Diverse Profiles Research Articles

EPCO-03. METABOLIC INSIGHT INTO GLIOMA HETEROGENEITY: MAPPING WHOLE EXOME SEQUENCING TOIN VIVO IMAGING WITH STEREOTACTIC LOCALIZATION AND DEEP LEARNING

Abstract Intra-tumoral heterogeneity (ITH) complicates the diagnosis and treatment of glioma, partly due to the diverse metabolic profiles driven by genomic alterations. While multiparametric imaging captures spatial and functional variations enabling ITH characterization, it falls short in assessing the metabolic activities underpinning phenotypic differences. This gap stems from the challenge of integrating easily accessible, co-located pathology and genomic data with metabolic insights. This study presents a multi-faceted approach combining stereotactic biopsy with clinical open-craniotomy for sample collection, voxel-wise analysis of MR images, regression-based GAM, and whole-exome sequencing. The aim is to demonstrate the potential of machine learning algorithms to predict variations in cellular and molecular tumor characteristics. This retrospective study enrolled ten treatment-naïve patients with radiologically confirmed glioma who underwent multiparametric MR scans (T1W, T1W-CE, T2W, T2W-FLAIR, DWI) prior to surgery. During craniotomy, at least one stereotactic biopsy was collected from each patient, with the screenshots of sample locations saved for spatial registration to pre-surgical MR data. Whole-exome sequencing was performed on flash-frozen tumor samples, prioritizing five glioma-related genes: IDH1, TP53, EGFR, PIK3CA, and NF1. Regression was implemented with a GAM using a univariate shape function for each predictor. Standard ROC analyses were used to evaluate detection, with AUC calculated for each gene target and MR contrast combination. Mean AUC for five gene targets and 31 MR contrast combinations was 0.75±0.11, with individual AUCs as high as 0.96 for IDH1 and TP53 with T2W-FLAIR and ADC, and 0.99 for EGFR with T2W and ADC. An average AUC of 0.85 across the five mutations was achieved using the combination of T1W, T2W-FLAIR, and ADC. These results suggest the possibility of predicting exome-wide mutation events from non-invasive, in vivo imaging by combining stereotactic localization of glioma samples with a semi-parametric deep learning method. This approach holds potential for refining targeted therapy by better addressing the genomic heterogeneity of glioma tumors.

Amide Functionalized Novel Pyrrolo-pyrimidine Derivative as Anticancer Agents: Synthesis, Characterization and Molecular Docking Studies.

The development of new therapies targeting crucial kinases involved in cancer progression is a promising area of research. Pyrazolo pyrimidine derivatives have emerged as potential candidates for this purpose. This study aims to synthesize pyrazolo pyrimidine derivatives (5a-5r), evaluate their molecular docking against key kinases, and assess their anticancer activity. The synthesis involved a multi-step procedure starting with the cyclization of 6-amino-2- methylpyrimidin-4(3H)-one (1) to form 2-methyl-4,7-dihydro-3H-pyrrolo[2,3-d]pyrimidin-4-ol (2). This was followed by chlorination to yield 4-chloro-2-methyl-4,7-dihydro-3H-pyrrolo[2,3-d]pyrimidine (3) and nucleophilic substitution to produce 2-methyl-4,7-dihydro-3H-pyrrolo[2,3-d]pyrimidin-4-amine (4). The final derivatives (5a-5r) were synthesized through amide bond formation with various carboxylic acids using DCC and DMAP. Structural elucidation was confirmed via NMR, mass spectrometry, and HRMS. Molecular docking studies were conducted against Janus kinase 1 (JAK1), Janus kinase 2 (JAK2), and cyclin-dependent kinase 4 (CDK4). Anticancer activity was evaluated against MCF-7, SET-2, and HCT-116 cell lines. Structural elucidation confirmed the successful synthesis of the derivatives. Molecular docking studies revealed promising binding affinities for selected derivatives, particularly those with heterocyclic substitutions. Anticancer activity evaluation showed diverse potency profiles, with several derivatives demonstrating IC50 values comparable to the reference drug, doxorubicin. Derivatives featuring nitro and heterocyclic moieties exhibited significant anticancer activity. The synthesized pyrazolo pyrimidine derivatives showed potential as lead compounds for further development due to their promising binding affinities and significant anticancer activity, particularly those with nitro and heterocyclic moieties.

Proteomics of circulating extracellular vesicles reveals diverse clinical presentations of COVID-19 but fails to identify viral peptides

Extracellular vesicles (EVs) released by virus-infected cells have the potential to encapsulate viral peptides, a characteristic that could facilitate vaccine development. Furthermore, plasma-derived EVs may elucidate pathological changes occurring in distal tissues during viral infections. We hypothesized that molecular characterization of EVs isolated from COVID-19 patients would reveal peptides suitable for vaccine development. Blood samples were collected from three cohorts: severe COVID-19 patients (G1), mild/asymptomatic cases (G2), and SARS-CoV-2-negative healthcare workers (G3). Samples were obtained at two time points: during the initial phase of the pandemic in early 2020 (m0) and eight months later (m8). Clinical data analysis revealed elevated inflammatory markers in G1. Notably, non-vaccinated individuals in G1 exhibited increased levels of neutralizing antibodies at m8, suggesting prolonged exposure to viral antigens. Proteomic profiling of EVs was performed using three distinct methods: immunocapture (targeting CD9), ganglioside-capture (utilizing Siglec-1) and size-exclusion chromatography (SEC). Contrary to our hypothesis, this analysis failed to identify viral peptides. These findings were subsequently validated through Western blot analysis targeting the RBD of the SARS-CoV-2 Spike protein’s and comparative studies using samples from experimentally infected Syrian hamsters. Furthermore, analysis of the EV cargo revealed a diverse molecular profile, including components involved in the regulation of viral replication, systemic inflammation, antigen presentation, and stress responses. These findings underscore the potential significance of EVs in the pathogenesis and progression of COVID-19.

Marine Gastropod Planaxis sulcatus (Born, 1778) of Uvari Coastal Waters: A Comprehensive Study on Its Antibacterial Activity, Biochemical Composition and FTIR Spectroscopy

Diverse nutritional profiles and potent antimicrobial properties distinguish marine gastropods from other members of the phylum Mollusca. This study targets the investigation of the antibacterial activity, biochemical and FTIR analysis of ethanol extracts of marine gastropod mollusc Planaxis sulcatus. The well diffusion method was used to carry out the antibacterial assay. The extract showed the maximum inhibition (21±2 mm inhibitory zone) against the human bacterial pathogen S. aureus, whereas K. pneumonia showed the lowest susceptibility (12 mm). The extracts had MIC values between 0.21 and 1.04 mg/ml. The biochemical assay's findings revealed that the majority of the snail's flesh (51%) is made up of protein, with only 5% of the mass coming from carbohydrates and very trace amounts of fat (0.2%). The FTIR analysis represents the presence of alkyl halides, nitro compounds, aromatic compounds, alkynes, nitriles, carboxylic acid, aldehyde, alkanes and alcohol in the gastropod extracts. The aforementioned observational result demonstrates the abundance of antibacterial substances in the gastropod extracts. Further research is necessary to fully understand the structural composition of the antibacterial substances found in this marine snail.

Bolstering the Prognostic Utility of Coronary Risk Assessments with PAI: A Physical Activity Metric.

Personal Activity Intelligence (PAI) translates heart rate during physical activity (PA) into a weekly score, that credits vigorous over low- and moderate intensity PA. We prospectively investigated the association between PAI and fatal and non-fatal coronary heart disease (CHD) in self-reported healthy participants from Norway, with specific reference to improving the accuracy of conventional coronary risk assessment. We studied 40 961 healthy adults (56% women) from the population based Trøndelag Health Study (the HUNT study). Individual data were linked to hospital and cause of death registries. The weekly PAI score of each participant was divided into four groups (PAI scores of 0, ≤50, 51-99, or ≥ 100). Adjusted hazard ratios [aHRs] and 95% confidence intervals (CIs) for fatal and non-fatal CHD related to PAI were estimated using Cox proportional hazard regression analyses. During a median follow-up period of 13.1 years (IQR, 12.7-13.6), 3303 (3109 non-fatal, 194 fatal) CHD events occurred. Compared with the inactive group (0 PAI), weekly PAI scores at baseline of 51-99 and ≥ 100 were associated with a lower risk of CHD [0.80 (0.71-0.91) and 0.86 (0.78-0.95), respectively]. By adding PAI to traditional risk factors, the net reclassification improvement of CHD was 0.472 (P < 0.001). PAI was inversely associated with CHD risk among healthy participants at baseline, and it's cardioprotective effect persisted across diverse risk factor profiles. A PAI score > 50 was substantially associated with a reduced risk of CHD. These findings have implications for improving the accuracy of conventional coronary risk assessments with PAI.

Barriers to Reverse Logistics of Construction and Demolition Waste

Objective: This study aims to identify the main barriers to implementing reverse logistics for construction and demolition waste (RCD), focusing on challenges faced by both small and large waste generators. Theoretical Framework: The research is grounded in reverse logistics theories, addressing sustainability and waste management frameworks. These concepts provide a basis for understanding the diverse challenges different generator profiles encounter. Method: A systematic literature review was conducted over nine months (October 2023 to July 2024) following the PRISMA method. Seven databases were consulted—Web of Science, Scopus, MDPI, Emerald, ScienceDirect, Taylor and Francis, and Wiley—resulting in 119 relevant articles. The study identifies and categorizes barriers for small and large generators. Results and Discussion: The results revealed 20 barriers for large generators and 7 for small generators, with 4 common barriers between both groups. These barriers highlight the complexity of RCD management and suggest specific policy and strategy needs. In the discussion, these barriers are analyzed in the context of the theoretical framework, revealing practical implications for improving reverse logistics systems. Research Implications: The findings provide valuable insights for both academic research and practical applications in waste management, contributing to the development of more effective strategies for RCD handling and disposal. This research has the potential to influence public policy and industry practices in waste logistics. Originality/Value: This study fills a gap in the literature by providing a comprehensive overview of barriers specific to different waste generator profiles. It advances theoretical knowledge and offers practical recommendations for improving RCD reverse logistics.

Refining Diagnostic Subtypes of Peripheral T-cell Lymphoma Using a Multiparameter Approach

Peripheral T-cell lymphoma (PTCL) is a heterogeneous category, and many cases are unclassifiable and designated as PTCL-not otherwise specified (PTCL-NOS). Gene expression profiling (GEP) has delineated two prognostic subtypes within PTCL-NOS, PTCL-TBX21, and PTCL-GATA3, characterized by distinctive transcriptomes and a different prognosis. To further evaluate the pathologic features of these subgroups, 101 PTCL cases that did not meet specific criteria for well-defined T-cell lymphoma entities underwent detailed pathologic, immunophenotypic (including TFH biomarkers) and GEP analyses, separating them into PTCL-NOS (n=63) and PTCL-TFH (a.k.a. nodal PTCL-TFH, NOS, and TFH lymphoma, NOS) (n=38). PTCL-NOS cases were further categorized into PTCL-GATA3 (n=22; 34%) and PTCL-TBX21 (n=41; 66%), and a significant association (p < 0.02) with overall survival (OS) was reaffirmed. Histopathological assessment showed PTCL-GATA3 cases were characterized by monotonous medium-sized or large transformed cells with a minimal tumor microenvironment (TME) compared to PTCL-TBX21 cases, which consisted of pleomorphic cells in a polymorphous TME (p < 0.05). GEP analysis validated these TME distinctions. Immunophenotypic analysis showed that PTCL-GATA3 cases were predominantly CD4+CD8- and associated with significantly higher LEF1, MYC, and CD30 expression (p < 0.05). PTCL-TBX21 displayed a more diverse biomarker profile with two subgroups: one expressing cytotoxic antigens and enriched in CD8+CD4- or CD8-CD4- phenotype, and another lacking cytotoxic markers but showing a CD4+CD8- phenotype with increased ICOS expression, but devoid of other TFH markers. The PTCL-TFH cases correlated with an angioimmunoblastic T-cell lymphoma (AITL) gene signature, had more EBER-positive cells than the PTCL-GATA3 and PTCL-TBX21 cases, and a subset had some morphologic features of AITL (p < 0.01). This study highlights the unique morphologic and phenotypic variations within the newly-identified PTCL subtypes and should enable more precise diagnosis and tailored therapeutic strategies in the future.

From problem-crumbling to innovation: The design of a comprehensive professional development training programme to enhance creative competence among TEFL educators

This paper explores creativity in English language teaching through a multiple-case study action research-based continuous professional development (CPD) training programme. It introduces a professional creativity framework for EFL teachers, fostering pedagogical innovation through a blended course delivery. The study, involving seven EFL (English as a Foreign language) teachers, employs a triangulation of methods and data sources, including action research, surveys, Think Aloud Protocol (TAP), reflective diaries, and semi-structured interviews. The research sample consists of primary and secondary EFL teachers. The CPD training integrates creativity into English lessons, enhancing professional creativity for EFL teachers. The findings shed light on the relationship between professional development and creative endeavours, highlighting the need for interventions to boost self-awareness and self-efficacy among TEFL teachers. The study underlines the significance of individual and group tasks, reflective practice, and technology-enabled communities of practice. Additionally, it offers a descriptive overview of diverse TEFL teacher creativity profiles, contributing to understanding this specific creativity domain and suggesting avenues for future research.

Enhancing early detection of cognitive decline in the elderly: a comparative study utilizing large language models in clinical notes

BackgroundLarge language models (LLMs) have shown promising performance in various healthcare domains, but their effectiveness in identifying specific clinical conditions in real medical records is less explored. This study evaluates LLMs for detecting signs of cognitive decline in real electronic health record (EHR) clinical notes, comparing their error profiles with traditional models. The insights gained will inform strategies for performance enhancement. MethodsThis study, conducted at Mass General Brigham in Boston, MA, analysed clinical notes from the four years prior to a 2019 diagnosis of mild cognitive impairment in patients aged 50 and older. We developed prompts for two LLMs, Llama 2 and GPT-4, on Health Insurance Portability and Accountability Act (HIPAA)-compliant cloud-computing platforms using multiple approaches (e.g., hard prompting, retrieval augmented generation, and error analysis-based instructions) to select the optimal LLM-based method. Baseline models included a hierarchical attention-based neural network and XGBoost. Subsequently, we constructed an ensemble of the three models using a majority vote approach. Confusion-matrix-based scores were used for model evaluation. FindingsWe used a randomly annotated sample of 4,949 note sections from 1,969 patients (women: 1,046 [53.1%]; age: mean, 76.0 [SD, 13.3] years), filtered with keywords related to cognitive functions, for model development. For testing, a random annotated sample of 1,996 note sections from 1,161 patients (women: 619 [53.3%]; age: mean, 76.5 [SD, 10.2] years) without keyword filtering was utilised. GPT-4 demonstrated superior accuracy and efficiency compared to Llama 2, but did not outperform traditional models. The ensemble model outperformed the individual models in terms of all evaluation metrics with statistical significance (p<0.01), achieving a precision of 90.2% [95% CI: 81.9%-96.8%], a recall of 94.2% [95% CI: 87.9%-98.7%], and an F1-score of 92.1% [95% CI: 86.8%-96.4%]. Notably, the ensemble model showed a significant improvement in precision, increasing from a range of 70%-79% to above 90%, compared to the best-performing single model. Error analysis revealed that 63 samples were incorrectly predicted by at least one model; however, only 2 cases (3.2%) were mutual errors across all models, indicating diverse error profiles among them. InterpretationLLMs and traditional machine learning models trained using local EHR data exhibited diverse error profiles. The ensemble of these models was found to be complementary, enhancing diagnostic performance. Future research should investigate integrating LLMs with smaller, localised models and incorporating medical data and domain knowledge to enhance performance on specific tasks.

Polysaccharide-induced colloidal stabilization of red wines: Impact on phenolic composition and color characteristic

Polysaccharides play a crucial role in wine quality and colloidal stability. Two types of polysaccharides were applied to three wines with diverse initial phenolic and polysaccharide profiles to evaluate their effects on the color characteristics of the wines. Changes in the colloidal properties, phenolic composition, and color parameters of the wines were analyzed over a one-year bottle aging. The results revealed that the addition of polysaccharides consisting mainly of arabinogalactans (AG) tended to have a higher absolute zeta (ζ) potential value (below -10 mV), indicative of enhanced colloidal stability, while mannoprotein (MP) had little effect. However, the addition of both polysaccharides can influence the colloidal particle size and turbidity of the wines, with distinct variations observed based on the initial matrix composition, especially the polysaccharide content. Furthermore, both polysaccharides promoted the formation and accumulation of anthocyanin derivatives, especially pyranoanthocyanin, while AG had a greater effect, with a maximum increase of nearly 14% compared with the control group at 12 M. The color characteristic of the wines changed accordingly, with a significant increase in the red hue (a* value), particularly in wines characterized by low polysaccharide content and high polyphenol level. Notably, the modifications in colloidal properties induced by polysaccharide displayed a significant correlation with polyphenols and color parameters, indicating that a stable colloidal system facilitates color stability. In practical winemaking applications, the addition of polysaccharides should consider factors such as their type, concentration, and the balance of the initial wine composition.

SALINITY-Induced Changes in Diversity, Stability, and Functional Profiles of Microbial Communities in Different Saline Lakes in Arid Areas

Saline lakes, characterized by high salinity and limited nutrient availability, provide an ideal environment for studying extreme halophiles and their biogeochemical processes. The present study examined prokaryotic microbial communities and their ecological functions in lentic sediments (with the salinity gradient and time series) using 16S rRNA amplicon sequencing and a metagenomic approach. Our findings revealed a negative correlation between microbial diversity and salinity. The notable predominance of Archaea in high-salinity lakes signified a considerable alteration in the composition of the microbial community. The results indicate that elevated salinity promotes homogeneous selection pressures, causing substantial alterations in microbial diversity and community structure, and simultaneously hindering interactions among microorganisms. This results in a notable decrease in the complexity of microbial ecological networks, ultimately influencing the overall ecological functional responses of microbial communities such as carbon fixation, sulfur, and nitrogen metabolism. Overall, our findings reveal salinity drives a notable predominance of Archaea, selects for species adapted to extreme conditions, and decreases microbial community complexity within saline lake ecosystems.

Pore-forming aegerolysin and MACPF proteins in extremotolerant or extremophilic fungi.

Aegerolysin proteins are involved in various interactions by recognising a molecular receptor in the target organism. The formation of pores in combination with larger, non-aegerolysin-like protein partners (such as membrane attack complex/perforin proteins [MACPFs]) is one of the possible responses in the presumed competitive exclusion of other organisms from the ecological niche. Bicomponent pairs are already observed at the gene level. Fungi growing under extreme conditions can be divided into ubiquitous and extremotolerant generalists which can compete with mesophilic species and rare, isolated extremophilic and extremotolerant specialists with narrow ecological amplitude that cannot compete. Under extreme conditions, there are fewer competitors, so fungal specialists generally produce less diverse and complicated profiles of specialised molecules. Since extremotolerant and extremophilic fungi have evolved in numerous branches of the fungal tree of life and aegerolysins are unevenly distributed across fungal genomes, we investigated whether aegerolysins, together with their partner proteins, contribute to the extreme survival ecology of generalists and specialists. We compiled a list of 109 thermo-, psihro-, acido-, alkali-, halo-, metallo- and polyextremo-tolerant/-philic fungal species. Several challenges were identified that affected the outcome: renaming fungal species, defining extremotolerant/extremophilic traits, identifying extremotolerant/extremophilic traits as metadata in databases and linking fungal isolates to fungal genomes. The yield of genomes coding aegerolysins or MACPFs appears to be lower in extremotolerant/extremophilic fungi compared to all fungal genomes. No candidates for pore-forming gene pairs were identified in the genomes of extremophilic fungi. Aegerolysin and MACPFs partner pairs were identified in only two of 69 species with sequenced genomes, namely in the ubiquitous metallotolerant generalists Aspergillus niger and A. foetidus. These results support the hypothesised role of these pore-forming proteins in competitive exclusion.

Evaluating tourism scenarios within the limit of acceptable change framework in Barcelona

This article introduces an expanded Limit of Acceptable Change model, enhancing the traditional approach by incorporating various tourism scenarios and a broader range of indicators. This approach allows to gain a more comprehensive understanding and foresee the effects of diverse tourist profiles and intensities of use in Barcelona. It considers factors like motivation, origin, and accommodation type, and evaluates their effects on key sustainability indicators. The study reveals that significant shifts in tourism patterns are required to impact these indicators noticeably, emphasizing the need to consider both tourist numbers and typologies in sustainable tourism management. This approach equips destination planners with a valuable tool for strategic decision-making and long-term planning.

Multi-Activity Step Counting Algorithm Using Deep Learning Foot Flat Detection with an IMU Inside the Sole of a Shoe

Step counting devices were previously shown to be efficient in a variety of applications such as athletic training or patient’s care programs. Various sensor placements and algorithms were previously experimented, with a best mean absolute percentage error (MAPE) close to 1% in simple mono-activity walking conditions. In this study, an existing running shoe was first instrumented with an inertial measurement unit (IMU) and used in the context of multi-activity trials, at various speeds, and including several transition phases. A total of 21 participants with diverse profiles (gender, age, BMI, activity style) completed the trial. The data recorded was used to develop a step counting algorithm based on a deep learning approach, and further validated against a k-fold cross validation process. The results revealed that the step counts were highly correlated to gyroscopes and accelerometers norms, and secondarily to vertical acceleration. Reducing input data to only those three vectors showed a very small decrease in the prediction performance. After the fine-tuning of the algorithm, a MAPE of 0.75% was obtained. Our results show that such very high performances can be expected even in multi-activity conditions and with low computational resource needs making this approach suitable for embedded devices.

From host individual traits to community structure and composition: Bartonella infection insights

BackgroundPhylogeny, combined with trait-based measures, offers insights into parasite sharing among hosts. However, the specific traits that mediate transmission and the aspects of host community diversity that most effectively explain parasite infection rates remain unclear, even for the Bartonella genus, a vector-borne bacteria that causes persistent blood infections in vertebrates.MethodsThis study investigated the association between rodent host traits and Bartonella infection, as well as how rodent community diversity affects the odds of infection in the Atlantic Forest, using generalized linear models. Additionally, we assessed how host traits and phylogenetic similarities influence Bartonella infection among mammal species in Brazil. To this end, rodents were sampled from ten municipalities in Rio de Janeiro, southeastern Brazil. Then, we calculated several diversity indices for each community, including Rényi’s diversity profiles, Fisher’s alpha, Rao’s quadratic entropy (RaoQ), Functional Diversity (FDis), Functional Richness (FRic), and Functional Evenness (FEve). Finally, we compiled a network encompassing all known interactions between mammal species and Bartonella lineages recorded in Brazil.ResultsWe found no significant relationship between diversity indices and the odds of Bartonella infection in rodent communities. Furthermore, there was no statistical support for the influence of individual-level traits (e.g., body length, sex, and age) or species-level ecological traits (e.g., locomotor habitat, dietary guild, and activity period) on Bartonella infection in rodents. A country-scale analysis, considering all mammal species, revealed no effect of host traits or phylogeny on Bartonella infection.ConclusionsThis study highlighted wild mammals that share Bartonella lineages with livestock, synanthropic, and domestic animals, underscoring the complexity of their maintenance cycle within the One Health framework. A key question arising from our findings is whether molecular host–cell interactions outweigh host body mass and ecological traits in influencing Bartonella infection, potentially opening new avenues for understanding host–parasite relationships and infection ecology.Graphical

Crack Propagation Tests for Load Sequences Developed Using Different Flight Parameters of a Trainer Aircraft

Abstract Military aircraft are subjected to highly variable and unpredictable loads due to diverse mission profiles, armament configurations, and individual piloting styles. This variability complicates the definition of precise load spectra, particularly in cases where data loss occurs due to Flight Data Recorder (FDR) malfunctions or data mishandling. This paper investigates the use of different flight parameters, such as load factor (nz ), barometric height (Hb ), and horizontal velocity (Vp ), to define load sequences for the PZL-130 “Orlik” TC-II military trainer aircraft. These sequences were then used to evaluate crack propagation using Compact Tension (CT) specimens. The results show that the incorporation of additional flight parameters improves the accuracy of crack propagation predictions when compared to direct strain measurements. This study highlights the potential of using available flight data to develop reliable load spectra for fatigue life estimation in military aircraft, even when direct load measurements are not financially feasible.

Trends in risk factor prevalence in young adults experiencing acute coronary syndrome

Abstract Introduction While for many decades the prevalence of coronary artery disease (CAD) and acute coronary syndrome (ACS) has been declining, it seems as this trend has reached a plateau, mostly in developing countries, but also in developed countries due to reasons such as immigration and unhealthy lifestyle concomitant to the pandemic of obesity and metabolic syndrome. Still, CAD remains the leading cause of death globally. Preventive cardiology guidelines addressed adequate control of traditional risk factors in order to reduce CAD burden, mortality and morbidity but to lesser extent fewer resources were invested for the younger population in their third or fourth decade for implementing this practical guideline. As global obesity pandemic emerged over the past decades, it emphasizes the need to re-evaluating risk factors, particularly the role of obesity and metabolic syndrome, in contributing to the rising incidence of ACS among the younger population. Purpose The study aims to analyze trends in risk factors among young adult which presented with ACS from 2005 to 2022. Results may inform targeted interventions and deepen understanding of ACS pathophysiology and severity. Methods The study encompassed 712 patients hospitalized between 2005 and 2022. Comparable groups were analyzed, including temporal changes, ST-elevation myocardial infarction (STEMI) vs. non-ST-elevation myocardial infarction (NSTEMI), different age groups, and various ethnicities. Categorical values were thoroughly examined, yielding insightful results. Results Temporal changes revealed that patients presenting with ACS before 2014 exhibited a higher incidence of Dyslipidemia and familial history (p=0.002 and p=0.005). Conversely, in the latter period, overweight and diabetes were more significant (p&amp;lt;0.001 and p=0.0176). In the STEMI vs. NSTEMI group, smoking was more prevalent in the STEMI group (p=0.0449), while diabetes, Dyslipidemia, and hypertension were more significant for the NSTEMI group (p=0.022, p=0.009, p&amp;lt;0.001). For the age group, the only observed difference was in hypertension for the 40-45 and 45-50 age group (p=0.0463). In the ethnicity group, individuals of Arab origin exhibited higher rates of smoking and familial cardiac background (p&amp;lt;0.001 and p=0.03), while in the non-Arab group, obesity was more significant (p&amp;lt;0.001). Conclusion The observed changes in the distribution of risk factors among patients with CAD align with global trends, indicating an increase in obesity. Belonging to the overweight population, prior to obesity, pose a prominent risk factor for ACS. Smoking remains a significant factor, with higher rates in patients presenting with STEMI, aligning previous research and re-emphasize the importance of prevention. Different demographic groups may exhibit distinct risk factors contributing to the common endpoint of CAD. Tailored intervention strategies considering diverse risk profiles are essential for effective coronary disease prevention.

2.Y.1. Communication in participatory health research with refugees and migrants

Abstract Innovative approaches are needed to transform public health research and address health inequities. Participatory Health Research (PHR) is one such approach, which aims to maximize the participation of those whose life or work is the subject of the research in all stages of the research process. PHR has advantages for both research outcomes, including increased relevance, meaningfulness and impact of research, as well as for those involved, in terms of ownership and empowerment to address their health priorities. PHR with migrants has potential to reduce health inequities through the active involvement of migrants in research about their health. In a framework for refugee and migrant health in the WHO European Region, MacFarlane et al. (2022) recommend the research field of migration and health to adopt PHR as the norm, for ethical reasons and to support effective research-policy-practice translation. PHR with migrants is increasingly used but is still rare and adhoc in the field of migration health research. There are also potential practical and ethical challenges that warrant critical reflection. One persistent challenge is communication, where differences in culture, language and knowledge areas need to be considered in multiple ways, for example, in the development of participatory partnerships, in the conduct of data collection that takes place as a result of such participatory partnerships and in dissemination processes. The aim of the workshop is to share different approaches on PHR with migrants and propose solutions to common challenges in communication. The workshop will be structured in a first part where presenters will draw upon their experience in PHR with refugees and migrants covering a broad range of topics relating to communication, and a second part of open discussion with presenters and the audience. The workshop will address two key questions: what challenges have we experienced, and lessons learnt. Anne MacFarlane presents emerging evidence about music and singing as culturally attuned arts based methods that can create innovative opportunities for communication for partnership building, fieldwork and dissemination. Ana Gama presents on using idea-generation workshops with vignettes representing migrants with diverse health-literacy profiles and its potential to address communication challenges. Key messages • Participatory health research with migrants warrants critical reflection around communication, ethics and partnership-building. • In participatory health research, using innovative and creative methods can create opportunities to overcome communication barriers and build meaningful collaborations. Speakers/Panelists Anne MacFarlane University of Limerick, Limerick, Ireland Ana Gama IHMT, Universidade Nova de Lisboa, Lisbon, Portugal

Resistance Profiles of the ESKAPEE Complex at Veracruz’ s Children Hospital, 2023

Abstract Introduction ESPAKEE complex bacteria are well known as a Multidrug Resistance Organisms that cause difficult mange infections. Management of these infections should be based on the monitoring of resistance profiles to provide appropriate therapy to reduce hospitalization costs and patient improvement. Materials and methods A cross-sectional, retrospective, descriptive study analyzed 179 ESKAPEE bacteria isolated from pediatric patients (0-18 years) between January 1 and December 31, 2023. Laboratory tests utilized VITEK 2.0 technology, reporting Minimal Inhibitory Concentration (MIC) and classifying them as resistant or non-resistant. Descriptive statistics were generated using SPSS v22. Results The study included 179 antibiograms. Among Enterobacter species, E. aerogenes (3) and E. cloacae (17) showed 100% resistance to cefalotin. S. aureus (22) exhibited the highest resistance to Oxacillin (36.4%). Klebsiella pneumoniae (40) demonstrated 97.5% resistance to Ampicillin, followed by resistance to first-generation cephalosporins: cefalotin 62.5%, and third-generation cephalosporins: ceftriaxone and ceftazidime both at 60%. Acinetobacter baumannii (9) showed 100% resistance to Fosfomycin. Pseudomonas aeruginosa (30) displayed 100% resistance to Ceftriaxone, Cefotaxime, and Cefuroxime. Enterococcus faecium (2) exhibited 100% resistance to ciprofloxacin, erythromycin, ampicillin, and levofloxacin, while Enterococcus faecalis (16) showed 50% resistance to tetracycline. E. coli (39) exhibited the highest resistance to Ampicillin (87.2%), while in first-generation cephalosporins: cefalotin 66.7%, third generation: cefotaxime 66.7%, ceftazidime 64.1%, and ceftriaxone 66.7%. Conclusions The ESKAPEE complex species isolated in the hospital displayed diverse resistance profiles against various antibiotic families. Key messages • Monitoring ESKAPEE bacteria’s resistance profiles enables physicians to select appropriate antibiotics at optimal dosages and timings. • Physician should know the rate of resistance of the antibiotics that they use for treatment of ESKAPEE bacteria.

Self-determination and self-affirmative paths of trans* and gender diverse people in Portugal: Diverse identities and healthcare

Abstract Background Trans* and gender diverse (TGD) people are very heterogeneous. While legal contexts and healthcare practices have been growingly endorsing self-determination and consent for gender affirmative care in some countries, gender affirmation trajectories need to be understood as unique and fluid processes, constructed and negotiated by each individual in a given social and cultural context. This study aimed to characterize diverse profiles of TGD people in Portugal, regarding individual choices and trajectories in social, legal, and medical gender affirmative processes. Methods A questionnaire, first developed in France and used in Brazil, Italy, Norway, and Chile, was adapted to the Portuguese context. The conducted survey is comprised of 120 questions, organized into six sections: 1) sociodemographic variables; 2) gender affirmation processes and medical and psychological care; 3) general health and sexual health; 4) mental health; 5) sexuality and sexual concerns; 6) experiences of discrimination and gender identity. Data were collected from a convenience sample of 115 adults who identified as TGD. Content analysis was performed on the written responses, and later categorized. Results Approximately 21% of people identified as men, 17% as trans men, 7% as women, 12% as trans women, 26% as non-binary persons, and 17% as agender or other identifications. Differences were calculated among profiles of TGD participants and their choices for affirmative care, social, and legal transition, revealing an association between the way people self-identify and the request for legal recognition of gender identity, as well as the choices of procedures (or aspirations) for medical affirmation (i.e., hormonal treatments, top surgery, bottom surgery). Conclusions The provision of health care practices consistent with the principles of self-determination requires training of health care professionals and adjustment of public policies, to allow for unique trajectories and profiles.