Biology Classes Research Articles

The role of biology curriculum in promoting student health, environmental awareness, and academic success: Teacher responsibilities

The biology curriculum significantly shapes students’ understanding of health and environment, equipping them with knowledge and skills necessary for responsible citizenship and informed decision-making. This study aims to examine how the biology curriculum affects students' education, focusing on how it helps students become more aware of health and environmental issues. The study utilized a mixed-methods research design. A Purposive sampling was utilized for this research. The study was carried out in four schools in Tirana: Gymnasium “Aleks Buda, “Gymnasium “Samiu,” Gymnasium “Isa Boletini,” and Gymnasium “Partizani.” The sample consists of 200 students and 20 teachers. The research instruments used for the collection of data were questionnaires, interviews, and classroom observation. Findings of the study show that students’ understanding of essential health-associated subjects was greatly improved by their participation in the biology class. It also highlights how important it is for teachers to raise students' achievement levels. The study shows the important role instructors play in fostering an encouraging and exciting atmosphere for education. Furthermore, instructors may pinpoint how to meet every student's distinctive educational requirements with customized supervision, offering individualized assistance along with helpful criticism. In conclusion, the curriculum acts as a catalyst for bringing important health issues, like disease prevention and individual well-being, to the public's attention while simultaneously encouraging a sense of responsibility for the sustainability of the environment and the preservation of our world.

Biology teaching that develops the metacognitive aspect of learning: How to learn competence

Higher-order thinking and metacognition are closely related and are part of learning to develop competence. The goal of this research was to determine the practice of teaching biology that develops metacognition and evaluate whether teachers require specific professional training for this purpose or if broader cognitive-focused training can also enhance metacognitive development in students. The original Teaching Observation Form (TOF) has been adapted for research objectives. A survey was designed to capture the subjective perspectives of 292 students and their teachers regarding metacognition development. Additionally, the research involved six biology teachers who were professionally trained in a program focused on higher-order thinking. The survey results indicate a self-assessed good teaching practice for the development of metacognition. However, analysis of the first lesson's video recordings showed that some components had been eliminated from biology classes which hindered students' ability to develop metacognition. Although higher-order thinking and metacognition are interconnected phenomena, professional development training focuses solely on higher-order thinking whose impact we established through analysis of other lessons does not induce the necessary positive changes for the comprehensive development of metacognition in students. In a nutshell, explicit professional development programs aimed at fostering metacognitive awareness among teachers need to be designed. These programs should instruct teachers on how to model the development of metacognition in students through their teaching.

Environmental education through the didactic game "treading the path of environmental equilibrium" in the teaching of biological sciences


 This study examines the use of educational game "Treading the Path Balanced Environment" as teachers to aid students in learning tool and Environment of content, Ecology and Environmental Education in the Life Sciences Education. This is qualitative-quantitative research used data collected through observations, evaluation questionnaires, application testing and filmic and photographic records in classes with 27 students of 3rd year high school students in a biology class of School Unit Professor José Kind in Teresina, PI. The research was based on theoretical as Piaget (1975) and Kishimoto (2000) that address the importance of play activities in cognitive development and demonstrate the learning of the contents in environmental education through educational game. It was found through statistical analysis, as the Hypothesis Testing (t test) that students improved their knowledge on environmental issues, demonstrating that the didactic game, combined with the lectures, presented contributions to the teaching-learning process. With the characteristics of a didactic game, provided a more fruitful and favorable environment for acquiring knowledge, promoted the motivation and socialization of students and teachers, allowed the discussion of environmental issues in context and interactively.

Integrative education as the basis for students� worldview knowledge in the process of teaching biology in high school

Relevance. The research relevance is predefined by the continuously developing system of integrative education, which puts forward new requirements for the process of teaching biology in high schools as the basis for the formation of students� worldview knowledge.Purpose. The research aims to conduct a theoretical and practical justification of the methodology of the formation of the worldview knowledge of students in the process of teaching biology in high school.Methodology. The primary research method is a pedagogical experiment, which allows a comprehensive consideration of all the contradictions in the research problem and improves the effectiveness of the process of teaching biology in high school. For this purpose, the auxiliary methods of mathematical statistics and graphical representation of the results of student achievement in the subject �biology� were used.Results. During empirical research, interviews and questionnaires with the participants of the experiment were also conducted, during which the interests of students in the subjects were determined. The worldview component in the content of school education, especially in biology classes, was identified, principles justified, stages of the process of formation of students� worldview knowledge identified and implemented. This led to the inclusionary approach in which forms and methods of integrative education, which promote the development of worldview skills of young people could be quantified and disclosed.Conclusions. Research materials are of practical value for graduate students of higher pedagogical educational institutions, and teachers of secondary general educational institutions which implement integrative education in their teaching activities in high schools. Thus, the purpose of education is not just the regurgitated transfer of knowledge in biology, but the preparation and adaptation of students to the new conditions of society.

Predictors of Complicated Disease Course in Adults and Children With Crohn’s Disease: A Nationwide Study from the epi-IIRN

Abstract Background Since data on predictors of complicated Crohn’s disease (CD) from unselected populations are scarce, we aimed to utilize a large nationwide cohort, the epi-IIRN, to explore predictors of disease course in children and adults with CD. Methods Data of patients with CD were retrieved from Israel’s 4 health maintenance organizations, whose records cover 98% of the population (2005-2020). Time-to-event modeled a complicated disease course, defined as CD-related surgery, steroid-dependency, or the need for >1 class of biologics. Hierarchical clustering categorized disease severity at diagnosis based on available laboratory results. Results A total of 16 659 patients (2999 [18%] pediatric-onset) with 121 695 person-years of follow-up were included; 3761 (23%) had a complicated course (750 [4.5%] switched to a second biologic class, 1547 [9.3%] steroid-dependency, 1463 [8.8%] CD-related surgery). Complicated disease was more common in pediatric- than adult-onset disease (26% vs 22%, odds ratio, 1.3; 95% confidence interval [CI], 1.2-1.4). In a Cox multivariate model, complicated disease was predicted by induction therapy with biologics (hazard ratio [HR], 2.1; 95% CI, 1.2-3.6) and severity of laboratory tests at diagnosis (HR, 1.7; 95% CI, 1.2-2.2), while high socioeconomic status was protective (HR, 0.94; 95% CI, 0.91-0.96). In children, laboratory tests predicted disease course (HR, 1.8; 95% CI, 1.2-2.5), as well as malnutrition (median BMI Z score −0.41; 95% CI, −1.42 to 0.43 in complicated disease vs −0.24; 95% CI, −1.23 to 0.63] in favorable disease; P < .001). Conclusions In this nationwide cohort, CD course was complicated in one-fourth of patients, predicted by laboratory tests, type of induction therapy, socioeconomic status, in addition to malnutrition in children.

Implementation of think pair square type cooperative learning to improve collaboration skills in high schools


 
 
 
 Think Pair Square Style Cooperative Education encourages each student to become a proficient and independent learner. Given that this learning emphasizes 21st-century skills such as critical thinking, creativity, and teamwork. It was such as necessary to assess how effectively the application of this method enhances students' critical thinking abilities in the real world. The objective of this project is to improve student cooperation in cell biology classes by implementing a cooperative learning model similar to the Think Pair Square. The Classroom action research model was developed by Kemmis and McTaggar, which served as the framework for the procedure employed in this study. The outlines of the four stages of classroom action research are technique—planning, implementation, observation, and reflection. This instructional approach is seen to be beneficial as it enables students to share their thoughts and helps them see alternative problem-solving approaches. Students can seek explanations from other students to explain how to solve the problem if they are struggling with that. From the Data results, there were rising scores in the form of scoring that serve as evidence for this. Students' collaboration skills scored an average of 1.6 (level 1, or basic level) in the pre-cycle, 2 (level 2, or medium level), and 3.56 (level 3, or trained level) in cycle 2. Think Pair Square's implementation at SMA in Bandung could improve collaboration both within and outside of the classroom, foster more active dialogue and idea exchange, and promote student contact.
 
 
 

Major cardiovascular events under biologic psoriasis therapies: a 19-year real-world analysis of FAERS data.

Over the years when biologic psoriasis therapies (TNF inhibitors, IL-12/23 inhibitors, IL-23 inhibitors, and IL-17 inhibitors) have been used in psoriasis patients, reports of major cardiovascular events (MACEs) have emerged. This study aims to investigate the association between MACEs and biologic psoriasis therapies by using information reported to the US Food and Drug Administration Adverse Event Reporting System (FAERS). FAERS data (January 2004 to December 2022) were reviewed. For each drug-event pair, the proportional reporting ratio (PRR) and the multi-item gamma Poisson shrinker (MGPS) algorithms were used to identify drug-adverse event associations. We filtered the query for indication and identified 173,330 reports with psoriasis indication in FAERS throughout the analyzed time frame. MACEs occurred in 4,206 patients treated with biologics. All the four biological classes had an elevated and similar reporting rates for MACEs relative to other alternative psoriasis treatments (PRR from 2.10 to 4.26; EB05 from 1.15 to 2.45). The descending order of association was IL-12/23 inhibitors>IL-17 inhibitors>IL-23 inhibitors>TNF inhibitors. The signal strength for myocardial infarction (PRR, 2.86; χ2, 296.27; EBGM 05, 1.13) was stronger than that for stroke, cardiac fatality, and death. All the biological classes demonstrated a little higher EBGM 05 score≥1 for the MACEs in patients aged 45-64 years. The time-to-onset of MACEs was calculated with a median of 228 days. Analysis of adverse event reports in the FAERS reflects the potential risk of MACEs associated with the real-world use of biological therapies in comparison to other alternative psoriasis treatments. Future long-term and well-designed studies are needed to further our knowledge regarding the cardiovascular safety profile of these agents.

An analysis of digital literacy skills of high school students in biology

<p>Digital literacy is a crucial skill for understanding information from various sources, such as the use of the internet and other digital media as a learning resource. Navigating the internet is an important skill to master to keep updated with the development of information and communication technology in the era of Industrial Revolution 4.0 and to master one of the 21st-century skills. Skills that someone should have in digital literacy include internet searching, hypertextual navigation, evaluating information, and synthesizing information. This study aims to determine the digital literacy skills of tenth-grade high school students in biology class. The research method follows the quantitative descriptive method. The population and sample were 62 tenth-grade high school students. The data collection technique is in the form of questionnaires focusing on four aspects of digital literacy. The results indicate that the digital literacy of tenth-grade high school students with an average score of 44% is in the fair category. Meanwhile, the results for each aspect of the digital literacy indicator obtained different scores, namely internet searching at 47% (fair), hypertext navigation at 27% (fair), evaluating information at 40.32% (fair), and synthesizing information at 60.48% (good). This research suggests how stakeholders can issue policies as a basis for improving students' digital literacy to support the learning process focusing more on 21st-century skills.</p>

The comparison of students' academic stress in biology class at public and private high schools

<p>Students are demanded by school assignments, and many of them feel under pressure when learning biology. This situation is a trigger for academic stress which has an impact on student achievement. This study aims to identify and compare the factors that influence academic stress on students studying biology at the senior high school level. The research method used was an ex post facto survey using a sample of 54 students with an age range between 16-18 years. Data were obtained through a questionnaire with 9 scales of answer choices and interviews. The results showed that the level of preference for biology subjects for both public and private high school students was quite good, but most students experienced academic stress with a fairly high category in terms of motivation, self-confidence, the education system, teachers, and school conditions. This research implies that teachers are expected to create learning strategies by paying attention to the psychological conditions of students so that student learning outcomes can be maximized.</p>

Involuntary Online Learners: Engaging Online Students Who Preferred F2F Science Classes During the COVID-19 Pandemic

AbstractIn this descriptive analysis, we consider the experiences of students who prefer face-to-face (F2F) classes but, due to the COVID-19 pandemic, had no alternative other than taking their introductory biology class online during the 2020–2021 academic year. We conducted focus group interviews with 12 college students who enrolled in an asynchronous online introductory biology course for non-majors. We interpret their experiences through the theoretical framing of student engagement, which generally centers students as the directors of their learning experiences. However, when reflecting on their online, technologically mediated experience, our participants regarded their instructors as the hub or convener of their interactions with content, technology, and other learners. We explore the implications of these findings for engaging other students who may find themselves involuntarily online, and make recommendations for pedagogy and communication around the culture of online learning.

When sequential use of mepolizumab and dupilumab in a severe atopic eosinophilic asthmatic questions the role of eosinophils in mediating the clinical expression of the disease: a case report

BackgroundThe advent of biologics has resulted in major progress in the treatment of severe T2 high asthmatics. There are currently several classes of biologics approved for severe asthma including anti-immunoglobulin E, anti-interleukin-5/interleukin 5R, anti-interleukin 4/interleukin 13R, and anti-thymic stromal lymphopoietin.Case presentationsHere we report the case of a 55-year-old Caucasian man with severe eosinophilic atopic asthma, who sequentially benefited from a treatment with mepolizumab, an anti-interleukin-5 monoclonal antibody, followed by treatment with dupilumab, an anti-interleukin-4/interleukin-13R antibody, the switch being justified by a flare-up of dermatitis while on mepolizumab. Overall, the patient has been followed for 72 months, including 42 months on mepolizumab and 30 months on dupilumab. Close monitoring of exacerbations, asthma control, lung function, asthma quality of life, and biomarkers shows that both biologics reduced asthma exacerbation and provided an improvement in asthma control and quality of life, with the patient achieving remission after 30 months on dupilumab. However, the effects of the two biologics on the biomarkers were very different, with mepolizumab controlling eosinophilic inflammation and dupilumab reducing serum immunoglobulin E and fractional exhaled nitric oxide levels.ConclusionThe originality of this case resides in the description of clinical status and biomarker evolution after a sequential use of mepolizumab and dupilumab in a severe atopic eosinophilic asthmatic. It shows that mepolizumab reduces exacerbation and improves asthma control by curbing eosinophilic inflammation whereas dupilumab provides asthma remission without controlling airway eosinophilic inflammation.

REAL-WORLD TREATMENT PERSISTENCE AMONG ADVANCED THERAPY-EXPERIENCED PATIENTS WITH ULCERATIVE COLITIS INITIATED ON USTEKINUMAB OR ADALIMUMAB

Abstract BACKGROUND Prior exposure to advanced therapies (ADT) is associated with reduced response to future therapies in patients with ulcerative colitis (UC). Therapy persistence is a proxy of real-world treatment performance. This study compared persistence among ADT-experienced patients with UC initiated on ustekinumab (anti-interleukin 12/23 antibody), or adalimumab (anti-tumor necrosis factor biologic). METHODS Adults with UC initiated on ustekinumab or adalimumab (index date) between 10/21/2019 and 03/02/2022 were selected from the IQVIA PharMetrics® Plus database. Patients were ADT-experienced (i.e., ≥1 claim for a non-index UC-indicated ADT) in the 12-month baseline period before the index date. Patients with other auto-immune diseases during the baseline period were excluded. Cohorts were balanced on baseline characteristics using inverse probability of treatment weights. Persistence was defined as the absence of gaps between days of therapy supply of >120 days for ustekinumab or >60 days for adalimumab. Composite endpoints of being persistent while on monotherapy (no immunomodulators or index ADT) and persistent while corticosteroid-free (<14 consecutive days of corticosteroid supply after day 90 post-index) were also assessed. Persistence endpoints were described post-maintenance phase until the earlier of 12 months, end of insurance eligibility, or data using weighted Kaplan-Meier analyses and weighted Cox proportional hazards models adjusted for the use of ≥2 biologics and class of biologics used pre-index. RESULTS There were 693 and 254 patients in the weighted ustekinumab versus adalimumab cohorts, respectively (Fig. 1). At 12 months after the maintenance phase start, 78.1% of the ustekinumab cohort and 59.2% of the adalimumab cohort were persistent on the index biologic; persistence was 2.44 times higher in the ustekinumab cohort relative to the adalimumab cohort (p-value: <0.001; Fig. 2a). Moreover, 66.7% of the ustekinumab cohort and 40.5% of the adalimumab cohort persisted on the index biologic while on monotherapy; persistence while on monotherapy was 2.53 times higher in the ustekinumab cohort relative to the adalimumab cohort (p-value: <0.001; Fig. 2b). Finally, 48.0% of the ustekinumab cohort and 42.8% of the adalimumab cohort were persistent while corticosteroid-free; persistence while corticosteroid-free was 1.24 times higher in the ustekinumab cohort relative to the adalimumab cohort (p-value 0.0447; Fig. 2c). CONCLUSIONS ADT-experienced patients with UC treated with ustekinumab were more persistent, including persistent while on monotherapy and while corticosteroid-free than patients treated with adalimumab. These findings may aid healthcare providers in choosing a biologic for ADT-experienced patients with UC. Figure 1 Selected baseline characteristics in weighted ustekinumab and adalimumab cohorts Figure 2 Persistence in weighted ustekinumab and adalimumab cohorts: a) persistent on index biologic, b) persistent and on monotherapy, c) persistent and corticosteroid-free

RETROSPECTIVE, SINGLE-CENTER, REAL-WORLD ANALYSIS OF BIOLOGIC AND IMMUNOMODULATOR THERAPY DISCONTINUATION IN ELDERLY IBD PATIENTS

Abstract BACKGROUND The population of elderly inflammatory bowel disease (IBD) patients is increasing each year, however use of immunomodulators and biologic therapy in this population remains low. Clinical IBD drug trials limit enrollment of elderly patients. This leads to poor understanding of medication adverse effects and long-term outcomes in this population. Medication sustainability reflects drug efficacy and safety of drugs, which lead to better adherence. The primary aim of this study was to compare the discontinuation rates of various IBD therapies in a cohort of elderly patients and provide some guidance on positioning therapies within this population. METHODS This was a single-center retrospective study conducted at an academic institution. Elderly IBD patients 60 years or older followed between 2016-2022 were included in the study. Patients had to be on either immunomodulator and/or biologic therapy. Chart review was performed to extract demographic data, duration of IBD therapy, and reasons for discontinuation. A Kaplan-Meier survival curve was generated per IBD therapy to depict drug sustainability stratified by reason for discontinuation. Statistical analysis was performed to assess for significant differences across survival curves. RESULTS A total of 224 elderly IBD patients were included in the study analysis. The cohort was comprised of 97 (43.3%) patients with ulcerative colitis (UC) and 127 (56.7%) patients with Crohn’s disease (CD). For both CD and UC, there were no significant differences in biologic drug discontinuation rates due to inadequate disease control (p=0.26 for CD; p=0.74 for UC). There was a significantly increased risk of elderly IBD patients stopping anti-TNF therapy due to medication adverse event compared to those on anti-integrin therapy (p=0.002) and immunomodulator therapy (p=0.003). CONCLUSIONS While the number of biologics used to treat IBD has increased in the last few decades, there is a paucity of studies examining real world sustainability of biologics particularly in elderly patients. With regards to effectiveness, our study showed that there was no significant difference among the three classes of biologics being discontinued due to poorly controlled disease. However, results of our study suggest that anti-TNF therapy is less sustainable in elderly IBD patients compared to other biologics and immunomodulator therapy due to patient experienced adverse events. Our results are pertinent to clinical practice as prescribing biologics other than anti-TNF therapy may increase an elderly patient’s therapy longevity and lead to optimized clinical outcomes. Figure 1 shows time to biologic discontinuation due uncontrolled disease by IBD subtype. For both Crohn’s disease and ulcerative colitis, there was no significant difference in drug survival per biologic with regards to discontinuation due to inadequately controlled disease. Figure 2 shows time to therapy discontinuation due to patient experienced adverse events. This included infections, infusion reactions, systemic reactions, laboratory abnormalities, financial burden, and non-compliance. There was a significantly increased risk of elderly IBD patients stopping anti-TNF over time due to adverse events compared to those on anti-integrin and immunomodulator therapy.

P824 Association between visceral adipose tissue and disease duration, clinical activity, and response to various biological agents in inflammatory bowel disease

Abstract Background The relationship between body fat composition and inflammatory bowel disease (IBD) progression, medical response, and prognosis is widely acknowledged. Visceral adipose tissue (VAT) has been shown to be profoundly responsible of most of the obesity-associated metabolic derangements, however it is also related to severity of inflammation. Although VAT can be estimated using computerized tomography, abdominal bioimpedance is a new and reliable technique without expense and radiation exposure. We investigated whether VAT is linked to the disease activity in severe IBD and the short-term response to biological therapies. Methods We prospectively evaluated 65 IBD patients, (n=26 with ulcerative colitis (UC) and n=39 with Crohn’s disease (CD) who had moderate-severe disease activity) at baseline before the initiation of biological therapy. We quantified VAT using abdominal bioimpedance (ViScan). VAT and other body fat metric measures (BMI, total and free fat mass, abdominal fat mass) were also analyzed. The response to biological agents was assessed by clinical (Mayo and CDAI) and endoscopical (mucosal healing) scores at 3 months. Results Out of the 65 patients, 22 individuals (33.8%) exhibited clinical and/or endoscopic response after 3 months. Among responders and non-responders, there was a comparable approximation of disease location (p=0.321) and behavior (p=0.239). Patients with CD had slightly lower levels of VAT, BMI, and free fat mass compared to those with UC. In non-responders with UC, VAT levels were lower than in responders, whereas in non-responders with CD, VAT levels were higher than in responders. No distinction was observed in the VAT response among other classes of biologics, including anti-TNF, ustekinumab, and vedolizumab. Conclusion In summary, VAT parameters using bioimpedance (ViScan) were found to be correlated with the disease activity and reliably identified IBD patients who responded well to various biological treatment in the short-term. Therefore, human fat indices might be novel biomarkers for disease severity and response to therapy.

P831 Acute infusion reactions due to different biologic agents in a large cohort of patients with Inflammatory Bowel Disease

Abstract Background The therapeutic armamentarium for inflammatory bowel disease (IBD) includes several biological agents: infliximab (IFX), adalimumab (ADA), vedolizumab (VED) and ustekinumab (UST). Persistence in therapy with these drugs is not satisfactory, not only due to the loss of clinical response over time but also due to adverse events. Acute infusion reactions (AIRs) occur during or within 24 hours of the infusion. The intensity of AIRs ranges from mild (flushing, dizziness, headache, itching, rash) to severe (anaphylactic). The primary aim of this study was to compare the prevalence rates of AIRs due to the different biological agents in a large cohort of patients with IBD and to assess risk factors for AIRs. Methods All reports of AIRs occurring from January 2021 to October 2023 in IBD patients treated with different biological agents (IFX, ADA, VED and UST) in a tertiary IBD center were retrospectively reviewed. The electronic records of the identified patients were checked for the type of IBD, whether Crohn's disease (CD) or ulcerative colitis (UC), type of biological agent, route of administration (intravenous or subcutaneous), concomitant immunosuppressive therapies, atopic status. Furthermore, the type of treatment for the AIRs and the subsequent therapy undertaken for IBD were also recorded. Results 22 AIRs were recorded out of 1911 patients (1.1%). Of these, 16/550 in patients on IFX biosimilars (2.9 %), 4/590 (0.7%) in patients on ADA biosimilars, 2/318 (0.6%) in patients on VED and 0/453 (0%) in patients on UST (Table 1). The difference in the prevalence of AIR rates observed with the different biological agents was statistically significant (p<0.01). 7 of 16 post-IFX AIRs were moderate-severe, with two episodes of anaphylaxis occurring in patients with CD. The two patients treated with VED experienced only mild symptoms, and no anti-reactive treatment has been used; two mild and two moderate AIRs, respectively, have been reported among patients on ADA. 12 of 22 AIRs occurred during the induction period (from the first to the third administration). 7 of 22 patients had previous allergic reactions. Conclusion Our real-world data on a large population of IBD patients treated with biologic agents confirm that AIRs are rare and occur mainly in patients treated with IFX biosimilars. Most patients who experienced AIRs were atopic. Almost all patients after AIRs changed biological agents within or out of the same biological class. Further studies are necessary to confirm our results and better characterise the profile of patients at greater risk of AIRs.

P694 Age is a strong of predictive risk factor for anti-TNF therapy related adverse events in IBD patients

Abstract Background Anti-TNFα is the first class of biologics approved for treatment of moderate-to-severely active Inflammatory Bowel Disease (IBD). More than two decades on, anti-TNFs remain one of the most commonly used biologics for both Ulcerative Colitis (UC) and Crohn’s Disease (CD), and often as first-line therapy. Although effective, they cause several adverse events (AEs), sometimes requiring withdrawal of therapy. We aimed to record AEs and understand factors that could predict risk of AEs. Methods All IBD patients exposed to anti-TNF therapy were identified from EMR at two centres of a large tertiary hospital between January 2009 and June 2022. All relevant demographic and clinical data were collected for those patients with well recorded AEs and follow-up. Data on cumulative AEs directly attributed to anti-TNFs that ranged from mild reactions to serious AEs (defined as those requiring review/withdrawal of anti-TNF), were collected. Adverse events (AEs) were recorded as per relevant systems involved e.g.- haematological, cardiac etc., including infections and malignancies as separate categories. All analysis (normalization, hypothesis testing, and visual reports were performed using R software package Version: R 4.2.1. Results A total of 844 IBD patients (Male =408) were included with an age range of 18-75yrs. Majority were Caucasian in ethnicity (514) and more patients with CD [605(71%)] were exposed to anti-TNF than UC. The age profiling analysis was performed across ethnic groups (Asian, Caucasian and Others). Age associated AE was reported across all the groups (data not shown). It must be mentioned that though not significant, Caucasian patients were more susceptible towards AE as compared to Asian. Conclusion · Patient age above 50yrs has a strong predictive risk factor for AEs related to anti-TNF therapy for IBD. · In our cohort, more than half of patients >50yrs reported at least one AE in UC, and the age was lower in CD. · Although Caucasians were more vulnerable to AEs, this was not statistically significant. · Clinicians should consider and discuss this risk before selecting patients for anti-TNF therapy. · With multiple biologic choices currently available, another class could be considered where possible, for the >50yr patient cohort.

P1162 Upadacitinib in Crohn’s Disease Patients: for what type of patients in real world setting ?

Abstract Background The oral selective JAK kinase inhibitor, Upadacitinib (UPA; Rinvoq®) has been shown to induce and maintain clinical response and remission in Crohn’s disease (CD), but also in rheumatic and skin diseases. We report here on the largest Swiss experience in "off label" use of this drug. Methods A chart review of the Crohn’s and Colitis Center Beaulieu Lausanne and Gastroenterology Center Bulle of CD patients was conducted. Results Eighty-nine IBD patients were exposed to UPA treatment. After exclusion of 22 patients (UC and unknown consent status) we analyzed patients’ characteristics of 67 CD patients (72% women) treated between April 2019 and Nov. 2023. All patients had previously failed or were intolerant to, at least, one anti-TNF agent, 75% had been exposed to 4 or more biologics/ small molecules and two-third had received all classes of biologics. Disease location and behavior were mostly ileo-colonic and inflammatory (L3B1) or ileal only and stricturing (L1B2). Half of the patients had co-existing extraintestinal manifestations (mostly spondylarthritis and arthralgias). Advanced combination therapy was used in 27% of cases with anti-TNF agents (n=10), vedolizumab (n=6) and ustekinumab (n=2). UPA was prescribed after a median disease duration of 14 years (range 1-68) for a mean treatment duration of 14 months (mo) (+/- 9.1 SD; range 1-37). Forty-four CD patients (66%) were still on UPA at the time of study completion. A partial or complete response was observed in 51/67 patients (76%) with a mean decrease of CRP of 10.4 mg/l (+/- 17.6 SD) and calprotectin of 610 mcg/g (+/- 1165 SD). Adverse events were mostly viral infections, acnea, hypercholesterolemia, fatigue and headaches. Conclusion Upadacitinib is a good treatment option in difficult to treat CD patients with aggressive disease behavior, alone or in combination in case of concomitant rheumatic and gastrointestinal indications.

YOLO-based marine organism detection using two-terminal attention mechanism and difficult-sample resampling

The presence of various types of noise in images of marine-life datasets, as well as the class imbalances in underwater datasets, can exacerbate the difficulty in achieving effective object detection. To address this problem, we proposed you only look once (YOLO)-based marine organism detection using a two-terminal attention mechanism and difficult-sample resampling process. First, a residual building unit (RBU) module with a two-terminal attention mechanism (RBU-TA) was proposed, incorporating a reinforced channel attention mechanism into a shortcut of the residual structure. The proposed method adaptively compressed noisy feature map channels, providing rich shallow image information for high-level deep convolutional features while avoiding shallow noise pollution. To address the imbalance of marine biological image classes, difficult-sample resampling was combined with a focal loss function to suppress excessive background negative samples and retrain targets that could be difficult to distinguish, thus improving their detection accuracy. Finally, the proposed method was validated using the underwater robot professional competition (URPC) and real-world underwater object detection (RUOD) datasets, and the mean average precision (MAP) values of the results improved by 10% and 7%, respectively. The proposed method greatly improved the target detection accuracy of organisms in complex marine environments.

Peer-reviewed presentation exchange in an undergraduate classroom.

Reading, presenting, and discussing peer-reviewed scientific reports, case studies, and reviews are essential to modern biology education. These exercises model crucial aspects of students' future professional activities and introduce the students to the current scientific concepts and methodology, data analysis, and presentation. A common format for working with primary literature is a journal club: presenting and discussing research literature in front of peers, which has many merits. However, in large modern classrooms, this format is very time-consuming and stressful, especially since presenting is not a commonly taught skill. We argue that student groups for whom the current educational and professional paradigms present a challenge due to a historical lack of representation or wellness issues are deprived of a key educational opportunity. To solve this problem, we formulated an approach called Peer-Reviewed Presentation Exchange (PRPE), which focuses on collaborative analysis, presentation, and review of research literature that includes (i) voice-narrated research presentations by students, (ii) checklists generated by the instructor to establish expectations for an informative presentation or review, and (iii) presentation assignment and peer review process. We tested this approach in an undergraduate cell biology class over 3 years. Pre- and post-assessments show significant gains in self-efficacy and knowledge not only by students who presented but also by the students who reviewed the presentations; therefore, peer-reviewed presentations are an effective tool for learning. Exit surveys show that the approach is seen as beneficial by most students. Our approach allows every student to speak and ask questions in a low-stress creative environment. It is an excellent customizable, trackable, and scalable low-stakes assessment tool.

Poor adherence to and persistence with biologics in generalized pustular psoriasis: A claim-based study using real-world data from two large US databases

BackgroundGeneralized pustular psoriasis (GPP) is a rare skin disease characterized by episodes of widespread sterile pustules. MethodsA retrospective cohort study using data from the US IBM MarketScan Commercial and Optum Clinformatics Data Mart databases between October 1, 2015 and March 31, 2020 was performed to describe adherence and persistence to biologics in patients with GPP. Patients were aged ≥18 years with newly diagnosed GPP (International Classification of Diseases code L40.1) and had ≥1 inpatient or ≥2 outpatient claims. ResultsBiologics were dispensed to 110 of 502 (22%) and 73 of 528 (14%) patients from MarketScan and Optum databases, respectively. The mean proportion of days covered (PDC) (range) was similar in both databases (MarketScan, 65% [8%-100%]; Optum, 59% [8%-99%]), and good adherence (≥80% PDC) was uncommon (MarketScan, 36%; Optum, 24%). Mean (standard deviation) persistence was similar in both databases (MarketScan, 287 [122] days; Optum, 261 [134] days). In Optum, the mean PDC was similar between age categories; good adherence was more common in patients aged 18 to 64 years (28%) versus ≥65 years (13%). Mean persistence was longer in patients aged 18 to 64 years (267 days) versus ≥65 years (242 days). ConclusionsOverall, adherence and persistence were generally poor and varied according to the biologic class, database, and age. Improving adherence may help improve GPP treatment outcomes.