Adult Group Research Articles

The Impact of High Burden Idiopathic Premature Ventricular Contractions in Pediatric versus Adult Populations. A Retrospective Cohort Study.

Idiopathic premature ventricular contractions (PVCs) can occur in up to 40% of children with structurally normal hearts. The study aims to assess the impact of high-burden idiopathic PVCs on children in comparison with adults in terms of symptoms, distribution of origin, management strategies, and safety considerations. This is a single-center retrospective cohort study that included patients with frequent PVCs (> 10% burden in Holter monitoring) and categorized by age into adult group (≥ 18years) and pediatric group. Data encompassed demographic profiles, clinical symptoms, echocardiographic findings, electrocardiographic analyses, and one-year follow-up management. A total of 224 PVC cases were collected during a 2-year study (120 children and 104 adults). Syncope occurred significantly more in children than adults (15.8% vs. 0.9%, p = 0.003). In children, the right ventricular outflow tract (RVOT) free wall was the predominant site (48 patients; 40%), while the septal RVOT was most common in adults (35 patients; 33.7%). Pediatric cases exhibited significantly higher PVCs originating from the outflow tract (92.5% vs. 69.2%; p = 0.001). Nevertheless, there were no significant differences between groups regarding the safety, acute, and one-year outcomes of RF ablation. Age disparities were evident in syncope incidence and PVC origin, with no variance in PVC-induced myopathy prevalence or the safety and outcomes of RF catheter ablation between children and adults.

Does age, sex, and area of substantia nigra echogenicity predict the MRI appearance of nigrosome-1?

The appearance of the substantia nigra (SN) can aid diagnosis of Parkinson's disease (PD). The effect of age and sex on the appearance of nigrosome-1 (SN subregion) on magnetic resonance imaging (MRI), and the relationship between nigrosome-1 (viewed with MRI) and SN echogenicity (viewed with transcranial ultrasound) is unknown. The study aimed to address these knowledge gaps. It was hypothesized that age, sex, and area of SN echogenicity predict area of MRI hyperintense signal in nigrosome-1. The cross-sectional study involved a group of healthy adults (n=105; aged 21-79years) and adults diagnosed with PD (n=37; aged 51-80years). Multilevel mixed-effects regression analysis was used to investigate if age, sex, side, and area of SN echogenicity predict area of nigrosome-1 hyperintense signal. Area of nigrosome-1 hyperintense signal increased by an average of 0.045mm2/year in healthy adults (p=0.016) but not in adults living with PD. Sex, side, and area of SN echogenicity did not predict area of nigrosome-1 hyperintense signal in either group. Disease duration predicted area of nigrosome-1 hyperintense signal in the PD group (coefficient=-0.41, p=0.014). The expected between-group differences (p<0.001) in median area of nigrosome-1 hyperintense signal (smallest area across sides: healthy=7.6mm2, PD=0.0mm2) and SN echogenicity (largest area across sides: healthy=14.3mm2, PD=29.3mm2) were observed. The results suggest that the MRI appearance of nigrosome-1 can vary with age but not sex or area of SN echogenicity. The results further understanding of the nigrosome-1 biomarker for PD and aid interpretation of nigrosome-1 MRI findings in clinical settings.

A grounded theory based kano model to develop age-friendly housing retrofit strategies for older people in China

ABSTRACT China’s aging population is rapidly growing, with home-based care becoming the preferred choice for many older adults. Age-friendly housing (AFH) is a key measure to improve their quality of life, yet a systematic decision-making framework remains lacking. This study develops a Grounded Theory-based Kano Model to prioritize AFH design strategies for different older adult groups. The results indicate that strategies related to mobility impairments have the highest priority, followed by those addressing external assistance, physical adjustments, vision, fine motor skills, and hearing loss. Different age groups show varied needs for mobility support and environmental visibility. Men place higher priority on eliminating indoor height differences and providing support than women. Older adults living alone or with caregivers have lower priorities for several design strategies. Those with arthritis, cerebrovascular diseases, or sensory impairments have greater demands for walking safety and communication-related modifications. The study reveals a direct link between design strategy priorities and physiological decline, providing empirical data for AFH design prioritization. These findings offer a basis for optimizing AFH retrofit subsidy policies for older adults with varying physical abilities and for cities at different economic levels.

Metacontrol instructions lead to adult-like event segmentation in adolescents.

Event segmentation, which involves dividing continuous information into meaningful units, changes as children develop into adolescents. Adolescents tend to segment events more coarsely than adults. This study explores whether adolescents could adjust their segmentation style to resemble that of adults when provided with explicit metacontrol-related instructions. We compared event segmentation in two adolescent groups and one adult group, while simultaneously recording EEG data. One adolescent group was instructed to perform segmentation as finely as possible, whereas the other adolescent group and adults received no specific instructions on segmentation granularity. EEG data were analyzed using multivariate pattern analysis and source reconstruction. The findings revealed that adolescents given fine-grained instructions adjusted their segmentation probability closer to adult levels, although they did not fully match adults in processing multiple simultaneous changes. Neurophysiological results indicated that adolescents with fine-grained instructions exhibited neural decoding performance more similar to adults. Increased activity in the inferior frontal gyrus in these adolescents compared to adults related to this. The results suggest that adolescents with fine-grained instructions demonstrated more persistent cognitive control and enhanced top-down attention than their peers and adults. The study shows that adolescent cognitive processes can be shifted toward adult-like performance through instructions.

Web-Based Exercise and Nutrition Intervention to Improve Leg Muscle Strength and Physical Functioning in Older Adults: Pre-Post Pilot Study.

The lifestyle intervention ProMuscle, which combines resistance exercise and an increased protein intake, was effective in improving muscle strength, muscle mass, and physical functioning in older adults. However, due to a growing shortage of health care professionals, the rapidly growing aging population cannot be personally guided in the future. Therefore, Uni2Move, a scalable web-based variant of ProMuscle, was designed to reach larger groups of older adults without putting additional burden on health care professionals. The current study investigated the effects of a web-based lifestyle intervention on muscle strength, protein intake, and physical functioning in healthy older adults. In addition, we conducted a qualitative study to gather key insights of the participants involved, as little is known about older adults' perceptions of web-based lifestyle interventions. A pre-post pilot study was conducted in the Netherlands. In the 24-week intervention, 19 healthy adults aged >55 years were included. They performed resistance training at home twice a week for 24 weeks via web-based workout videos. Videos (45-60 minutes) were recorded by the fitness trainer and mainly focused on training leg muscles. In addition, older adults were advised on increasing protein intake via two web-based consultations by a dietitian in the first 12 weeks and via an e-learning course in the second 12 weeks. Intervention adherence and acceptance was measured in week 25. The 1 repetition maximum knee extension strength, repeated chair rise test, and protein intake were measured at baseline, week 13, and week 25. Linear mixed models were used to test differences over time. Semistructured interviews were used to gather experiences of participants. Atlas.ti version 22 was used to analyze the interviews. The mean age of participants (n=19) at baseline was 69 (SD 7) years. The 1 repetition maximum knee extension strength and repeated chair rise test improved significantly during the 24-week intervention with a mean difference of 7.0 kg (95% CI 4.8-9.3; P<.001) and -1.2 seconds (95% CI -1.7 to -0.6; P<.001), respectively. Total protein intake per day did not change, whereas protein intake during breakfast had increased significantly after 13 weeks with a mean difference of 6.9 g (95% CI 1.1-12.7; P=.01). Qualitative research revealed that advantages of the program included no need to travel and exercising in their own environment. Disadvantages were the lack of physical interaction and no corrections by the trainer. The results of the web-based exercise and nutrition intervention Uni2Move indicate potential improvements of muscle strength and physical functioning in healthy middle-aged and older adults. Providing such lifestyle interventions on the internet could reach an increased number of older adults, providing the opportunity to contribute to the health and independence of the rapidly growing aging population.

Awake Bruxism Is Unrelated to Smoking, Despite the Different Psychological Status: A Pilot Study.

The aim of the present study is to get deeper into the complex interplay that might exist between awake bruxism (AB), tobacco smoking, and anxiety and/or depression symptoms in a group of healthy young adults. The study participants were recruited by advertising the investigation at the University of Siena, Siena, Italy. The inclusion criteria were being in good general health, without systemic diseases or oral diseases. People with ongoing medical or dental treatment and those with a history of systemic disease or temporomandibular disorders were excluded. The participants who were included in the study received a questionnaire containing three sections for the assessment of AB behaviors, anxiety and depression symptoms, and the number of cigarettes smoked. A total of 141 healthy young adults met the inclusion criteria. Different awake masticatory muscle activities showed different strengths of association with anxiety and depression symptoms. However, no relationship was found between the number of smoked cigarettes and the frequency of the various masticatory muscle activities considered. The result of the present study shows no clear-cut association between the frequency of self-reported AB behaviors and smoking in healthy individuals.

Midterm to Long-term Follow-up After Limited Saucerization of a Discoid Lateral Meniscus: Radiological and Functional Outcomes With Age-Dependent Variations.

A discoid lateral meniscus (DLM) is the most common meniscus variant and is commonly treated with arthroscopic saucerization. There are mixed data regarding long-term results after surgery, especially in terms of radiological parameters. The aim was to evaluate the functional and radiological results of patients who underwent arthroscopic saucerization for a symptomatic DLM. It was hypothesized that successful outcomes can be achieved by avoiding excessive resection while reshaping only to an extent that prevents mechanical symptoms. Case series; Level of evidence, 4. This study retrospectively analyzed pediatric and adult patients who had a symptomatic discoid meniscus between 2000 and 2018, who underwent arthroscopic saucerization with at least 10 mm of peripheral length, and who had at least 5 years of follow-up. Radiological parameters were measured on both preoperative and follow-up radiographs. Patient-reported outcome measure scores were recorded at follow-up. The study included 57 knees of 53 patients (mean age, 27.6 years [range, 6-65 years]). The mean follow-up duration was 12.1 years (range, 5.0-23.1 years). There were 31 knees in the pediatric group and 26 knees in the adult group. No significant difference was found between the groups or between preoperative and follow-up values for the femorotibial angle (P > .05). When the preoperative and follow-up Kellgren-Lawrence grades were compared, no change was observed in the pediatric group (P = .125), while grades were shown to progress in the adult group (P < .001). The mean Lysholm score was 94.61 ± 7.61 and 84.23 ± 14.90 for the pediatric and adult groups, respectively (P = .001). Overall, 2 patients underwent arthroscopic surgery because of a symptomatic recurrence of symptoms, and 2 patients underwent arthroplasty because of osteoarthritis. The 10-year survival rate was 90.6%. Limited saucerization of a DLM helped to preserve coronal-plane knee joint alignment. Functional and radiological results were superior in the pediatric patients. Even when alignment was more varus in older patients, preoperative and follow-up femorotibial angles were not statistically significant. This outcome may be used to guide treatment in appropriately selected cases.

P-242. Disparities and inequities in the burden of pneumococcal disease in US adults

Abstract Background Understanding the impact of social determinants of health on pneumococcal disease (PD) is important. The purpose of this study was to conduct a targeted literature review (TLR) of the clinical and economic burden of PD in US adults with a focus on examining disparities and inequities by race, geography, urbanicity, income, education, and employment. Methods Original research studies reporting burden of PD in US adults published between 2012 and January 2024 were identified through a US focused TLR in Pubmed (vial Medline) and a review of surveillance data from the CDC website. The original search was supplemented with targeted searches via Google Scholar in areas for which data were not identified via Pubmed or the CDC website. Results Of 4,133 identified publications, 16 studies were identified: 10 described disparities by race, 7 by geography, 2 by urbanicity, 3 by income, 1 by education and 1 by employment. Black adults had the highest incidence and longest length of stay due to IPD and bacteremic community acquired pneumonia (CAP) and highest mortality rates from CAP compared to other racial groups across all adult age groups; Black adults living in poverty experienced a 2.1 times higher rate of PD compared to white adults. Pneumococcal disease also varied by geography and urbanicity. Lower urbanicity displayed higher mortality rates for PD. Incidence of all-cause CAP was higher in early retirees 18–64 years old and their adult dependents compared to their employed counterparts and their adult dependents. PD health care expenditures mirror the patterns observed for disease burden. Vaccination rates were lower in Black adults compared to white adults and in adults who resided in rural areas, were less educated and had a lower income. Conclusion This TLR confirms that disparities and inequities in the burden of PD among US adults exist with higher disease burden and lower pneumococcal vaccination in Black adults, those living in rural areas and with lower education and income. There is a paucity of studies examining inequities and social disparities of health in PD. Additional studies are needed to examine disparities and inequities in PD according to race, geography, urbanicity, income, education, and employment. Disclosures Salini Mohanty, DrPH, MPH, Merck &amp; Co., Inc.: Employee|Merck &amp; Co., Inc.: Stocks/Bonds (Public Company) Kelly D. Johnson, PhD, Merck &amp; Co., Inc.: Employee|Merck &amp; Co., Inc.: Stocks/Bonds (Public Company) Sheba Nellore, MBA, Merck: Advisor/Consultant Lindsay McNamee, BSc, Merck &amp; Co Inc.: Advisor/Consultant Hanane Khoury, PhD, Merck: Advisor/Consultant Laura De Benedetti, BSc, Merck &amp; Co, Inc: Advisor/Consultant Elmira Flem, MD, PhD, Merck: Stocks/Bonds (Private Company) Kristen A. Feemster, MD, MPH, MSHPR, FAAP, Merck &amp; Co., Inc., Rahway, NJ, USA: Grant/Research Support|Merck &amp; Co., Inc., Rahway, NJ, USA: Stocks/Bonds (Public Company) Nicole Cossrow, PhD, Merck: Stocks/Bonds (Public Company)

P-680. Estimated Respiratory Syncytial Virus (RSV)-Related Hospitalizations and Deaths among Adults in Norway between 2010–2019

Abstract Background RSV can trigger acute cardiac events and cause respiratory disease in adults, but the true burden of RSV-associated disease and mortality remains largely underestimated due to limited standard-of-care testing and reduced test sensitivity. We retrospectively estimated the incidence of hospitalizations and deaths attributable to RSV in adults in Norway from 2010 to 2019 Methods Counts of weekly hospitalizations and monthly deaths due to cardiorespiratory (ICD-10 codes: I00-I99, J00-J99), respiratory (J00-J99), and cardiovascular (I00-I99) diseases were obtained from the Norwegian Patient Registry and Norwegian Cause of Death Registry national databases, respectively. A quasi-Poisson regression model was fitted, stratified by age group, to estimate the number of hospitalizations and deaths attributable to RSV while considering temporal trends and virus activity. RSV and influenza hospitalizations in children aged &amp;lt; 2 years and adults aged ≥65 years, respectively, were used as proxies for viral activity. Annual RSV-attributable hospitalization incidence and mortality rates were calculated using populations at risk as denominator. Results For all three study outcomes, RSV-attributable incidence and mortality rates increased with age. The highest RSV-attributable rates were observed in patients aged ≥65 years (range from 2010 to 2019 - hospitalizations per 100,000 person-years: 148-265 for cardiorespiratory, 81-143 for respiratory, and 124-221 for cardiovascular; deaths per 100,000 person-years: 19-35 for cardiorespiratory, 11-19 for respiratory, and 10-18 for cardiovascular). In any given year, the RSV-attributable cardiorespiratory disease hospitalization incidence and mortality rates were two times higher than the rates for respiratory disease alone. For the three outcomes, the attributable proportion of RSV hospitalizations was 2 to 3 times higher in adults aged 18-44 years than in those aged ≥65 years. Conclusion In Norway, RSV contributes substantially to both respiratory and cardiovascular diseases across all adult age groups, emphasizing the need for effective preventive strategies. Including cardiovascular disease increased measured burden by nearly 2-fold compared to respiratory disease alone. Disclosures Maribel Casas, PhD, Pfizer: Advisor/Consultant Tor Molden, PhD, Pfizer: I am an employee of Pfizer Caihua Liang, MD, PhD, Pfizer: Stocks/Bonds (Private Company) Aleksandra Polkowska-Kramek, n/a, Pfizer: employee of P95 which received funding from Pfizer to conduct this study Bradford D. Gessner, M.D., M.P.H., Pfizer: Employee|Pfizer: Stocks/Bonds (Public Company) Elizabeth Begier, MD, M.P.H., Pfizer Vaccines: Employee|Pfizer Vaccines: Stocks/Bonds (Private Company)

Evaluation of a non-invasive right ventriculo-arterial coupling parameter in repaired tetralogy of Fallot by cardiovascular magnetic resonance imaging and correlation with exercise testing

Abstract Background and purpose Invasively measured right ventricle (RV) to pulmonary arterial coupling (RVPAc) quantifies RV performance within the context of its afterload but requires cardiac catheterization thereby limiting widespread use. We sought to compare a volumetric non-invasive RVPAc parameter in a contemporary cohort of children and adults with repaired tetralogy of Fallot (rToF), to investigate the impact of pulmonary regurgitation (PR) and RV outflow tract obstruction (RVOTO), and to correlate RVPAc with exercise capacity. Methods We retrospectively compared 99 pediatric and 117 adult patients with rToF who had performed cardiovascular magnetic resonance imaging (CMR) and exercise testing (CPET) within 1 year. Sanz’s method was used to non-invasively calculate RV-PA coupling as the ratio of RV end-systolic volume over stroke volume (ESV/SV); where a ratio &amp;gt;1 is considered ‘uncoupled’ [1]. Right-ventricular outflow tract gradient was obtained by echocardiography; PR fraction and Nakata-index [2], to quantify PA size, were calculated by CMR. We also calculated ‘effective SV’ by subtracting regurgitant volume from RV SV; which allowed for calculation of ‘effective’ RVPAc. Exercise capacity was measured as percentage of predicted peak oxygen consumption (%VO2) during cardio-pulmonary exercise testing. Subgroups were established depending on PR-RVOTO combination (cut-off defined as PR &amp;gt;30% and RVOTO &amp;gt; 25mmHg). Results RVPAc was significantly higher in the adult group [1.24 (1.03-1.49) vs. 1.00 (0.88-1.15); p&amp;lt;0.001]. According to PR-RVOTO, RVPAc was overall comparable between pediatric and adult cohorts (respectively p=0.379 and 0.053). RVPAc highly correlated with RV ejection fraction (RVEF) (r=-0.991, p&amp;lt;0.001), moderately correlated with indexed RV ESV (r= 0.696, p&amp;lt;0.001) and QRS duration (0.598, p&amp;lt;0.001), and weakly correlated with indexed RV end-diastolic volume (RVEDVi) (r=0.351, p&amp;lt;0.001), indexed RV SV (r= -0.241, p&amp;lt;0.001), LV ejection fraction (LVEF)(r= -0.382, p&amp;lt;0.001) and Nakata-index (r=0.264, p=0.002). There was no significant association between RVPAc and RV outflow tract gradient (p=0.109) or pulmonary regurgitant fraction (p=0.411). RVPAc was not significantly correlated with %VO2 (p=0.294). This remained true for subgroup analysis in the pediatric and adult cohorts separately. Regression models, which included age, BSA and either RVEF, RVPAc or ‘effective RVPAc’ to predict exercise capacity (%VO2) demonstrated an overall poor fit (adjusted R2 0.170; 0.176 and 0.181 respectively). Conclusion Adults with rToF have higher RVPAc ratio than pediatric patients which could signify progressive RV-PA ‘uncoupling’ with age or era-related pathological effects. Non-invasive RVPAc correlates with RVEF, RV volumes, PA size, LVEF and QRS duration, which could be used to track progressive RV dysfunction. Nonetheless, its clinical use appears limited as it does not predict exercise capacity better than RVEF.

P-2156. Impact of Metagenomic Next-Generation Sequencing of Plasma Cell-Free DNA on Infectious Diseases Management in Adult and Pediatric Patients

Abstract Background Plasma metagenomic next-generation sequencing (mNGS) is a noninvasive diagnostic test that uses cell-free DNA to identify a variety of pathogens. mNGS has the potential to identify difficult to detect pathogens and avoid invasive procedures while ensuring appropriate antibiotic use. However, the broad range of organisms detected makes it difficult to discern pathogens from colonization. The impact and ideal patient population for this test remain uncertain.Figure 1. Reason for Ordering mNGSNote: patients could have more than one reason for ordering mNGS Methods This was a retrospective evaluation of adult and pediatric patients who had mNGS ordered during their admission at Atrium Health's Carolinas Medical Center or Levine Children's Hospital from July 2019 through July 2023. The aim of this study was to characterize the use of mNGS including patient demographics, testing indication, result concordance with conventional testing and clinical impact of results. Figure 2. Suspected Site of InfectionNote: patients could have more than one suspected site of infection Results A total of 67 adult and 44 pediatric patients were included with 72 and 50 mNGS orders, respectively. Most of the patients were immunosuppressed including 72% of adult and 94% of pediatric patients. The most common reasons for ordering mNGS were probable infection with negative cultures, rule-out infection, and lack of improvement on current therapy (Figure 1). The suspected sites of infection are shown in Figure 2. There were 48 adult patients and 23 pediatric patients with a positive test. Of those that were positive, the results were fully concordant with conventional testing for 13% of adult and 26% of pediatric patients. At least one organism detected by mNGS was suspected to be the causative pathogen in 69% of adult and 43% of pediatric positive tests. Clinical impact was largely uncertain, and a negative impact was not identified in either group. The adult group had a positive impact in 33% of patients compared to 12% of pediatric patients. The most common positive impacts were confirmed and new diagnosis of which the most frequent suspected sites were cardiac and respiratory. Conclusion mNGS was used primarily in immunocompromised patients with suspected, indeterminant infections. This data suggests mNGS may assist in the identification of organisms causing deep-seated infections or infections caused by pathogens otherwise difficult to detect but remains non-contributory to management in a majority of cases. Disclosures All Authors: No reported disclosures

P-702. Epidemiology of Respiratory Pathogens and the Impact of Seasonality, Patient Demographics, and Diagnostic Testing Approach: A Retrospective Analysis from 2022 to 2023

Abstract Background Respiratory tract infections (RTIs) are a significant concern for public health due to their widespread transmission and high rates of illness and death reported globally. The use of multiplex molecular methods has allowed for the detection of a broad range of respiratory viruses and their subtypes, as well as some bacteria. This study investigates the epidemiology of respiratory pathogens detected in different demographic populations, emphasizing the importance of a flexible diagnostic testing approach to adapt to the complex dynamics of respiratory pathogens during the peak season. Distribution Rates of Respiratory Targets in Young, Adult, and Elderly Patients (n=1,520) Analysis of distribution rates of 19 respiratory targets during the respiratory season of 2022-2023, stratified by age. Methods During the 2022-23 respiratory disease season, the Diasorin LIAISON PLEX® Respiratory Flex Assay was used to prospectively test 1,520 patients across six clinical sites in the United States. As part of an observational study, retrospective analyses were conducted to compare the detection rates and frequencies of 19 respiratory targets (14 viral and 5 bacterial targets). The results were stratified by age. Results Many respiratory pathogens displayed age- and season-specific patterns. Enterovirus/rhinovirus was detected more frequently in patients &amp;lt; 21 years old (27%) than in the adult group (14%) and elderly group (9%), p&amp;lt; 0.01. Flu A prevalence was found to be higher in adults (21-65 y) at 25% and 33% in the elderly ( &amp;gt;65 y) population, p≤0.05. Individuals &amp;lt; 21 years had a lower incidence of SARS-CoV-2 (8%) compared to adults (35%) and the elderly (40%), p&amp;lt; 0.001. The most common viruses found in all three populations were flu A, human coronavirus, SARS-CoV-2, and flu A-H1, while the other pathogens were more population-specific. Conclusion The results of the study offer valuable insights into the complex dynamics of respiratory pathogens. They emphasize the importance of flexible multiplex PCR testing strategies that consider the different circulating patterns of these pathogens across different populations. This approach can help customize respiratory testing based on factors such as seasonality, patient demographics, and acceptable costs, and in line with diagnostic stewardship, adapt testing protocols to meet the specific needs of respiratory testing. Disclosures All Authors: No reported disclosures

P-2345. Recent Incidence Rate of Herpes Zoster Among Immunocompetent Adults Aged 18 and Older in the United States

Abstract Background There is a lack of current herpes zoster (HZ) incidence data among younger age groups of immunocompetent adults in the United States (US), with rigorous exclusion criteria for potential immunocompromising (IC) or chronic conditions. Here we assess not only incidence but also HZ severity across age groups.Table 1.US HZ IR/1000 PY by age groups in: overall population, selected chronic disease, and immunocompetent participants between January 1, 2017 to March 31, 2022 - IR: Incidence Rate. PY: Person Years at risk. CI: Confidence Interval. US: United States. - N=number of people at risk at corresponding age group (time-varying) during their follow up period. - n=number of people with HZ among N. Methods Our retrospective cohort study used 2015-2022 Merative MarketScan database to estimate age-specific incidence rate (IR) of HZ (ICD-10 code B02.xx and antiviral ± 7 days) among ≥18 years of age (YOA), continuously enrolled for 15 months, with no prior diagnosis of or vaccination against HZ: 1- overall; 2- with selected chronic disease [i.e., diabetes, asthma, COPD, CKD, depression, stress, and/or trauma] and no IC/Auto-immune disease (AID); 3- Immunocompetent [no IC/AID conditions/medications, no chronic conditions]. Index date was 1st day of 16th month of continuous enrollment. Individuals were assigned to ∼10 year age groups, reassessed annually. Censoring occurred at first HZ, first zoster vaccine, or loss of coverage. HZ post-herpetic neuralgia (PHN) %, HZ hospitalization % were calculated. Sensitivity analysis was conducted using only one diagnosis code.Table 2.Number (%) of HZ cases that developed PHN by age groups in: overall population, selected chronic disease, and immunocompetent participants - N=number of people with HZ in age group. - n=number of people from N who have PHN with at least 180 days of continuous enrollment following HZ. - %=n/N*100. - Note: Age is computed at HZ event date. Results 20,673,677 participants met inclusion criteria overall. 15.3% had ≥1 selected chronic disease, 57.2% were immunocompetent. Overall HZ IR increased with age: 1.16, 3.08, 3.99, and 5.65/1000 Person-Years (PY) in 18-29, 30-39, 40-49, and 50-59 YOA (Table 1). Chronic disease HZ IR was higher than immunocompetent, but HZ case # 18-49 YOA was higher in immunocompetent than chronic disease. Immunocompetent HZ IR also increased with age: 0.77, 1.99, 2.35, and 3.24/1000 PY in the same groups. PHN % (Table 2) increased with age whereas hospitalization % (Table 3) was similar across same groups; both % were higher for chronic disease and overall than for same immunocompetent age groups. In the sensitivity analysis the IRs increased ∼30% on average.Table 3.Number (%) of HZ-associated hospitalizations by age groups in: overall population, selected chronic disease, and immunocompetent participants - N=number of people with HZ in age group. - n=number of people from N who have HZ-associated hospitalization. - %=n/N*100. - Note: Age is computed at HZ event date. Conclusion HZ burden increases with age among US ≥18 YOA across all populations, with a large number of HZ cases in immunocompetent 30-49 YOA without clear HZ risk factors. Although the incidence is high ≥50 YOA, the results highlight the burden in non-IC/AID 18-49 YOA. Funding: GSK Disclosures Rachel A. Cohen, MPH, GSK: Employed|GSK: Stocks/Bonds (Private Company) Yves Brabant, MEng, GSK: Employed Driss Oraichi, PhD, GSK: I am a full time employee of GSK|GSK: Stocks/Bonds (Private Company) Agnes Mwakingwe-Omar, MD, PhD, GSK: Employed|GSK: Stocks/Bonds (Private Company) Bruno Anspach, M.Mol.Bio, GSK: Employed|GSK: Stocks/Bonds (Private Company) Desmond Curran, PhD, GSK: employee|GSK: Stocks/Bonds (Public Company) Mitra Yousefi, PhD, GSK: Employed by GSK between March 2018 and November 2023|Moderna: Employee at Moderna since December 2023 Huifeng Yun, MD, PhD, GSK: fulltime employee of GSK|GSK: Stocks/Bonds (Public Company)

Institutional, neighborhood, and life stressors on loneliness among older adults

BackgroundLoneliness is a public health epidemic in the United States (US), with older adults being vulnerable to experiencing loneliness. Predictors of loneliness are less understood among racial/ethnic groups of US older adults, and few studies have included perceived institutional discrimination (PID), stressful life events (SLE), and perceived neighborhood characteristics (PNC) as antecedent stressors of loneliness in diverse older adult samples. Our study assessed the relationship between these stressors and loneliness among specific racial/ethnic groups of older adults.MethodsWe used the Health and Retirement Study data (n = 9,904) to examine whether PID, SLE, and PNC were associated with loneliness. Loneliness was measured using the 11-item UCLA Loneliness Scale. PID included unfairly not hired for a job, unfairly prevented from moving into a neighborhood, and unfairly treated by the police. SLE included moving to a worse neighborhood/residence, being robbed or burglarized, and unemployed/looking for a job. PNC were measured as discohesion and disorder. Lagged multivariate linear regression models regressed loneliness (2014/2016 HRS waves) on PID, SLE and PNC (2010/2012 HRS waves) measured as cumulative totals and individual items. Models were stratified by Black (BOAs), Hispanic/Latinx (HOAs), and White (WOAs) older adults.ResultsCumulative totals of PID, SLE, and neighborhood discohesion were associated with loneliness among BOAs while only discohesion was associated with loneliness among HOAs. Cumulative totals for PID, SLE, and PNC were associated with loneliness among WOAs. Individual stressors predicting loneliness for BOAs were moving to a worse residence and being robbed/burglarized. For HOAs, being prevented from moving to a neighborhood was associated with greater loneliness while being robbed/burglarized was associated with less loneliness. Individual stressors predicting greater loneliness for WOAs were being unfairly not hired for a job, receiving unfair treatment during police encounters, and moving to a worse residence.ConclusionsOur study finds racial/ethnic variation in psychosocial stressors predicting loneliness four years later. Nevertheless, neighborhood discohesion was the most salient stressor and was associated with greater loneliness across all racial/ethnic groups. Future research and interventions should consider the differing stress appraisal processes across groups and to support the development of resources and policies to ameliorate loneliness among diverse older adults.

International and Historical Variation in the Age–Crime Curve

Our goals were to assess competing narratives within criminology about contextual variation in the age–crime curve (ACC)—most prominently, whether the ACC shows constancy or difference across societies and historically and whether the prevalence of adolescent lawbreaking is high, with a majority of teens committing crime, contributing to a steep peak followed by rapid, continuous descent among adjacent adult age groups. We analyzed historical and cross-national evidence from numerous sources that revealed significant variance in ACCs. Strongly at odds with invariance projections of an adolescent peak and rapid descent, the predominant age–crime patterns outside the United States were postadolescent peaks and spread-out age distributions. Teen prevalence was typically much lower than the projection that a majority of teens commit crime, whereas the prevalence of adult crime was often sizable and serious. We illustrate using understudied societies how a socio-cultural framework that draws on age-graded expectations, social control practices, age-structured crime opportunities and stressors, and resultant lifestyle differences across significant life stages (adolescence, young adulthood, midlife) can apply to understanding cross-national differences in the age–crime relationship. Methodological challenges and future areas of research are discussed.

P-711. Persistence of Immunogenicity and Safety of the Respiratory Syncytial Virus Prefusion F Protein Vaccine (RSVPreF3 OA) Administered to Adults 50–59 Years of Age (YOA)

Abstract Background The immune response induced by RSVPreF3 OA in adults 50–59 YOA, including adults with chronic conditions that increase the risk for RSV disease, was non-inferior in terms of RSV-A/-B neutralization titers compared to that in older adults (≥ 60 YOA) at 1 month (M) post-vaccination. Methods This was a phase 3, observer-blind, placebo-controlled multi-country study (NCT05590403). Adults 50–59 YOA at increased risk (AIR) for RSV disease due to specific chronic conditions and not at increased risk for RSV disease (non-AIR) 50–59 YOA adults were randomized (2:1) to receive 1 dose of RSVPreF3 OA (AIR-RSV, non-AIR-RSV) or placebo (AIR-placebo, non-AIR-placebo). A control group of adults ≥ 60 YOA received RSVPreF3 OA (RSV-OA). We assessed the immune response at 1M and 6M post-vaccination. Humoral immunity (HI) and cell-mediated immunity (CMI) were assessed in terms of RSV-A/-B neutralization titers and RSVPreF3-specific CD4+ T-cell frequencies. Safety up to study end (12M post-vaccination) was also assessed. Results 1533 participants received RSVPreF3 OA or placebo. In all RSV groups, RSV-A/-B neutralization titers (Figure 1) and RSVPreF3-specific CD4+ T-cell frequencies (Figure 2) increased substantially from pre-vaccination to 1M post-vaccination and remained above baseline levels at 6M (4.9–5.2-fold for RSV-A and 3.3–3.6-fold RSV-B neutralization titers). Within 6M post-vaccination, 3.9% (AIR-RSV), 0.8% (non-AIR-RSV), 2.1% (AIR-placebo, non-AIR-placebo) and 2.4% (RSV-OA) of participants reported serious adverse events (SAEs). Eight potential immune-mediated diseases (AIR-RSV: 4; AIR-placebo: 1; RSV-OA: 3) were reported within 6M post-vaccination. Of these, one case of cold type hemolytic anemia (RSV-OA, onset at day 53 post-vaccination, also SAE) was considered vaccine-related by the investigator. Five deaths (AIR-RSV: 4; AIR-placebo: 1), none considered vaccine-related, were reported up to study end (12M). Conclusion At 6M post-vaccination, HI and CMI remained above baseline both in RSVPreF3 OA-vaccinated adults 50–59 YOA with/without chronic conditions and in adults ≥60 YOA (RSV-OA). Up to 12M, the safety profile in adults 50–59 YOA was similar to the safety profile in those ≥ 60 YOA and was considered acceptable. Funding: GSK Disclosures Murdo Ferguson, MD, GSK: Study related payments for training and the conduct of the study as a study site Tino F. Schwarz, Prof. Dr. MD, AstraZeneca: Honoraria|Bavarian Nordic: Advisor/Consultant|Bavarian Nordic: Honoraria|Biogen: Honoraria|Biontech: Advisor/Consultant|Biontech: Honoraria|CSL Vifor: Honoraria|CSL-Seqirus: Advisor/Consultant|CSL-Seqirus: Honoraria|Diasorin: Honoraria|GSK: Advisor/Consultant|GSK: Honoraria|Janssen-Cilag: Honoraria|Merck-Serono: Honoraria|Moderna: Advisor/Consultant|Moderna: Honoraria|MSD: Honoraria|Novavax: Advisor/Consultant|Novavax: Honoraria|Pfiser: Honoraria|Roche: Honoraria|Sanofi-Aventis: Honoraria|Synlab: Honoraria|Takeda: Advisor/Consultant|Takeda: Honoraria Sebastián A. Núñez, Dr., GSK: Support for attending meetings and/or travel Juan Rodríguez García, MD, GSK: Advisor/Consultant|GSK: Grant/Research Support|GSK: Honoraria|Pfizer: Honoraria|Pfizer: Support for attending meetings and/or travel|Sanofi: Honoraria|Sanofi: Support for attending meetings and/or travel Carlos Zala, MD, GSK: Grant/Research Support|GSK: Support for attending meetings and/or travel (EACS 2023) Josef Grosskopf, MD, GSK: Advisor/Consultant|GSK: Expert Testimony|GSK: Grant/Research Support|GSK: Honoraria|GSK: Support for attending meetings and/or travel|Lilly: Grant/Research Support|New Amsterdam Pharma: Grant/Research Support|Novartis: Grant/Research Support|Pharmalog: Grant/Research Support|Syneos: Grant/Research Support|Winecker Pharma: Grant/Research Support Christine Voors-Pette, MD, QPS Netherlands B.V.: Ex-Employee of QPS Netherlands B.V. Hiwot Amare Hailemariam, MD, PhD, GSK: Salary as GSK employee with stock options|GSK: Stocks/Bonds (Public Company) Caroline Portaels, DVM, GSK: Salary as GSK employee with stock options|GSK: Stocks/Bonds (Public Company) Magali de Heusch, PhD, GSK: Salary as GSK employee with stock options|GSK: Stocks/Bonds (Public Company) Bruno Salaun, PhD, GSK: Salary as GSK employee with stock options|GSK: Stocks/Bonds (Public Company) Silvia Damaso, MSc, GSK: Salary as GSK employee with stock options|GSK: Stocks/Bonds (Public Company) Marie-Pierre David, Master in Statistics, GSK: As GSK employee, I’m part of a patent application|GSK: Salary as GSK employee with stock options|GSK: Stocks/Bonds (Public Company) Dominique Descamps, MD, GSK: Salary as GSK employee with stock options|GSK: Stocks/Bonds (Public Company) Judith Hill, Dr., GSK: Salary as GSK employee with stock options|GSK: Stocks/Bonds (Public Company) Corinne Vandermeulen, MD, PhD, GSK: Salary as GSK employee with stock options|GSK: Stocks/Bonds (Public Company) Veronica Hulstrøm, MD, PhD, GSK: Salary as GSK employee with stock options|GSK: Stocks/Bonds (Public Company)

P-1162. Colonization Rates and Antimicrobial Susceptibility of Mycoplasma hominis and Ureaplasma urealyticum in Adolescent Girls: Comparison with Young Adults

Abstract Background Sexually transmitted infection rates are increasing among adolescents and young adults and remain a serious health problem worldwide. Mycoplasma hominis and Ureaplasma species are sexually transmitted and considered etiologic agents causing various urogenital diseases. This study aimed to estimate the prevalence and antimicrobial susceptibility of M. hominis and U. urealyticum in adolescent girls and to compare them with young women. Methods We evaluated the results of M. hominis and U. urealyticum isolated from vaginal swab culture between January 2011 and August 2023. The data were selected from young women aged 12-26 and analyzed by dividing the two groups into adolescents (12-18 years) and young adults (19-26 years). Results Among 66 adolescent girls, 58 (87.9%) were positive for mycoplasma culture. Twenty-nine (43.9%) had both M. hominis and U. urealyticum. Compared with the young adult group, colonization rates of M. hominis (45.5% [30/66] vs. 21.7% [64/295], P=0.0002) and U. urealyticum (86.4% [57/66] vs. 79.4% [219/295], P=0.0373) were significantly higher in the adolescent group. As age increased, colonization rates of M. hominis (rho = -0.6703; 95% confidence interval [CI], -0.8840 to -0.2248) and U. urealyticum (rho = -0.5993; 95% CI, -0.8550 to -0.1091) tended to decrease. Macrolides (azithromycin, clarithromycin, and erythromycin) susceptibility rate of M. hominis was less than 10% in both groups. Of M. hominis isolates from adolescents, susceptibility rates to azithromycin, clarithromycin, and erythromycin were 0.0%, 6.7%, and 0.0%, respectively. Ninety percent and 76.7% of M. hominis isolates from adolescents were susceptible to doxycycline and tetracycline. Compared with the young adult group, the macrolides susceptibility rate of U. urealyticum was significantly lower in the adolescent group: azithromycin (36.8% vs. 53.4%, P=0.0368), clarithromycin (47.4% vs. 68.9%, P=0.0031), and erythromycin (38.6% vs. 54.3%, P=0.038). Susceptibility rates of U. urealyticum to doxycycline and tetracycline were 94.7% and 87.7% in the adolescent group. Conclusion Compared with young adults, higher rates of colonization and resistance to macrolides for both M. hominis and U. urealyticum were more frequently observed in adolescent girls. Disclosures All Authors: No reported disclosures

A cross sectional investigation of the development of rhythmic preferences with motor and perceptual tests

The preferred period hypothesis posits a slowing down of motor and perceptual rhythmic preferences with age, both reflecting an increase in the common internal oscillation period. This study further investigates the preferred period hypothesis by improving the measurement of perceptual rhythmic preferences through two tasks, tempo adjustment and tempo judgment, conducted in auditory and visual modalities. The study was conducted with three groups of children (5–6, 8–9, and 11–12 years old), and a group of young adults (21 to 30 years old) during the same time of the day. Correlational analyses show that the relationship between motor and perceptual rhythmic preferences strengthens between childhood and adulthood. Multilevel analyses reveal a general slowing down of motor and perceptual rhythmic preferences, contingent on the task and modality, with distinct trajectories for males and females. Our study indicate that the range of preferred rhythms narrows with age, becoming less variable in young adulthood, at the expense of a single and consistent, default rhythm. In brief, the preferred period appears only in young adults, with no support for the idea of a slowing down of an internal oscillation that would be reflected by both motor and perceptual rhythmic preferences.

Assessing sign language comprehension in adults with intellectual disability and deafness.

Language comprehension is an essential component of human development that is associated not only with expressive language development and knowledge acquisition, but also with social inclusion, mental health, and quality of life. For deaf and hard-of-hearing adults with intellectual disability, there is a paucity of measures of receptive sign language skills, although these are a prerequisite for individualized planning and evaluation of intervention. Assessments require materials and procedures that are accurate, feasible, and suitable for low levels of functioning. We adapted measures of English-language comprehension in young children-a direct assessment and a caregiver questionnaire-into Austrian Sign Language and to the target group of adults with intellectual disability and used them with a non-preselected sample of 67 deaf and hard-of-hearing adults with intellectual disability living in therapeutic communities specifically for deaf and hard-of-hearing people with multiple disabilities in Austria. Findings for both assessments demonstrate their construct validity, excellent internal consistency, and a large symmetrical distribution over the referential age range. Acceptance by the deaf and hard-of-hearing individuals and the caregivers and time-efficient administration suggest high practicability. We recommend further implementation in clinical practice, albeit with cautious interpretation of the results, and the inclusion of the instruments in research on intellectual disability and deafness.

Histopathological Study of the Lesions of Upper Gastrointestinal Tract Endoscopic Biopsy Specimen in Adult Age Group in a Tertiary Care Hospital

Histopathological Study of the Lesions of Upper Gastrointestinal Tract Endoscopic Biopsy Specimen in Adult Age Group in a Tertiary Care Hospital