Evaluation Of Candidates Research Articles

Frailty as a Prognostic Indicator in Lung Transplantation: A Comprehensive Analysis

Introduction: Frailty is a complex pathobiological process characterized by diminished physiological reserve and increased vulnerability to stressors, which has been associated with unfavorable outcomes before and after lung transplantation. Methods: We undertook an extensive narrative review, encompassing a thorough exploration of original papers, observational studies, case reports, and meta-analyses published between 1990 and July 2023, in various databases, including PubMed, Embase, Cochrane Library, Wiley Online Library databases, and Google Scholar. The search terms [frailty] AND [lung transplant] were utilized. Additionally, the reference lists of retrieved articles were examined. Inclusion criteria comprised studies written in English and involving human subjects. The identified studies were categorized into pre-transplant and post-transplant populations, and the measurement tools used to assess frailty were analyzed, along with the clinical implications reported in the studies. Results: From 1 January 1990 to 1 July 2023, a total of 10 studies on frailty and lung transplantation were identified through online sources and bibliographic searches, involving a total of 2759 patients. Among these studies, six focused on the pre-transplant population, while four examined the post-transplant population. The Fried Frailty Phenotype (FFP) and the Short Physical Performance Battery (SPPB) were the most employed tools for measuring frailty. A table presents additional frailty assessment instruments and the clinical implications described in the studies. Conclusions: Frailty is prevalent both in patients with end-stage respiratory diseases awaiting lung transplantation and in postoperative lung transplant recipients. Most transplant centers recognize the value of assessing frailty in the evaluation of potential candidates for lung transplantation. Frailty has been shown to impact mortality on the waitlist and in the post-transplant period. However, the most effective methods for measuring frailty in lung transplant candidates and recipients have yet to be determined. Strategies to reverse frailty are available and show promising results on outcomes.

Comparative evolution of influenza A virus H1 and H3 head and stalk domains across host species.

For decades, researchers have studied the rapid evolution of influenza A viruses for vaccine design and as a useful model system for the study of host/parasite evolution. By performing an exhaustive analysis of hemagglutinin protein (HA) sequences from 49 lineages independently evolving in birds, swine, canines, equines, and humans over the last century, our work uncovers surprising features of HA evolution. In particular, the canine H3 stalk, unlike human H3 and H1 stalk domains, is not evolving slowly, suggesting that evolution in the stalk domain is not universally constrained across all host species. Therefore, a broader multi-host perspective on HA evolution may be useful during the evaluation and design of stalk-targeted vaccine candidates.

Immunogenicity, Efficacy, and Safety of a Novel Synthetic Microparticle Pre-Erythrocytic Malaria Vaccine in Multiple Host Species.

We previously reported a protective antibody response in mice immunized with synthetic microparticle vaccines made using layer-by-layer fabrication (LbL-MP) and containing the conserved T1BT* epitopes from the P. falciparum circumsporozoite protein. To further optimize the vaccine candidate, a benchtop tangential flow filtration method (LbL-by-TFF) was developed and utilized to produce vaccine candidates that differed in the status of base layer crosslinking, inclusion of a TLR2 ligand in the antigenic peptide, and substitution of serine or alanine for an unpaired cysteine residue in the T* epitope. Studies in mice revealed consistent superiority of the Pam3Cys-modified candidates and a modest benefit of base layer crosslinking, as evidenced by higher and more persistent antibody titers (up to 18 months post-immunization), a qualitative improvement of T-cell responses toward a Th1 phenotype, and greater protection from live parasite challenges compared to the unmodified prototype candidate. Immunogenicity was also tested in a non-human primate model, the rhesus macaque. Base layer-crosslinked LbL-MP loaded with T1BT* peptide with or without covalently linked Pam3Cys elicited T1B-specific antibody responses and T1BT*-specific T-cell responses dominated by IFNγ secretion with lower levels of IL-5 secretion. The Pam3Cys-modified construct was more potent, generating antibody responses that neutralized wild-type P. falciparum in an in vitro hepatocyte invasion assay. IgG purified from individual macaques immunized with Pam3Cys.T1BT* LbL-MP protected naïve mice from challenges with transgenic P. berghei sporozoites that expressed the full-length PfCS protein, with 50-88% of passively immunized mice parasite-free for ≥15 days. Substitution of serine for an unpaired cysteine in the T* region of the T1BT* subunit did not adversely impact immune potency in the mouse while simplifying the manufacture of the antigenic peptide. In a Good Laboratory Practices compliant rabbit toxicology study, the base layer-crosslinked, Pam3Cys-modified, serine-substituted candidate was shown to be safe and immunogenic, eliciting parasite-neutralizing antibody responses and establishing the dose/route/regimen for a clinical evaluation of this novel synthetic microparticle pre-erythrocytic malaria vaccine candidate.

Assessing the Reliability of Creatinine-Estimated Glomerular Filtration Rate in Living Kidney Donor Candidates: Does it Measure up to the Measured Rate?

Abstract A living donor kidney transplant is the best therapy option for patients with end stage renal disease (ESRD); however, it is associated with an increased risk of ESRD development in the donor. Thorough evaluation of the donor candidate’s kidney function status is essential for the appropriate selection of candidates with minimal risk of post-donation kidney dysfunction. In this study, glomerular filtration rate (GFR) values measured by iohexol plasma clearance (mGFR) and estimated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi) creatinine equations (eGFR), with and without the race factor (2009 and 2021 CKD-Epi equations, respectively), were compared in a cohort of 303 kidney donor candidates. GFR values were analyzed using Bland-Altman plots, linear regression, Mann-Whitney U tests, and p10 and p30 values. Bland-Altman analysis revealed a lack of agreement between the 2009 and 2021 CKD-Epi eGFR and corresponding mGFR values, with both equations showing a negative bias of 10 – 11 mL/min/1.73m2 and indicating an underestimation of creatinine-eGFR. eGFR underestimation was confirmed by Mann-Whitney U analysis; median GFR values were significantly lower for both CKD-Epi equations as compared to corresponding iohexol-measured values (2009: 85.86; 2021: 87.29; mGFR: 96.58). Despite the overall underestimation, over 14% of donor candidates with eGFR >90 mL/min/1.73m2 had an mGFR value <90 mL/min/1.73m2. Conversely, 36% - 38% of donors with normal kidney function of >90 mL/min/1.73m2 as determined by iohexol-mGFR had corresponding eGFR values <90 mL/min/1.73m2. eGFR showed a significant but poor correlation with mGFR, with R2 values of 0.2775 and 0.2803, respectively. While the 2021 eGFR equation had better accuracy as compared to the 2009 equation (p30 of 81% versus 76%), it displayed low overall accuracy with a p10 of <43%. Separate analysis of Black donor candidates’ eGFR and mGFR values revealed similar trends as observed for the total cohort. While exclusion of the race factor in the 2021 CKD-Epi equation slightly improved accuracy (p30 of 77% versus 72%), the correlation with mGFR remained poor for both equations (R2: 0.1455 and 0.1377 for the 2009 and 2021 equations, respectively). The results of this study confirmed that creatinine-eGFR values, regardless of the race factor, differ significantly from iohexol-mGFR. Our data shows that even potential kidney donors with eGFR >90 mL/min/1.73m2 cannot be presumed to have normal kidney function, while eGFR <90 mL/min/1.73m2 cannot accurately exclude donor candidates. We conclude that creatinine-eGFR cannot reliably serve as a substitute for mGFR in the context of living donor kidney function evaluation.

Optimality Theory Paradigm in the Formation of Active Participles Arabic Quadrilateral Verbs

This article aims to investigate the implementation of the Optimality Theory (OT) paradigm in the formation of Active Participle (AP) in quadrilateral verbs in the Arabic language. This approach involves morphological and contrastive linguistic analyses to understand the patterns of PA formation from quadrilateral verbs, with a focus on the hierarchy of criteria and candidate evaluation based on OT principles. The research methodology includes an in-depth study of various forms of PA produced by quadrilateral verbs, identifying rules and preferences that lead to changes in the word forms. The research findings indicate that OT provides profound insights into the complexity of the morphology of quadrilateral verbs, illustrating consistent patterns of change as well as variations depending on grammatical and semantic contexts. The implications of these research findings significantly contribute to the understanding of Arabic linguistic structure, morphological theory, and contrastive analysis methods. By paving the way for further research, this article suggests that paradigm serves as an effective conceptual framework to explain morphological phenomena in the Arabic language, enriching Arabic linguistic literature and supporting the development of advanced morphological analysis methods. This study opens avenues for deeper exploration of linguistic intricacies, fostering academic insights into the Arabic language's structural nuances.

Evaluation of Outer Surface Protein Vaccine Candidates of Borrelia burgdorferi for Lyme Disease

Lyme disease affects several hundred thousand people worldwide annually, yet there is no registered vaccine for the disease available for human use. The disease is caused by Borrelia burgdorferi sensu lato complex bacteria, which harbor numerous outer surface proteins, and many of which have been targeted for vaccine development. However, to effectively combat various Borrelia species, the target protein should ideally be conserved and located in the chromosome. In this study, we evaluated the potential of seven conservative, chromosome-encoded outer surface proteins as vaccine candidates. Unfortunately, four of the initial candidates could not be produced in E. coli. The remaining BB0028, BB0158, and BB0689 proteins were administered to mice in both the free form and as conjugates with virus-like particles (VLPs). In most cases, high antibody titers were obtained, confirming the good immunogenicity of the selected proteins. However, for BB0158 and BB0689 proteins, adverse effects were observed following the injection of free proteins, which were not observed when they were coupled to VLPs. Bactericidity tests of the obtained antibodies suggested that none of the vaccine candidates could induce the production of bactericidal antibodies.

The 2022 Vaccines Against Shigella and Enterotoxigenic Escherichia coli (VASE) Conference: Summary of abstract-based presentations

The global nonprofit organization PATH hosted the third Vaccines Against Shigella and Enterotoxigenic Escherichia coli (VASE) Conference in Washington, DC, on November 29 to December 1, 2022. With a combination of plenary sessions and posters, keynote presentations, and breakout workshops, the 2022 VASE Conference featured key updates on research related to the development of vaccines against neglected diarrheal pathogens including Shigella, enterotoxigenic Escherichia coli (ETEC), Campylobacter, and Salmonella. The presentations and discussions highlighted the significant impact of these diarrheal pathogens, particularly on the health of infants and young children in low- and middle-income countries, reflecting the urgent need for the development and licensure of new enteric vaccines. Oral and poster presentations at the VASE Conference explored a range of topics, including: the global burden and clinical presentation of disease, epidemiology, and the impact of interventions; the assessment of the value of vaccines against enteric pathogens; preclinical evaluations of vaccine candidates and models of enteric diseases; vaccine candidates in clinical trials and human challenge models; host parameters and genomics that predict responses to infection and disease; the application of new omics technologies for characterization of emerging pathogens and host responses; novel adjuvants, vaccine delivery platforms, and immunization strategies; and strategies for combination/co-administered vaccines. The conference agenda also featured ten breakout workshop sessions on topics of importance to the enteric vaccine field, which are summarized separately. This article reviews key points and highlighted research presented in each of the plenary conference sessions and poster presentations at the 2022 VASE Conference.

Cardiac evaluation of the liver transplant candidate.

This review aims to summarize recent changes in the cardiac evaluation of adult liver transplant candidates. Over the last several years, there have been significant advances in the use of coronary computed tomography angiography (CCTA) with and without fractional flow reserve (FFR) and increasingly widespread availability of coronary calcium scoring for risk stratification for obstructive coronary artery disease. This has led to novel strategies for risk stratification in cirrhotic patients being considered for liver transplant and an updated American Heart Association (AHA) position paper on the evaluation of liver and kidney transplant candidates. The diagnosis of cirrhotic cardiomyopathy has been refined. These new diagnostic criteria require that specific echocardiographic parameters are evaluated in all patients. The definition of pulmonary hypertension on echocardiography has been altered and no longer utilizes right atrium (RA) pressure estimates based on inferior vena cava (IVC) size and collapse. This provides more volume neutral estimates of pulmonary pressure. Although CCTA has outstanding negative predictive value, false positive results are not uncommon and often lead to further testing. Revised diagnostic criteria for cirrhotic cardiomyopathy improve risk stratification for peri-operative volume overload and outcomes. Refined pulmonary hypertension criteria provide improved guidance for right heart catheterization (RHC) and referral to subspecialists. There are emerging data regarding the safety and efficacy of TAVR for severe aortic stenosis in cirrhotic patients. Increased utilization of noninvasive testing, including CCTA and/or coronary calcium scoring, can improve the negative predictive value of testing for obstructive coronary artery disease and potentially reduce reliance on coronary angiography. Application of the 2020 criteria for cirrhotic cardiomyopathy will improve systolic and diastolic function assessment and subsequent perioperative risk stratification. The use of global strain scores is emphasized, as it provides important information beyond ejection fraction and diastolic parameters. A standardized one-parameter echo cut-off for elevated pulmonary pressures simplifies both evaluation and follow-up. Innovative transcutaneous techniques for valvular stenosis and regurgitation offer new options for patients at prohibitive surgical risk.

Hospital Exposure Prior to Total Hip Arthroplasty: Are Perioperative Outcomes Impacted?

AbstractAs demand for total hip arthroplasty (THA) continues to grow, identifying risk factors for poor perioperative outcomes may help guide preoperative planning. Therefore, the aim of the present study was to determine the risk of adverse outcomes following THA after a preoperative health care event (PHE). This was a single-institution retrospective review of all patients who underwent primary THA from September 2011 to April 2022. Patients were stratified based on whether they had a PHE or not. PHEs were defined as an emergency department visit or hospital admission within 90 days of surgery. Binary logistic regression was fit for discharge disposition, 30- and 90-day readmission, and 1 year revision while controlling for all significant covariates. We identified a total of 11,598 patients' status post-THA, of whom 273 had a PHE. PHE patients were significantly more likely to require facility discharge (odds ratio [OR]: 2.490; p < 0.001) than those who did not have a PHE. Additionally, any PHE predisposed patients to significantly higher 30-day (OR: 1.992; p = 0.013) and 90-day (OR: 2.387; p < 0.001) readmission rates. Patients with two or more PHEs were at an even greater risk of facility discharge (OR: 3.679; p = 0.001), readmission within 30 days (OR: 4.204; p = 0.009), and readmission within 90 days (OR: 7.965; p < 0.001). Patients who undergo THA after having a PHE are at significantly higher risk of facility discharge and readmission. A temporary recovery period and evaluation of surgical candidacy following a PHE and prior to THA may lead to better postoperative outcomes. Level III Evidence Retrospective Cohort Study

Evaluating vaccine-elicited antibody activities against Neisseria gonorrhoeae: cross-protective responses elicited by the 4CMenB meningococcal vaccine.

The bacterial pathogen Neisseria gonorrhoeae is an urgent global health problem due to increasing numbers of infections, coupled with rampant antibiotic resistance. Vaccines against gonorrhea are being prioritized to combat drug-resistant N. gonorrhoeae. Meningococcal serogroup B vaccines such as four-component meningococcal B vaccine (4CMenB) are predicted by epidemiology studies to cross-protect individuals from natural infection with N. gonorrhoeae and elicit antibodies that cross-react with N. gonorrhoeae. Evaluation of vaccine candidates for gonorrhea requires a suite of assays for predicting efficacy in vitro and in animal models of infection, including the role of antibodies elicited by immunization. Here, we present the development and optimization of assays to evaluate antibody functionality after immunization of mice: antibody binding to intact N. gonorrhoeae, serum bactericidal activity, and opsonophagocytic killing activity using primary human neutrophils [polymorphonuclear leukocytes (PMNs)]. These assays were developed with purified antibodies against N. gonorrhoeae and used to evaluate serum from mice that were vaccinated with 4CMenB or given alum as a negative control. Results from these assays will help prioritize gonorrhea vaccine candidates for advanced preclinical to early clinical studies and will contribute to identifying correlates and mechanisms of immune protection against N. gonorrhoeae.

Feasibility and Acceptability of a Multiple Mini-interview Format for Evaluation of Small Animal Internal Medicine Residency and Internship Candidates.

The multiple mini-interview (MMI) format assesses candidates' performance in various competencies and is becoming commonplace in medical school and residency programs. This interview format compares to and surpasses the traditional interview in validity, reliability, feasibility, and acceptability. We developed a MMI to assess resident and specialty intern candidates for Small Animal Internal Medicine over a 3-year period. Our aims were to assess acceptability by obtaining impressions from interviewers and candidates of the MMI process and to evaluate feasibility by quantifying time required. In total, 61 resident candidates completed the survey, a response rate of 70% of total interviewees. Respondents reported the MMI as more stressful (82%, 95% CI: 70%, 91%) and less enjoyable (62%, 95% CI: 49%, 74%). While 54% (95% CI: 41%, 67%) of respondents preferred a traditional interview process, 70% (95% CI: 57%, 81%) perceived that the MMI was fairer and 51% (95% CI: 38%, 64%) felt it allowed them to better demonstrate their strengths. Most (63%, 95% CI: 49%, 75%) reported that their experience with the MMI would lead them to rank the program more highly. Interviewers preferred the MMI process due to improved perceived fairness and time efficiency. MMI required less total time, 29.5 hours versus 112 hours for the traditional interview over 3-years (p = .002) and lower per applicant time investment (.34 hours/applicant vs. 1.2 hours/applicant, p = .0001). In conclusion, the MMI process was acceptable to interviewees, preferred by interviewers, and was feasible in terms of time savings compared to traditional interviews.

Synthesis, molecular docking, analgesic, anti-inflammatory, and ulcerogenic evaluation of thiophene-pyrazole candidates as COX, 5-LOX, and TNF-α inhibitors.

The thiophene bearing pyrazole derivatives (7a-j) were synthesized and examined for their in vitro cyclooxygenase, 5-lipoxygenase, and tumour inducing factor-α inhibitory activities followed by the in vivo analgesic, anti-inflammatory, and ulcerogenic evaluations. The synthesized series (7a-j) were characterized using 1H NMR, 13C NMR, FT-IR, and mass spectral analysis. Initially, the compounds (7a-j) were evaluated for their in vitro cyclooxygenase, 5-lipoxygenase, and tumour inducing factor-α inhibitory activities and the compound (7f) with two phenyl substituents in the pyrazole ring and chloro substituent in the thiophene ring and the compound (7g) with two phenyl substituents in the pyrazole ring and bromo substituent in the thiophene ring were observed as potent compounds among the series. The compounds (7f and 7g) with effective in vitro potentials were further analyzed for analgesic, anti-inflammatory, and ulcerogenic evaluations. Also, to ascertain the binding affinities of compounds (7a-j), docking assessments were carried out and the ligand (7f) with the highest binding affinity was docked to know the interactions of the ligand with amino acids of target proteins.

The dark side of the mood. Candidate evaluation, voter perceptions, and the driving role of (dark) personality traits

Voter perceptions of leadership traits impact overall candidate evaluations. Less is however known about the impact of candidates’ personality traits, and especially the “darker” ones (narcissism, Machiavellianism, psychopathy), above and beyond the structuring role of partisan attitudes. We present a multi-method approach combining an experimental design and a post-electoral survey on the 2020 US Presidential election. Survey data (study 1) shows that perceived personality affects candidate evaluation beyond partisanship. Experimental evidence (study 2) confirms a causal relationship between candidate personality and subsequent evaluation: exposure to a negatively (positively) framed candidate personality reduces (increases) candidate likeability. Moreover, exposure to candidates scoring higher on the dark traits is more impactful than exposure to candidates scoring lower on those same traits. Across both studies, the results highlight the relevance of dark triad personality traits for candidate favorability, and the existence of asymmetric effects for politicians scoring higher vs. lower on dark traits.

Pre-Treatment Pulmonary Assessment Have Limited Utility in B-Cell Lymphoma Patients Treated with Autologous Anti-CD19 CAR T-Cell Therapy

Introduction Pulmonary function tests (PFT) play a pivotal role in hematopoietic cell transplantation (HCT), with routine evaluation in HCT candidates. However, their predictive value in chimeric antigen receptor T-cell (CAR-T) therapy outcomes remains uncertain. To address this gap, we conducted a retrospective analysis of PFT metrics and pulmonary comorbidity definitions, following the Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI), in B-cell lymphoma patients treated with autologous CD19-CAR-T cell therapy. Patients and Methods In this retrospective analysis, we included adult patients (age ≥ 18 years) with B-cell lymphoma who received treatment at a tertiary medical center with commercially available or point-of-care (POC) anti-CD19 CAR T-cell therapy (Kedmi et al., Transplant Cell Ther. 2022) as their 3rd line of treatment or above, between 2017 and 2022. Patients underwent routine PFT assessment before CAR-T cell therapy, as part of institutional practice, including spirometry, body plethysmography, and single-breath diffusing capacity for carbon monoxide (DLCO). Patients were categorized into three pre-treatment pulmonary comorbidity groups (normal, moderate, severe) based on HCT-CI definitions for forced expiratory volume in 1 second (FEV1) and DLCO expressed as precent of predicted value (>80%, 66-80%, <66%, respectively). Results A total of 192 patients (median age, 60 [range 46-69]) were included. Aggressive B-cell lymphoma was the predominant diagnosis (n=166, 86%) followed by indolent B-cell lymphoma (n=18, 9.4%), and Mantle cell lymphoma (n=8, 4.2%). Most patients had a good performance status (KPS ≥ 90, 78%), although with high-risk disease features (pre-lymphodepletion LDH was elevated in 108 [56%]). Seventy-eight (41%) patients received bridging therapy. POC CAR-T were used in 56%, while 44% received commercial CAR-T (26% axi-cel, 18% tisa-cel). Pre-CAR-T smoking history was documented in 25% of patients. The median pre-treatment measured-to-predicted DLCO and FEV1 were 96% and 92%, respectively. Seventy-four percent of patients had normal DLCO, and 77% had a normal FEV1. The calculated normal, moderate, and severe pulmonary comorbidity levels, per the HCT-CI, were 64%, 23%, and 13%, respectively. With a median follow-up of 17.6 months (IQR 8.5-29.7), the median overall survival (OS) was not reached, and the median progression-free survival (PFS) was 7.6 months. There was no correlation between pulmonary comorbidity level and the best overall response rate. Categorical PFT results (FEV1 and DLCO) and pulmonary comorbidity (per-HCT-CI) were not associated with reduced OS (p=0.3, p=0.4, p=0.6, respectively) or reduced PFS (p=0.058, p>0.9, p=0.2, respectively) in a univariable Cox regression analysis. However, FEV1 as continuous measure and FEV1 categorized into 2 levels (normal vs. moderate-severe) were associated with reduced PFS ( Figure 1). FEV1 (as a continuous metric) association with PFS remained consistent (HR 0.99 [95% CI 0.98-1], p=0.007) in a multivariable Cox regression adjusted for pre CAR T KPS score, elevated LDH level, and co-stimulatory CAR-T domain. Nevertheless, this association is minor, with unclear clinical significance. No association was observed between pulmonary function measures and immune-toxicities, including cytokine release syndrome grade >2 or immune effector cell-associated neurotoxicity grade > 2. Conclusions To the best of our knowledge, this is the first study evaluating the relationship between PFTs and the outcomes of CAR T-cell treatment. Our results indicate that among standard measures of pulmonary assessment, only FEV1 was predictive of poor PFS, though with minor association, with unclear clinical significance. We did not observe any association with overall survival. These findings suggest that pre-CAR-T pulmonary assessment may have limited utility in evaluating CAR-T candidates. Nevertheless, further validation in a multicenter setting is required.

Effect of the “Naked neck” gene (Na) on the growth of indigenous chicken fed with suboptimal feed rations in Cameroon

The effect of the naked neck gene (Na) was assessed on growth parameters of the native chicken fed with two suboptimal rations (R1 and R2), and one optimal ration (R3) from 6 to 16 weeks of age. A total of 270 hens of 3 genetic types (homozygous (NaNa) naked neck, heterozygous (Nana) and normal type (nana) chicken) for three different feed rations including two sub-optimal rations (R1, R2) and one optimal ration (R3). Hence, 30 pullets per experimental unit for each genetic type receiving the same ration were used. The animals were subjected to the same experimental conditions except for the tested factor. The starter ration was served during the first six weeks then relayed by the experimental rations. A two-way ANOVA was used to test the main effects and interactions whereas the animal model was used for the estimates of the genotype and feed ration on the growth and related traits. Irrespective of the genotype, the highest growth parameter (p<0.05) was obtained with R3 with the lowest feed efficiency from 12 to 16 weeks. The mortality rate (MR) ranged from 3 to 9% cumulated at 6 and 8 weeks of age. The overdominance effect was confirmed for both the bodyweight (BW) and MR. The Na gene improved the weight gain from +1 to + 14 g from 10 to 16 weeks with optimal feed conditions against -6.67 to +4.33g with suboptimal feed. The more beneficial effect on FCR has been observed in homozygote NaNa with +1.07 to +1.27g and -0.43 to -1.63g for R3 and R1 respectively. This study confirms the importance of the Na gene as a good candidate to improve the growth rate and feed efficiency of native chickens. It also provides an effective protocol for the evaluation of major gene candidates for selection in low input production systems.

16 Relative Contributions of Motor and Non-Motor Symptoms to Caregiver Burden in Parkinson’s Disease Patients Being Evaluated for Deep Brain Stimulation

Objective:Parkinson’s disease (PD) is a neurodegenerative disorder affecting over 10 million people worldwide. PD is characterized by both motor (e.g., tremor, rigidity, and bradykinesia) and non-motor (including cognitive impairment and neuropsychiatric symptoms such as apathy, disinhibition, executive dysfunction) symptoms. Caregiver burden is prevalent in those providing care for patients with PD and can result in negative health complications. Past work shows associations between motor symptoms, cognitive impairment, neuropsychiatric symptoms, and caregiver burden in PD. However, their relative contributions are poorly understood. This study examined these relationships, hypothesizing that while motor symptoms, cognitive impairment, and neuropsychiatric symptoms would all affect caregiver burden, neuropsychiatric symptoms would predict burden above and beyond the contribution of the other factorsParticipants and Methods:Participants were 42 people living with PD who were assessed at a hospital-based tertiary movement disorders specialty clinic for deep brain stimulation (DBS) candidacy evaluation with their caregiver. Motor exam was assessed by a PD specialist using the Unified Parkinson’s Disease Rating Scale (UPDRS). The Mini Mental State Examination (MMSE) assessed global cognition. Frontal Systems Behavior Scale (FrSBe) Family Form captured caregiver ratings of neuropsychiatric symptoms under 3 subscales: apathy, disinhibition, and executive dysfunction. The Multidimensional Caregiver Strain Index (MCSI) captured caregiver burden. Linear regression analyses examined relationships between caregiver burden (MCSI) and motor symptoms (UPDRS), cognitive impairment (MMSE), and neuropsychiatric symptoms (FrSBe).Results:Using linear regression analyses, cognitive impairment (R2=0.08, F(1,41)=4.42, p=0.04) and neuropsychiatric symptoms (R2=0.35, F(1, 41)=21.0, p<0.01) predicted caregiver burden but motor symptoms did not (R2=0.03, F(1,41)=1.30, p=0.26). Hierarchical linear regression revealed that neuropsychiatric symptoms predicted caregiver burden above and beyond the contribution of cognitive impairment (AR2=0.28, AF(1)=12.7, p=0.001), accounting for an additional 28% of the variance in caregiver burden. Follow-up linear regression to examine the relationships between caregiver burden and the FrSBe subscales indicated that apathy (p<0.001), versus disinhibition (p=0.16) and dysexecutive behaviors (p=0.80), was the driver of the significant relationship.Conclusions:Consistent with our hypothesis, results revealed that cognitive impairment and neuropsychiatric symptoms (specifically apathy) were independent predictors of caregiver burden, with neuropsychiatric symptoms predicting caregiver burden above and beyond the contribution of cognitive impairment. Somewhat surprisingly, motor symptoms were not a predictor of caregiver burden contrary to some previous research, though findings are mixed. Results highlight the importance of assessing for neuropsychiatric symptoms in PD, which may be overlooked by care providers relative to motor or cognitive symptoms, but which appear stressful to caregivers. Future directions include reexamining results in a larger more heterogenous sample including people living with PD at different disease stages (i.e., everyone in the present sample had severe enough symptoms to be considering DBS). Cognitive measures of executive functioning (which are more specific to PD than measures of global cognition) should also be included in future works. Development of supportive caregiver interventions specifically targeting apathy in PD may be useful. Longitudinal designs would be helpful to reexamine relationships following DBS surgery, as there are some reports of increased neuropsychiatric symptoms following the procedure.

Developing A Fair Hiring Algorithm Using LLMs

In this project, our primary objective is to revolutionize hiring practices by harnessing the potential of advanced technologies, specifically Large Language Models (LLMs). We strive to develop an impartial and comprehensive hiring algorithm that addresses biases and advocates for diversity, ultimately fostering a more equitable workforce and enhancing overall organizational outcomes. The methodology encompasses two crucial phases: data collection involving diverse candidate resumes and unbiased job descriptions, followed by leveraging LLMs and LangChain for pre-training and fine-tuning using carefully curated unbiased training data. Custom prompts are carefully designed to guide the algorithm's decision-making process during candidate evaluation. The algorithm's fairness was evaluated through bias detection, equal opportunity assessment, and adverse impact analysis, ensuring equitable outcomes, establishing the foundation for a fair hiring algorithm and promoting inclusivity in recruitment. Keywords - LLM, LangChain, Python, Agent, Chains.

63 A Literature Review of Cortical Mapping, fMRI, and Standards of Care in Pediatric Epilepsy Surgical Workup

Objective:Epilepsy includes recurrent, unprovoked seizures and affects 470,000 children in the US, of which 7% have drug-resistant epilepsy due to failing two or more antiseizure medication trials. For some patients with drug-resistant epilepsy, surgery has been successful in reducing seizure burden. Functional MRI (fMRI) and intracranial mapping of neurocognitive functions, especially language, are increasingly done to assess potential functional loss from epilepsy surgery. However, these procedures vary by medical institute. The purpose of this review was to examine published literature on fMRI and intracranial mapping procedures for pediatric epilepsy surgery workup toward development of a standardized protocol that can be used across institutes as a guide to standard-of-care best practices for predicting loss of function associated with epilepsy surgery.Participants and Methods:Our literature review includes information from 8 electronic databases for peer-reviewed, English language studies of evaluation for pediatric epilepsy surgery candidacy. Thirty-one studies were selected based on inclusion criteria. Only studies including fMRI and intracranial mapping conducted with pediatric patients being worked up for epilepsy surgery were selected.Results:Our review revealed that the most common task used in fMRI and intracranial mapping procedures is visual-object naming, but type of naming tasks and the way they are administered varies widely across medical institutes and includes published measures and those created on site. Variability makes examining findings across studies and designing best practice for these procedures challenging.Conclusions:Creating gold-standard procedures for fMRI and intracranial mapping administration for epilepsy surgery evaluations is critical in optimizing treatment and functional outcomes for our pediatric patients. Our review is an initial step in this process.

RESUME SUMMARIZER AND JOB DESCRIPTION MATCHER USING NATURAL LANGUAGE PROCESSING AND SPACY

In the HR recruitment process, one pivotal stage is "Summarizing & Screening." At this juncture, recruiters grapple with the laborious task of manually sifting through a myriad of resumes to shortlist suitable candidates. This project aims to streamline and automate this process using two innovative tools. Firstly, the "Resume Summarizer" leverages advanced natural language processing techniques to swiftly extract pertinent details from candidates' resumes, offering a concise summary that underscores their skills, experience, and qualifications. This summary can be tailored to match specific job requirements, facilitating recruiters in the comparative evaluation of multiple candidates. Secondly, the "Job Description Matcher" assists recruiters in expeditiously and accurately aligning job descriptions with candidate resumes. By employing natural language processing, this tool identifies keywords and phrases that align with the job opening's prerequisites, generating a compatibility score to rank resumes according to their alignment with the job description. This innovation greatly expedites candidate selection and enhances recruiters' efficiency. Importantly, this project employs a unique approach, incorporating regular expressions to extract essential information from resumes, setting it apart from existing NLP-based models and systems. Keywords: Natural Language Processing, Text Analysis, Data Extraction, Keyword matching, Regular Expressions, Optical Character Recognition (OCR), N-Gram Model, Name Entity Recognition (NER), Unsupervised NER.

70 Uncovering Comorbid Neuropsychological Disorders in Children with Unilateral Hearing Loss Under Consideration for Cochlear Implantation

Objective:Children with unilateral hearing loss (UHL) have difficulty hearing in noisy environments and localizing sounds, impacting learning and social opportunities across contexts. Using a visible device like a cochlear implant (CI) may improve functioning but can also create psychological risk. Audiological measures alone are insufficient for predicting social, emotional, educational, adaptive, and quality-of-life post-operative outcomes, which are highly variable in this population and can also be impacted by a secondary diagnosis. Extending beyond audition to consider the “whole child” through neuropsychological evaluation may produce a sharper picture of potential outcomes, with or without surgical/audiological intervention. Given recent FDA approval for CI in children with UHL, more are receiving this elective surgery despite difficulties predicting who will experience significant benefit. Here we describe neuropsychological profiles of children with UHL who underwent CI candidacy evaluation at a tertiary pediatric hospital.Participants and Methods:During pre-operative clinical care, CI candidates completed targeted neuropsychological evaluation to identify patient- and family-level factors that could impact CI use and outcomes from surgery. Cognitive, language, attention/executive, visuoperceptual/visuomotor, academic, adaptive, and emotional/behavioral functioning were assessed. Evaluations integrated history, observations, caregiver report forms, and performance-based test data.Results:18 individuals were evaluated (age 7-months to 16-years). Most had left-sided UHL (67%) and were male (61%). Known hearing loss etiologies were congenital cytomegalovirus (n=5), enlarged vestibular aqueduct (n=1), traumatic brain injury (n=1), meningitis (n=1), cholesteatoma (n=1), neurofibromatosis type 1 (n=1), and Waardenburg syndrome (n=1). Indices of general cognitive ability were generally low average to average. Patterns of cognitive impairment were not restricted to language-based tasks (e.g., Beery VMI-6 range 56-109, M=89.42, SD=16.27). Standardized parent ratings of everyday executive functioning, social/emotional/behavioral functioning, and adaptive skills were collected. Eight (44%) had a behavioral health diagnosis: Attention Deficit Hyperactivity Disorder (n=2), Global Developmental Delay (n=2), Unspecified Neurodevelopmental Disorder (n=2), Autism Spectrum Disorder (n=1), and Depression (n=1). Thirteen (72%) received or will receive a CI, of whom 38% had a behavioral health diagnosis. Average Area Deprivation Index (a marker of socio-economic status) was lower for individuals who ultimately received CIs (M=18%tile) compared to those who did not (M=25%tile).Conclusions:There may be increased rates of neurodevelopmental/psychological conditions among children with UHL, especially when the etiology involves the central nervous system. Albeit preliminary, results align with findings from bilateral hearing loss samples. Findings highlight the importance of routine neuropsychological screening in children with UHL and close interdisciplinary collaboration for optimal outcomes. Socio-economic disparities among those who do and do not receive CI need further exploration as those who did not receive CIs tended to be from less resourced neighborhoods. Additional research is warranted to understand the full range of risk and protective factors for children with UHL and how these relate to outcomes for those who opt for cochlear implantation.