlights health issues and the need for support for fathers with multiples. Fathers with multiples showed a high percentage of short sleep durations, worries, and stress related to childcare. The need for mental health support, accumulation of knowledge and experience on support for fathers with multiples, and development of support systems were suggested.

Characteristics of ResectionParameters in Robot-Assisted Total Knee Arthroplasty With the Ligament Balancing Workflow.

Robotic-assisted total knee arthroplasty (TKA) is a novel orthopedic technique. The workflow of robotic-assisted TKA is quite different from that of traditional manual TKA and may result incompletely different resection parameters. Understanding these parameters may help surgeons better perform robotic-assisted TKA. This study aims to analyze the specific resection parameters of robotic-assisted TKA. We retrospectively reviewed 85 MAKO-assisted TKA surgeries performed by three surgeons at our institution between May 2021 and November 2023. All patients had unilateral primary knee arthritis, and a Triathlon PS (Stryker) knee prosthesis was used. Intraoperative resection plan, radiological outcomes, and clinical outcomes were collected among them. The angle between the transepicondylar axis (TEA) and the femoral prosthesis axis was defined as rTEA, the angle between the posterior condylar axis (PCA) and the femoral prosthesis axis was defined as rPCA. The t-test and the Chi-square test (or Fisher's exact probability test) were used to determine differences in categorical variables. rTEA averaged 2.7° (range, 0°-6.7°), and rPCA averaged 4.9° (range, 0.2°-9.6°). The mean resection of the medial distal femur was 7.7 mm (range, 3.0-12.5), that of the lateral tibial plateau was 6.4 mm (range, 1.5-13.0), and that of the medial posterior condyle of the femur was 10.6 mm (range, 6.5-17.5), whereas that of the lateral posterior condyle of the femur was 6.7 mm (range, 2.0-13.0). Robotic-assisted TKA using the ligament balancing workflow generally resulted in greater external rotation than reported reference values for conventional manual TKA within the existing literature, with reference to both the TEA and PCA. In addition, tibial resection was generally less, and the joint line was generally shifted upwards.

Tridimensional Evaluation of Condyle-Fossa Relationship in Mexican Population Using CBCT

Background: This study aims to compare the condylar position in Mexican population with the values of Ikeda Spatial Condyle Analysis with different sagittal skeletal pattern, age and sex using a cone beam computed tomography (CBCT). Objective: To evaluate the condyle-fossa relationship in patients with skeletal patterns and sex using Ikeda Spatial Condyle Analysis assessed with CBCT. Materials and Methods: An observational analytical cross-sectional study, 86 condyles CBCT images were used for this study (August 2023- December 2024). The patients were divided into 3 groups according to 3 criteria: age (12-60 years old with intervals of 5 years); sex (female and male); and skeletal pattern as ANB classification (Class I, Class II, and Class III). Temporomandibular joint space (TMJS): (SAS, sagittal anterior space; SSS, sagittal superior space; SPS, sagittal posterior space; CMS, coronal medial space; CLS, coronal lateral space and CCS, coronal central space) were measured and compared. Statistical analyses were performed using two-sample T test, Mu Test, and Anderson- Darling probability test (p&lt;0.05). Results: The mean age of the participants (n = 43) was 30.9 ± 10.9 years (62.7% female). Differences in condyle-fossa relationships were significantly different between Mexican population and Ikeda Condyle Analysis values (p &lt; 0.05). The mean values showed no statistical differences according to sex or sagittal skeletal pattern. The sagittal measurements showed the mean ratio of SAS (2.1+/- 0.6), SSS and SPS (2.5+/-0.7) and (1.8+/- 0.5), respectively. The coronal measurements showed the mean ratio of CMS (2.3+/- 0.7), CCS and CLS (2.5+/- 0.8) and (2.1+/- 0.6), respectively. Conclusions: The Mexican tridimensional condylar position showed significant differences compared with the Ikeda condylar position. These results can be associated to racial anatomical differences. The condyle-fossa relationship values for skeletal pattern; Left / Right condyles and sex, showed ..

Comparative Efficacy of Ventriculosubgaleal Shunt Versus Ventricular Reservoir in Achieving Shunt Independence for Infants With Posthemorrhagic Hydrocephalus by 6 Months.

Low-birth weight, premature infants often have severe intraventricular hemorrhage (IVH), which can result in posthemorrhagic hydrocephalus (PHH), sometimes requiring cerebrospinal fluid diversion. Initial temporizing management of PHH includes placement of a ventriculosubgaleal shunt (VSGS) or ventricular access device (VAD). Studies have found similar permanent shunt conversion rates between VSGS and VAD but were limited by sample scope and size. The rate of conversion to permanent shunt within 6 months post-IVH in premature infants, comparing the efficacy of VSGS and VAD, remains underexplored. This retrospective study used International Classification of Diseases-10 codes in the PearlDiver Mariner database to analyze the medical records of premature infants diagnosed with grade 3 or 4 IVH who underwent VAD or VSGS treatment. A 2:1 matching process was used to control demographics, IVH severity, degree of prematurity, and associated respiratory or gastrointestinal conditions. We assessed the rates and odds of conversion to permanent shunts within 6 months, using Kaplan-Meier plots for shunt-free probability and log-rank tests for distribution comparisons. Our matched analysis included 222 infants (VAD, n = 145, VSGS, n = 77) and demonstrated no difference in the proportion of gender, respiratory conditions, necrotizing enterocolitis, extreme prematurity, and Grade III or IV IVH. The odds of requiring a permanent shunt were significantly lower in the VSGS group compared with the VAD group within 6 months (odds ratio: 0.22, 95% CI [0.12, 0.41], P < .001). From day 60 onward, Kaplan-Meier plots indicated a notable divergence in shunt-free probability within 6 months (Log-Rank P < .001). This study highlights a significant reduction in the need for permanent shunt placement within 6 months for post-IVH in premature infants who underwent VSGS vs VAD, suggesting that VSGS may be a more favorable temporizing procedure for managing PHH in this vulnerable population.

Fracture resistance and behavior of endodontically treated maxillary premolars with varying ferrule heights and post numbers: A laboratory study.

To investigate how varying ferrule heights and the number of glass fiber posts affect fracture resistance and behavior of endodontically treated maxillary first premolars with substantial loss of tooth structure. Twenty-four extracted endodontically treated human maxillary first premolars were divided into three groups (n=8) based on ferrule height and post number. The groups were as follows: premolars of 2mm ferrule height that were restored with single posts (control group), premolars of 0.5mm ferrule height that were restored with single posts in palatal canals (single-post group), and premolars of 0.5mm ferrule height that were restored with double posts in palatal and buccal canals (double-post group). All groups were then restored with composite core and metal-ceramic crowns cemented with zinc phosphate cement. All specimens were subjected to 10,000 thermal cycles at temperatures of 5°C and 55°C, as well as 1.2 million cyclic loadings of 49N load at 1.2Hz using a chewing simulator. The specimens were loaded to fracture in a universal testing machine and fracture behavior was examined under stereomicroscope and divided into restorable and unrestorable fracture modes. Fracture loads and modes were analyzed by one-way ANOVA, Tukey's post hoc test, and Fisher's exact probability test (p≤0.05). The control group showed the highest mean fracture load (1127±172) of all groups (p<0.001). The specimens in the single-post group showed numerically higher mean fracture load (522±171) but with no significant difference compared to the ones in the double-post group (518±157; p>0.967). In the control group, 75% of specimens showed unrestorable fractures compared to 50% and 12.5% in single-post and double-post groups. The specimens in the control group had similar unrestorable fractures, starting from the coronal part and extending obliquely to the cervical third of the root below resin level. Two specimens in the control group showed unrestorable fractures in the middle third of the root. No middle-third root fractures were observed in single-post and double-post groups, and unrestorable fractures in both groups were similar to those of the control group. The single-post group had two specimens with core-post crown complex restorable fractures, while the control and double-post groups had one specimen each. The remaining specimens showed cervical-third root restorable fractures above resin level. The ferrule height significantly influences the fracture resistance of endodontically treated premolars compared to the number of placed posts. Nonetheless, more restorable fractures are seen in endodontically treated premolars restored with double posts than single posts regardless of ferrule height.

The Prevalence and Pattern of Physical Activity and Its Relation to Socio-Demographic Correlates among the Population in Makkah, Saudi Arabia

Background:-Although promoting a healthy lifestyle that includes physical activity is essential to preventing chronic diseases, little is known about the prevalence of physical activity and its correlation to socioeconomic factors among the population of Makkah in Saudi Arabia. Thus, this study aims to explore the prevalence and pattern of physical activity and its relation to socio-demographic correlates among this population. Methods:-A web-based cross-sectional convenience non-probability study was used study to choose 385 participants aged-&gt;18 from Makkah's general population between May 2023 and September 2023. The Arabic version of the Global Physical Activity Questionnaire (GPAQ), which had previously been validated, was used to explore physical activity. The exact probability test and the Pearson chi-square test were used to evaluate the correlation between social-demographic factors and physical activity. Results:-Overall, exactly 105 (27.3%) of the study participants engaged in physical activity, of whom 15.1% practiced walking, 9.6% practiced weightlifting/bodybuilding, 0.3% played football, and 1.3% practiced other types. The predominant reasons cited for not engaging in physical activity were time insufficiency, reported by 60%, lack of interest (19.3%), lack of suitable places (16.4%), and health limitations (4.3%). Conclusion:-We found that majority of the studied participants were physically inactive; lack of time is their main barrier. There is a need to encourage and motivate them to engage in physical activity to cultivate a healthy lifestyle in the general population.

Cis-Regulation of an m6A Eraser by an Insertion Variant Associated with Survival of Patients With Non-Small Cell Lung Carcinoma.

N6-methyladenosine (m6A) serves as one of the crucial RNA modifications for genes involved in cancer progression. Here, 7273 expression quantitative trait loci potentially regulating 30 m6A pathway genes are identified from the GTEx database, with 69 single nucleotide polymorphisms significantly associated with survival of non-small cell lung carcinoma (NSCLC) patients (n = 1523) from the ongoing genome-wide association study after false positive probability tests. Notably, the rs151198415 locus, situated in a potential enhancer region, demonstrated a prolonged survival effect with the C>CCACG insertion, which is validated in an independent prospective cohort (n = 237), yielding a pooled hazard ratio of 0.72 (p = 0.007). Mechanistically, the rs151198415 C>CCACG insertion engaged in long-range interaction with the promoter of m6A eraser ALKBH5, promoting ALKBH5 transcription by the creation of an EGR1 binding site. Then, ALKBH5 upregulated FBXL5 expression by m6A demethylation, which is dependent on the ALKBH5 H204 amino acid site and specific m6A sites on FBXL5 mRNA. Finally, the ALKBH5-FBXL5 axis reduces intracellular reactive oxygen species levels, leading to PI3K/AKT and NF-kB pathway inhibition and consequently suppresses NSCLC proliferation and metastasis in vitro and in vivo. Triggered by an insertion variant, this remote cis-regulation of m6A eraser and the downstream molecular events modulate the survival of NSCLC patients.

Are local climate assemblies politically representative of the macro-public they represent, and does this matter?

Abstract Using the results of a follow-up survey circulated to the participants of the Herefordshire Citizens Climate Assembly (HCCA), I compare their stated political identity with the political makeup of the county of Herefordshire (the macro public from which they were drawn) using probability testing based on a hypergeometric distribution. I also assess recent recruitment data for three other climate-themed deliberative citizens panels, to determine whether political party allegiance affects volunteer rate. I conclude that there were significantly fewer Conservative voters than would have been needed for the HCCA to be politically representative of the wider population from which its members were drawn. This is mirrored in the recruitment data for the three more recent climate-themed deliberative citizens panels, where Conservative voters systematically ‘under-volunteered’ to take part compared to supporters of left-leaning parties. I consider the potential reasons for this disparity in representation between participants of differing political identities, and make recommendations relating to recruitment for future assemblies.

Knowledge and perception of cancer screening tests among Indian community

Health authorities can enhance the success of health screening programs and promotional campaigns by measuring the level of community awareness about cancer screening. Therefore, the primary purpose of this research was to evaluate the general population's understanding of cancer and its prevention in India. From January to June of 2023, a large-scale cross-sectional survey was conducted in India to gauge the general population's opinion on cancer screening. Researchers used a computerised, pre structured questionnaire to collect data after reviewing the primary sources extensively. Digital surveying was used to disseminate the questionnaire, protecting the confidentiality and anonymity of all respondents. The Pearson chi-square test and the exact probability test were used to analyse the data in this study to uncover any underlying links in the study's sparse frequency distributions. The study's findings underscore the urgent need for increased education on cancer, cancer screening, and risk reduction initiatives. Participants with chronic diseases and a cancer history in their families showed significantly higher levels of awareness, highlighting the potential for targeted education and screening programs to improve public health.

An optimal exact confidence interval for the difference of two independent binomial proportions.

The difference between two proportions is the most important parameter in comparing two treatments based on independent two binomials and has garnered widespread application across various fields, particularly in clinical trials. There exists significant interest in devising optimal confidence intervals for the difference. Approximate intervals relying on asymptotic normality may lack reliability, thus calling for enhancements in exact confidence interval construction to bolster reliability and precision. In this paper, we present a novel approach that leverages the most probable test statistic and employs the -function method to construct an optimal exact interval for the difference. We juxtapose the proposed interval against other exact intervals established through methodologies such as the Agresti-Min exact unconditional method, the Wang method, the fiducial method, and the hybrid score method. Our comparative analysis, employing the infimum coverage probability and total interval length as evaluation metrics, underscores the uniformly superior performance of the proposed interval. Additionally, we elucidate the application of these exact intervals using two real datasets.

Relationship between severe radiodermatitis and skin barrier functions in patients with head and neck cancer: A prospective observational study

ObjectiveSevere radiodermatitis with erosion is a painful condition that affects quality of life; therefore, developing methods for its prevention is an urgent issue. Therefore, this study aimed to determine the morphological characteristics of the development and healing processes of severe radiodermatitis in patients with head and neck cancer and to explore the association between skin barrier function and development of severe radiodermatitis. MethodsIn this prospective observational study, the cervical regions of patients with head and neck cancer who underwent radiotherapy at a university hospital from October 2022 to March 2023 were photographed, and morphological characteristics of the development and healing process of severe radiodermatitis were extracted using the qualitative sketch method. Skin barrier function, including skin microbiota and dermal echogenicity, was investigated before initiating radiotherapy, and its relationship with radiodermatitis was examined using the Mann–Whitney U test or Fisher's exact probability test. ResultsNine patients were followed for a median of 61 (range 55–87) days with a total of 88 observations. The morphological characteristics of severe radiodermatitis were “localized erosion–epithelialization” and “widespread erosion–crusting,” and compared to non-severe radiodermatitis, with low levels of Staphylococcus aureus (P ​= ​0.024), Staphylococcus hominis (P ​= ​0.024), and reduced dermal echogenicity (P ​= ​0.036). Furthermore, the “widespread erosion–crusting” was associated with a subepidermal low echogenic band. ConclusionsTo prevent severe radiodermatitis, in addition to moisturizing the irradiated area and protecting it from mechanical irritation, improving skin barrier function before radiotherapy initiation may be effective.

Clinical characteristics and associated factors of pediatric acute necrotizing encephalopathy: a retrospective study.

In the clinic, pediatric acute necrotizing encephalopathy (ANE) primarily affects children under five years of age and is characterized by severe brain damage and high mortality. However, some challenges remain regarding the diagnosis and treatment of ANE. In the present study, we analyzed the clinical characteristics and related factors of ANE with the aim of providing improved diagnostic and treatment strategies. Thirty-four pediatric ANE patients admitted to Zhejiang University School of Medicine Hospital between February 2019 and December 2023 were included in this study. To identify the factors associated with mortality, clinical, laboratory and imaging data were analyzed with independent-sample t tests, Mann‒Whitney U tests, Fisher's exact probability tests and receiver operating characteristic (ROC) curve analyses. In this cohort of 34 patients, the most common symptoms were fever, seizures, altered consciousness, vomiting, diarrhea and shock. The mortality rate was 55.9%. Laboratory tests revealed that patients who died had higher creatinine, lactate, activated partial thromboplastin time (APTT), thrombin time (TT), interleukin-6 (IL-6), interleukin-10 (IL-10), creatine kinase (CK), and D-dimer than survivors. Imaging examinations predominantly revealed symmetrical lesions in the thalamus. The fatal group displayed lower Glasgow Coma Scale (GCS) scores and severe complications. Other factors related to mortality included the arterial pH, GCS score and hospitalization duration. The most common symptoms of ANE are fever, seizures, altered consciousness, vomiting, diarrhea and shock, and ANE has a high mortality rate. The GCS score and arterial pH are critical biomarkers for assessing the severity of ANE.

Therapeutic effect of proprioceptive neuromuscular facilitation combined with muscle energy technique on post-stroke dysphagia.

According to the Global Burden of Disease Study the prevalence of stroke worldwide has significantly increased from 1990 to 2019, making it the second leading cause of death worldwide. Approximately 70%-80% of stroke patients are unable to live independently due to disability. To explore the therapeutic effect of proprioceptive neuromuscular facilitation (PNF) combined with muscle energy technique (MET) on post-stroke dysphagia. A total of 122 stroke patients with dysphagia admitted to our hospital from January 2017 to December 2020 were divided into the control group (n= 61) and the study group (n= 61). Patients in the control group received conventional rehabilitation plans, while those in the study group were given a combined therapy of MET and PNF. Standard Swallowing Function Assessment Scale (SSA), Videofluoroscopic Swallow Study (VFSS), Swallowing Quality of Life (SWAL-QOL) scores, Water Swallow Test (WST) grading, and efficacy indicators were compared between two group with t-tests, Wilcoxon signed-rank test, χ2 test or Fisher's exact probability test. After treatment, the study group showed lower SSA score (P= 0.036), and VFSS, P= 0.013 than the control group. The changes in SSA score (P= 0.013) and VFSS score (P< 0.001) in the study group were greater than the control group. Furthermore, after treatment, both the study group and the control group showed a decrease in WST grading (P< 0.001); and the degree of post-treatment WST grading decline in the study group was higher (P= 0.009). Besides, after treatment, the SWAL-QOL score of the study group was higher than the control group (P< 0.001); and the effective rate of patients in the study group was higher than that in the control group (P= 0.021). Compared with traditional rehabilitative training strategies, PNF combined with MET can effectively improve swallowing function, and enhance the quality of life in patients with post-stroke dysphagia.

Tumor Heterogeneity of STEAP4 in Malignant Progression of Oral Squamous Cell Carcinoma.

Background: Recent research suggests that STEAP4, a metalloreductase in vivo, plays a crucial role in various types of tumorigeneses, especially in gastrointestinal cancers. However, few oncogenes have been reported in oral squamous cell carcinoma (OSCC). Therefore, this study aimed to explore the potential role of STEAP4 in OSCC. Methods: The expression level of STEAP4 in OSCC tissues and adjacent normal tissues, was detected using immunohistochemistry. Publicly available online tools were utilized to analyze the expression, prognostic significance, and related enriched pathways of STEAP4 in head and neck squamous cell carcinoma (HNSCC) and OSCC. The relationship between STEAP4 expression and clinicopathological parameters in OSCC patients was validated using the χ2 test and Fisher's exact probability test. Results: STEAP4 exhibited low expression in both HNSCC and OSCC. Whereas the prognosis for HNSCC patients was favorable, OSCC patients had poor outcomes. Genetic variability analysis revealed no alterations in STEAP4 in OSCC, whereas gene amplification was observed in HNSCC, suggesting tumor heterogeneity in STEAP4 among these cancer types. Conclusion: STEAP4, as a risk factor associated with poor patient prognosis, shows tumor heterogeneity in OSCC patients, that is potentially related to genetic mutations or differences in histological distribution of oral mucosa. These findings indicate that STEAP4 could serve as an independent predictor for assessing the prognosis of OSCC patients.

Evaluation of the Safety and Efficacy of Foldable One-Piece Intraocular Lens A1-UV for the Treatment of Cataracts: Summary of Two Clinical Trials

Objective: Through the combined analysis of data from two clinical trials, the clinical safety and efficacy of aspheric intraocular lens A1-UV implantation in cataract patients was evaluated at 1 year after surgery. Methods: A total of 239 subjects (239 eyes) were enrolled, including 117 subjects in the A1-UV group (study group), 61 subjects in the SN60WF group (control group 1) and AQBHL group (control group 2), respectively. Follow-up time points included: preoperative, intraoperative and postoperative 1~2days, 1 week, 1 month, 3 months, 6 months and 1 year. The evaluation indexes included: visual acuity, refraction, contrast sensitivity, intraocular pressure and complications. Statistical methods mainly include Wilcoxon rank-sum test, independent samples t-test, chi-square test or Fisher exact probability test. Results: The uncorrected distance visual acuity of the A1-UV group increased from logMAR 0.77±0.33 preoperatively to 0.15±0.22 at 1 year after surgery, from 0.74±0.33 in the SN60WF group to 0.18±0.23 at 1 year after surgery, and from 0.78±0.34 in the AQBHL group to 0.21±0.24 at 1 year after surgery. For best-corrected distance visual acuity, the A1-UV group increased from logMAR 0.60±0.36 preoperatively to 0.05±0.10 at 1 year after surgery, the SN60WF group increased from 0.59±0.36 preoperatively to 0.07±0.15 at 1 year after surgery, and the AQBHL group increased from 0.59±0.35 preoperatively to 0.08±0.11 at 1 year after operation. There was no significant difference between the A1-UV group and the other two groups (all P&gt;0.05). At different follow-up times after surgery, the residual diopters was significantly lower than that before operation (all P&lt;0.05), and the refractive error before operation was effectively corrected. The contrast sensitivity was high, and the visual function was better. The mean intraocular pressure of the subjects implanted with A1-UV was within the normal range during each follow-up period after surgery. None of the patients had serious adverse events related to intraocular lens. Conclusion: The efficacy and safety of A1-UV foldable one-piece intraocular lens in cataract treatment are good

Time to Treatment and Outcomes of Hemorrhagic Stroke, Comparing Patients Entering Surgery before and after 120 Minutes Upon Arrival at the Emergency Department Pattani Hospital

Background: The duration between a patient’s hospital arrival and the point at which they enter surgery for hemorrhagic stroke affects survival, length of stay, health care costs, and outcome (Glasgow Outcome Scale). Therefore, a study to explore the effects of time on these outcomes is warranted. Objective: To compare treatment outcomes of patients with hemorrhagic stroke having entered surgery before and after 120 minutes upon arrival at the emergency department. Materials and Methods: A therapeutic and interventional study with a retrospective observational cohort design at Pattani Hospital in patients with hemorrhagic stroke who received treatment between October 2018 and April 2023. A retrospective review of medical records, which collected clinical characteristics and the time to treatment. Glasgow Outcome Scale was evaluated at 72 hours, two weeks, one month, and date of hospital discharge. Length of stay, health care costs, and survival status at date of hospital discharge were analyzed. Comparative analysis was performed by Fisher’s exact probability test and t-test, and prognostic analysis was performed by risk ratio. Results: Of all the patients in the present study, 49 and 182 received treatment before and after 120 minutes, respectively, upon arrival at the emergency department. Clinical characteristics of gender, age, underlying conditions, regular medications, and level of consciousness were not significantly different between the two groups. Patients who entered surgery within 120 minutes of arrival had more occurrences of basal ganglia hemorrhage compared with those who received surgery thereafter. Furthermore, patients who received surgery within 120 minutes had a 11.4% increased chance of survival. The number needed to treat (NNT) hemorrhagic stroke patients with a time to treatment of under 120 minutes is 9. However, there was an associated increase in complications, health care cost, and length of stay. The Glasgow Outcome Scale improvement was greater only in the two-week follow-up period. These results were similar when subarachnoid hemorrhage and anticoagulating medication used were excluded. Conclusion: Patients with hemorrhagic stroke who receive early surgical treatment have lower mortality rates. Adequate provision of personnel and facilities for delivering prompt care should be made available. Measures should be taken to reduce the complications of patients who receive surgical treatment after 120 minutes upon arrival at the emergency department.

Evaluating the impact of loperamide on irinotecan-induced adverse events: a disproportionality analysis of data from the World Health Organization pharmacovigilance database (VigiBase).

SN-38, the active metabolite of irinotecan, may cause adverse events necessitating treatment discontinuation and management. Diarrhea, which is treated with loperamide, is one such event. However, loperamide may delay SN-38 elimination, causing more adverse events. Therefore, understanding the adverse events caused by symptomatic drugs is crucial for safe drug therapy. This study aimed to assess the association between loperamide and irinotecan-induced adverse events. We analyzed data up to December 2022 from VigiBase, the World Health Organization's adverse event database. The study used reporting odds ratios (RORs) to evaluate the associations between concomitant medications and irinotecan-induced adverse events. Fisher's exact probability test was used to analyze the adverse events. Logistic regression analysis was performed to identify associated adverse event signals. Of the 32,520,983 cases analyzed, 57,454 involved the use of irinotecan. Among these, 1589 (2.8%) patients were co-treated with loperamide. Signals for neutropenia (ROR 1.37, 95% confidence interval (CI) 1.20-1.57, p < 0.001), anemia (ROR 1.81, 95% CI 1.43-2.30, p < 0.001), and alopecia (ROR 1.89, 95% CI 1.30-2.74, p < 0.01) were detected with concomitant loperamide. Multivariate logistic regression analysis confirmed that concomitant loperamide use was associated with signals for neutropenia, anemia, and alopecia. Our results suggest that loperamide increases the risk of irinotecan-induced adverse events and enhances irinotecan toxicity. The study methodology may be useful for predicting adverse event risk when choosing symptomatic therapy drugs during irinotecan use.

Three-year results of XEN gel stent implantation in the treatment of glaucoma

Objective: To evaluate the long-term efficacy and safety of XEN gel stent implantation in patients with refractory glaucoma. Methods: A retrospective case series study was conducted. Clinical data were collected from patients who received medical treatment at the First Affiliated Hospital of Fujian Medical University between January 2020 and September 2020 and underwent XEN gel stent implantation by the same surgeon. Preoperative and postoperative clinical parameters, including the intraocular pressure (IOP), number of ocular hypotensive medications, best-corrected visual acuity, surgical success rates, status of filtering blebs, and complications, were recorded at 1 day, 1 week, 1, 2, 3, 6, 12, 18, 24, and 36 months after surgery. Statistical analyses were performed using the analysis of variance (ANOVA), the least significant difference (LSD) method, and the Fisher's precision probability test. Results: A total of 8 patients (8 eyes) with glaucoma meeting the criteria were included, consisting of 6 males (6 eyes) and 2 females (2 eyes). The preoperative IOP reached (30.88±12.17) mmHg (1 mmHg=0.133 kPa), and the IOP at all postoperative follow-up time points was significantly lower than the preoperative value (P<0.05). At 3 years after surgery, the IOP was (14.38±1.60) mmHg, with a reduction of 53.43% [(16.50±12.07) mmHg]. Only 2 patients required monotherapy for IOP control, and there was no significant decline in best-corrected visual acuity in 7 patients. The surgical outcome at 3 years postoperatively was a complete success in 6 patients, a qualified success in 1 patient, and a failure in 1 patient. The filtering blebs were generally flat and diffuse, with only mild to moderate vascularization. One patient presented elevated IOP at 3 months, and after a subsequent revision of the XEN gel stent, the IOP became stable with the administration of travoprost eye drops. Conclusion: The XEN gel stent implantation proved to effectively reduce the IOP in glaucoma patients, with a high degree of safety demonstrated up to 3-year long-term follow-up.

8192 A Two-Cycle Clinical Audit Testing Inpatient Management Of Hypophosphatemia In A UK District Hospital

Abstract Disclosure: J. Porto: None. E. Ssemmondo: None. N. Obike: None. A. Abobaker: None. R. March: None. N. Tun: None. T. Pawlak: None. Objective: A clinical audit was conducted to assess if there was any improvement in management of hypophosphatemia among patients admitted to the medical wards using the local Trust protocol, following structured edcational sessions to the junior doctors covering medical wards. Design and methodology: The 2 cycles of the audit were conducted between March 2020 and September 2021 in Scarborough district Hospital. The clinical notes of 52 patients (20 in the first cycle and 32 in the re-audit) with hypophosphatemia were reviewed. These were identified using the electronic laboratory results of patients within the study period. The aspects of the trust protocol for management of hypophosphatemia that were audited; documentation of symptoms associated with low phosphate levels, cardiac monitoring in severe hypophosphatemia, identification of the likely cause of hypophosphatemia, the presence or absence of associated acute kidney injury (AKI) and initiation of phosphate replacement. The results of the first audit were presented at the local hospital clinical governance meeting (August 2020). Following this, 2 teaching sessions and 2-case based discussion on hypophosphatemia were organised for all the doctors in the department of medicine. The re-audit was subsequently conducted after the fourth teaching session. The proportions of each audited item were compared between the first audit and the re-audit using Fisher exact probability test. Results:25% of patients in the first audit had severe hypophosphatemia compared to 28% in the re-audit. In patients with severe hypophosphataemia, only 33.3% had cardiac monitoring during the re-audit cycle compared to 60% in the first cycle, and the difference was not statistically significant (p=0.58). There was significant improvement in the documentation of symptoms of hypophosphataemia amongst inpatients during the re-audit cycle compared with the initial cycle; 62.5% vs only 10% (P 0.002). Most patients had an underlying cause of the hypophosphatemia identified (80% and 62.5%-first and second cycle respectively). AKI was associated with hypophosphataemia in 15% &amp; 34.4% (P 0.2) in the first and second cycles respectively. Despite low phosphate levels, 25% and 28.1% at the initial audit and the second cycle respectively did not receive any form of phosphate replacement. Conclusion: The two-cycle clinical audit showed that the teaching sessions on management of hypophosphatemia increased the awareness of the importance to document whether the patients were symptomatic or asymptomatic following the drop in their phosphate levels, which can help to identify patients at risk of developing complications, such as cardiac arrythmias. However, these sessions were not sufficient to improve overall management of patients with low phosphate levels. Presentation: 6/1/2024

The Influence of Organizational Communication, Information Technology and Motivation on Employee Performance: Job Satisfaction as an Intervening Variable

An organization can manage human resources that have performance in accordance with the goals of the organization, Low employee performance affects the image of the organization. The data analysis method uses a probability test of all population elements with a sample of 100 individuals. The study uses Structural Equation Modeling (SEM) and uses SmartPLS. For hypothesis testing, the Path Coefficient is used which aims to measure the direct effect, while the Indirect Effect is used to assess the indirect effect. Based on the results of the study, it explains that organizational communication does not affect employee performance, organizational communication does not affect job satisfaction, information technology does not affect employee performance, information technology does not affect job satisfaction, motivation affects Employee Performance, motivation affects job satisfaction, job satisfaction affects employee performance, job satisfaction does not mediate organizational communication on employee performance, job satisfaction does not mediate information technology on employee performance and job satisfaction is able to mediate motivation on employee performance at the Solok City Health Office.