Cutoff For Statistical Significance Research Articles

Young lung adenocarcinoma: Molecular analysis pointing to early acquisition of aggressive mutations.

e20089 Background: Lung adenocarcinoma in young adults (≤50) has an aggressive course even in the presence of targetable mutations. Prior US studies were conducted predominantly in the Northeast where smoking prevalence is low compared to Kentucky. To assess the mutation spectrum in this high-risk population we performed a descriptive analysis of mutations in patients 50 years old and younger (YA), compared the survival of YA patients with and without NGS, and compared the survival of YA to patients older than 50 seen at an NCI designated Comprehensive Cancer Center situated in the tobacco belt. Methods: Using the Kentucky Cancer Registry (KCR) we identified 139 YA patients with lung adenocarcinoma seen at our institution between 01/2015 to 11/2023, 54 had NGS testing. 933 patients over age 50 were identified for comparison. Adenocarcinoma specimens were analyzed using next-generation sequencing of DNA (DNA-592-gene panel or whole exome) or RNA (whole transcriptome or +1,500-gene panel) at Caris Life Sciences or Foundation Medicine. Hazard ratios (HR) for survival were calculated using the Cox proportional hazards model. The cutoff for statistical significance was a p-value < 0.05 as calculated by the Chi-square test. Results: Of the 54 YA patients with NGS, 28 (52%) were female, 48 were white (88%), 3 Black (6%), and 3 Asian (6%). Only 18% were never smokers (median 28 pack years), and 44% had a family history of lung cancer. Targetable mutations were noted in 27 (50%). EGFR was mutated in 9 patients (17%), 2 with exon 19 deletion, 2 with exon 20 insertion, and 5 with exon 21 L858R. ALK rearrangement was seen in 3 patients (5%), while 3 (5%) had ERBB2 mutations. There was a mutation of KRAS in 17 patients (31%), and 16 of the 17 were transversion mutations. (13/17 G12C, 1/17 G12R, 1/17 G12V and 1/17 G13C). TP53 was mutated in 44 patients (81%), and 16 patients (30%) had mutations in homologous recombination repair (HHR) genes. The tumor mutation burden was high in 28 (52%) of patients. PD-L1 expression was > 50% in 22/54, 1-49% in 18/54, and 0% in 10/54 (4/54 NA). Survival was not significantly different between YA patients with and without NGS nor between YA and older patients. Conclusions: We identified a high prevalence of KRAS G12C, previously associated with increasing age and environmental insults, and EGFR exon 21 L858R in a YA population. Alterations in HHR genes and TP53 were present at high rates. Acquisition of aggressive forms of KRAS and EGFR mutation, as well as the high prevalence of TP53 and HHR defects, may contribute to early disease development. This highlights the importance of early tobacco cessation efforts and the need to assess germline mutations. Lung cancer remains a therapeutic challenge even in young patients with actionable mutations, as outcomes remain poor, equivalent to older patients.

Evaluation of different mouthwashes through their effect on their influence on the force loss of orthodontic elastic ligatures

Background: In several orthodontic treatments, elastomeric chains are utilised to produce force, however, this force degrades over time, which may impact tooth mobility. This study aims to investigate how different mouthwashes (Chlorhexidine 0.2%, Sensodyne, and Listerine) may affect the force degradation of two different types of elastic ligatures (Ortho Matrix and 3M Unitek) through the amount of force remaining. Materials and methods: Two control groups and six experimental groups each included 600 pieces of the elastomeric chains Ortho matrix (OM) and 3M Unitek (3M). Pieces were stretched to a 25mm thickness, placed on pins set into an acrylic block, and kept at 37°C in artificial saliva. For the duration of the study, each of the test groups spent one minute immersed in one of three distinct kinds of mouthwash. Ten continuous thermocyclers with temperatures ranging from 5 to 55 degrees Celsius were performed each day, alternating between cold and hot water baths. While calculating the forces, we considered six different time intervals: the beginning, 24 hours, 1, 2, 4, and 6 weeks. The one-way analysis of variance (ANOVA) test and the t-test were used to compare the mean force of a number of different mouthwashes, elastomeric chains, and times. A value of 0.05 was chosen as the cutoff for statistical significance. Results: Over time, both types of elastomeric chains significantly lost force at 6 weeks (p<0.05). At all times, the 3M Unitek (3M) created more force than the Ortho matrix (OM) elastomeric chain. Compared to other mouthwashes, chlorhexidine mouthwash had a substantially less impact on force degradation, with discernible very simple change when compared to control groups (Artificial saliva). Conclusion: According to findings, the 3M Unitek offered a higher force level than the other sort of elastomeric chains, and there is a difference that is clinically significant between the two types of elastomeric chains. It is possible that the pH of the mouthwashes, as opposed to other substances, contributes to the gradual loss of power over time. Mouthwashes containing chlorhexidine had the third-smallest influence on the force degradation of elastomeric chains, after Sensodyne and Listerine..

The adherence to asthma medication for hospitalized children with asthma: A cross-sectional study in a tertiary hospital in Riyadh, Saudi Arabia.

The aim of the study was to assess adherence to asthma controller therapy and factors that influence asthma control and to determine the association between asthma knowledge of the caregiver and asthma control among admitted children with asthma. A cross-sectional study was conducted between November 2022 and May 2023 in a tertiary care hospital. Children with a diagnosis of asthma aged 2-14 years, who were admitted to the hospital with an exacerbation of asthma were identified. Caregivers of the admitted children were interviewed using the Asthma Knowledge Questionnaire and Pediatric Inhaler Adherence Questionnaire. Demographic and clinical data were described using descriptive analyses, where mean and standard deviation were used for normally distributed continuous variables, median and interquartile range (IQR), if otherwise. A P < 0.05 was set as a cutoff for statistical significance. A total of 144 caregivers completed the survey. Median score for parents' knowledge of asthma was 64%, with an IQR of 59-67. Both mother's and father's educational levels were associated with a good level of knowledge: odds ratio (OR) = 2.48, 95% confidence interval (CI) = 1.1-5.6, and OR = 5.33, 95% CI = 2.23-12.7, respectively. Median adherence to metered dose inhaler (MDI) was 4 (IQR = 2-6). Children who had been admitted to the general ward in the last 6 months were three times more likely to be nonadherent to MDI (OR = 3.03, 95% CI = 1.18-7.82). Forty-three percent of children who were nonadherent to MDI were less likely to have their asthma controlled (OR = 0.43, 95% CI = 0.17-1.06). This study revealed that a low level of knowledge among caregivers of asthma patients is linked to inadequate adherence to asthma controller therapy. As medication adherence is crucial for achieving desirable asthma control and improving the quality of life for this population, efforts need to be made to enhance the knowledge level of parents of children with asthma.

Predicting FDG-PET Images From Multi-Contrast MRI Using Deep Learning in Patients With Brain Neoplasms.

18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is valuable for determining presence of viable tumor, but is limited by geographical restrictions, radiation exposure, and high cost. To generate diagnostic-quality PET equivalent imaging for patients with brain neoplasms by deep learning with multi-contrast MRI. Retrospective. Patients (59 studies from 51 subjects; age 56 ± 13 years; 29 males) who underwent 18 F-FDG PET and MRI for determining recurrent brain tumor. 3T; 3D GRE T1, 3D GRE T1c, 3D FSE T2-FLAIR, and 3D FSE ASL, 18 F-FDG PET imaging. Convolutional neural networks were trained using four MRIs as inputs and acquired FDG PET images as output. The agreement between the acquired and synthesized PET was evaluated by quality metrics and Bland-Altman plots for standardized uptake value ratio. Three physicians scored image quality on a 5-point scale, with score ≥3 as high-quality. They assessed the lesions on a 5-point scale, which was binarized to analyze diagnostic consistency of the synthesized PET compared to the acquired PET. The agreement in ratings between the acquired and synthesized PET were tested with Gwet's AC and exact Bowker test of symmetry. Agreement of the readers was assessed by Gwet's AC. P = 0.05 was used as the cutoff for statistical significance. The synthesized PET visually resembled the acquired PET and showed significant improvement in quality metrics (+21.7% on PSNR, +22.2% on SSIM, -31.8% on RSME) compared with ASL. A total of 49.7% of the synthesized PET were considered as high-quality compared to 73.4% of the acquired PET which was statistically significant, but with distinct variability between readers. For the positive/negative lesion assessment, the synthesized PET had an accuracy of 87% but had a tendency to overcall. The proposed deep learning model has the potential of synthesizing diagnostic quality FDG PET images without the use of radiotracers. 3 TECHNICAL EFFICACY: Stage 2.

The Effect of Cement Space Parameters on the Marginal Adaptation of Milled Endocrowns: An In Vitro Study.

Background Cement film space plays a significant role in achieving good adaptation of indirect restorations. The objective of this study is to investigate the effect of cement space parameters on the marginal adaptation of computer-aided design (CAD)/computer-assisted manufacturing (CAM) endocrowns. Methodology The coronal part of 10 freshly extracted human mandibular molars was reduced to a level of 1.5 mm above the cementoenamel junction (CEJ); then, root canal treatment was performed. On each tooth, four lithium disilicate endocrowns with different cement space parameters (40, 80, 120, and 160 µm) were designed and fabricated using CAD/CAM. Endocrowns were seated to their prepared teeth, and the vertical marginal gap was measured in 20 equidistant points for each endocrown using a stereomicroscope on 90×magnification.The mean marginal gaps of the four groups were compared using a one-way analysis of variance (ANOVA) and the Tukey honestly significant difference (HSD) test considering p<0.05 as the cutoff for statistical significance. Results The mean marginal gap of the 40 µm, 80 µm, 120 µm, and 160 µm groups were 46.25±21.20 µm, 21.75±11.10 µm, 15.94±06.62 µm, and 13.10±07.08 µm, respectively. One-way ANOVA showed a significant difference in the marginal gaps between groups (p<0.001). The Tukey post hoc test showed a statistically significant mean difference between 40 µm and each of the other three groups (p<0.001). Conclusion The cement space parameter variation affects the marginal adaptation of endocrowns. The cement space of 40 µm resulted in a higher marginal gap than cement spaces of 80, 120, and 160 µm.

A confocal laser scanning microscopic evaluation of nonthermal atmospheric plasma on the dentinal tubule penetration of bioceramic and epoxy resin-based root canal sealers.

Using confocal laser scanning microscopy (CLSM), the current study assessed the impact of nonthermal atmospheric plasma (NTAP) on the dentinal tubule penetration of bioceramic and epoxy resin-based root canal sealers (CLSM). Forty human mandibular premolar teeth with a single root that had just undergone extraction were chosen and biomechanical preparation of root canals was done with ProTaper Gold rotary Nickel-titanium instruments. Samples were divided into four groups (n = 10). Group 1: Bioceramic sealer (BioRoot RCS); Group 2: Epoxy resin-based sealer (AH Plus) without application of NTAP; Group 3: Bioceramic sealer (BioRoot RCS); and Group 4: Epoxy resin-based sealer (AH Plus) with the application of NTAP for 30 s. In Groups 3 and 4, all of the samples underwent obturation with the appropriate sealers following NTAP application. For determination of the sealer's dentinal tubule penetration values, slices with a thickness of 2 mm were taken from the middle third of sample's root and examined using CLSM. The acquired data were statistically analyzed with one-way analysis of variance and the Post hoc Tukey's test. The cutoff for statistical significance was P < 0.05. In comparison to other groups, the maximum sealer penetration values into dentinal tubules were significantly higher in Group 3 for Bioceramic sealer with NTAP application and Group 4 for Epoxy resin-based sealer with NTAP application. NTAP application increased the dentinal tubule penetration of bioceramic and epoxy resin-based sealers in comparison to groups without NTAP application.

249. Characteristics and outcomes of cryptococcosis among patients with COVID-19 compared to non-COVID-19 controls

Abstract Background It remains unclear if there is an association between COVID-19 and cryptococcosis. The purpose of this study was to compare demographic characteristics and outcomes of cryptococcosis between patients with COVID-19 to non-COVID-19 controls. Methods Patients 18 years and older with cryptococcosis were identified from TriNetX, a global federated research network, and separated into two cohorts based on a diagnosis of COVID-19 within 3 months prior to the index diagnosis of cryptococcosis. The primary outcome was the percent mortality in each group. The secondary outcomes included the proportion of patients in each group who had underlying comorbidities, received immunosuppressive medications, or required hospitalization or ICU admission. Propensity score matching was performed to control for differences between groups based on demographics and comorbidities. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for outcomes, with p &amp;lt; 0.05 as the cut off for statistical significance. Results A total of 6252 patients with cryptococcosis were included, of which 4.5% (n=283) had COVID-19 prior to diagnosis of cryptococcosis. Mortality was similar between patients with and without COVID-19 (13% vs 10%, p=0.075). Patients with cryptococcosis and previous COVID-19 were older (55.2 ± 14.5 years vs 52 ± 15.2 years, p=0.0005) and more likely to be non-Hispanic (73% vs 65%, p=0.0049). More patients with COVID-19 had a history of transplant (30% vs 13%, p &amp;lt; 0.0001), malignancy (37% vs 21%, p &amp;lt; 0.0001), and diabetes (35% vs 19%, p &amp;lt; 0.0001), but not HIV (29% vs 31%, p=0.5482). Prednisone and dexamethasone use were higher among patients with previous COVID-19 (32% vs 15%, p &amp;lt; 0.0001 and 17% vs 7%, p &amp;lt; 0.0001, respectively). Hospitalization rates were similar (54% vs 57%, p=0.278), but more patients with COVID-19 required ICU admission (19% vs 11%, p &amp;lt; 0.0001). In propensity score-matched analysis, patients with COVID-19 remained at higher odds of ICU admission (OR 1.85, 95% CI 1.15-2.97, p=0.010), but lower odds of hospitalization (OR 0.57, 95% CI 0.41-0.81, p=0.001). Conclusion Patients with COVID-19 who developed cryptococcosis had higher rates of comorbidities, corticosteroid use, and ICU admission but did not experience higher mortality compared to non-COVID-19 controls. Disclosures George R. Thompson, III, MD, Amplyx: Advisor/Consultant|Amplyx: Grant/Research Support|Astellas: Advisor/Consultant|Astellas: Grant/Research Support|Cidara: Advisor/Consultant|Cidara: Grant/Research Support|F2G: Advisor/Consultant|F2G: Grant/Research Support|Merck: Grant/Research Support|Pfizer: DSMB|Scynexis: Advisor/Consultant|Scynexis: Grant/Research Support.

LOW CARDIOVASCULAR RISK REDUCTION BEHAVIORS AMONG HYPERTENSIVES ATTENDING FOLLOW-UP CARE AT A TERTIARY-LEVEL HOSPITAL IN ADDIS ABABA, ETHIOPIA

Introduction: Cardiovascular disease (CVD) outcomes in hypertensives are substantially influenced by risk-reduction behaviors. Even though hypertensives in Ethiopia have a high prevalence of behavioral risks for negative CVD outcomes, little is known about risk-reduction behaviors in this population. Therefore, this study aimed to investigate the CVD risk reduction behaviors among adult hypertensives in Addis Ababa, Ethiopia. Method: A cross-sectional design was used. A sample of 384 hypertensives was selected using a systematic random sampling technique from the hypertension clinic registry. Epi data version 3.10 was used to clean the data, and SPSS version 25.0 was used for analysis. Descriptive statistic was used to determine participants’ CVD risk reduction behavioral status. Bivariate chi-square test and ordinal logistic regression analyses were run to identify variables associated with participants' ranked CVD risk reduction behavioral status at the p-value &lt; .05 cutoff for statistical significance. Results: The mean (± standard deviation) age of participants was 53.61 (± 12.34) years, (range, 30-82 years), and 51.2% were males. The majority (56.5%) of them were at low CV risk reduction practices. Only 45.1% were at target BP control. The absence of comorbidities (p &lt; .001), clinic visits every 3 months for hypertension (p = .041), normal body mass index (p = .008), hypertension duration of 5–9 years (p = .034), and young age adults (p = .041) were the characteristics significantly associated with the high CVD risk reduction practice. Conclusion: Hypertensives' adoption of CVD risk reduction behaviors was low, with a variety of unmanaged risk factors and a few cardioprotective behaviors. Healthcare providers may improve patients’ CV risk-reduction behavior through teaching lifestyle changes and more frequent clinic visits.

Antidiabetic Activity of Mung Bean or Vigna radiata (L.) Wilczek Seeds in Alloxan-Induced Diabetic Mice.

Despite the development of oral hypoglycemic medications, diabetes and its associated complications continue to be significant clinical issues. The purpose of this study was to examine the antidiabetic effects of Vigna radiata (L.) Wilczek seeds in mice that had been given alloxan to cause diabetes. In Swiss albino mice, diabetes was brought on by a single intraperitoneal injection of the drug alloxan (150 mg/kg). For 14 days, glibenclamide (5 mg/kg) and methanol extract of V. radiata seeds (100, 200, and 400 mg/kg) were given orally. Following oral administration of V. radiata to mice, the blood glucose levels (BGL) and body weight were measured at 7 and 14 days. The mice were sacrificed at the end of the trial, and blood samples were taken for the evaluation of insulin, glycated hemoglobin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), high-density lipoprotein (HDL), total cholesterol (TC), and triglyceride (TG) levels. It was determined how much glycogen was present in the liver. Additionally, the total phenolic and flavonoid contents of V. radiata were determined, along with the in vitro DPPH (2, 2 diphenyl-1-picrylhrazyl) free radical-scavenging activity. P < 0.05 was chosen as the cutoff for statistical significance. Following oral administration of V. radiata for 14 days, diabetic mice's BGL and bad cholesterol (TC and TG) levels significantly decreased, while HDL levels increased. Treatment with V. radiata significantly decreased the levels of AST, ALT, and glycated hemoglobin when compared with diabetes control. On the other hand, it raised insulin levels and the amount of liver glycogen. V. radiata underwent phytochemical analysis, which identified the presence of tannins, saponins, phenols, alkaloids, terpenoids, steroids, flavonoids, and glycosides. Per gram of V. radiata seed extract, the total phenolic content was 43.12 ± 3.14 mg of gallic acid equivalents, while the total flavonoid content was 38.35 ± 2.6 mg of quercetin equivalents. Ascorbic acid was shown to have an IC50 value of 18.64 µg/ml during a DPPH-scavenging assay, while V. radiata had an IC50 value of 73.35 µg/ml. According to the findings of the current study, the methanolic extract of the seeds from the plant V. radiata possesses significant antidiabetic characteristics that are on par with those of the commonly used drug glibenclamide. Hence, V. radiata seems to be effective as a natural antidiabetic.

Self-Reported COVID-19 Infections and Social Mixing Behavior at Oncology Meetings

Purpose/Objective(s)The COVID-19 pandemic largely suspended conventional in-person scientific meetings because of the risk of disease spread. In the era of vaccination and social distancing practices, meetings have slowly begun to return to in-person formats. We surveyed attendees and potential attendees of two United States oncology meetings to identify rates of mixing behavior and the subsequent rate of self-reported COVID-19 infection.Materials/MethodsWe collected reported social mixing behavior and COVID-19 positivity of actual and potential in-person oncology meeting attendees of the American Society of Clinical Oncology (ASCO) Quality Care Symposium in Boston, Massachusetts on September 24-25, 2021, and the American Society for Radiation Oncology (ASTRO) Annual Meeting in Chicago, Illinois on October 24-27, 2021 via survey. Participants were identified through publicly available meeting materials and targeted via email when possible. Recruitment was also conducted through Twitter and a radiation oncology newsletter, as well as an anonymous link made available to emailed recruits, with sharing encouraged. In-person respondents to the later ASTRO survey who had attended the ASCO meeting were excluded from the analysis. Statistical significance was determined using Fisher's exact test for rates of COVID-19 positivity and the chi-squared statistic for differences in group characteristics, with a cutoff for statistical significance p<0.05.ResultsResponse rates from attendees with publicly available emails were 27.4% for the ASCO meeting and 14.3% for the ASTRO meeting. The ASCO survey produced 94 responses, with 48 responding as in-person attendees. The ASTRO survey produced 370 responses, with 267 responding as in-person attendees. Across both meetings, 3 of 308 (1.0%) of in-person attendees versus 2 of 141 (1.4%) of non-attendees tested positive for COVID-19 (p=0.65). Among in-person attendees, there were similar low COVID-19 positivity rates among those spending more (>20) vs less (≤20) hours attending live sessions (2.2% vs 0%, p=0.25) and between those who went to indoor social events vs those who did not during the meeting periods (0.8% vs 1.9%, p=0.44). Attendees largely felt that they would feel comfortable attending additional in-person meetings after experiencing the ASCO (87.5%) or ASTRO (91.9%) meetings and that mask compliance was good or excellent at the ASCO (100%) and ASTRO (94.6%) meetings.ConclusionThis study indicates that in-person meetings do not seem to be contributing to high rates of new COVID-19 infections in the setting of mask mandates, vaccine mandates, and decreased room capacity allowances. The rate of self-reported COVID-19 infection of both in-person attendees and non-attendees was very low and the meetings were successful at creating an environment where participants felt safe. These findings support the possibility of a path forward for at least partially in-person conferences as new variants emerge and COVID-19 becomes endemic.

Awareness of age-related macular degeneration and its associated risk factors

Background Age-related macular degeneration (AMD) is a progressive retinal degenerative disease divided into two types: early dry non-neovascular AMD and advanced wet neovascular AMD. It is recognized as the leading cause of irreversible blindness in high-income nations, with an increasing incidence among the elderly. This study aims to assess the awareness of AMD among the Saudi population and identify the groups with the least knowledge and the factors influencing their level of knowledge. Patients and methods A cross-sectional study was conducted using a validated questionnaire adapted from the AMD Alliance International Global Report. Univariate analysis was performed to determine the factors associated with awareness of AMD, and the odds ratio and 95% confidence interval were calculated. Two-tailed analysis with P value less than 0.05 was used as the cutoff for statistical significance. Results Among the 1008 participants who agreed to participate, the most common age group was 41–50 years (33.7%) and nearly two-thirds (63%) were female. Only 7.6% of participants were aware of AMD, whereas 92.4% were not aware, and higher educational levels were associated with increased awareness of AMD. Conclusion There is a low level of awareness of AMD among the Saudi population. A great emphasis on the importance of AMD education and awareness of modifiable risk factors is necessary, especially among the high-risk population.

Endoscopic Findings in Patients With Upper Gastrointestinal Bleeding in Ogun State, Nigeria.

IntroductionAlthough the global incidence of upper gastrointestinal bleeding (UGIB) appears to have reduced substantially in the past few decades, acute UGIB still carries significant morbidity and mortality worldwide. There are currently no published data on UGIB in Ogun State, Nigeria. This study examined the endoscopic findings in patients with UGIB in Ogun State. MethodologyThe study was a retrospective cross-sectional survey of patients with UGIB who had upper gastrointestinal endoscopy at three endoscopy centers in Ogun State, Southwest Nigeria, from January 2015 to December 2021. Patients’ data, which included age, gender, and endoscopic findings, were extracted from the endoscopy registers into a spreadsheet and analyzed statistically. Summary statistics included means ± standard deviation for continuous variables and frequencies and percentages for categorical variables. Categorical variables were compared for differences by chi-square test or Fisher’s exact test as appropriate. The statistical significance cutoff was p-value <0.05.ResultsA total of 171 had endoscopy for UGIB during the period under review but 168 had complete data. Out of the 168, 113 (67.3%) were males, giving a male-to-female ratio of 2:1. The mean age of the patients was 52.4 ± 18.1 years, with an age range of 7-85 years. The modal age group was ≥60 years (75; 39.9%). The most common endoscopic finding was peptic ulcer disease (77; 45.8%), followed by esophagogastric varices (27; 16.1%), erosive mucosal disease (25; 14.9 %), portal hypertensive gastropathy (15; 8.9%), suspected malignancies (11; 6.6%), hemorrhagic gastritis (7; 4.2%), gastric antral vascular ectasia (2; 1.2%), and Mallory-Weiss tear (1; 0.6%), respectively. Forty-four patients (26.2%) had no lesion that could explain UGIB. ConclusionPeptic ulcer disease was the most common cause of UGIB among our patient population, and the elderly male patients were the most affected.

The effect of bolus size on masticatory parameters at swallowing threshold in children using a hard, solid, artificial test food.

The effect of different bolus sizes on food breakdown has been studied in adults, but not in children. The objective of this study was to study median particle size (MPS) and other parameters of masticatory function at swallowing threshold (ST) in 8–10‐year‐old‐children with two different bolus sizes. A randomized crossover trial was undertaken in 89 eight to ten‐year‐old children. The study was performed with informed consent and ethical approval. The artificial test food used was made of a condensation silicone (Optosil Comfort) following a standardized protocol. Two bolus sizes (three or four quarters of a 20‐mm diameter, 5‐mm thick tablet) were randomized to avoid an order effect and tested in different sessions. Variables were: MPS (X 50) at ST, number of cycles until ST, sequence and cycle duration as well as cycles/g. Comparisons were performed with paired t and Wilcoxon tests, regressions and correlations were run. Cutoff for statistical significance was .05. Statistically significant differences were found for all variables; X 50 (2.5 ± 0.8 vs. 2.8 ± 0.7 mm, p < .001), cycles until ST (38 vs. 40, p = .022), sequence (25 vs. 27 s, p = .003), and cycle duration (650 vs. 683 ms, p = .015) and cycles/g (27 vs. 21 cycles/g, p < .001), three or four quarters, respectively. In conclusion, in children, as in adults, chewing on a bigger bolus size leads to a larger MPS (X 50) at ST. When chewing on a larger bolus the number of cycles increases, but not enough to swallow the same particle size since the number of cycles/g is less with a bigger bolus size.

MP51-16 DISTRIBUTION OF MENTAL ILLNESS AMONG PATIENTS WITH GENITOURINARY CONGENITALISM

You have accessJournal of UrologyPediatric Urology IV (MP51)1 Sep 2021MP51-16 DISTRIBUTION OF MENTAL ILLNESS AMONG PATIENTS WITH GENITOURINARY CONGENITALISM William Shibley, Michael Sadighian, Debbie Goldberg, Claire De La Calle, Thomas Gaither, Johsias Maru, Lindsay Hampson, and Hillary Copp William ShibleyWilliam Shibley More articles by this author , Michael SadighianMichael Sadighian More articles by this author , Debbie GoldbergDebbie Goldberg More articles by this author , Claire De La CalleClaire De La Calle More articles by this author , Thomas GaitherThomas Gaither More articles by this author , Johsias MaruJohsias Maru More articles by this author , Lindsay HampsonLindsay Hampson More articles by this author , and Hillary CoppHillary Copp More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002077.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Little information exists regarding the concomitant mental health disorders among patients with Genitourinary Congenitalism (GUC). We aim to better understand the distribution of mental health disorder (MHD) related emergency or inpatient encounters among GUC patients in comparison with the general population. METHODS: We queried the Office of Statewide Health Planning and Development database which captures all encounters at California-licensed hospitals, emergency rooms, and ambulatory surgery centers from 1995-2017. We identified patients with GUC including bladder exstrophy, posterior urethral valves, prune belly syndrome (PBS), epispadias, spina bifida, and differences in sexual development (DSD) utilizing ICD and CPT codes. MHD encounters were identified when primary diagnosis included ICD-9 codes 291-305, 307-309, and 311-314 or ICD-10 codes F2-F6, F10-F48, F50-F69, and F80-F99. For each GUC patient, we randomly selected non-GUC patients, frequency matched 5:1 by birth year and facility type. Analysis was conducted with t-tests, chi-square tests, and multivariate logistic regression. Odds ratios with 95% confidence intervals are reported (OR, CI). SAS was used to analyze data with p<0.05 as our cutoff for statistical significance. RESULTS: GUC patients were significantly more likely to have a MHD, multiple MHDs, an MHD encounter, and more MHD encounters than the general population (Table 1). After controlling for gender, race, ethnicity, and age at first encounter, GUC increased odds of having two or more MHD encounters (OR 1.31, CI 1.25-1.37). Among GUC conditions, spina bifida (OR 1.66, CI 1.57-1.76), PBS (OR 1.48, CI 1.02-2.14), and DSD (OR 1.35, CI 1.22-1.51) had increased odds of having two or more MHD encounters. CONCLUSIONS: Individuals with GUC are more likely to receive MHD related emergency or inpatient care than their non-GUC counterparts. In particular, spina bifida, DSD, and PBS patients may be most affected by MHD conditions given that they are more likely to have repeated encounters. Clinicians should be aware of the increased risk of MHD in these patients and share resources for treatment of MHD in affected GUC patients. Further study is needed to understand why patients with GUC are at higher risk of multiple MHD encounters and the impact MHD has on clinical and quality of life outcomes. Source of Funding: UCSF Urology © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e902-e902 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information William Shibley More articles by this author Michael Sadighian More articles by this author Debbie Goldberg More articles by this author Claire De La Calle More articles by this author Thomas Gaither More articles by this author Johsias Maru More articles by this author Lindsay Hampson More articles by this author Hillary Copp More articles by this author Expand All Advertisement Loading ...

Social integration after moving to a new city predicts lower systolic blood pressure.

Residential mobility is linked to higher incidence of cardiovascular disease (CVD) and mortality. A mechanism by which residential relocation may impact health is through the disruption of social networks. To examine whether moving to a new city is associated with increased CVD risk and whether the extent to which movers rebuild their social network after relocating predicts improved CVD risk and psychosocial well-being, recent movers (n=26), and age- and sex-matched nonmovers (n=20) were followed over 3months. Blood pressure, C-reactive protein/albumin ratio (CRP/ALB), social network size, and psychosocial well-being were measured at intake (within 6weeks of residential relocation for movers) and 3months later. Multiple regression indicated higher systolic blood pressure (SBP) for movers (M=107.42, SD=11.39), compared with nonmovers (M=102.37, SD=10.03) at intake, though this trend was not statistically significant. As predicted, increases in movers' social network size over 3months predicted decreases in SBP, even after controlling for age, sex, and waist-to-hip ratio, b=-2.04mmHg, 95% CI [-3.35, -.73]. Associations between increases in movers' social ties and decreases in depressive symptoms and stress were in the predicted direction but did not meet the traditional cutoff for statistical significance. Residential relocation and movers' social network size were not associated with CRP/ALB in this healthy sample. This study provides preliminary evidence for increased SBP among recent movers; furthermore, it suggests that this elevation in CVD risk may decrease as individuals successfully rebuild their social network.

Traces of SARS-CoV-2 RNA in Peripheral Blood Cells of Patients with COVID-19.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the third virus that caused coronavirus-related outbreaks over the past 20 years. The outbreak was first reported in December 2019 in Wuhan, China, but rapidly progressed into a pandemic of an unprecedented scale since the 1918 flu pandemic. Besides respiratory complications in patients with COVID-19, clinical characterization of severe infection cases showed several other comorbidities, including multiple organ failure, and septic shock. To better understand the systemic pathogenesis of COVID-19, we interrogated the virus's presence in the peripheral blood cells, which might provide a form of trafficking or hiding to the virus. By analyzing >2 billion sequence reads of high-throughput transcriptome sequence data from 180 samples of patients with active SARS-CoV-2 infection or healthy controls collected from 6 studies, we found evidence of traces of SARS-CoV-2 RNA in peripheral blood mononuclear cells in two samples from two independent studies. In contrast, the viral RNA was abundant in bronchoalveolar lavage specimens from the same patients. We also devised a “viral spike-to-actin” RNA normalization as a metric to compare across various samples and minimize errors caused by intersample variability in total human RNA abundance. Our observation suggests immune presentation and discounts the possibility of extensive viral infection of lymphocytes or monocytes.

The Prevalence and Risk Factors of Hypokalemia in Pregnancy-Related Hospitalizations: A Nationwide Population Study.

Background There are no nationwide population studies conducted to analyze the prevalence and risk factors associated with hypokalemia during pregnancy in the U.S. Method We retrieved data from the Nationwide Inpatient Sample (NIS) and the National Inpatient Sample of Healthcare Cost and Utilization Project (HCUP) for pregnant patients with hypokalemia from 2012 to 2014. We used a chi-squared test to analyze categorical variables and an adjusted Wald test to compare quantitative variables. We applied logistic regression models to calculate adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) to identify the risk factors for hypokalemia. We used a p value <0.05 as the cutoff for statistical significance. Result Among 12,431,909 pregnancy-related discharges, females of younger age (mean age 27.0 ± 6.2 vs. 28.1 ± 6.0, p < 0.001), of African American race, using government-paid insurance, with an income level in the first quartile, and of a higher Charlson Comorbidity Index score (≥1) were found to have a higher likelihood of hypokalemia during pregnancy (p < 0.001). Gestational hypertension (GH) (including pre-eclampsia and eclampsia, aOR 2.03, 95% CI 1.94–2.12, p < 0.001), hyperemesis gravidarum (aOR 33.18, 95% CI 31.61–34.83, p < 0.001), and post-partum hemorrhage (aOR 1.42, 95% CI 1.31–1.53, p < 0.001) were found to be independently associated with a higher rate of hypokalemia during pregnancy. Conclusion The prevalence of hypokalemia during pregnancy was less than 1% in this large, nationwide population-based study. There were significant differences between those patients who developed hypokalemia during pregnancy. Notably, those who had hypokalemia were younger, of African American race, and of a low-income level. Congestive heart failure, coronary artery disease, Cushing's syndrome, GH, and hyperemesis gravidarum were found to be associated with hypokalemia during pregnancy.

Health related quality of life and associated factors with medication adherence among tuberculosis patients in selected districts of Gandaki Province of Nepal

BackgroundTuberculosis is one of the significant public health problems of Nepal. Adherence to medication is very important for improving quality of life and preventing complication. Adherence to tuberculosis medications has significant economic and therapeutic consequences as non-adherence patients are at greater risk of developing complications which affect their health status and overall quality of life. The study aims to determine the factors associated with medication adherence and its effect on health related quality of life among tuberculosis patients in selected districts of Gandaki Province. MethodsA health facility based cross-sectional study was carried out among 180 tuberculosis patients registered under DOTS and receiving treatment more than or equal to 60 days. WHOQOL-BREF tools to assess quality of life and Morisky medication adherence scale (MMAS-8) was adopt to assess medication adherence. Data was entered in Epi-data and analysis was performed with the help of the Statistical Package for Social Science (SPSS). The odds ratio with a 95% CI was calculated and p-value of <0.05 was considered as cutoff for statistical significance. ResultsA total 180 TB patients were participated in this study. Overall quality of life ranges from 10.75 to 89.25 with Mean ± SD as 55.96 ± 14.65. More than three-fourth (79.4%) respondents were adhere to medication. Medication adherence and health related quality of life was found statistically significant with relationship with health workers, favourable time at DOTS centre, absence of co-infection. Participants who were highly adhered to medication had good quality of life. ConclusionMajority of tuberculosis patients adhering to medication had good quality of life. Especial emphasis should be given to tuberculosis patients with co-infection, health workers should behave friendly and provide appropriate counselling in order to maintain the medication adherence and quality of life.

Immunotherapeutic early-phase clinical trials and malignant gliomas: A single-center experience and comprehensive immunophenotyping of circulating leukocytes

BackgroundImmunotherapeutic early-phase clinical trials (ieCTs) increasingly adopt large expansion cohorts exploring novel agents across different tumor types. High-grade glioma (HGG) patients are usually excluded from these trials.MethodsData of patients with recurrent HGGs treated within multicohort ieCTs between February 2014 and August 2019 (experimental group, EG) at our Phase I Unit were retrospectively reviewed and compared to a matched control group (CG) of patients treated with standard therapies. We retrospectively evaluated clinical, laboratory, and molecular parameters through univariate and multivariate analysis. A prospective characterization of circulating leukocyte subpopulations was performed in the latest twenty patients enrolled in the EG, with a statistical significance cutoff of P < .1.ResultsThirty HGG patients were treated into six ieCTs. Fifteen patients received monotherapies (anti-PD-1, anti-CSF-1R, anti-TGFβ, anti-cereblon), fifteen patients combination regimens (anti-PD-L1 + anti-CD38, anti-PD-1 + anti-CSF-1R). In the EG, median progression-free survival and overall survival (OS) from treatment initiation were 1.8 and 8.6 months; twelve patients survived more than 12 months, and two of them more than 6 years. Univariate analysis identified O6-methylguanine DNA methyltransferase (MGMT) promoter methylation and total protein value at six weeks as significantly correlated with a better outcome. Decreased circulating neutrophils and increased conventional dendritic cells levels lead to significantly better OS.ConclusionsA subgroup of EG patients achieved remarkably durable disease control. MGMT promoter methylation identifies patients who benefit more from immunotherapy. Monitoring dynamic changes of innate immune cell populations may help to predict clinical outcomes.

Risk Factors for Placental Malaria and Birth Weight Outcome among Pregnant Women Attending Mawenzi Regional Referral Hospital, Moshi North Eastern Tanzania

Objective: This study aimed to determine the Prevalence and Risk Factors for Placental Malaria and its associated effects on Pregnancy Outcome among Pregnant Women in Mawenzi Regional Referral Hospital in Kilimanjaro Region.&#x0D; Methodology: This was a hospital based cross-sectional study. We derived our study sample from previous survey of 700 pregnant women who attended labor ward at MRRH between 2018- 2019 in which we obtained study subjects by random sampling. The study included 350 subjects. We extracted data from the dataset using data extraction sheet and was analyzed using IBM SPSS software version 24. Chi–square was performed and we accepted an error of 5% level P&lt;0.05 was the cut off for statistical significance.&#x0D; Results: The prevalence of PM was 7.1% among the pregnant women in the study area. Primigravida had more cases of PM (11%) as compared to multigravida (2.7%). Pregnant women who had gestation age below 37 weeks attributed more cases of PM (9.6%) as compared to 6.7% of PM infections in pregnant women at gestation age of 37 weeks and above. Low birth-weight was estimated at 32% of all subjects who were identified with PM as compared to 6.2% of subjects without placental malaria and their difference was statistically significant (P&lt;0.001). Gestational age of less than 37 weeks was associated with LBW with proportion of 21% among women with PM and it has strong statistical significance of P (&lt;0.001). The use of bed nets was associated with PM among the non-user at 28% P (&lt;0.001).&#x0D; Conclusion: PM is still a major public health problem in low malaria endemic areas and the groups at risk are women who are Primigravida, women not using bed nets and women who gives birth at gestation age of &lt;37 weeks. We recommend more studies on PM in low endemic.