Chi-square Test Of Independence Research Articles

Trends in socio-demographic characteristics and substance use among high school learners in a selected district in Limpopo Province, South Africa.

Substance use is an escalating public health problem in South Africa resulting in risky behaviours and poor educational attainment among adolescents. There is a huge battle to overcome substance use among learners as more drugs become easily available with the mean age of drug experimentation reported to be at 12 years of age. It is important to continuously understand the trends in substance use in order to assess if there are positive changes and provide evidence for the development of context-specific effective interventions. This paper outlines the prevalence of substance use among selected high schools in a district in Limpopo province. To determine the prevalence of substance use among selected high school learners in a district in Limpopo Province, a cross-sectional school survey of 768 learners was conducted. Data was analysed using SPSS v 26. Descriptive analysis was used to describe the independent and dependent variables and Chi-Square test was used to investigate associations between demographic characteristics and substance use among high school learners. The most abused substances by learners were alcohol (49%), cigarettes (20.8%) and marijuana (dagga/cannabis) (16.8%). In a lifetime, there was a significant difference (P < 0.05) in cigarette smoking with gender, school, and grade; with more use in males (14.2%) than females (7.6%); in urban schools (14.6) than peri-urban (6.7%) and more in Grade 12 (6.4%). There was a significant difference (P < 0.05) in alcohol use with more use in Grade 10 (12.6%) and varied use among male and female learners but cumulatively more alcohol use in females (27.7%). Drug use varied, with an overall high drug use in urban schools (20.7%). Substance use is rife among high school learners in the district and health promotion initiatives need to be tailored within the context of socio-demographic characteristics of learners including the multiple levels of influence such as peer pressure, poverty, unemployment and child headed families. Additional research is required to investigate the factors leading to a notable gradual increase in use among female learners and into the environmental and family settings of learners in influencing substance use.

Motivation and Job Satisfaction of Part-Time Instructors at ISPSC

This study was conducted to assess the perceived level of job satisfaction of Part time Instructors in Ilocos Sur Polytechnic State College concerning their motivation level. The research identified the profile of the respondents concerning their age, sex, civil status, salary, educational attainment, length of service and number of trainings and seminars attended. This study aimed to evaluate motivation in terms of physiological needs, safety and security needs, social needs, self-esteem needs, self-actualization needs, work itself, advancement and job satisfaction in terms of salary and benefits, job opportunities, work recognition, working condition and supervision and among part- instructors in Ilocos Sur Polytechnic State College. The study used descriptive and correlation research design. It involved the one hundred fifty-four (154) Part-time Instructors of the six campuses of Ilocos Sur Polytechnic State College This study used survey-questionnaire composed of three parts to gather the data needed. The first part of the questionnaire includes the profile of the Part-time Instructors of ISPSC which served as the respondents. The second part of the questionnaire consists of the level of motivation and the third part is about the Job satisfaction of the respondents. The questionnaire was collected for tabulation. Mean, standard deviation, pearson correlation coefficient, chi-square test for independence, one way annova were used to analyze the data. Based on the findings of the study, the following conclusions were drawn: Demographic factors such as age, sex, civil status, length of service, salary and education level varies, thus, do not significantly influence their motivation and job satisfaction. Secondly, while Part-time Instructors exhibit high motivation in areas like social connections and career advancement opportunities, their motivation in physiological and safety needs is moderate. Thirdly, they express satisfaction with job opportunities and recognition but show lesser satisfaction with salary and benefits, suggesting room for improvement in compensation packages. Moreover, the study emphasizes the strong link between motivation and job satisfaction, highlighting how motivated part-time faculty tend to be more engaged and resilient. Overall, the consistently high levels of motivation and job satisfaction across ISPSC campuses reflect a positive organizational climate and effective management practices, with potential for further enhancement through fostering an inclusive and supportive work environment. The recommendations presented to the college cover a range of aspects to enhance Part-Time Instructors' experience at ISPSC. First, it is suggested that salary increases or modifications be made, maybe based on merit, in order to address particular issues raised by employees. Transparency and clear communication about such modifications should be prioritized. Second, it's critical to emphasize open and honest communication on the causes of any delays in salary, benefits, and perks. Clarity regarding compensation guidelines and career progression prospects should also be provided. Thirdly, it's important to keep work schedules flexible to meet the needs of part-time instructors in terms of both their personal and professional obligations. In order to improve teaching abilities and career advancement, it is also stressed how crucial it is for part-time faculty members to participate in organized professional development programs that include workshops and advice from seasoned faculty members. Finally, the need to continuously address motivation and job satisfaction among part-time faculty is emphasized, suggesting a focus on both addressing concerns and highlighting positive aspects of the work environment to cultivate a supportive and satisfying workplace culture.

#1770 Clinical characteristics and outcomes in patients with ANCA-associated vasculitis (AAV) and kidney involvement—a Swedish single-center cohort

Abstract Background and Aims Poor patient outcomes in ANCA-associated vasculitis (AAV) with kidney involvement is attributed to multiple factors such as delay in diagnosis, inadequate efficacy of treatments and long-term complications due to the disease as well as the toxic effects of immunosuppressive therapy. The aim of the present study was to evaluate the clinical characteristics of a Swedish cohort of patients with AAV (granulomatosis with polyangiitis; GPA and microscopic polyangiitis; MPA) and kidney involvement to study causes of death and predictors of all-cause mortality. Method This retrospective single-centre cohort study included 93 patients from the Uppsala region in mid-Sweden, diagnosed with AAV and kidney involvement between 1993 and 2023. Clinical and laboratory variables were obtained from review of electronic medical records as well as patient follow-up visits. Differences between groups were assessed using independent t-test and Chi-square test. Multivariable logistic regression analyses were performed to evaluate the influence of risk factors of interest on all-cause mortality. Results 93 patients, 71 (76%) were clinically diagnosed with MPA, and 22 (24%) with GPA. The median age at diagnosis was 66.5 ± 13 years. eGFR at diagnosis was 29 ± 23.5 ml/min/1.73 m2 and 15% of patients were dialysis-dependent AAV at diagnosis. Patients with MPA and GPA received comparable induction therapy except for PLEX which was significantly more frequent in patients with GPA (52% vs 26% respectively, p = 0.041). 56 (60%) of patients died during follow up and survival time was 7.1 ± 6.9 years. Baseline clinical and biochemical characteristics are shown in Table 1. A multivariate logistic regression showed that older age at diagnosis (OR 95% CI 1.012-1.110; p = 0.013) and being dialysis-dependent at diagnosis (OR 95% CI 1.343-16.079; p = 0.015) significantly predicted all-cause mortality (Table 2). Causes of death are presented in Fig. 1. Infections was the most common cause of death (30%). Conclusion Long-term prognosis and patient survival were significantly associated with age and dialysis-dependency at diagnosis in this cohort of patients diagnosed with AAV and kidney involvement. Infections was the most common cause of death.

#671 Perinatal factors, age of onset, early glycaemic control, sex and the development of microvascular complications in type 1 diabetes after 30 years

Abstract Background and Aims Long-term glycaemic control and duration of disease are both well-established risk factors for the development of complications in type 1 diabetes (T1D). The effect of perinatal factors, age at onset of T1D and early glycaemic control on development of diabetic complications have not been fully evaluated. The aim of this study was to investigate the long-term impact of such factors in childhood-onset type 1 diabetes. Method 90 subjects diagnosed with T1D between the ages of 0-14 years were included in this prospective observational cohort study in in a geographically defined area in northern Sweden. Baseline data for these subjects have previously been reported by Svensson M et al (Diabetes Care 2004). Outcome and follow-up data was obtained during approximately 30 years of follow-up from the Swedish National Diabetes Registry (NDR). Differences between groups were assessed using independent t-test and Chi-square test. Kaplan-Meier survival curves were used to illustrate time-to-diabetic nephropathy (DN) by sex and age at onset. Multivariable logistic regression analyses were performed to evaluate the influence of risk factors of interest on the development of DN, assessed as any degree of albuminuria without signs of other underlying conditions. Results Forty-one subjects (46%) developed any degree of DN during the follow-up period of mean 33 (range 19-40) years after T1D onset. Moreover, 80 subjects (89%) had any degree of retinopathy (RP) and among those, 18 (20%) had proliferative diabetic retinopathy (PDR), and 13 (4%) had both PDR and DN. Mean HbA1c during the first five and ten years after diagnosis was higher in subjects who developed DN or PDR compared to those who did not develop these complications; DN 58 ± 16 vs 51 ± 13 (p = 0.038) and 63 ± 16 vs 55 ± 11 mmol/mol (p = 0.007), respectively; PDR 60 ± 13 vs 53 ± 15 (p = 0.059) and 67 ± 10 vs 56 ± 14 mmol/mol (p = 0.002), respectively. Women had an increased risk of PDR compared to men (28% vs 11%, p = 0.045) and a near-significantly higher risk of DN (55% vs 36%, p = 0.087) (Table 1). Time to DN by sex and by age at onset are shown in Figure 1A and B. Women seemed to have a somewhat lower risk in the early years, but in the later years the risk was increased. A young age at onset of diabetes prolonged the time to development of DN but after twenty years of diabetes duration, no difference was seen. In a multivariate regression analysis, older age of gestation was negatively associated with (OR 95% CI 0.894-0.989, p = 0.017) and hyperglycaemia (higher HbA1c) during the first five years (OR 95% CI 1.004-1.078, p = 0.028) were positively and independently associated with development of DN (Fig. 1C). Conclusion Interestingly, longer gestational time at birth and, more well-known, poor early glycaemic control were associated with development of DN after 30 years of diabetes duration. However, there was no impact of age of onset or sex on the long-term risk for DN.

Gender and Mentorship in Military Medicine: A Survey Study.

Mentorship is essential for professional development and advancement within the military. In civilian medicine, the intersection between gender and mentorship holds important implications for research opportunities, academic success, and career progression. However, the intersection of gender and mentorship has not yet been explored within the field of military medicine. The purpose of this study, therefore, was to investigate the role of gender in mentorship within the field of military medicine. We investigated gender and mentorship within military medicine by developing and distributing a 16-item Likert survey to active-duty military physicians. We used the Chi-squared test of independence and the independent samples t-test to examine the role of gender in mentorship among the 16 questions. The male respondents reported more same-gender mentors than females (male [M]: 61.9% vs. female [F]: 33.0%), whereas the female respondents had significantly more mentors of the opposite gender than males (M: 12.4% vs. F: 47.3%). A higher proportion of males indicated no preference compared to females. Conversely, a significant preference for a same-sex mentor was expressed by female respondents compared to male respondents (M: 5.2% vs. F: 30.1%). In contrast, female respondents considered having a mentor more important than their male counterparts (t(206) = -2.26, P = .012, F: 3.86 vs. M: 3.57). Both male and female respondents had significantly more female mentees ($\chi _{\left( 1 \right)}^2$ = 12.92, P < .001, Cramer's V = 0.254). While the female participants in our study preferred female mentors, the male participants had more same-gender mentors than the female participants. In addition, more females reported that they did not have the time to be mentored. Our results, therefore, suggest that training males to be better mentors to females and providing accessible mentorship training to females may promote equitable career development within military medicine.

Gender bias in movie posters through the lens of Spatial Agency Bias

Research has shown that women are perceived as having less agency than men. Numerous studies have found portrayals of gender inequality in different aspects of media, including movie posters. However, no study has examined movie posters to assess portrayals of agency between genders. This study attempts to fill the literature gap by examining the top 250 grossing movie posters of all time in the US through the lens of Spatial Agency Bias to determine if there are differences in portrayed agency based on one’s gender in movie posters. The two levels of the independent variable – gender – are female and male, and the two levels of the dependent variable – spatial positioning – are left and right. A chi-squared test of independence was utilized to determine whether there were statistically significant levels of gender stereotyping in movie posters with regard to agency. The study found that women are portrayed in positions of less agency compared to men on movie posters. The implications of this study are gender inequality in various contexts through the unfavorable stereotyping of women relative to men in their perceived levels of agency. Although the causes of this discrepancy were outside the scope of this study, potential causes, implications, solutions, and future directions are discussed.

Exploring the Multi-Sensory Coupling Relationship of Open Space on a Winter Campus

Exploring the combined effects of multisensory interactions in open spaces can help improve the comfort of campus environments. Nine typical spaces on a university campus in Fuzhou were selected for this study. Subjects perceived the environment and then completed an on-site subjective questionnaire. At the same time, meteorological data (global radiation, air temperature, globe temperature, wind speed, relative humidity, and illumination intensity) were measured to determine the interactions between visual and acoustic and thermal perceptions. Differences in the meteorological parameters between the measuring points were described using a one-way ANOVA and Tukey’s post hoc test, and a chi-square test of independence was used to determine significant associations between thermal, acoustic, and visual comfort, which in turn led to the study of interactions between visual, acoustic, and thermal comfort using a two-way ANOVA. The following conclusions were drawn: (1) the Thermal Comfort Vote (TCV) increased with the increasing Acoustic Comfort Vote (ACV) at all levels of thermal stress. (2) The highest and lowest Acoustic Sensation Vote (ASV) values for each sound type were derived from either “slightly cold” or “warm” conditions. Both the Thermal Comfort Vote (TCV) and the Acoustic Comfort Vote (ACV) were positively correlated. (3) When “neutral”, the Thermal Sensation Vote (TSV) increased with increasing illumination intensity (LUX). (4) The Sunlight Sensation Vote (SSV) increased with the increasing Universal Thermal Climate Index (UTCI) when illumination intensity (LUX) was moderate and bright. (5) The highest and lowest Acoustic Sensation Vote (ASV) values for each sound type came from either “slightly cold” or “warm” conditions.

Exploring Emotional Intelligence and Workplace Environment Among Women Employees

This study explores the relationship between emotional intelligence (EI) and the workplace environment among female employees. The research investigates emotional intelligence levels and their impact on workplace relationships. The study employs a cross-sectional survey design to collect data from female employees, focusing on self-awareness, self-regulation, motivation, empathy, and social skills. A sample of 99 women employees participated in the survey. Data analysis includes descriptive analysis, reliability analysis, chi-square tests of independence, cluster analysis, linear regression, and factor analysis. Results indicate significant associations between emotional intelligence levels and workplace ratings. K-means clustering identifies three clusters based on emotional intelligence and workplace ratings, reflecting different levels of emotional intelligence and corresponding workplace ratings. However, linear regression analysis suggests that emotional intelligence does not significantly predict workplace ratings. Factor analysis reveals that while a single factor might explain a portion of the variance in emotional intelligence, there may be other factors at play as well, possibly two. These findings provide insights into the complex relationship between emotional intelligence and the workplace environment among female employees, emphasizing the need for further research to fully understand the underlying dynamics.

Health-Related Lifestyles among University Students: Focusing on Eating Habits and Physical Activity

The transition to higher education at University is a critical moment for young adults to acquire unhealthy habits regarding physical activity (PA) and adherence to a healthy diet. Negative behaviors might be maintained in the years to come with a major risk of suffering from a Non-Communicable Disease. This study aims to determine the relationship between diet and PA in the student community of University of Milano-Bicocca. Students between 18 and 30 years old completed an online survey (6949 students). Two analyses of covariance (ANCOVA), chi-square tests of independence, and a binomial logistic regression were performed to examine the relationship between adequacy of food consumption and PA, in association also with sociodemographic characteristics. Data show a strong correlation between behaviors analyzed, with a proportional positive association between PA and healthy diet. Nevertheless, a third of the sample students incur in incorrect habits for both diet and PA. Further, students performing intensive PA have the healthiest food consumption in general but the worst red meat and pork intake. Accordingly, men practice more PA but have a less adequate diet, exactly contrary to women. In conclusion, policies promoting consciousness of well-being would transform Universities into healthy hubs for virtuous habits.

United States Veterans with comorbid chronic fatigue syndrome and chronic pain: do women differ from men?

ABSTRACT Objective: Examine group differences among women and men United States Veterans with chronic fatigue syndrome (CFS) and chronic pain (CP). Method: Administrative data from the VA Corporate Data Warehouse were derived from a cohort that met criteria for CP in 2018. Differences across sociodemographic characteristics, psychiatric comorbidities, and pain-related healthcare utilization were examined. Analyses included group comparisons (chi-square tests for independence or independent samples t-tests) and effect size differences (Cohen’s d or Cramer’s V). Results: The period prevalence for comorbid CFS and CP was greater among women Veterans (1.20% vs. 0.61%). Women Veterans with CFS and CP were younger (d = 0.80), more likely to be Black, and less likely to be White (V = 0.13). Women Veterans with CFS and CP were more likely to have fibromyalgia (V = 0.23), headache (V = 0.24), or urogenital, pelvic, and menstrual pain (V = 0.14), and less likely to have neuropathy relative to men; they were also more likely to have depression (V = 0.15) or anxiety (V = 0.13). Conclusions: Comorbid CFS and CP are more prevalent among women Veterans relative to men. Group differences in pain clusters and psychiatric comorbidities may have implications for clinical offerings to women Veterans with these conditions.

Predictors and Prevalence of Alcohol and Cannabis Co-use Among Filipino Adolescents: Evidence From a School-based Student Health Survey.

This study explored the prevalence and predictors of alcohol and cannabis co-use among 9263 Filipino adolescents, using data from the 2019 Global School-based Student Health Survey (GSHS). We conducted a cross-sectional secondary analysis of the GSHS, targeting adolescents aged 13-17 years and excluding cases with incomplete data on alcohol and cannabis use. Our analysis employed the bivariate chi-square test of independence and multivariable logistic regression using Stata version 18 to identify significant predictors of co-use, with a p-value threshold set at 0.05. The weighted prevalence of co-users was 4.2% (95% confidence interval [CI], 3.4 to 5.3). Significant predictors included male gender (adjusted odds ratio [aOR], 4.50; 95% CI, 3.31 to 6.10; p<0.001) and being in a lower academic year, specifically grade 7 (aOR, 4.08; 95% CI, 2.39 to 6.99; p<0.001) and grade 8 (aOR, 2.20; 95% CI, 1.30 to 3.72; p=0.003). Poor sleep quality was also a significant predictor (aOR, 1.77; 95% CI, 1.29 to 2.44; p<0.001), as was a history of attempted suicide (aOR, 5.31; 95% CI, 4.00 to 7.06; p<0.001). Physical inactivity was associated with lower odds of co-use (aOR, 0.45; 95% CI, 0.33 to 0.62; p<0.001). Additionally, non-attendance of physical education classes (aOR, 1.48; 95% CI, 1.06 to 2.05; p=0.021), infrequent unapproved parental checks (aOR, 1.37; 95% CI, 1.04 to 1.80; p=0.024), and lower parental awareness of free-time activities (aOR, 0.63; 95% CI, 0.45 to 0.87; p=0.005) were associated with higher odds of co-use. Factors not significantly linked to co-use included age group, being in grade 9, always feeling lonely, having no close friends, being bullied outside school, and whether a parent or guardian understood the adolescent's worries. The findings highlight the critical need for comprehensive interventions in the Philippines, addressing not only physical inactivity and parental monitoring but also focusing on gender, academic grade, participation in physical education classes, sleep quality, and suicide attempt history, to effectively reduce alcohol and cannabis co-use among adolescents.

Factors of pre-war educational migration: an investigation of polish medical and dental students in Ukraine

BackgroundLow admission rates at Polish medical universities led many students to study abroad. Ukraine provided an appealing option for years. The purpose of the study is to investigate the most important factors that motived Polish students enrolled at I. Horbachevsky Ternopil National Medical University in Ukraine to pursue medical and dentistry studies in lower middle-income countries, just before the outbreak of the war. It has become incredibly important to determine crucial economic and non-economic factors.MethodsThe paper draws on a quantitative survey (N = 94) conducted among medical and dental students from Poland who had studied at I. Horbachevsky Ternopil National Medical University in Ukraine using a semi-structured questionnaire. To test whether there was a relationship between the importance of the motives, Pearson’s chi-square independence test was employed.ResultsThe study found the key economic and non-economic factors for pursuing Ukrainian studies were rejection from Polish tuition-free programs, lower Ukrainian tuition and living costs compared to Poland and to other European Union countries. Determining reasons for choosing Ternopil University were recruiter and friend recommendations and its prestige among Ukrainian medical schools. Gender influenced the ranking of motives.ConclusionThe article examines the unique pre-war educational migration from Poland to Ukraine – occurring counter to typical flows from lower to higher a lower income country. The study showed that universities should strengthen recruiting efforts and highlight competitive tuition and living costs to attract international students, especially from relatively more developed nations.

Abstract PO3-22-06: Safety and efficacy of trastuzumab deruxtecan and concomitant radiation therapy in patients with metastatic HER2-positive breast cancer

Abstract Background Trastuzumab deruxtecan (T-DXd) currently represents the standard of care for the treatment of patients with metastatic HER2-positive (HER2+) breast cancer (BC) after disease progression in the first line, which includes taxanes and trastuzumab. This recommendation is based on the results of the DESTINY-Breast03 trial, which demonstrated improved efficacy compared to trastuzumab emtansine (T-DM1). Radiation therapy (RT) is frequently required in the metastatic setting, either for palliative purposes or with ablative intent in cases of oligometastatic or oligoprogressive disease. The aim of our study is to evaluate the safety of using T-DXd and concomitant radiation therapy (RT) in a consecutive series of HER2+ BC patients. Methods We conducted a retrospective evaluation of patients diagnosed with metastatic HER2+ BC who initiated treatment with T-DXd between May 2021 and May 2023 at our institution, with or without receiving RT. We collected clinical data pertaining to the diagnosis of metastatic disease, T-DXd treatment, acute toxicities, survival data, and biological characteristics of both the primary tumor and metastases. The primary objective of this study was to assess the association between RT and any adverse events greater than grade (G) 2. Results We retrospectively evaluated data from 30 consecutive patients who were treated with T-DXd, with or without RT. Among these patients, ten received RT either immediately before (within a month) or during T-DXd treatment, while the remaining 20 did not. The median age of the patients was 72 years (range 34-88), and the median follow-up period was 9 months. Thirteen patients received T-DXd as the fourth or subsequent line of systemic anti-HER2 treatment, eight patients received it as the third line, and seven patients received it as the second line. Two patients, who experienced early metastatic disease relapse (&amp;lt; 6 months after completion of adjuvant anti-HER2 therapy), received T-DXd as their first-line treatment. The median prescribed total dose of RT was 34 Gy (range 20-48), with a median number of fractions of 4 (range 2-10). The median equivalent dose in 2 Gy fractions (EQD2) was 64 Gy (range 23.3-104), and the median biologically effective dose (BED) was 76 Gy (range 28-125). The most commonly treated sites were bone (70% of cases), followed by brain (20%) and liver (10%). A chi-square test of independence was conducted to examine the relationship between the administration of RT and the development of toxicity exceeding G2. However, this analysis did not reveal a significant relationship (p = .27). Regarding the specific toxicities of interest associated with T-DXd, three cases of grade 3 fatigue were reported in the group that did not receive RT, while one case was observed in the RT group. Overall, only one case of grade 3 nausea was reported, and it occurred in the group that did not receive RT. G2 interstitial lung disease, which led to discontinuation of T-DXd, was observed in one case in the RT group and one case in the no-RT group. Conclusions Our initial data is promising regarding the potential safety of this combination, as it indicates that concurrent RT did not lead to an increase in severe acute toxicity. However, larger series of data are required to validate and confirm these findings. Citation Format: Luca Visani, Carlotta Becherini, Niccolo' Bertini, Ilaria Bonaparte, Luca Burchini, Carolina Orsatti, Marianna Valzano, Marco Banini, Viola Salvestrini, Erika Scoccimarro, Vieri Scotti, Isacco Desideri, Giulio Francolini, Lorenzo Orzalesi, Marco Bernini, Cinzia Tommasi, Jacopo Nori, Simonetta Bianchi, Icro Meattini, Lorenzo Livi. Safety and efficacy of trastuzumab deruxtecan and concomitant radiation therapy in patients with metastatic HER2-positive breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-22-06.

Abstract PO4-15-11: HER2 STATUS AND TUMOR HETEROGENEITY IN INVASIVE BREAST CARCINOMAS: CLINICAL PATHOLOGICAL IMPACT

Abstract Human epidermal growth factor receptor 2 (HER2) is a major player in breast carcinogenesis with a range of 15-20% of cases harboring gene amplification and overexpression turning the tumor eligible to over eight anti-HER2 drugs in the past 15 years. Recently, novel anti-HER2 antibody-drug conjugates (ADCs) treatment was recently approved to metastatic breast cancer bearing some HER2 expression albeit not due to gene amplification. Immunohistochemically classified, by ASCO-CAP Guidelines (2018), as 1+ cases were enrolled in clinical trials and benefited by the addition of ADCs to chemotherapy. Despite being classified as HER2 negative, most tumors exhibit detectable levels of HER2 protein, reinforcing the importance of HER2 expression evaluation. HER-2 intratumoral heterogeneity (ITH) is reported in up to 40% of breast cancers and is defined as the coexistence of subpopulations of tumor cells with different HER2 gene or protein expression. In this scenario, it becomes very important to evaluate the spectrum of HER-2 expression in correlation with pathological factors as ITH is associated with poor prognosis and anti-HER2 resistance. We designed a retrospective linear study to reanalyze all HER2 immunohistochemical core biopsy slides of patients with primary invasive breast carcinomas (IBC) diagnosed and treated at São Paulo Federal University Hospital between 2019 and 2023. Clinical variables (age, laterality, tumor size by ultrasound imaging, BI-RADS) were collected from clinical files. HER2 slides were reviewed by three observers and reported regarding status by ASCO-CAP 2018 guidelines, HER2 heterogeneity and patterns. Statistical analyses were performed with Chi-Square test of independence, Fisher's exact test and Mann–Whitney U test using IBM® SPSS® Statistics (26.0) software. 353 cases were included; the mean age of the patients at the time of diagnosis was 58 years old. 191 cases (54,1%) were left sided and 162 cases (45,9%) were right sided. Regarding BI-RADS report, the major category was 4 (140 cases), followed by 5 (119 cases). Out of the 164 patients who underwent clinical follow-up at our institute, 14 deaths were reported. Concerning pathological features, IBC of no special type was the prevalent histological subtype with 304 cases (86,1%), followed by invasive lobular carcinoma, with 26 cases (7,4%). 296 cases (83,9%) were HER2 negative and 42 (11,9%) were HER2 positive; 15 cases were HER2 2+ (4,2%). Amongst negative cases, 235 were HER2 0+ and 61 were HER2 1+. Considering ITH, 287 cases (81,3%) were HER2 homogenous with 0+ score as the most prevalent, presenting with 232 cases (80%). 66 cases (18,7%) had ITH, with 1+ as the most prevalent primary score, with 34 cases (51,5%), followed by 3+, with 17 cases (25,8%). Not only HER2 positive carcinomas, but also the presence of heterogeneity in HER2 expression was associated with death outcome (p=0,003 and p=0,001, respectively). Also, HER2 positive IBC had larger tumor size compared to HER2 negative carcinomas (mean size of 25,6 mm x 31,3 mm, respectively; p=0,012); HER2 heterogeneity showed no statistical significance when associated with tumor size (p=0,165). We conclude that ITH is prevalent in HER2 expression and should be addressed in pathology reports since it may play an additional role in tumor progression and drug response, especially in the ADCs scenario. Citation Format: Karla Calaça Kabbach Prigenzi, Lisandra Gonzalez Porta Nova, Adilson Monteiro dos Santos Filho, Ana Luiza da Cruz, Lucas de Figueiredo Barbosa, Angela Flavia Waitzberg. HER2 STATUS AND TUMOR HETEROGENEITY IN INVASIVE BREAST CARCINOMAS: CLINICAL PATHOLOGICAL IMPACT [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-15-11.

Self-Perception of Sexual Dysfunction of Adult Brazilian Women of Reproductive Age: A Cross-Sectional Study.

Sexual dysfunction (SD) comprises disorders in sexual desire, arousal, orgasm, and lubrication. The importance of self-perceived SD relies on its relation to personal values, sex education, and partnership. We aimed to analyze the association between self-perceived SD and the Female Sexual Function Index (FSFI) in adult women of reproductive age and the correlation between age and sexual function. This analytical cross-sectional study included 285 women aged 18 to 49 years, sexually active for at least four weeks, cisgender and heterosexual, and with Internet access. Women were divided into control (CG, control group; without SD) or study group (SG, study group; with SD) and responded to a self-applicable online survey containing a sociodemographic characterization, an interview about SD knowledge, and the FSFI test. The Chi-square test of independence (χ2) analyzed the association between self-perceived SD and FSFI-assessed SD. Pearson's correlation coefficient investigated the correlation between age and FSFI. Included women had a mean age of 29.57 years ± 7.11 years. Self-perceived SD showed a moderate association (Cramer's V = 0.590) with the FSFI score (χ2 [2] = 91.500; p < 0.001). A weak, negative, and significant correlation was observed between age and the FSFI desire domain (r = -0.120; p = 0.030; r2 = 1.440). Women with self-perceived SD were 68% more likely to present FSFI-assessed SD. Regarding the FSFI desire domain, sexual function decreased with age.

Bedtime Regularity and Sleep Sufficiency in Children with Tourette Syndrome

ObjectiveDespite research demonstrating sleep disturbance in children with Tourette Syndrome (TS), few studies have examined bedtime regularity and sleep sufficiency, two important sleep health dimensions. Therefore, this study examined bedtime regularity and sleep sufficiency in children with TS relative to matched healthy controls, and its associated demographic, clinical, and behavioral factors. MethodParticipants were 384 parents or caregivers of children aged 3 to 17 years, including 192 with current TS and 192 matched healthy controls drawn from the 2020-2021 cycle of the National Survey of Children’s Health. Parents completed questions assessing demographics (i.e., age, race, sex), clinical (i.e., ADHD, ASD, anxiety, depression, tic severity, behavioral or conduct problems, ADHD medication, health-condition related impairment), and behavioral (i.e., screen time) characteristics. Mann-Whitney U test and chi-square test of independence were performed to compare groups on bedtime regularity and sleep sufficiency, respectively. Ordinal regression and binary logistic regression without and with backward elimination were performed to evaluate indicators of bedtime regularity and sleep sufficiency, respectively, in children with TS. ResultsChildren with current TS had significantly poorer bedtime regularity, but not sleep sufficiency, relative to matched healthy controls. In children with TS, anxiety and two or more hours of daily screen time were associated with higher likelihood of poor bedtime regularity. Autism was associated with lower likelihood of insufficient sleep, and depression was associated with increased likelihood of insufficient sleep. ConclusionsFindings put forth screen time, anxiety, and depression as intervention targets to optimize sleep health in children with TS.

Comparing Clark’s 2017 Category II Electronic Fetal Monitoring Algorithm to Actual Management When Umbilical Cord Arterial pH Was Less Than 7 [ID 2683452

INTRODUCTION: Our previously published study reported that, in only 47% of labors resulting in a baby with severe acidemia (defined as umbilical cord arterial pH less than 7), intrapartum electronic fetal monitoring (EFM) was interpreted as concerning, with delivery expedited. We compared Clark’s EFM Category II algorithm to EFM interpretation and actual management of these deliveries. METHODS: Institutional review board approval was obtained. A retrospective cohort study was performed on deliveries with umbilical cord arterial pH less than 7. Two groups were identified in actual management: 1) expedited delivery (urgent/emergent operative vaginal delivery or cesarean section) and 2) nonexpedited delivery. We then reviewed all fetal heart tracings (FHTs) to determine whether the algorithm would have recommended expedited delivery or not. Data were analyzed using chi-squared test for independence and Fisher's exact test. RESULTS: Thirty deliveries were identified with severe fetal acidemia. Forty-seven percent were delivered in expedited fashion. The Clark algorithm recommended expedited delivery in 30%. The algorithm was not applicable to 3 out of 30 deliveries. Of actually expedited deliveries, the algorithm agreed with expediting 75% of the time, 78% of which should have been delivered even earlier. Of actually nonexpedited deliveries, the algorithm would have only expedited 7% of those. CONCLUSION: The Clark 2017 Category II FHT algorithm had a lower sensitivity for predicting severe fetal acidemia and recommending expedited delivery. Although only 47% of babies with severe acidemia were delivered in expedited fashion, the Clark algorithm would only have expedited delivery in 30% overall.

Prostate Cancer Recurrence: Examining the Role of Salvage Radiotherapy Field and Risk Factors for Regional Disease Recurrence Captured on 18F-DCFPyL PET/CT

PurposeThe role of elective pelvic nodal irradiation in salvage radiotherapy (sRT) remains controversial. Utilizing 18F-DCFPyL PET/CT, this study aimed to investigate differences in disease distribution after whole pelvic (WPRT) or prostate bed (PBRT) radiotherapy and to identify risk factors for pelvic lymph node (LN) relapse. MethodsThis retrospective study included patients who underwent 18F-DCFPyL PET/CT with a PSA > 0.1 ng/mL after either radical prostatectomy (RP) or RP and sRT. Disease distribution on 18F-DCFPyL PET/CT in patients after salvage PBRT and WPRT was compared using Chi-square tests for independence. Risk factors were tested for association with pelvic LN relapse after RP and after salvage PBRT using logistic regression. Results979 18F-DCFPyL PET/CTs performed at our institution between 1/1/2022 – 3/24/2023 were analyzed. There were 246 patients meeting criteria, of which 84 received salvage RT after RP (post-salvage RT group) and 162 received only RP (post-RP group). Salvage PBRT patients (n = 58) had frequent pelvic nodal (53.6%) and nodal-only (42.6%) relapse. Salvage WPRT patients (n = 26) had comparatively lower rates of pelvic nodal (16.7%, p = 0.002) and nodal-only (19.2%, p = 0.04) relapse. The proportion of distant metastases in the salvage PBRT (34.5%) and WPRT (46.2%) groups did not differ (p = 0.309). Multiple patient characteristics were associated with pelvic LN disease in the post-RP group, including ISUP grade (Odds Ratio 2.01, p = 0.001) and seminal vesicle invasion (OR 3.85, p = 0.021). ConclusionAt PSA persistence or progression, salvage WPRT in this cohort resulted in lower rates of nodal involvement than salvage PBRT, but did not reduce distant metastases. Certain risk factors increase the likelihood of pelvic LN relapse after RP and can help inform salvage RT field selection. MicroAbstractOptimal patient selection for salvage whole pelvic radiotherapy (WPRT) remains uncertain. This study utilized 18F-DCFPyL PET/CT, a novel and highly sensitive imaging modality, to compare disease distribution after prostate bed (PBRT) or WPRT. PBRT resulted in higher rates of pelvic nodal and nodal-only recurrences, indicating that WPRT may benefit patients at higher risk for lymph node disease.

« Avec autisme », « autiste », « sur le spectre », « avec un TSA » ? Étude des préférences de dénomination et des facteurs pouvant les influencer auprès de la population française

IntroductionAutism-related language preferences are increasingly studied. While there are some guidelines established in international journals and a relatively clear consensus when it comes to the English language, studies in other languages are still rare. When it comes to this conversation, the preferences are often split between person-first language and identity first language (i.e., person with autism or autistic person). Some languages, such as French, have a different grammatical construction: the adjective comes after the noun, which leads to “person” always coming first. However, the presence of the “with” still leads to the same conversation as happens in English when it comes to “separating” the person from their autism. Our study expands on previously published results regarding French-speaking adults’ language preferences when it comes to autism, as well as identifying some factors that could be related to these choices. MethodsWhile participating in a larger survey regarding autistic masking and mental health, participants were invited to select their language preference amongst four options (autistic person, person with autism, person on the autism spectrum and person with Autism Spectrum Disorder) so that the items would reflect their choice throughout the questionnaires. One thousand seven hundred and fifty-seven responses were collected, split in 4 groups: 689 formally diagnosed autistic persons, 265 persons on a waitlist for autism assessment, 353 persons self-identifying as autistic and 450 non-autistic persons. Chi-square independence tests were conducted to identify potential factors that could influence language preferences. ResultsIFL (autistic person) was favored by the formerly diagnosed autistic group (65%), the self-identified group (46.7%) and the waitlist group (49.1%). The non-autistic group was the only one to favor PFL (person with ASD) (39.1%). Age was significantly associated with language preference, with younger people endorsing IFL while people aged 56 and over favored PFL (but IFL was favored when the non-autistic group was excluded from the analysis). Gender was also significantly associated with language preference, with non-binary people overwhelmingly endorsing IFL (71.8% in the total sample, 76.5% when excluding the non-autistic group). Being cisgender was another factor that was significantly associated with language preference, with TGD people also showing a major preference for IFL. Self-stigma was not associated with language preference. Finally, internalized shame was also associated with language preference, with people showing a lower level of internalized shame showing more preference for IFL than those with a higher level of internalized shame. DiscussionOverall, our results confirm a strong preference for IFL in autistic French-speaking adults and highlight some factors such as age, gender, and internalized shame that could play a role in these preferences. This study was not a study on language preferences and we might not have covered the whole range of possible preferences. Other limits include a self-reported diagnosis status and the inability to reach people with higher support needs. We encourage researchers to include in their data collection forms the possibility for the participants to choose their preferred language.

The Epidemiological Burden of Neurovascular Pathology in Nigeria: A Systematic Review and Pooled Patient-Level Analysis

Vascular neurosurgery has developed significantly in Nigeria, but its burden and challenges remain unclear. This study systematically reviewed vascular neurosurgical literature from Nigeria. Four research databases and gray literature sources were searched from 1962-2021. ROBINS-I tool was used to assess risk of bias. Descriptive, narrative, and statistical analyses were conducted on all variables. Where appropriate, paired t-tests and Chi-squared independence tests were used (α= 0.05). 56 articles were included and 3203 patients pooled for analysis. Risk of bias was moderate-high. Most articles were published over the last 20 years with retrospective cohort studies and case reports being the most common study designs. The cohort had a relatively even gender split and an average age of 49 years (±22). Cerebrovascular accidents accounted for over 85% of diagnoses, with most etiologies being traumatic. Headache and motor deficit were the most prevalent clinical features. X-ray and carotid angiography were the most commonly reported imaging modalities, closely followed by computed tomography (CT) and CT angiography. The top two radiological diagnoses were ischemic cerebrovascular disease and intracerebral hematoma. Aneurysmal clipping and hematoma evacuation were the most commonly reported treatment modalities. Outcome at last follow-up was favorable in 48%. The mortality rate was 6%. Post-treatment complications included chest infection and rebleeding. This study illustrates the epidemiological burden of neurovascular pathology (based on the available data in published literature) in Nigeria, and raises awareness amongst service providers and researchers of the attendant challenges and epochal trends seen within vascular neurosurgery in Nigeria.