Discrimination Scores Research Articles

Untargeted metabolomics unravels the effects of ginkgolide B-producing Lactiplantibacillus plantarum and co-induced fermentation of ginkgo kernel juice and their underlying vascular endothelial cell protection activity

The objective of this study was to investigate the fermentation mechanism of ginkgo kernel juice (GKJ) under unfermented (Group A), Ginkgolide B (GB)-producing Lactiplantibacillus plantarum fermented (Group B), and co-induced fermented (Group C) conditions. The conditions were optimized and further evaluated for their vascular endothelial cell protective effects in vitro. The co-induced fermented GKJ group extensively promoted GB and total phenol contents, reaching 109.94 and 599.57 μg/mL, respectively. While pH declined from 5.90 to 3.42 during fermentation, the highest total viable count (8.85 log CFU/mL) was detected at 16 h in the L. plantarum group. The co-induced group recorded the highest total phenol contents (594.05 μg/mL) and markedly induced the survival rate, reactive oxygen species formation, and lactate dehydrogenase assay cytotoxicity of H2O2-induced human umbilical vein endothelial cells. An untargeted metabolomics analysis identified 2633 metabolites in the groups. The principal component and orthogonal partial least squares discriminant score plots showed a clear metabolite distinction among the fermentation groups. From the Kyoto Encyclopedia of Genes and Genomes analysis, 309 differential accumulated metabolites (DAMs) were up-regulated and 604 were down-regulated in the A vs. B group, while 702 downregulated and 304 upregulated DAMs were exhibited in the B vs. C group. These DAMs were primarily lipids and lipid-like molecules, organic acids and their derivatives, organoheterocyclic compounds, organic oxygen compounds, benzenoids, phenylpropanoids and polyketides, and unclassified compounds at the superclass level. Overall, the results indicated that L. plantarum and co-induced fermentation improved the cell protection efficacy of GKJ, showing excellent potential for drug delivery applications.

Cochlear implantation in otosclerosis: surgical and audiological outcomes between ossified and non-ossified cochlea.

To evaluate (1) Audiological and surgical outcomes in patients with otosclerosis following cochlear implantation. (2) surgical difficulties and outcomes between both groups. (3) Audiological outcomes between both groups. Retrospective study conducted at Otology and Skull Base Surgery Center. Data were analyzed from 111 patients with otosclerosis (114 ears) who underwent cochlear implant surgery using the cochlear implant database. Demographic characteristics (age, sex, and operated ear), auditory outcomes, and operative details (extent of cochlear ossification, surgical approach [posterior tympanotomy or subtotal petrosectomy], electrode insertion [partial/complete, scala tympani or vestibuli], and complications) were analyzed Auditory outcomes were assessed over at least one year follow-up period using pure tone audiometry and speech discrimination scores. Patients were divided into two groups (with and without cochlear ossification) to compare auditory outcomes and surgical outcomes. The mean age of patients with ossified and non-ossified cochlea was 60.04 and 62.22years respectively. Sixty-five of 114 ears had cochlear ossification, with complete round window involvement in 75.4% of these patients, while the rest had partial or complete basal turn ossification. Subtotal petrosectomy was performed in 63.1% and 28.6% of ossified and non-ossified cochlea respectively while the rest underwent cochlear implantation through posterior tympanotomy. Only one case had scala vestibuli insertion and four had incomplete electrode insertion. Six patients underwent re-implantation due to infection, device failure, and erosion of the posterior canal wall. Auditory outcomes among patients with ossified otosclerosis were slightly better than those without ossification but this difference was not statistically significant. Cochlear implantation for otosclerosis yields excellent auditory outcomes with a low rate of surgical complications, despite the high incidence of cochlear ossification.

Methods and measures of source monitoring in children: A scoping review.

Source monitoring (SM) refers to attributing sources of information. There are various methods for measuring SM in children. We searched the PubMed, PsycINFO, Embase, Web of Science and Cochrane Library databases from their inception to February 24, 2023, to summarize the methods and measures of SM in children, identifying 141 studies. The procedure for the SM tasks encompassed encoding, interval and testing. The encoding tasks were classified into ground-based activities (n = 67), computer-based experiments (n = 42) and mixed methods (n = 34). The testing approaches were categorized into old/new recognition and source discrimination, n-alternative forced-choice, yes/no questions and recall/direct questions. Among 10 commonly used indicators, source-correct, source-incorrect, discrimination score and source accuracy were recommended to present the SM function. We also discussed the advantages and disadvantages of different SM methods in children, providing a reference for researchers to design and select SM measurements that meet their research objectives.

Predicting functional outcome in ischemic stroke patients using genetic, environmental, and clinical factors: a machine learning analysis of population-based prospective cohort study.

Ischemic stroke (IS) is a leading cause of adult disability that can severely compromise the quality of life for patients. Accurately predicting the IS functional outcome is crucial for precise risk stratification and effective therapeutic interventions. We developed a predictive model integrating genetic, environmental, and clinical factors using data from 7819 IS patients in the Third China National Stroke Registry. Employing an 80:20 split, we randomly divided the dataset into development and internal validation cohorts. The discrimination and calibration performance of models were evaluated using the area under the receiver operating characteristic curves (AUC) for discrimination and Brier score with calibration curve in the internal validation cohort. We conducted genome-wide association studies (GWAS) in the development cohort, identifying rs11109607 (ANKS1B) as the most significant variant associated with IS functional outcome. We employed principal component analysis to reduce dimensionality on the top 100 significant variants identified by the GWAS, incorporating them as genetic factors in the predictive model. We employed a machine learning algorithm capable of identifying nonlinear relationships to establish predictive models for IS patient functional outcome. The optimal model was the XGBoost model, which outperformed the logistic regression model (AUC 0.818 versus 0.756, P < .05) and significantly improved reclassification efficiency. Our study innovatively incorporated genetic, environmental, and clinical factors for predicting the IS functional outcome in East Asian populations, thereby offering novel insights into IS functional outcome.

Abstract C013: Racial disparities in Interpersonal Processes of Care (IPC) during early stage breast cancer chemotherapy: Associations with symptoms and the ability to receive dose-intensive chemotherapy

Abstract Purpose: Documented racial disparities exist in the dose intensity of early-stage breast cancer (ESBC) chemotherapy, partly due to chemotherapy symptom toxicity and subsequent dose modifications. Effective communication is crucial for early symptom mitigation. We explored the associations between racial differences in patient-clinician communication, symptom experience, and the ability to receive the full dose of ESBC chemotherapy. Methods - A descriptive, correlational design compared clinician communication, symptoms, and the ability to obtain dose-intensive ESBC chemotherapy by race. Multi-site - large, urban breast cancer outpatient clinics. Patients completed the 18-item Interpersonal Processes of Care (IPC) and 13-item Symptom Distress Scale (SDS) at baseline and each chemotherapy visit. The IPC assesses clarity of communication, elicitation of concerns, explaining results, shared decision-making, compassion, discrimination due to race/ethnicity, and disrespectful office staff. Mean scores for IPC and SDS were calculated for each visit, and average scores across all visits were created for each participant; chemotherapy dose intensity - Receiving 85% or more of the prescribed chemotherapy within the projected timeline, dichotomized to yes or no—Analysis - IBM® SPSS®, version 27. Descriptive statistics were generated for raw data. Pearson’s correlations were used to examine bivariate associations and univariate and multivariate logistic or linear regression models to explore associations further. Results – N = 216 women, 37% - Black and 63% - White. The mean age was 52.99 ± 12.31 years. IPC - Black patients reported significantly higher (worse) IPC scores for "lack of clarity," "discrimination," and "disrespectful office staff" compared to White patients (all ps ≤ 0.01). Associations of SDS and IPC - Patients with higher IPC subscale scores for "lack of clarity," "discrimination," and "disrespectful office staff," and lower scores for "compassion and respect" experienced significantly higher levels of symptom distress (all ps &amp;lt; 0.05). Associations between IPC and Dose Intensity - Patients reporting higher (worse) discrimination scores were less likely to receive 85% of the prescribed chemotherapy. The IPC "discrimination" subdomain score was significantly associated with chemotherapy dose intensity (χ2(1)=6.910, p=0.009). Each one-unit increase in perceived "discrimination" subdomain score increased the likelihood of not receiving prescribed chemotherapy (B=0.985, OR=2.602, p=0.014) by approximately 160.2%. Conclusions - Black patients perceive poorer quality IPC than White patients during ESBC chemotherapy. Specific subdomains of IPC are associated with worse symptom distress and the inability to receive the full dose of ESBC chemotherapy, primarily driven by perceived discrimination. We must understand the relationship between race, communication, symptoms, and the ability to receive appropriate chemotherapy dose intensity. Citation Format: Margaret Q. Rosenzweig, Hiba Q. Abujaradeh. Racial disparities in Interpersonal Processes of Care (IPC) during early stage breast cancer chemotherapy: Associations with symptoms and the ability to receive dose-intensive chemotherapy [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C013.

Abstract B149: Investigating Disparities in Cost-Associated Barriers to Medication Adherence in Breast Cancer Survivors in the National Institutes of Health All of Us Research Program

Abstract Purpose: Medication adherence (e.g., endocrine therapy, antihypertensives) during survivorship remains suboptimal. Racial disparities in medication adherence continue to persist, yet reasons for this disparity are not fully understood. This study aimed to assess racial differences in cost-associated barriers to medication adherence. Methods: This cross-sectional analysis utilized data from the National Institutes of Health All of Us Research Program. Cohort eligibility included identifying as Black/African American or White, being at least 18 years old, and having a diagnosis of breast cancer. Survivors must have completed the Healthcare Access and Utilization survey, a validated assessment of factors impacting healthcare behaviors. Comparisons between patient characteristics (e.g., age, annual income, marital status, employment, education, etc.) and survey responses were analyzed by race using Pearson’s chi-square tests. Univariable and multivariable logistic regression models were fitted to investigate the unadjusted and adjusted associations of cost-related barriers to medication adherence and race. Results: Among the 1,840 breast cancer survivors included in this cohort, the mean age was 63.8 (standard deviation (sd) = 10.4). The majority of survivors were White (94.3%) (5.7% Black), married (58.9%) and unemployed (57.4%). The mean score for racial discrimination in healthcare was 10.3 (sd = 3.8) (range = 7 - 35). Most survivors did not report any cost-related barriers to adherence (74.9%); however, 19.5% of survivors asked their doctor for lower cost medication to save money. When compared with White survivors, a higher proportion of Black survivors reported that they could not afford prescription medicines (6.5% vs. 12.4%). In the multivariable model, no significant association by race was observed (p=0.387). Survivors who reported annual household income levels above $50k were less likely to report cost-reported barriers when compared to survivors who reported a household income of &amp;lt;$25k (p&amp;lt;0.001). Each one-point increase in perceived discrimination in healthcare increased the odds of reporting a cost-related barrier to adherence by a factor of 1.10 (95% confidence interval: 1.07, 1.13). Conclusions: Although racial differences were not noted for overall cost-related barriers, results highlight a need to understand nuanced differences in perceived cost-related barriers to adherence and how survivors navigate those differences. Further research is needed to understand providers’ roles in encouraging medication adherence and how discrimination in healthcare may serve as a barrier to adherence. Citation Format: Arnethea L. Sutton, Jian He, Lakeshia Cousin, Keesha Powell-Roach, Mandy J. Hill, Wendy Bottinor. Investigating Disparities in Cost-Associated Barriers to Medication Adherence in Breast Cancer Survivors in the National Institutes of Health All of Us Research Program [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B149.

Study of word-in-noise perception scores at saccular acoustic sensitivity level: randomized clinical trial

BackgroundIn humans, saccular acoustic sensitivity has been confirmed. The aim of this study was to determine the scores of the word-in-noise perception test at the saccular acoustic sensitivity level.MethodologyIn this randomized clinical trial study, 101 participants in the age group of 14 to 25 years with normal hearing and middle ear function, detectable vestibular evoked myogenic potentials (VEMP), normal states of mental health, and night sleep were investigated. The scores of word-in-noise perception and word-in-noise discrimination tests were evaluated for each person at two intensity levels, most comfortable level (MCL) and saccular acoustic sensitivity. Mann-Whitney was used for the multiple comparisons.ResultsThere was a significant difference between the scores of the word-in-noise perception test at MCL and saccular acoustic sensitivity (U = 3971.50, Z = − 2.10, p’ = 0.04), and also between the scores of the word-in-noise discrimination test at the MCL compared to saccular acoustic sensitivity (U = 399.89, Z = − 2.49, p’ = 0.04). Word-in-noise discrimination scores in MCL (U = 3484.00, Z = -3.72, p’ = 0.00) and saccular acoustic sensitivity (U = 705.50, Z = − 3.78, p’ = 0.00) were higher than word-in-noise perception.ConclusionsWord-in-noise perception and word-in-noise discrimination scores are higher in saccular acoustic sensitivity level than MCL, suggesting that the vestibular system participates in loud speech perception. Also, in people with normal hearing thresholds, word-in-noise perception scores will be lower than word-in-noise discrimination scores for both loud and common intensity levels.

Discriminating Factors of Formal and Informal Micro-Credits Programs in Bangladesh: An Efficiency Approach

Purpose: The study aims to identify the factors influencing the choice of formal and informal micro- credits programs in poverty alleviation of Bangladesh especially in Haor area. Methodology: The study has covered a total of 2340 households’ respondents where 1560 actual microcredit users and 780 eligible micro-credit users while they did not use micro-credits as control (50% of the cases) group for comparison purpose. The characteristics of control households are almost similar to the cases (micro-credits recipient) households. Total survey area has been divided into thirty clusters and the survey was made with a structured questionnaire to measure the impact on poverty of both types of credits and find out the dimensions of discrimination. The group means, pooled group correlation matrix, covariates for discrimination, and validation of two-group discriminant finally Fisher’s linear discriminant function were used to reach in the conclusion. Findings: The study identified that the installment types are the most important predictors in discriminating between formal and informal micro-credits groups, followed by duration of loan, interest rate, gender of loan receivers, earning status of loan receivers, and regular income source in the households and so on and this is also confirmed by cross-validation analysis. Fisher’s linear discriminant function forecasted that the new member with discriminant scores above 0.44 supposed to borrow from the informal sources however the members having below of the score will borrow from formal sources. Practical Implications: The lenders will be able to design effective micro-credit programs considering the needs of the users. Originality/Value: The research is the first attempt to identify the discriminating factors between formal and informal micro-credits with large volume of solid primary data. Limitations: The study did not make any in-depth-interview regarding the issue.

Comparison of Performance for Cochlear-Implant Listeners Using Audio Processing Strategies Based on Short-Time Fast Fourier Transform or Spectral Feature Extraction.

We compared sound quality and performance for a conventional cochlear-implant (CI) audio processing strategy based on short-time fast-Fourier transform (Crystalis) and an experimental strategy based on spectral feature extraction (SFE). In the latter, the more salient spectral features (acoustic events) were extracted and mapped into the CI stimulation electrodes. We hypothesized that (1) SFE would be superior to Crystalis because it can encode acoustic spectral features without the constraints imposed by the short-time fast-Fourier transform bin width, and (2) the potential benefit of SFE would be greater for CI users who have less neural cross-channel interactions. To examine the first hypothesis, 6 users of Oticon Medical Digisonic SP CIs were tested in a double-blind design with the SFE and Crystalis strategies on various aspects: word recognition in quiet, speech-in-noise reception threshold (SRT), consonant discrimination in quiet, listening effort, melody contour identification (MCI), and subjective sound quality. Word recognition and SRTs were measured on the first and last day of testing (4 to 5 days apart) to assess potential learning and/or acclimatization effects. Other tests were run once between the first and last testing day. Listening effort was assessed by measuring pupil dilation. MCI involved identifying a five-tone contour among five possible contours. Sound quality was assessed subjectively using the multiple stimulus with hidden reference and anchor (MUSHRA) paradigm for sentences, music, and ambient sounds. To examine the second hypothesis, cross-channel interaction was assessed behaviorally using forward masking. Word recognition was similar for the two strategies on the first day of testing and improved for both strategies on the last day of testing, with Crystalis improving significantly more. SRTs were worse with SFE than Crystalis on the first day of testing but became comparable on the last day of testing. Consonant discrimination scores were higher for Crystalis than for the SFE strategy. MCI scores and listening effort were not substantially different across strategies. Subjective sound quality scores were lower for the SFE than for the Crystalis strategy. The difference in performance with SFE and Crystalis was greater for CI users with higher channel interaction. CI-user performance was similar with the SFE and Crystalis strategies. Longer acclimatization times may be required to reveal the full potential of the SFE strategy.

Economical hybrid novelty detection leveraging global aleatoric semantic uncertainty for enhanced MRI-based ACL tear diagnosis

This study presents an innovative hybrid deep learning (DL) framework that reformulates the sagittal MRI-based anterior cruciate ligament (ACL) tear classification task as a novelty detection problem to tackle class imbalance. We introduce a highly discriminative novelty score, which leverages the aleatoric semantic uncertainty as this is modeled in the class scores outputted by the YOLOv5-nano object detection (OD) model. To account for tissue continuity, we propose using the global scores (probability vector) when the model is applied to the entire sagittal sequence. The second module of the proposed pipeline constitutes the MINIROCKET timeseries classification model for determining whether a knee has an ACL tear. To better evaluate the generalization capabilities of our approach, we also carry out cross-database testing involving two public databases (KneeMRI and MRNet) and a validation-only database from University General Hospital of Larissa, Greece. Our method consistently outperformed (p-value<0.05) the state-of-the-art (SOTA) approaches on the KneeMRI dataset and achieved better accuracy and sensitivity on the MRNet dataset. It also generalized remarkably good, especially when the model had been trained on KneeMRI. The presented framework generated at least 2.1 times less carbon emissions and consumed at least 2.6 times less energy, when compared with SOTA. The integration of aleatoric semantic uncertainty-based scores into a novelty detection framework, when combined with the use of lightweight OD and timeseries classification models, have the potential to revolutionize the MRI-based injury detection by setting a new precedent in diagnostic precision, speed and environmental sustainability. Our resource-efficient framework offers potential for widespread application.

Generative models for synthetic data generation: application to pharmacokinetic/pharmacodynamic data.

The generation of synthetic patient data that reflect the statistical properties of real data plays a fundamental role in today's world because of its potential to (i) be enable proprietary data access for statistical and research purposes and (ii) increase available data (e.g., in low-density regions-i.e., for patients with under-represented characteristics). Generative methods employ a family of solutions for generating synthetic data. The objective of this research is to benchmark numerous state-of-the-art deep-learning generative methods across different scenarios and clinical datasets comprising patient covariates and several pharmacokinetic/pharmacodynamic endpoints. We did this by implementing various probabilistic models aimed at generating synthetic data, such as the Multi-layer Perceptron Conditioning Generative Adversarial Neural Network (MLP cGAN), Time-series Generative Adversarial Networks (TimeGAN), and a more traditional approach like Probabilistic Autoregressive (PAR). We evaluated their performance by calculating discriminative and predictive scores. Furthermore, we conducted comparisons between the distributions of real and synthetic data using Kolmogorov-Smirnov and Chi-square statistical tests, focusing respectively on covariate and output variables of the models. Lastly, we employed pharmacometrics-related metric to enhance interpretation of our results specific to our investigated scenarios. Results indicate that multi-layer perceptron-based conditional generative adversarial networks (MLP cGAN) exhibit the best overall performance for most of the considered metrics. This work highlights the opportunities to employ synthetic data generation in the field of clinical pharmacology for augmentation and sharing of proprietary data across institutions.

Outcomes of Active Middle Ear Implants: Speech Perception and Quality of Life.

To evaluate audiological outcomes, quality of life, and complications in patients implanted with Active middle ear implants (AMEI). The secondary objective is to investigate the required duration after implantation to reach satisfactory outcomes. This retrospective study included 31 patients implanted with Active middle ear implants (AMEI) with different methods of floating mass transducer attachment. Patients with incomplete medical records and those who did not respond to postoperative follow-up were excluded. Patients were assessed preoperatively, and at one, three, and six months postoperatively. The assessment included Pure Tone Average (PTA4), speech reception threshold (SRT), and speech discrimination score (SDS). The Speech Spatial and Qualities of Hearing scale (SSQ12) was also used to evaluate levels of satisfaction. There are no significant differences found in PTA and SRT between the 3-, 6-, and 12-month visits. The speech reception threshold (SRT) showed a statistically significant improvement at 3, 6, and 12 months post-operative measures compared to pre-operative. Additionally, the SDS exhibited a significant increase only after 12 months, compared to the 3-month time point. However, satisfaction levels did not significantly differ between the 6-month and 12-month measurements following surgery. The Vibrant Soundbridge improves subjective satisfaction scores and audiological test scores in patients with different types of hearing loss. AMEI has a low risk of medical or surgical complications, the ease of using a hearing implant, and the social benefits of good hearing and communication.

Othering and Marginalizing the “Queer” in Rwanda: Findings from Public Perceptions and Lived Experiences of LGBT People

Abstract Introduction The multidimensionality of stigma that LGBT people experience globally necessitates research to explore the processes at work. The study aimed to quantify the level of othering and explore the process of LGBT othering in Rwanda. Methods We conducted a sequential cross-sectional mixed-methods study of LGBT lived experiences in Rwanda. We recruited 499 participants to complete the LGBT-specific survey and 1254 for the non-LGBT survey. We conducted 16 in-depth interviews (IDIs) with non-LGBT participants. For LGBT participants, we completed six focus groups with 59 participants, six in-depth interviews, and three digital storytelling interviews. For the quantitative surveys, we conducted multivariable linear regressions and reported beta coefficients and 95% confidence interval estimates examining LGBT discrimination (LGBT survey) and attitudes toward LGBT (non-LGBT survey). We used deductive and inductive thematic and narrative analysis to analyze the qualitative data. Results In adjusted analyses of the non-LGBT survey, as compared to those who knew zero LGBT persons, persons who knew more than five had lower negative attitude scores (β = − 1.3, 95% CI − 2.2, − 0.5), while the score was lower for those that knew one to five (− 0.2), it was not significant (95% CI − 0.8, 0.5). In the LGBT survey, adjusted analyses indicated that there was no significant difference found in discrimination between bisexual, gay, or lesbian participants. However, as compared to cisgender participants, transgender participants had discrimination scores that were 2.1 points higher (95% CI 1.1, 3.0), and gender non-confirming individuals had scores that were one point higher (95% CI 0.2, 1.9). The qualitative findings showcased how societal “othering” occurs in the everyday life of LGBT Rwandans, with large ramifications in creating feelings of isolation and hampering one’s capacity to live authentically and with dignity. Conclusion The findings from our study indicate a high level of othering of the LGBT community across multiple domains, including housing, employment, healthcare, education, religion, and family within Rwanda. Policy Implications The findings highlight the importance of social education campaigns about LGBT people, particularly among vital societal role-holders, including healthcare providers and educators. Integrating the rich historical and indigenous culture related to LGBT could be successful in combating anti-West rhetoric.

Granulocyte Colony-Stimulating Factor Improves Prednisolone Responsiveness and 90-Day Survival in Steroid-Eligible Severe Alcohol-Associated Hepatitis: The GPreAH Study a Randomized Trial.

Severe alcohol-associated hepatitis (SAH) carries high 1-month mortality. Corticosteroids provide a modest 28-day but not 90-day survival benefit, due to development of infections and organ failures. Granulocyte colony-stimulating factor (GCSF) has shown promise in patients with SAH by its immunomodulatory and regenerative capabilities. We studied the safety and efficacy of combination (GCSF + prednisolone, GPred) therapy in management of steroid-eligible patients with SAH. Steroid eligible patients with SAH (discriminant function scores 32-90) were randomized to receive prednisolone (GrA, n = 42), GPred (GrB, n = 42), or GCSF alone (GrC, n = 42). GCSF was given as 150-300 mcg/d for 7 days followed by every third day for a maximum of 12 doses in 1 month. Prednisolone 40 mg/d was given for 7 days and continued for 28 days in responders (Lille score <0.45). Baseline characteristics of patient groups were comparable. On intention-to-treat analysis, the primary endpoint of 90-day survival was achieved in 64.3% (27/42) in prednisolone, 88.1% (37/42) in GPred, and 78.6%(33/42) in GCSF groups, respectively ( P = 0.03, prednisolone vs GPred). The 28-day survival was not different between the groups (85.7%, 95.2%, and 85.7%, respectively [ P = 0.27]). The GPred group had more responders by day 7 (71.4% vs 92.9% vs 76.2%, P = 0.037) and had greater reduction in discriminant function (-7.33 ± 4.78, -24.59 ± 3.7, -14.59 ± 3.41, P = 0.011) and MELDNa (-1.69 ± 1.26, -7.02 ± 1.24, -3.05 ± 0.83, P = 0.002) by day 90. The prednisolone-only group had higher incidence of new infections (35.7%, 19%, 7.1%, respectively, P < 0.002). Acute kidney injury (33.3%, 7.1%, 11.9%, P = 0.002), hepatic encephalopathy (35.7%, 9.5%, 26.2%, P = <0.001), and rehospitalizations (59.5%, 14.3%, 30.9%, P =<0.01) were lower in the GPred group. Addition of GCSF to prednisolone improves steroid responsiveness and 90-day survival with fewer infections and new onset complications in patients with SAH.

AROMHA Brain Health Test: A Remote Olfactory Assessment as a Screen for Cognitive Impairment.

Cost-effective, noninvasive screening methods for preclinical Alzheimer's disease (AD) and other neurocognitive disorders remain an unmet need. The olfactory neural circuits develop AD pathological changes prior to symptom onset. To probe these vulnerable circuits, we developed the digital remote AROMHA Brain Health Test (ABHT), an at-home odor identification, discrimination, memory, and intensity assessment. The ABHT was self-administered among cognitively normal (CN) English and Spanish speakers (n=127), participants with subjective cognitive complaints (SCC; n=34), and mild cognitive impairment (MCI; n=19). Self-administered tests took place remotely at home under unobserved (among interested CN participants) and observed modalities (CN, SCC, and MCI), as well as in-person with a research assistant present (CN, SCC, and MCI). Olfactory performance was similar across observed and unobserved remote self-administration and between English and Spanish speakers. Odor memory, identification, and discrimination scores decreased with age, and olfactory identification and discrimination were lower in the MCI group compared to CN and SCC groups, independent of age, sex, and education. The ABHT revealed age-related olfactory decline, and discriminated CN older adults from those with cognitive impairment. Replication of our results in other populations would support the use of the ABHT to identify and monitor individuals at risk for developing dementia.

Testing for Measurement Invariance (MI): Do the Structures of Microaggression, Discrimination, and Resilience Among Black Women Living with HIV Remain the Same Across Time?

Assessing measurement invariance and the interplay of discrimination, microaggressions, and resilience among Black women living with HIV (BWLWH) across time utilizing latent class and repeated measure analysis may provide novel insights. A total of 151 BWLWH in a southeastern U.S. city completed surveys focused on multiple forms of microaggressions and discrimination (race, gender, sexual orientation, or HIV-related) and resilience factors (social support, self-efficacy, post-traumatic growth) at baseline, 3months, and 6months. To capture the psychosocial domains of discrimination, microaggressions, and resilience, three latent factors were developed and measured across three time points. Latent class analysis was also conducted to identify and compare meaningful subgroups based on varying levels of discrimination, microaggressions, and resilience reported. Three latent classes were created. MI testing suggested that measurement invariance was partially met (established metric invariance and scalar invariance), and it is possible to compare factor means of discrimination, microaggressions, and resilience across time. Latent factor mean scores of microaggressions and discrimination decreased after 3 and 6months and increased for resilience after 6months and varied over time across the three latent classes identified. The subgroup with the lowest level of discrimination and microaggressions and the highest level of resilience reported at baseline, experienced increases in resilience after months 3 and 6. Clinical interventions, research, and policies aimed at promoting resilience and reducing structural and social barriers linked to racism, sexism, HIV stigma, and classism are needed to improve the health and well-being of BWLWH.

Short-term efficacy of platelet-rich plasma in the treatment of persistent olfactory dysfunction: systematic review and meta-analysis.

To assess the short-term effects of topical platelet-rich plasma (PRP) injection on persistent refractory olfactory dysfunction. A comprehensive literature search of the PubMed, SCOPUS, EMBASE, Web of Science, Google Scholar, and Cochrane databases was conducted for articles up to November 2023. The search focused on studies that compared the amelioration of olfactory dysfunction between a topical PRP treatment cohort and a control group (receiving either placebo or no treatment), along with pre- and post-treatment comparisons. Subgroup analysis of the evaluation of olfactory function was also performed. The improvement in olfactory scores 1-3months post-treatment (standardized mean difference = 1.5354 [95% confidence interval: 0.7992; 2.2716], I2 = 83.8%) was greater in the treatment group than in the control group. In the treatment group, PRP increased the threshold, discrimination, and identification (TDI) score for Sniffin' Sticks by > 5.5 (minimum clinically significant difference; mean difference = 6.1789 [3.9788; 8.3789], I2 = 0.0%), indicating clinically significant improvement based on verified examinations. The rate of significant improvement among patients was 0.6683 [0.5833; 0.7436] after treatment. All TDI subdomains were significantly and similarly improved after treatment. This meta-analysis suggests that injection of PRP into the olfactory fissure or surrounding mucosal areas is an effective treatment for persistent refractory olfactory dysfunction in the short term.

Comprehensive Analysis of the Contributing Factors to the Hearing Abilities of Patients With Vestibular Schwannoma

Background and Objectives This study aimed to comprehensively assess the factors influencing hearing ability in patients with vestibular schwannoma, focusing on tumor size, location, primary complaint, and contralateral hearing threshold.Subjects and Method This was a retrospective analysis of 50 patients diagnosed with vestibular schwannoma by magnetic resonance imaging (MRI) at Nowon Eulji Medical Center. Tumor size and location were evaluated using a 3-T MRI system, and pure-tone threshold and speech discrimination were retrieved. To investigate the relationship between tumor size and hearing, we conducted a multiple regression analysis with several variables, including tumor size, tumor location, patient age, and gender.Results When patients were categorized into groups according to their primary complaint at initial presentation, no significant differences were observed in pure tone thresholds but different speech discrimination were detected among the groups. When patients were classified according to the tumor location, the extrameatal group exhibited lower pure-tone thresholds and higher speech discrimination scores than the intrameatal group. Multiple regression analysis indicated that differences in pure tone thresholds and speech discrimination scores between affected and unaffected sides were more pronounced in cases with smaller tumor sizes and extrameatal tumor locations, emphasizing the greater impact of location over size.Conclusion Using both tumor size and location, it is possible to predict the differences in pure-tone thresholds and speech discrimination between the affected and unaffected sides. Extrameatal invasion of the tumor appears to be the most important factor among them.

Ethnoracial Differences in Social Determinants of Health and Acute Mental Health Symptoms Among Adults Hospitalized After Emergency Care

Abstract: Research has established relationships between social determinants of health (SDOH) and mental health, with mixed findings on which ethnoracial groups are most vulnerable to deleterious outcomes. The current study examines ethnoracial differences in SDOH and their associations with acute mental health symptoms among patients hospitalized after emergency care. Using data collected in a multi-site study of 1,318 diverse adults admitted to inpatient units, we performed analyses using linear regression models. Findings show that Multiracial/Indigenous and Black adults had significantly higher discrimination and financial stress scores. However, compared with White adults, the positive association between extreme discrimination and acute mental health symptoms was diminished among Latinx (B=–2.3; p=.02) and Black individuals (B=–1.6; p=.05) as was the positive association between financial insecurity and acute mental health symptoms for Black adults (B=–2.3; p=.04). This study provides evidence of differential experiences of SDOH and mental health challenges that may warrant tailored interventions.

The effect of smell training on COVID-19 induced smell loss.

while smell training appears to be effective for post viral smell loss, its effectiveness in COVID-19 induced smell loss is currently not well known. Therefore, we aim to investigate the potential effect of smell training on patients with COVID-19 induced smell loss. we conducted a case-control study with two comparable cohorts. One of which (n=111) was instructed to perform smell training twice daily for 12 weeks, therapeutical adherence was monitored on a daily schedule, while the other cohort (n=50) did not perform smell training. The Sniffin' Sticks Test (SST) was used to objectify participants' sense of smell at baseline and after 12 weeks, reported as a Threshold, Discrimination, and Identification (TDI) score. We also determined the association between therapeutical adherence and the TDI scores. we found a significant difference in psychophysical smell function between patients with COVID-19 induced smell disorders who performed 12 weeks of smell training and those who did not. Median TDI difference between groups was 2.00 However, there was no association between the therapeutical adherence and olfactory function. we discovered a significant moderate difference in psychophysical smell function between patients with COVID-19-induced smell disorders who performed smell training and those who did not, implying a possible advantage of training. However, no relationship was found between therapeutical adherence of smell training and olfactory function.