Changes In Ratings Research Articles

Spinal manipulation and electrical dry needling as an adjunct to conventional physical therapy in patients with lumbar spinal stenosis: a multi-center randomized clinical trial

BACKGROUND CONTEXTNonoperative management of lumbar spinal stenosis (LSS) includes activity modification, medication, injections, and physical therapy. Conventional physical therapy includes a multimodal approach of exercise, manual therapy, and electro-thermal modalities. There is a paucity of evidence supporting the use of spinal manipulation and dry needling as an adjunct to conventional physical therapy in patients with LSS. PURPOSEThis study aimed to determine the effects of adding thrust spinal manipulation and electrical dry needling to conventional physical therapy in patients with LSS. STUDY DESIGN/SETTINGRandomized, single-blinded, multi-center, parallel-group clinical trial. PATIENT SAMPLEOne hundred twenty-eight (n=128) patients with LSS from 12 outpatient clinics in 8 states were recruited over a 34-month period. OUTCOME MEASURESThe primary outcomes included the Numeric Pain Rating Scale (NPRS) and the Oswestry Disability Index (ODI). Secondary outcomes included the Roland Morris Disability Index (RMDI), Global Rating of Change (GROC), and medication intake. Follow-up assessments were taken at 2 weeks, 6 weeks, and 3 months. METHODSPatients were randomized to receive either spinal manipulation, electrical dry needling, and conventional physical therapy (MEDNCPT group, n=65) or conventional physical therapy alone (CPT group, n=63). RESULTSAt 3 months, the MEDNCPT group experienced greater reductions in overall low back, buttock, and leg pain (NPRS: F=5.658; p=.002) and related-disability (ODI: F=9.921; p<.001; RMDI: F=7.263; p<.001) compared to the CPT group. Effect sizes were small at 2 and 6 weeks, and medium at 3 months for the NPRS, ODI, and RMDI. At 3 months, significantly (p=.003) more patients in the MEDNCPT group reported a successful outcome (GROC≥+5) than the CPT group. CONCLUSIONPatients with LSS who received electrical dry needling and spinal manipulation in addition to impairment-based exercise, manual therapy and electro-thermal modalities experienced greater improvements in low back, buttock and leg pain and related-disability than those receiving exercise, manual therapy, and electro-thermal modalities alone at 3 months, but not at the 2 or 6 week follow-up.

An EDucation and eXercise intervention for gluteal tendinopathy in an Irish setting: a protocol for a feasibility randomised clinical trial (LEAP-Ireland RCT)

Background Gluteal tendinopathy (GT) is a degenerative tendon condition characterised by pain over the greater trochanter of the hip. A randomised controlled trial (RCT) in Australia found that 14 sessions of EDucation on load management plus eXercise (EDX) delivered over 8 weeks resulted in greater improvements in global rating of change and pain outcomes at 8 and 52 weeks, compared with corticosteroid injection or ‘wait and see’. Typically, 5-6 physiotherapy sessions are provided in public and private physiotherapy settings in Ireland, therefore, the aim of this study is to examine the feasibility of conducting an RCT to investigate effectiveness of 6 sessions of the EDX programme compared to usual care. Methods We will randomly allocate 64 participants with GT to physiotherapist-administered EDX or usual care. The EDX intervention (EDX-Ireland) will be delivered in 6 sessions over 8 weeks. To determine feasibility of an RCT, we will assess recruitment and retention and outcome measure completion. The health status outcomes to be assessed at baseline, 8 weeks and 3 months include: Global Rating of Change, pain severity, the Victorian Institute of Sport Assessment-Gluteal Questionnaire (VISA-G), the Patient-Specific Functional Scale, the Pain Catastrophizing Scale, Patient Health Questionnaire (PHQ), Pain Self-Efficacy Questionnaire, the EQ-5D-5L, the Central Sensitisation Inventory and hip abductor muscle strength. We will explore acceptability of the EDX-Ireland intervention from the perspective of patients and treatment providers, and the perspective of referrers to the trial. A Study Within A Trial will be also applied to compare recording of exercise adherence using app-based technology to paper-based diary. Discussion There is a need to establish effective treatments for GT that potentially can be implemented into existing health systems. The findings of this feasibility trial will inform development of a future definitive RCT. Registration The trial is registered prospectively on ClinicalTrials.gov (NCT05516563, 27/10/2022).

Interpreting the Significance of Changes in Health-Related Quality-of-Life Scores.

To determine the significance to patients of changes in health-related quality-of-life (HLQ) scores assessed by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30). A subjective significance questionnaire (SSQ), which asks patients about perceived changes in physical, emotional, and social functioning and in global quality of life (global QL) and the QLQ-C30 were completed by patients who received chemotherapy for either breast cancer or small-cell lung cancer (SCLC). In the SSQ, patients rated their perception of change since the last time they completed the QLQ-C30 using a 7-category scale that ranged from "much worse" through "no change" to "much better." For each category of change in the SSQ, the corresponding differences were calculated in QLQ-C30 mean scores and effect sizes were determined. For patients who indicated "no change" in the SSQ, the mean change in scores in the corresponding QLQ-C30 domains was not significantly different from 0. For patients who indicated "a little" change either for better or for worse, the mean change in scores was about 5 to 10; for "moderate" change, about 10 to 20; and for "very much" change, greater than 20. Effect sizes increased in concordance with increasing changes in SSQ ratings and QLQ-C30 scores. The significance of changes in QLQ-C30 scores can be interpreted in terms of small, moderate, or large changes in quality of life as reported by patients in the SSQ. The magnitude of these changes also can be used to calculate the sample sizes required to detect a specified change in clinical trials.

Credit rating downgrades and systemic risk

We examine whether changes in issuer credit ratings by the three main providers are associated with changes in systemic risk. First, we find that rating downgrades result in an increase in bank systemic risk, whereas upgrades do not proportionally reduce systemic risk. Second, we document that the positive relationship between rating downgrades and systemic risk can be mitigated by accounting-based stability factors, such as profitability and capital, but also enhanced by sovereign rating downgrades. Finally, we show that sovereign rating downgrades have a greater effect on bound banks’ systemic risk compared to non-bound banks.

Validity of the Anchor in Estimating the Smallest Subjectively Experienced Difference: Presenting an Anchor-Item Before vs After the Outcome Measure

In some fields of research, psychologists are interested in effect sizes that are large enough to make a difference to people’s subjective experience. Recently, an anchor-based method using a global rating of change was proposed as a way to quantify the smallest subjectively experienced difference—the smallest numerical difference in the outcome measure that, on average, corresponds to reported changes in people’s subjective experience. According to the method, the construct of interest is measured on two occasions (Time 1 and Time 2). At Time 2, people also use an anchor-item to report how much they experienced a change in the construct. Participants are then categorized as those who stayed the same, those who changed a lot, and those who changed a little. The average change score for those who changed a little is the estimate of the smallest subjectively experienced difference. In the present study, I examined two aspects of the method’s validity. First, I tested whether presenting the anchor-item before or after the Time 2 outcome measure influences the results. The results suggest that any potential influence of the anchor-position, assuming there is an influence, is likely to be small. Second, I examined the anchor-item’s validity correlations when the delay between Time 1 and 2 is one day to also see if the pattern is similar to past research where the delay was two and five days. The observed pattern of validity correlations was very similar. I note directions for future research.

Changes in guests’ hotel evaluations due to covid-19: The case of the world heritage city of Cuenca

Purpose - The COVID-19 pandemic has had an unprecedented impact on the tourism sector changing the guest satisfaction during hotel stays. In this paper, we analyse how this perception has changed considering various pandemic stages. Methodology - Using 1595 reviews for hotels in Cuenca left on the Booking platform, we analyse the changes in the ratings of the stay and identify the factors that have the greatest influence on customer satisfaction and dissatisfaction by conducting a ANOVA analysis. We also consider the urban/rural area, type of traveler, nationality, gender and room type. Findings - he main results show an improvement in guest ratings after the worst moments of the pandemic, albeit with lower scores than in 2019 and 2020, indicating that the services offered by the hotel are key elements for customer satisfaction. Therefore, hotel managers should continue on the path taken, as it seems to be producing results, and try to enhance the services offered to guests. Originality - The outbreak of the COVID -19 pandemic necessitates a detailed analysis of the changes in hotel ratings and hotel characteristics evaluated positively and negatively by guests. However, a review of the literature reveals a gap in this regard, especially when considering different points in time during the pandemic.

Sex‐specific plasma markers of cholesterol‐metabolism and plant sterols predict cognitive decline in older people – a ten years follow‐up study

AbstractBackgroundMultiple studies in clinical settings show that there is a link between a dysregulation of cholesterol metabolism and neurodegenerative pathologies and dementia. Diet‐based plant sterols may also interfere with neurodegeneration and cognitive decline through cholesterol‐lowering properties. In this study, we investigate whether circulating levels of cholesterol, its precursors, and metabolites, as well as triglycerides, and phytosterols predict cognitive decline ten years later in the general population. As a secondary objective we address the role of sex and the APOE genotype on these relationships.MethodWe considered 206 individuals aged 65 and older from a population‐based prospective study from Lausanne, Switzerland. A comprehensive cognitive assessment was performed at baseline and after ten years. We quantified the plasma levels of cholesterol, high‐density lipoprotein (HDL‐) cholesterol, triglyceride, cholesterol precursors (lathosterol, lanosterol, desmosterol, dihydrolanosterol), cholesterol derivatives (cholestanol), oxysterols (24S‐hydroxycholesterol [24S‐OHC], 7α‐hydroxycholesterol, 27‐hydroxycholesterol), and phytosterols (campesterol, campestanol, stigmasterol, sitosterol, sitostanol and brassicasterol) at baseline and after five years. Regression analysis (considering several possible confounder including APOE‐genotype) determined the relationship between baseline sterol levels, and their changes between baseline and five‐year follow‐up, with measures of cognitive decline (i.e. changes in Clinical Dementia Rating (CDR), Mini‐Mental State Exam and CDR Sum of Boxes) at ten years. Analyses were performed in the whole cohort, and in males and females independently.ResultHigher levels of baseline HDL‐cholesterol and lanosterol were associated with cognitive decline after ten years in the whole cohort. Decrease over time of 24S‐OHC was also associated with cognitive decline. In males, several cholesterol‐related sterols (cholestanol, lathosterol, lanosterol, 7α‐hydroxy‐cholesterol) and the phytosterol sitosterol were associated with cognitive decline. In females, only cholesterol and campestanol were associated with cognitive decline. The APOE genotype did not affect these associations.ConclusionIn this cohort of older people from the general population, plasma markers of cholesterol synthesis and metabolism and as well as phytosterols are associated with cognitive decline after ten years. These findings have potential relevance for sex‐specific risk assessment and prevention of cognitive decline in older people.

The association between change and stability in subjective health ratings and dementia risk: a multi‐cohort study in Swedish and Danish twins

AbstractBackgroundPoorer self‐rated health (SRH) is associated with increased dementia risk (Stephan et al., 2021). However, it is unclear whether genetic and/or environmental variance accounts for this risk. Although SRH declines with age (Finkel et al. 2020), it is unknown whether rates of change in SRH are independently associated with dementia outcomes. Using a validated latent dementia index (LDI) (Beam et al., 2022), we tested whether stability and change components of SRH predicted LDI via genetic and environmental pathways in two international cohorts of twins.MethodOur data consisted of two samples of monozygotic (MZ) and dizygotic (DZ) twins. We used data from the Swedish Adoption Twin Study of Aging (SATSA; Ntwins = 548, Npairs = 339) and the Longitudinal Study of Aging Danish Twins (LSADT; Ntwins = 3238, Npairs = 2561). Bivariate Cholesky decompositions and three‐level growth‐curve models with predictive intercepts and slopes were used for our cross‐sectional and longitudinal analyses respectively. All models were estimated in Mplus (Muthen &amp; Muthen, 2017) using maximum likelihood with robust standard errors.ResultsCross‐sectional model results indicate that those with poorer SRH have lower LDI scores (b = ‐0.01, p = .008), even after adjusting for shared genetic covariance, age, sex, education, and depressive symptoms. Predictive growth models indicate that rates of change in SRH are negatively associated with LDI after adjusting for age, sex, education, and depressive symptoms (b = ‐0.17, p = .032). The degree of genetic confounding in the association between rates of change and LDI was inconclusive.ConclusionOur study provides novel insights into the relationship between individual ratings of health and dementia risk. SRH predicted dementia likelihood after controlling for genetic confounding, opening up the possibility that subjective ratings of health account for unique variance in dementia risk. Additionally, changes in SRH also predicted dementia likelihood beyond their mean score. Taken together these results highlight the importance of subjective health measures in understanding dementia risk.

Tau accumulation within the default mode network as a predictor of longitudinal clinical decline in atypical Alzheimer’s disease

AbstractBackgroundIdentifying individuals with symptomatic Alzheimer’s disease (AD) at greater risk of steeper cognitive decline would allow professionals and loved‐ones to make better‐informed medical, support, and life‐planning decisions. In typical AD, the magnitude of cerebral tau accumulation in vivo predicts clinical deterioration. Despite its promise, the utility of tau PET in predicting cognitive decline in individuals with atypical clinical presentations of AD remains unclear. We examined the relationship between baseline tau PET signal and the rate of subsequent clinical decline across atypical AD syndromes.MethodFifty‐seven A/T/N‐positive patients (mean age = 64.13 ± 7.72; 24M/33F) with atypical syndromes of AD (19 Posterior Cortical Atrophy, 16 logopenic variant of Primary Progressive Aphasia, 16 dysexecutive AD, five early‐onset AD with single‐domain impairment, and one Corticobasal Syndrome) and 24 amyloid‐negative control participants were included in this study. All participants underwent 18F‐Flortaucipir (FTP) PET, amyloid PET, and structural MRI scans at baseline. The rate of clinical decline was quantified as the annualized change in Clinical Dementia Rating Sum‐of‐Boxes scores (CDR‐SB) at baseline and follow‐up visits (mean time interval = 1.24 ± 0.34 years). General linear model analyses were performed to examine the pattern of baseline cortical tau deposition in atypical AD patients and its relationship with the rate of clinical decline.ResultCompared with amyloid‐negative controls, atypical AD patients showed prominent FTP uptake in posterior cortical regions at baseline, including bilateral posterior cingulate cortex/precuneus and lateral temporo‐parietal cortices, which canonically constitute the posterior default mode network (DMN). A brain‐behavior regression analysis revealed widespread regions within the DMN where the magnitude of baseline FTP uptake predicted the rate of change in CDR‐SB, with anterior DMN regions (medial prefrontal and anterior temporal cortices) most strongly predicting clinical decline.ConclusionGreater baseline tau accumulation in the anterior DMN, possibly suggesting more extensive tau spread in this network, predicts faster clinical decline in atypical AD. This may serve as an imaging biomarker to guide prognostication for patients with atypical AD and their families and to inform the design of clinical trials, including potentially recruiting multiple clinical phenotypes of AD into a single trial.

Effect of masker selection schemes on the perceived affective quality of soundscapes: A pilot study

The perceived quality of a given soundscape may be improved by adding "pleasant" sounds via a speaker or electroacoustic system to the existing soundscape as maskers. Ideally, the choice of sounds should be automated to minimize the time and labor required to maintain such a system. Hence, we investigate the effect of several automated masker selection schemes on improving the ISO Pleasantness of urban soundscapes in a controlled laboratory environment. An ambisonic recording and 360-degree video of a location exposed to traffic noise was made and reproduced via a stacked planar speaker array and virtual reality headset. Simultaneously, maskers from a fixed candidate pool were overlaid on the reproduced soundscape in one of the following methods: random selection across the entire pool, fixed selection based on results in the literature, random selection across a restricted pool based on model-agnostic analysis of a pre-existing dataset, and random selection across a restricted pool based on a deep neural network trained on a pre-existing dataset. We also investigated a control condition with no added maskers, and evaluated the results based on changes in ISO Pleasantness ratings given by participants to the soundscape under each masker selection scheme, relative to the control condition.

The effect of tax credit reporting on the efficiency of enterprise labor investment

This paper uses the data of A-share listed enterprises in Shanghai and Shenzhen from 2010 to 2022 as samples for empirical analysis. The empirical research finds that tax credit reporting has A significant positive impact on the labor investment efficiency of enterprises, and this impact is achieved by reducing the internal and external financing constraints of enterprises. In addition, the heterogeneity test results show that the labor investment efficiency of private enterprises is more likely to be affected by the change of corporate tax credit rating.

Context changes judgments of liking and predictability for melodies.

Predictability plays an important role in the experience of musical pleasure. By leveraging expectations, music induces pleasure through tension and surprise. However, musical predictions draw on both prior knowledge and immediate context. Similarly, musical pleasure, which has been shown to depend on predictability, may also vary relative to the individual and context. Although research has demonstrated the influence of both long-term knowledge and stimulus features in influencing expectations, it is unclear how perceptions of a melody are influenced by comparisons to other music pieces heard in the same context. To examine the effects of context we compared how listeners' judgments of two distinct sets of stimuli differed when they were presented alone or in combination. Stimuli were excerpts from a repertoire of Western music and a set of experimenter created melodies. Separate groups of participants rated liking and predictability for each set of stimuli alone and in combination. We found that when heard together, the Repertoire stimuli were more liked and rated as less predictable than if they were heard alone, with the opposite pattern being observed for the Experimental stimuli. This effect was driven by a change in ratings between the Alone and Combined conditions for each stimulus set. These findings demonstrate a context-based shift of predictability ratings and derived pleasure, suggesting that judgments stem not only from the physical properties of the stimulus, but also vary relative to other options available in the immediate context.

Finding our Voice: Evaluation of Goal Setting Using the Habits of Preceptors Rubric in Terms of Focus, "SMARTness," and Impact.

Effective leadership propels teams from effectiveness to greatness and is accomplished when everyone achieves and contributes their full potential, or "voice." The Clinician Educators Program Teaching and Learning Curriculum fosters preceptor development using the Habits of Preceptors Rubric (HOP-R) to guide participants in finding their precepting "voice." After the HOP-R self-assessment, participants select a habit of focus (HOF) and craft a SMART (specific/measurable/achievable/relevant/time-bound) goal. This report describes a pilot rubric, SMART-EP (emotional intelligence(EI)/professionalism), exploring goal "SMARTness" alongside change (impact) in participants' perceived precepting capabilities. HOP-R self-ratings (2018-2020) and HOF/SMART goals (2019-2020) were retrospectively reviewed by two raters. Perceived preceptor capabilities were measured by analyzing the change in self-assessed habit level ratings between the first/fourth-quarter surveys. SMART goals were categorized by HOF and inclusion of SMART-EP components. Participants were guided in the inclusion of SMART, but not -EP, components. In aggregate, 120 participants completed HOP-R surveys (2018-2020). Within-subject changes across all 11 habits were significant (P < .001). For the SMART-EP rubric analysis (2019-2020), 71 participants had an average "SMARTness" score of 3.92 (of 5) with corresponding interrater reliability of 0.91. Goals included 2.77 (of 4) EI traits and 1.72 (of 3) professionalism components. The SMART-EP rubric provided insights into preceptor development opportunities among participants. Beyond SMART components, participants often included elements of EI and professionalism. Ratings confirm and support the consistency of the HOP-R as a tool to assess precepting habits.

Protocol for a pragmatic trial testing a self-directed lifestyle program targeting weight loss among patients with obstructive sleep apnea (POWER Trial)

BackgroundObesity comprises the single greatest reversible risk factor for obstructive sleep apnea (OSA). Despite the potential of lifestyle-based weight loss services to improve OSA severity and symptoms, these programs have limited reach. POWER is a pragmatic trial of a remote self-directed weight loss care among patients with OSA. MethodsPOWER randomizes 696 patients with obesity (BMI 30–45 kg/m2) and recent diagnosis or re-confirmation of OSA 1:1 to either a self-directed weight loss intervention or usual care. POWER tests whether such an intervention improves co-primary outcomes of weight and sleep-related quality of life at 12 months. Secondary outcomes include sleep symptoms, global ratings of change, and cardiovascular risk scores. Finally, consistent with a hybrid type 1 approach, the trial embeds an implementation process evaluation. We will use quantitative and qualitative methods including budget impact analyses and qualitative interviews to assess barriers to implementation. ConclusionsThe results of POWER will inform population health approaches to the delivery of weight loss care. A remote self-directed program has the potential to be disseminated widely with limited health system resources and likely low-cost.

ESG 평가등급 변동이 기업의 재무적 성과에 미치는 영향: 광고선전비 조절효과를 중심으로

ESG 평가등급 변동이 기업의 재무적 성과에 미치는 영향: 광고선전비 조절효과를 중심으로

Reliability and Validity of Kansas City Cardiomyopathy Questionnaire in Arabic Patients with Chronic Heart Failure.

Background: The Kansas City Cardiomyopathy Questionnaire (KCCQ) is the most specific and widely used questionnaire for assessing health-related quality of life (HRQoL) in chronic heart failure (CHF). This study aimed to examine reliability and validity of the KCCQ in Arabic patients with CHF. Material and Methods: Patients with CHF filled out the Arabic versions of the Minnesota Living with Heart Failure (MLHF) and KCCQ questionnaire, and performed a six-minute walk test (6MWT) on their first visit. On the return, the patients filled out the KCCQ along with the global rating of change (GRC) scale. Internal consistency, test-retest reliability, and construct validity were examined. Results: A total of 101 Arabic patients with CHF, with a mean (SD) age of 55 (11) years old, completed the study. The Cronbach's alpha was 0.97, and the ICC2,1 = 0.95 (95%CI: 0.92 to 0.97, p < 0.001). The Arabic version of KCCQ was correlated with the MLHF (r = -0.57, p = 0.01) and with the 6MWT (r = 0.70, p < 0.001). Conclusions: The Arabic version of KCCQ is a reliable and valid measure of HRQoL, which could be utilized in routine clinical practice for Arabic-speaking patients with CHF.

Flattening the curve: COVID-19 induced a decrease in arousal for positive and an increase in arousal for negative words

AbstractIn this study, we compared affective ratings of emotional valence and arousal for 882 Serbian words at three points in time: before the onset of the COVID-19 pandemic (2018), during the COVID-19 lockdown (2020), and after the government measures were abandoned (2022). We did not observe a significant change in average valence or arousal ratings across time points. A more detailed look into the data revealed the change in arousal that was different across the valence values. An increase in their linear correlations and a decrease in the nonlinearity of the GAMM smooth demonstrated that, upon the onset of the COVID-19 pandemic, emotionally negative words elicited higher arousal ratings, whereas emotionally positive words elicited lower arousal ratings. It revealed that our participants became more sensitive to the negative content and less sensitive to the positive content. Our results add to the findings, which showed that the relationship between emotional valence and arousal is a function of contextual factors, which primarily influence the arousal of words.

The Polysomnographical Meaning of Changed Sleep Quality-A Study of Treatment with Reduced Time in Bed.

Reports of poor sleep are widespread, but their link with objective sleep (polysomnography-PSG) is weak in cross-sectional studies. In contrast, the purpose of this study was to investigate the association between changes in subjective and objective sleep variables using data from a study of the reduction in time in bed (TIB). One sleep recording was carried out at baseline and one at treatment week 5 (end of treatment) (N = 34). The Karolinska Sleep Quality Index improved and was correlated with improvement in sleep efficiency (r = 0.41, p < 0.05) and reduction in TIB (r = -0.47, p < 0.01) and sleep latency (r = 0.36, p < 0.05). The restorative sleep index showed similar results. Improvements in the insomnia severity index (ISI) essentially lacked correlations with changes in the PSG variables. It was suggested that the latter may be due to the ISI representing a week of subjective sleep experience, of which a single PSG night may not be representative. It was concluded that changes in the subjective ratings of sleep are relatively well associated with changes in the PSG-based sleep continuity variables when both describe the same sleep.

FRI301 Prolactin And Obesity: Analysis Off Weight Oscillation In The Follow-up Of Macroprolactinomas

Abstract Disclosure: M.C. Oliveira: None. D. Paixão Côrtes Aguiar: None. E.R. Corso: None. C.G. Rech: None. J.F. Lima: None. Introduction: Prolactin can be a modulator of body composition and weight and has been associated with obesity. However, the data, especially regarding weight behavior when normalizing hyperprolactinemia, are controversial. Methods: We retrospectively reviewed our data on a large sample of patients with treated macroprolactinomas, with or without normalization of PRL levels. Results: The sample consisted of 73 patients, 35 F, 38 M, and 15 to 86 years. In 42 cases (57.5%), the MRI showed suprasellar extension of the tumor, and in 37 (50.6%) some sort of invasion. In the presentation, the patients' weight varied between 49 and 156 kg, and the BMI (n=69) was between 18 and 52. Obesity was present in 39 patients (56.5%) and overweight in 19 (27.5%). Obesity was classified as class 1 in 19 cases (48.7% of obese patients), class 2 in 7 (17.9%), and class 3 in 13 cases (33.3%). The occurrence of obesity showed no significant difference between gender (p= 0,627) or the presence of suprasellar tumor extension. Of the patients with invasion (38/68), 92% were obese or overweight, with a significant association between both (p= 0,05). The obesity/overweight did not show an association (p= 0.716) with hypopituitarism or with specific deficiencies: GH, ACTH, and TSH, all with p= 1,000, and hypogonadism, p= 0,649. There was no correlation between initial weight and PRL levels (r= -0.033; p= 0.783). The follow-up ranged from 6 and 202 months. All patients used, at some point, bromocriptine or cabergoline. In 51 cases (69.9%) the PRL normalized. Of those who did not normalize, 19 had a reduction in the PRL level superior to 50%, in 14 cases in a percentage greater than 90%. There was a correlation between the initial weight and the percentage reduction in PRL at the last visit: higher initial weights correlated with smaller reductions in PRL (r= -0.470; p= 0.042). The last weight (n 64) was 89 ± 23,8 kg and the last BMI was 31,4 ± 6,9. In 36 cases (56.3%) the weight decreased: 18 of them with significant loss (reduction &amp;gt;5% of initial weight). Another 27 patients (42.2%) had weight gain: 18 of them with significant gain (&amp;gt;5% of the initial). In 12 patients, there was a class change in weight rating, 5 cases for a better classification and 7 for a worse. Significant weight loss was not associated with PRL normalization, p= 0.149. Conclusion: The prevalence of obesity and overweight in patients with macroprolactinomas far exceeds that found in the general population. In one-third of the cases, obesity is class 3. A meaningful association between obesity and tumor invasion was observed. There was no correlation between initial weight and PRL levels, and significant weight loss was also not associated with PRL normalization. Presentation: Friday, June 16, 2023

Field evaluation of organic and synthetic insecticides against the hala scale, Thysanococcus pandani (Hemiptera: Halimococcidae), on Maui, Hawaii.

The hala scale, Thysanococcus pandani Stickney, is an invasive insect that infests hala trees, Pandanus tectorius, and has recently arrived in the Hawaiian Islands of Maui, Oahu, and Molokai. Hala scale is native to Thailand, Indonesia, and Singapore and was accidentally introduced to Maui, with its first detection in Hana in 1995. The hala tree is a frequently planted ornamental plant throughout Hawaii's urban landscape and is also a native tree found in coastal areas of ecological suitability throughout the state. These trees are integral to native Hawaiian weaving traditions, as the leaves were used to make items such as sails, hats, or mats. The spread of T. pandani threatens the continuation of these practices, as the plant material may not be sufficient for weaving. Hala trees infested with T. pandani can have negative effects such as deformation, discoloration, and early tree death. Experimental field trials were set up to evaluate the efficacy of organic and chemical insecticides as potential treatments to mitigate the damage of T. pandani infestations. This was done on the Island of Maui, where T. pandani is widespread. These trees were artificially inoculated with T. pandani and evaluated throughout the trials for changes in plant height, canopy width, scale removal, and visual infestation ratings. The results of 2 repeated field trials indicated that flupyradifurone and buprofezin were effective treatments in the reduction of the hala scale infestation and improving visual aspects related to plant health.