Cumulative Summary Research Articles

P-2155. Early Diagnosis of Dengue, Malaria, Scrub Typhus, Leptospira Using CBC and LFT Parameters in a Tertiary Care Hospital - A 10-year retrospective study

Abstract Background Dengue, malaria and scrub typhus/leptospirosis are significant infectious diseases prevalent in tropical and subtropical regions. Timely and accurate diagnosis of these diseases is crucial for initiating appropriate treatment and preventing complications. Dengue shows increased Hb, AST should be greater than ALT, as well as a decrease in platelets, along with lymphocytes in the differential count should be observed. Scrub typhus/leptospirosis reveal dropping platelets, along with an increase in total count, alkaline phosphate, and GGTP should be observed. Malaria indicates reduced Hb and platelets, along with an increase in total bilirubin, alkaline phosphate, and GGTP should be noted. Additionally, monocytes and lymphocytes should be seen in the differential count. Methods This retrospective study conducted between January 2014-March 2024 at a tertiary hospital in India. We systematically reviewed the medical records of these patients, focusing on demographical, CBC and LFT parameters. Data were entered into an Excel spreadsheet, and descriptive statistics were employed for data interpretation. Results During the study period, a total of 99,431 were admitted. For Dengue 80.93% CBC and LFT were followed. In Scrub Typhus/Leptospirosis 58.6% were followed and in malaria 62.5% followed the CBC and LFT as shown in Table 1. Table 1:Cumulative summary of Dengue, Malaria, Scrub Typhus/LeptospiraCATEGORYFREQUENCY (N)PERCENTAGE (%)Total number of patients admitted99,431100%Total number of Dengue test done12,02012.08%NS-1 Ag Positive1,72614.35%CBC and LFT matched1,39780.93%Not matched32919.06%Total number of Scrub Typhus/Leptospirosis done2,8252.84%Positive IgM ELISA1505.30%CBC and LFT matched8858.6%Not matched6241.3%Total number of Malaria test done7,8807.92%Positive MP by QBC320.40%CBC and LFT matched2062.5%Not matched1237.5% Conclusion This study highlights the significant burden of Dengue, Scrub Typhus/Leptospirosis, and Malaria in a tertiary care setting in India. While Dengue was the most prevalent, all three diseases demonstrated the potential for early diagnosis by utilizing both CBC and LFT parameters. Disclosures All Authors: No reported disclosures

Antibiogram development for Australian residential aged care facilities.

Knowledge of local antibiotic resistance data, provided by antibiograms (a cumulative summary of in vitro-antimicrobial-susceptibility-test results), can aid prescribing of appropriate empirical antibiotics. This study aimed to explore the feasibility of antibiogram development for residential aged care facilities (RACFs). Retrospective observational study of culture and sensitivity data. Nine RACFs in Queensland, Australia. Available antimicrobial susceptibility results were collected retrospectively for all residents of recruited RACFs from January 1, 2020, to December 31, 2022. Data were managed and analyzed with WHONET software®, and antibiograms were developed in accordance with the CLSI-M39 guidelines. Antibiogram data beyond the standard 12-months and pooling of data from geographically similar RACFs were explored as options to improve feasibility and validity of the antibiograms. The most prevalent bacteria in the RACFs were Escherichia coli and Staphylococcus aureus. Due to the low number of positive cultures (less than 30) for individual RACFs, an annual antibiogram was not feasible. Extending the time-period to three years improved feasibility of antibiograms for E.coli in seven RACFs and S.aureus in five RACFs. Combining the data from closely located RACFs allowed for sufficient urinary and skin swab isolates to produce annual pooled antibiograms for all three years. Use of extended time period antibiograms can provide RACF specific urinary and skin/soft tissue resistance data without the necessity of private pathology provider input. However, pooled syndromic antibiograms can be made available on an annual basis, which may be the preferred option.

ANALYSIS OF BLACK SPOTS ON JL. RAYA KAKAP KUBU RAYA DISTRICT WITH Z-SCORE METHOD

Kubu Raya is a district in West Kalimantan Province. It is directly adjacent to Pontianak City, the province's capital. This condition increases mobility and vehicle traffic, resulting in a relatively high accident rate.Traffic accident data came from the Kubu Raya Regency Police Station, and field observations obtained data on road condition and completeness. The analysis methods used are weighting, Z-Score, and CUSUM (Cumulative Summary).The number of accidents in Jalan Raya Kakap during 2020 - 2022 amounted to 26 incidents. The characteristics of traffic accidents on Jalan Raya Kakap for three years (2020 - 2022) are that victims with minor injuries are more than victims of death and serious injuries, namely seven victims in 2020, 8 victims in 2021, and 18 victims in 2022. STA points 0 - 1 have the highest number of accidents during the 3-year period, which is 152 STA points. 2-3 by 129, and point STA. One black spot falls into the high accident vulnerability category: point STA. 0-1. Two black spots fall into the high accident vulnerability category: STA points. 2-3 and STA. 7-8. Four black spots fall into the medium category. Three black spots fall into the low category. Moreover, four points are categorized as not accident-prone.

A-076 Abbott Alinity ci System Automated Sample Interference Indices for Immunoassays

Abstract Background The Alinity ci system Sample Interference Indices (HIL) provides a more accurate and consistent method for interpretation of interferents than time consuming visual interpretation. The Alinity c system uses specific wavelength pairs and an algorithm to provide a Sample Interference Index that can correlate with sample interference due to hemolysis, bilirubin and turbidity present in serum/plasma samples. Using just a single aspiration from a sample, the individual or all 3 indices can be selected to be reported. These values in combination with assay specific endogenous interference can be used to determine the potential for HIL interference in the Alinity i immunoassays. Methods The HIL methodology will be reviewed and discussed. The study followed Clinical and Laboratory Standards Institute (CLSI) protocol EP7-A2. Interferences were studied up to concentrations of 1000 mg/dL for hemoglobin, 30 mg/dL for bilirubin (unconjugated) and 1000 mg/dL for triglycerides in serum. Serial dilutions of the sample pools were analyzed in replicates of 4 on the Alinity c system. A cumulative summary was compiled of the Hemolysis, Icterus and Lipemia indices for 100 Alinity immunoassays. Results Using known concentrations of hemoglobin, bilirubin and Intralipid, the Abbott Semi-Quantitative Index (concentration range in mg/dL) and Qualitative Index (Blank, 1+, 2+, 3+ 4+) were confirmed on the Alinity c system. Correlation studies show a linear relationship (r = 1.0) of the indices with increasing concentration of analyte. An easy-to-use guide was created that combines the HIL Qualitative and Quantitative Index scores with the assay specific interference results to provide a guide to potential interferents for the Alinity i immunoassays. This guide provides background information on the causes of HIL interferences, conversion factors from Conventional to SI units and denotes the specific concentrations of interferents which could lead to an over or under estimation in the presence of hemoglobin, bilirubin and/or lipemia. In addition, the effects of the influence of two or more HIL interferents on assay reported results is discussed. The majority (96%) of the 100 immunoassays had no significant interference using samples with elevated H, I or L index values. The remaining 3 assays showed slight interference. Conclusion The Alinity ci system provides a simple and automated procedure for determining the sample indices (HIL) for patient specimens. These HIL values in combination with assay specific endogenous interference results can be used to determine the potential for HIL interference in the Alinity i immunoassays to avoid misdiagnosis.

Effectiveness of Monetary Policy in Indonesia

This research investigated the effectiveness of the monetary policy in Indonesia. A cumulative summary test was used to determine the response of economic growth to monetary policy between 1990-2020. Furthermore, the data on gross national income, money supply, inflation, exchange rate, and interest rate was processed using error correction model regression. The results showed that monetary policy improved economic growth through channels of inflation and money supply, and the correlation was strong and valid both in the short and long term. The correlation of exchange rate and interest rate to economic growth was also observed to be significant only in the long term. The four variables had a significant, simultaneous effect on Indonesia's GDP. Therefore, the government needs to pay special attention to the enactment of monetary policy.

Multi-Sized cumulative Summary Structure Driven Light Weight in Frequent Closed Itemset Mining to Increase High Utility

Multi-Sized cumulative Summary Structure Driven Light Weight in Frequent Closed Itemset Mining to Increase High Utility

Safety of opicapone after 5 years of post-marketing experience worldwide (P14-11.013)

<h3>Objective:</h3> Review the safety data of opicapone (OPC) after five years of marketing experience worldwide. <h3>Background:</h3> OPC is a once-daily catechol-O-methyltransferase (COMT) inhibitor proven to be effective in PD patients with motor fluctuations. OPC marketing authorisation was first granted on 24 June 2016 (EU). It was launched in October 2016 and is currently marketed in over 18 countries worldwide (including the US since September 2020). <h3>Design/Methods:</h3> Patient exposure to marketed OPC was estimated based on worldwide ex-factory sales cumulatively until 30 September 2021 (assuming the ex-factory amounts delivered were entirely dispensed and administered, and were used at the dosage of 1 hard capsule/day). From the first marketing authorisation until 30 September 2021, safety data was pooled and analysed from global post-marketing sources, including spontaneous, health authorities, literature reports, and non-interventional studies. Cumulative summary tabulations of adverse events arranged by primary System Organ Class (SOC) and preferred terms within each SOC were retrieved and sorted. <h3>Results:</h3> The estimated patient exposure was 1 413 624 patient-months during the period, corresponding to 117 802 patient-years. In the 5-year period, 4035 events were reported, 545 (13.5%) serious and 3490 (86.5%) non-serious. This corresponds to an incidence of 34.3 reports per 1000 patient-years. The 5 SOCs with the highest number of events were “Nervous system disorders”, “General disorders and administration site conditions”, “Psychiatric disorders”, “Gastrointestinal disorders” and “Surgical and medical procedures”. The 10 most frequently reported adverse events were “Dyskinesia”, “Muscle rigidity”, “Hallucination”, “Bradykinesia”, “Constipation”, “Tremor”, “Gait disturbance”, “Freezing phenomenon”, “Sleep disorder” and “Reduced facial expression”. <h3>Conclusions:</h3> Safety reports during 5 years of post-marketing experience with OPC were uncommon, and mostly refer to non-serious adverse events. Motor-symptoms of PD were among the most frequently reported adverse events. No new relevant safety concern was identified. OPC continues to have an adequate safety and tolerability profile with a favourable benefit-risk ratio. <b>Disclosure:</b> Mr. Guedes has received personal compensation for serving as an employee of BIAL - Portela &amp; C.ª, S.A.. Joana Graça has received personal compensation for serving as an employee of BIAL - Portela &amp; C.ª, S.A.. Ms. Sampaio has nothing to disclose. Mariana Vieira has received personal compensation for serving as an employee of Bial - Portela &amp; Cª, S.A.. Francisco Rocha has received personal compensation for serving as an employee of BIAL - Portela. Helena Gama has received personal compensation for serving as an employee of Bial-Portela &amp; Cª S.A..

Modeling clinical trajectory status of critically ill COVID-19 patients over time: A method for analyzing discrete longitudinal and ordinal outcomes.

Early in the COVID-19 pandemic, the World Health Organization stressed the importance of daily clinical assessments of infected patients, yet current approaches frequently consider cross-sectional timepoints, cumulative summary measures, or time-to-event analyses. Statistical methods are available that make use of the rich information content of longitudinal assessments. We demonstrate the use of a multistate transition model to assess the dynamic nature of COVID-19-associated critical illness using daily evaluations of COVID-19 patients from 9 academic hospitals. We describe the accessibility and utility of methods that consider the clinical trajectory of critically ill COVID-19 patients.

Barriers and Facilitators to Substance Use Disorder Treatment: An Overview of Systematic Reviews.

objective:This investigation explored the barriers and facilitators to substance use disorder (SUD) treatment in the integrated paradigm.methods:A search technique for barriers and facilitators of SUD treatment was applied to the PubMed and Web of Science databases to identify relevant systematic reviews. The eligibility criteria included systematic review (SR) or SR plus meta-analysis (MA) articles published before the end of 2021, human research, and the English language. Each of the 12 relevant review articles met the inclusion criteria. AMSTAR was utilised to evaluate the methodological quality of the systematic reviews.results:Two authors analysed 12 SR/SR-MA articles to identify barriers or facilitators of SUD treatment. The cumulative summary results of these 12 evaluations revealed that barriers and facilitators may be classified into 3 levels: individual, social and structural. By analysing these review papers, 37 structural barriers, 21 individual barriers and 19 social barriers were uncovered, along with 15 structural facilitators, 9 social facilitators and 3 individual facilitators.conclusions:The majority of barriers indicated in the review articles included in this analysis are structural, as are the majority of facilitators. Consequently, the design of macro models for the treatment of substance use disorders may yield various outcomes and potentially affect society and individual levels.

A review on use of coir fibre in road construction

The development of transportation is crucial factor for the development of the nation. In India, tremendous growth marked in urbanization and population in last few decades which plays a major role in road construction. As a result, to provide wide connectivity via road network with the growing population, road construction is being done on almost all types of soils. At present, it has become a necessity to construct pavements even on loose soil or expansive soil, for making roads on a large scale. However, these loose and expansive soils can be modified by using natural resources which makes the soil more durable, increases the strength of the soil, makes the process more environment friendly, and also reduces the overall cost of construction. Among all the natural resources, presently coir fibre is becoming more popular as a reinforced material because of its easy availability, good wearing resistance, and longer durability. India is the largest producer of coir which is a versatile natural fibre extracted from the husk of coconut fruit in an abundant quantity. As flexible pavements are mostly preferred in India so, in this paper, an attempt has been made to study the improvement in the performance of soil subgrade and bituminous mix by the addition of coir fibre along with other natural fibres. This literature determines how unconfined compressive strength, California bearing ratio value, and other engineering properties at maximum dry density and the optimum moisture content gets improved by the coir fibre addition in subgrade soil on varying fibre content, fibre length, and height of application of fibre in subgrade layer. The paper also summarizes the change in stability, flow and volumetric properties of coir fibre reinforced bituminous mix by varying the binder content, fibre content, and fibre length. The enhanced effect in the properties of coir admixed subgrade and bituminous mix can be observed when various agents like bitumen, sodium hydroxide, carbon tetrachloride, etc. were used. It was concluded that 0.5–1% of CF required for stabilizing subgrade soil whereas, 0.2–0.5% CF is suitable for reinforcing the bituminous mix. The study confers the cumulative summary of the research outcomes in the area of road construction by using coir fibre.

Analisis Daerah Rawan Kecelakaan (Black Site) Dan Titik Rawan Kecelakaan (Black Spot) Provinsi Lampung

Traffic accidents are the main indicator of road safety levels. There were 2,225 traffic accidents throughout 2019 in Lampung Province with 724 deaths, 1240 seriously injured, and 2015 minor injuries. The research was conducted to the identification of the black site and black spot in Lampung Province. The method used in this research is the EAN, Z-score, Frequency of accidents method calculates accident-prone areas to get the value of the accident location (Black Site) and the Cumulative Summary method to identify the black spot. The results showed from 93 roads, there is 1 road which is the highest black link of each road status. The accident-prone area (black site) is Jalan Lintas Tengah Sumatra and accident-prone points (black spot) at KM 18-26 are influenced by land use, road geometric, and traffic signs.

Threats of Climate Change and Its Possible Solutions Through Utilization of Potential Microbes on Crop Production

The emission of green house gas in the globe contributes for the occurrence of climate change through changes in temperature, rain fall and climate extremes. Many changes involve microbes that contribute to or amplify human impacts. Since the basic chemistry of Earth’s surface is determined by biological activity-especially that of microbes we must look to studies of microbiology to help us understand how and why the Earth is changing and to find solutions for such undesirable changes. Many of related literatures highly indicates climate change threats projected a 50% global temperature increment, yield reduction showing drop of up to 50% from 2050 to 2100. The predicted changes in temperature, precipitation patterns, and CO 2 concentrations in the future could significantly impact the fluxes of soil mineral N and N leaching and also consequences of increases in soil salinity and a decrease in the depth of the water table. Literatures also indicate with the change in climate, the insects, pests and diseases are expected to expand their range and may find new and more vulnerable hosts. However different artificial measures were applied for ultimate goal of maximizing productivity and economic returns, an intimate role of microbes for green house reduction, sustainable soil fertility improvement, control of weeds, pest and plant diseases were reported. The reports indicated that a potential microbe called Prochlorococcus and Synechococcus remove about 10 billion tons of carbon from the air each year, a mixture of Bacillus thuringiensis spores as a pesticide, B. thuringiensis accounts for over 90 per cent of the total share of today's bio insecticide market and diazotroph bacteria ( Rhizobium , Bradyrhizobium , Sinorhizobium , Frankia ) through symbiotic association accounted 79% atmospheric N fixation and showed an efficacy as potent plant growth promoters. The cumulative summary of many literatures ensures the capability of replacing artificial measures with biological control measures for climate change threats. Keywords: Greenhouse gases; Bio control; Climate change; Microorganisms DOI : 10.7176/JNSR/9-19-05 Publication date :October 31 st 2019

Application of an Array of Metal-Oxide Semiconductor Gas Sensors in an Assistant Personal Robot for Early Gas Leak Detection

This paper proposes the application of a low-cost gas sensor array in an assistant personal robot (APR) in order to extend the capabilities of the mobile robot as an early gas leak detector for safety purposes. The gas sensor array is composed of 16 low-cost metal-oxide (MOX) gas sensors, which are continuously in operation. The mobile robot was modified to keep the gas sensor array always switched on, even in the case of battery recharge. The gas sensor array provides 16 individual gas measurements and one output that is a cumulative summary of all measurements, used as an overall indicator of a gas concentration change. The results of preliminary experiments were used to train a partial least squares discriminant analysis (PLS-DA) classifier with air, ethanol, and acetone as output classes. Then, the mobile robot gas leak detection capabilities were experimentally evaluated in a public facility, by forcing the evaporation of (1) ethanol, (2) acetone, and (3) ethanol and acetone at different locations. The positive results obtained in different operation conditions over the course of one month confirmed the early detection capabilities of the proposed mobile system. For example, the APR was able to detect a gas leak produced inside a closed room from the external corridor due to small leakages under the door induced by the forced ventilation system of the building.

Nurses' use of conscientious objection and the implications for conscience.

To explore the meaning of conscience for nurses in the context of conscientious objection (CO) in clinical practice. Interpretive phenomenology was used to guide this study. Data were collected from 2016 - 2017 through one-on-one interviews from eight nurses in Ontario. Iterative analysis was conducted consistent with interpretive phenomenology and resulted in thematic findings. Iterative, phased analysis using line-by-line and sentence highlighting identified key words and phrases. Cumulative summaries of narratives thematic analysis revealed how nurses made meaning of conscience in the context of making a CO. Conscience issues and CO are current, critical issues for nurses. For Canadian nurses this need has been recently heightened by the national legalization of euthanasia, known as Medical Assistance in Dying in Canada. Ethics education, awareness, and respect for nurses' conscience are needed in Canada and across the profession to support nurses to address their issues of conscience in professional practice. Ethical meaning emerges for nurses in their lived experiences of encountering serious ethical issues that they need to professionally address, by way of conscience-based COs. This is the first study to explore what conscience means to nurses, as shared by nurses themselves and in the context of CO. Nurse participants expressed that support from leadership, regulatory bodies, and policy for nurses' conscience rights are indicated to address nurses' conscience issues in practice settings.

Enhanced Passive Surveillance Methods Using CDC and State Child Blood Lead Surveillance Data

Local, state and national child blood lead level (BLL) surveillance is typically conducted passively. The increasing need to detect increases in the proportion of elevated child BLLs from surveillance data have highlighted the need for methods to detect and investigate changes of public health importance in a timely manner.Our objective was to develop and assess a modified Cumulative Summary (CUSUM)/Shewhart chart alerting algorithm for analysis of child BLL surveillance data that can be applied continually to improve the time to detect changes in reported BLL surveillance patterns.Geographic and temporal data-aggregation strategies were applied on routinely collected child BLL surveillance data employing an alerting algorithm using a sliding buffer concept. The algorithm accounts for long term trends, seasonal variation and serial autocorrelation of child BLLs. The algorithm was applied on 20 jurisdictions: two with a known increase in the proportion of children &amp;lt; 6 years of age with BLLs &amp;#8805; 5 µg/dL and data from 18 randomly selected counties from the CDC Child Blood Lead Surveillance System.Alert signals retrospectively identified time periods in the two jurisdictions where a known increase occurred. No signals were identified among 17/18 (94.4%) randomly selected counties where no known changes occurred. The one county where a signal was identified appears appropriate to the data patterns, where a 67% decrease of children &amp;lt; 6 years of age tested occurred from the previous year. The algorithm accomplished adjustment for seasonality and de-trending.The modified algorithm provides a framework for enhanced passive surveillance by identifying changes in proportion of children w/ BLLs &amp;#8805; 5 µg/dL. Algorithm settings are empirical and need to be set at the local level. The algorithm methodology needs replication at the local level. Further study is required to define alerting signal triggers when considering public health action compared with statistical significance.

Change analysis on historical shorelines extracted from medium resolution satellite images: a case study on the southern coast of Peninsular Malaysia

Information on changes of coastal zones such as erosions and accretions can be monitored by identifying conditions of shorelines. Shorelines provide the boundary information of land and water, which can be performed by using satellite images rather than by using traditional ground survey, which is known as laborious and expensive. In this study, the historical satellite images of Landsat sensors were gathered from year 1977 to 2017. Additionally, one image of SPOT-5 was also included to get more data for analysis. For each satellite image acquired, supervised machine learning techniques were used to classify the image into land and water classes. Then, the shoreline GIS vector were extracted after locating boundaries of both classes and applying post-processing stages on the classified images. The historical shorelines extracted were used to do further change analysis using End Point Rate method to examine the differences between the older shorelines and the newer shorelines. At this stage, two baselines were created for inner and outer baselines to control the analysis boundary limit. Then, transects of the historical shorelines were created for every 50 m interval. The rate of change statistics represent a cumulative summary of the processes affected during the observation duration. The research findings observed that the southern region of Peninsular Malaysia which known as Tanjung Piai was affected mostly by erosion while the western coast was affected by accretion. The erosion regions were affected by the living population along the coastal areas while the accretion was caused by land reclamation against erosion or built-up area expansion. This study was conducted to observe the most affected areas in the southern Peninsular Malaysia for more than 30 years’ duration, potentially due to sea level rises besides natural processes and anthropogenic activities.

Mapping the archives: 9

ABSTRACTThis is the ninth (and possibly last) instalment of RiDE’s occasional series of short informational pieces on archives in the field of drama and theatre education and applied theatre and performance. Each instalment has included summaries of one or more collections of significant material in the field. The intention has been to provide a cumulative directory of archival resources, updated as and when necessary, and one that acts as an ongoing resource for researchers, teachers, students and practitioners. We have included not only the established, fully catalogued and well-known collections, but also the lesser known, possibly quite small and ‘emergent’ collections and significant collections contained within larger archives. This instalment contains reports from two countries, South Africa and Singapore, that both have – in very different ways – thriving drama education/applied theatre scenes, but ones in which archives have only recently begun to emerge as a vital means of capturing that legacy. It also contains a cumulative summary of all the archives that have been mapped to date, cross-referenced to the RiDE issues in which their details appeared.

Antimicrobial susceptibility testing

There continues to be considerable confusion and debate regarding the utility of antimicrobial susceptibility testing (AST) to aid in the antimicrobial selection process. With the renewed emphasis on antimicrobial stewardship in both human and veterinary medicine, it is important to consider all disease preventive and diagnostic tools available. The scientific literature is equivocal regarding the correlation between the in vitro susceptibility test result and clinical outcome. These studies also highlight key points that practitioners should consider when using both individual animal AST results and cumulative diagnostic summaries to select antimicrobial therapeutics.

Abstract LB-153: Pan-cancer patterns of DNA methylation dysregulation and copy number alteration burden

Abstract Alterations both in the genome and epigenome are required for cancer development. In this study, we developed and investigated a summary measure of global DNA methylation dysregulation, the Methylation Dysregulation Index (MDI) in data from fourteen cancers (n = 5,603: bladder, breast, renal clear cell, renal papillary cell, esophagus, thyroid and uterine corpus endometrial carcinomas; colonic, lung, pancreatic, and prostate adenocarcinomas; head and neck and lung squamous cellular carcinomas; and hepatocarcinomas). We then compared the burden of DNA methylation dysregulation with somatic genetic alteration cumulative burden summary measures. We accessed the Level 1 Infinium HumanMethylation450K BeadChip and clinical data from 5603 tumors and 699 adjacent normal tissues in The Cancer Genome Atlas (TCGA) database. Information of fraction of the genome with copy number alterations (FGA) was retrieved from cBioportal. The raw DNA methylation data was preprocessed using RnBeads. Beta-values were background corrected using methylumi-noob and normalized using the functional normalization to increase comparability and reduce the noise of potential batch effects. Probes marked as Non-CpG, allosomes, cross-reactive probes or containing SNPs, and those with low quality were filtered before the analyses. We calculated the difference between the beta value per probe of tumor DNA methylation and the median beta value for the same probe for the adjacent normal tissue DNA methylation samples for each tumor type. The average absolute difference across all the interrogated probes corresponds to the MDI value. We examined the relation of MDI across tumors types as well as with age, gender, tumor stage, and the estimated percentage of tumor cells in the sample. We observed that MDI was significantly associated with tumor stage in head and neck squamous cell (P-trend = 4.24E-03), kidney clear cell (P-trend = 1.35E-08) and kidney papillary (P-trend = 4.86E-11) cancers, after adjusting for age, gender and estimated tumor purity. Our findings were consistent when the MDI calculation was restricted to probes stratified by genomic context (CpG islands, N-shores, N-shelves, open sea, S- shores, and S-shelves). Tumor stage in prostate adenocarcinoma and thyroid carcinoma were borderline significant (P-trend = 1.04E-02, and P-trend = 1.20E-02 respectively), however, the genomic context findings for these cancer types were inconsistent. The FGA was positively correlated to MDI for all tumor types (ρ = 0.54, P&amp;lt;2.2E-16). When analyzing by tumor type, MDI and FGA spearman correlation ranged between 0.21 and 0.80 and was significant for all the tumors except uterine cancer. This work contributes to the understanding of the impact of epigenetic alterations and their relation with genetic alterations across human cancers. DNA methylation dysregulation seems particularly important for kidney (clear cell and papillary) and head and neck squamous cellular cancers, and it might be related independently to cancer progression after adjusting for age and gender. Citation Format: Lucas A. Salas, Kevin C. Johnson, Brock C. Christensen. Pan-cancer patterns of DNA methylation dysregulation and copy number alteration burden. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr LB-153.

Associations between extreme precipitation and gastrointestinal-related hospital admissions in Chennai, India.

Background: Understanding the potential links between extreme weather events and human health in India is important in the context of vulnerability and adaptation to climate change. Research exploring such linkages in India is sparse.Objectives: We evaluated the association between extreme precipitation and gastrointestinal (GI) illness-related hospital admissions in Chennai, India, from 2004 to 2007.Methods: Daily hospital admissions were extracted from two government hospitals in Chennai, India, and meteorological data were retrieved from the Chennai International Airport. We evaluated the association between extreme precipitation (≥ 90th percentile) and hospital admissions using generalized additive models. Both single-day and distributed lag models were explored over a 15-day period, controlling for apparent temperature, day of week, and long-term time trends. We used a stratified analysis to explore the association across age and season.Results: Extreme precipitation was consistently associated with GI-related hospital admissions. The cumulative summary of risk ratios estimated for a 15-day period corresponding to an extreme event (relative to no precipitation) was 1.60 (95% CI: 1.29, 1.98) among all ages, 2.72 (95% CI: 1.25, 5.92) among the young (≤ 5 years of age), and 1.62 (95% CI: 0.97, 2.70) among the old (≥ 65 years of age). The association was stronger during the pre-monsoon season (March–May), with a cumulative risk ratio of 6.50 (95% CI: 2.22, 19.04) for all ages combined compared with other seasons.Conclusions: Hospital admissions related to GI illness were positively associated with extreme precipitation in Chennai, India, with positive cumulative risk ratios for a 15-day period following an extreme event in all age groups. Projected changes in precipitation and extreme weather events suggest that climate change will have important implications for human health in India, where health disparities already exist.Citation: Bush KF, O’Neill MS, Li S, Mukherjee B, Hu H, Ghosh S, Balakrishnan K. 2014. Associations between extreme precipitation and gastrointestinal-related hospital admissions in Chennai, India. Environ Health Perspect 122:249–254; http://dx.doi.org/10.1289/ehp.1306807