Effective Preventive Measures Research Articles

Knowledge about and attitude towards COVID-19 vaccination of rural residents in Zambales, Philippines

Vaccines are among the most effective preventive measures developed to minimize the risks of COVID-19. This cross-sectional study employs an online survey to determine the knowledge and attitude toward COVID-19 vaccination among the general population in rural Zambales, Philippines. A total of 690 residents responded to the knowledge and attitude towards COVID-19 vaccination survey questionnaire (KAC19V-SQ) regarding the residents' knowledge about and attitude towards COVID-19 vaccination. Television, Facebook and YouTube are the residents' primary sources of COVID-19 vaccine information. Almost all of them (98.0%) know about the COVID-19 vaccine, but only 81.3% of the residents know about its effectiveness. Most (69.7%) indicated they want to get vaccinated. Zambales residents' knowledge about COVID-19 vaccination was low. Despite having a low level of knowledge, respondents showed a favorable attitude (mean±SD:2.76±0.47) toward COVID-19 vaccination. Women had a less favorable attitude than men. Furthermore, a moderately positive correlation (r=0.511, p<0.01) was noted between knowledge and attitude towards COVID-19 vaccination. It is imperative that the government works in tandem with public health experts, local government officials, and academic institutions to develop and implement initiatives geared towards enhancing public awareness and fostering a positive outlook towards COVID-19 vaccination.

The Diagnosis, Treatment, and Prevention of Recurrent Urinary Tract Infection.

Urinary tract infection has a one-year prevalence of 11% in women and ranges among the most common reasons for consulting a primary care physician and for receiving a prescription for antibiotics. In the case of recurrent urinary tract infection (rUTI), there are questions about the further work-up, treatment, and preventive measures. The systematic literature search performed for the update of the German clinical practice guideline on uncomplicated urinary tract infection (043-044) (up to February 2022) was supplemented with a selective search for clinical trials (up to August 2023). Urine culture and ultrasonography are reasonable steps in the diagnostic evaluation of rUTI. Further invasive testing is suggested for men but is not routinely indicated for women. Antibiotics are among the most effective preventive measures (risk ratio [RR] 0.15, 95% confidence interval [0.1; 0.3]) but carry a high risk of side effects. Non-antibiotic preparations such as cranberry juice (RR 0.74 [0.5; 0.99]), mannose (RR 0.23 [0.14; 0.37]), and vaginal estrogen (RR, 0.42 [0.30; 0.59]) can also reduce the infection rate, with a low risk of side effects. Increased daily fluid intake has been shown to lower infection rates in the short term (odds ratio [OR] 0.13 [0.07; 0.25]); the use of hygienically advisable wiping techniques after passing stool or urine has been little studied but can be implemented with no risk. rUTI poses a challenge for the treating physician. The measures to be taken must be considered on an individual basis. Vulnerable groups, such as older patients, need special attention.

Global, regional, and national burden of trachea, bronchus, and lung cancer among women of reproductive age, 1990–2019

BackgroundTrachea, bronchus, and lung (TBL) cancer has demonstrated a discernible feminization and a tendency towards younger onset in recent decades. Therefore, our objective is to examine the most recent patterns in the worldwide prevalence of TBL among women of reproductive age on a global, regional, and national scale. MethodsTo assess the prevalence trends of TBL in women of reproductive age, we calculated the estimated annual percentage change (EAPC), age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and disability-adjusted life years (DALYs) for 204 countries and territories from 1990 to 2019. These calculations were based on the Global Burden of Disease (GBD) 2019 database. ResultsFrom 1990 to 2019, there was a global increase in the absolute number of incidence cases, deaths, and DALYs of TBL in women of reproductive age. However, the ASIR, ASDR, and age-standardized DALY rates were decreasing over this period, with EAPC of -0.77 (95 % confidence interval [CI]: -1.03 to -0.51), -1.08 (95 % CI: -1.34 to -0.82), and -1.10 (95 % CI: -1.36 to -0.84), respectively. This trend was observed even in regions with higher Socio-Demographic Index (SDI). East Asia consistently had the highest ASIR, ASDR, and age-standardized DALY rate, but there was a decreasing trend. Conversely, Eastern Sub-Saharan Africa displayed an increasing burden pattern. When examining countries individually, Monaco, Greenland, and Palau had the highest ASIR. Moreover, in most countries, the ASIR for TBL increased with age, particularly among women aged 35–49 years. ConclusionsDespite a global decline in ASIR, ASDR, and age-standardized DALY rates for TBL in women of reproductive age over the past three decades, there is still a troubling increase observed in low- and low-middle SDI regions. It is crucial to implement effective preventive and curative measures in these regions in order to address this concerning trend.

#2209 Hypoglycemia induced by hemodialysis in diabetic and non-diabetic patients, how to prevent it? A prospective study

Abstract Background and Aims Hemodialysis-induced hypoglycemia, a documented complication associated with adverse clinical outcomes, including mortality, is linked to factors such as impaired gluconeogenesis, inadequate nutritional status, reduced insulin clearance, glucose loss to the dialysate, and autonomic neuropathy. Glycemic variability is recognized as an independent risk factor for morbidity and mortality. This study aims to investigate the incidence of hypoglycemia during hemodialysis (HD) by exploring protocol-related factors and their impact, such as in-nutrition during HD. Additionally, the study seeks to examine the relationship between nutritional and inflammatory statuses and variations in intradialytic glycemia in both diabetic and non-diabetic patients. Method This prospective study, conducted between September and December 2023, examined the glycemic profiles of HD patients at a hospital HD program. All patients undergo hemodialysis with a dialysate containing 100 mg/dL of glucose. Plasma glucose levels were assessed at the start, 2:30 hours post-initiation, and the end of sessions. Following the 2:30-hour mark, patients received a meal (523 Kcal). Glycose variability was computed by averaging blood glucose differences across all sessions. Data collected included demographics, hemodialysis specifics, and lab results. Inflammatory and nutritional statuses were evaluated using lab tests at the study's beginning and conclusion [ferritin, protein C reactive (PCR), interleukin 6 (IL-6) and albuminemia, urea, creatinemia, cholesterol, respectively]. Anthropometric measurements and bioimpedance assessments were performed, with values averaged for better representation. Categorical variables are shown with frequencies/percentages, and continuous variables with means/standard deviations or medians/interquartile ranges for skewed distributions. The study used repeated measures ANOVA for glycemic profiles, correlation analyses for outcome influences on glycemia, and parametric/non-parametric tests for relations in diabetic and non-diabetic groups. Significance was set at p<0.05, analyzed with SPSS version 29 for Mac OS 13. Results 63 patients, 67.2% (n=43) were males, the medium age was 72.0±11.8 and 50.8% (n=32) had diabetes. Among 9072 measurements, hypoglycemia was observed in 0.07% (n=6) of diabetic patients and 0.01% (n=1) in non-diabetic individual. The initial blood glucose measurement was 139.5±260.0 mg/dL, the second was 117.05±35 mg/dL, and the third was 132.8±21.3 mg/dL. Significant differences were observed in all measurements [F (1.17, 73.58)=23.62; p<0.001]. The mean glycemic variation between the first and second measurements was 23.8±46.0 mg/dL, and for the third measurement was 5.5±71.5 mg/dL. There was no significant correlation found between glycemic and nutritional parameters neither between inflammatory parameters. In the subgroup analysis comparing diabetic and non-diabetic patients, the diabetic group demonstrated lower serum creatinine levels (6.8±2.7 mg/dL) and total cholesterol (137.4±35.6 mg/dL), coupled with a higher Charlson Index (8.2±1.7). These differences were statistically significant (p=0.055, p=0.035, p<0.001). In the subsequent analysis, no other statistically significant associations were observed. Conclusion Contrary to what is described in the literature, the studied population exhibited a very low incidence of hypoglycemic events. This underscores the importance of nutrition during HD, along with the use of a glucose-containing dialysate, as an effective preventive measure against intradialytic hypoglycemia. Careful consideration of these factors is warranted to prevent adverse health consequences for our patients. It is plausible that diabetic patients may face an elevated risk of malnutrition, necessitating heightened concern and a more proactive preventive approach.

Favorable Lifestyle Behaviors as Reverse Risk Factors and Treatment for Postpartum Depression

Background. Lifestyle behaviors such as sleep, sedentary behavior, physical activity (PA) or exercise, and diet may influence risk for postpartum depression (PPD) or serve as treatment options for those diagnosed with PPD. The purpose of this review was to summarize existing research about four key lifestyle behaviors (sleep, sedentary behavior, PA and exercise, and diet) and their potential influence on PPD. Methods. Studies that were published in English after 2000 were drawn from the PubMed database. Observational studies, systematic reviews, meta-analyses, and randomized, controlled trials that enrolled >50 participants were considered for inclusion. Results. Quality sleep and PA or exercise during pregnancy and the postpartum period may reduce PPD risk or help improve PPD symptoms. Data regarding the utility of intervening on diet patterns or specific nutrients for lessening PPD risk or serving as PPD treatment are inconsistent. Evidence for vitamin D supplementation is extensive, while evidence supporting other vitamins, nutrients, and minerals remains inconclusive. Research linking sedentary behavior and PPD is extremely limited. Conclusion. Sleep quality and PA or exercise may reduce the risk of PPD or mitigate its symptoms. Further high- quality research studies examining the relationship between sedentary behavior and PPD risk are necessary. Healthy lifestyle behaviors, alone or in conjunction with other evidence-based strategies recommended by healthcare providers, may serve as effective preventive measures and treatments for PPD in the pregnancy and postpartum periods.

Breastfeeding and risk of food allergy and allergic rhinitis in offspring: a systematic review and meta-analysis of cohort studies.

Breastfeeding for more than 6months proves to be an effective preventive measure against AR. However, large prospective high-quality studies are needed to investigate the potential risk of FA in children with prolonged breastfeeding. • The impact of breastfeeding on allergic rhinitis and food allergy in offspring is controversial. • Previous meta-analyses fail to prove the effect of breastfeeding on food allergy in offspring of all ages. • Breastfeeding for more than 6months proves to be an effective preventive measure against AR. However, it potentially elevates the risk of FA in children. Non-breastfeeding is linked to an increased risk of AR in children, but there is no evidence of an association between breastfeeding patterns and FA in children. • The impact of breastfeeding on allergic rhinitis and food allergy in offspring may vary with the time and pattern of breastfeeding.

A Literature-Based Framework for Analysing Fall-From-Height Accidents and Safety Preventive Measures in the Construction Industry

Fall-from-height accidents are a significant cause of injuries and fatalities in construction industries. The occurrence of this accident may have been caused by any number of contributing factors. In addition, various preventive measures have been proposed to prevent this accident from occurring. To capture the true condition of a fall from height accident, the causes of the accident, the effects of the accident, and the preventive actions should be rendered out. Therefore, it is possible to analyse these accidents in order to determine their fundamental causes and implement effective preventative measures. This article presents a literature-based framework for analysing fall-from-height accidents. A literature review was conducted to examine existing studies and identify similar themes and patterns on fall from height accidents in the construction industry to illustrate the framework. Where the framework outlines the key factors that contribute to the accident. The framework comprises four main components: (1) fall from height accident, (2) causes of accident, (3) effect of accident, and (4) development of safety preventive measures. Along with the literature review that was carried out, an identification and outlining of the factors and subfactors of causes of accidents, effects of accidents, and preventative safety measures was taken out. The proposed framework provides a structured approach for analysing fall-from-height accidents, which can help organizations to identify the underlying causes of such accidents and implement appropriate measures to prevent them. The framework is flexible and can be adapted to suit the needs of other industries and organizations. The paper also discusses the future research directions.

Critical Threshold-Based Heat Damage Evolution Monitoring to Tea Plants with Remotely Sensed LST over Mainland China

Tea plants (Camellia sinensis (L.) Kuntze) are a cash crop that thrive under warm and moist conditions. However, tea plants are becoming increasingly vulnerable to heat damage (HD) during summer growing seasons due to global climate warming. Because China ranks first in the world in both harvested tea area and total tea production, monitoring and tracking HD to tea plants in a timely manner has become a significant and urgent task for scientists and tea producers in China. In this study, the spatiotemporal characteristics of HD evolution were analyzed, and a tracking method using HD LST-weighted geographical centroids was constructed based on HD pixels identified by the critical LST threshold and daytime MYD11A1 products over the major tea planting regions of mainland China from two typical HD years (2013 and 2022). Results showed that the average number of HD days in 2022 was five more than in 2013. Daily HD extent increased at a rate of 0.66% per day in 2022, which was faster than that in 2013 with a rate of 0.21% per day. In two typical HD years, the tea regions with the greatest HD extent were concentrated south of the Yangtze River (SYR), with average HD pixel ratios of greater than 50%, then north of the Yangtze River (NYR) and southwest China (SWC), with average HD pixel ratios of around 40%. The regions with the least HD extent were in South China (SC), where the HD ratios were less than 40%. The HD LST-weighted geographical centroid trajectories showed that HD to tea plants in 2013 initially moved from southwest to northeast, and then moved west. In 2022, HD moved from northeast to west and south. Daily HD centroids were mainly concentrated at the conjunction of SYR, SWC, and SC in 2013, and in northern SWC in 2022, where they were near to the centroid of the tea planting gardens. The findings in this study confirmed that monitoring HD evolution of tea plants over a large spatial extent based on reconstructed remotely sensed LST values and critical threshold was an effective method benefiting from available MODIS LST products. Moreover, this method can identify and track the spatial distribution characteristics of HD to tea plants in a timely manner, and it will therefore be helpful for taking effective preventative measures to mitigate economic losses resulting from HD.

Ziabetus (Prediabetes): A Harbinger of Critical Stage in the Continuum of Glucose Metabolism Disorder: A Review

Background: Prediabetes is a metabolic condition characterized by blood glucose levels higher than normal but below the threshold for diabetes mellitus. It represents a critical stage in the progression towards type 2 diabetes mellitus (T2DM) and is associated with an increased risk of cardiovascular disease and other complications. The two major pathophysiologic defects responsible for losing glucose tolerance are insulin resistance and β-cell glucose insensitivity, both appearing in subjects of Intermediate Hyperglycaemia. In classical literature, Unani physicians have described the initial symptoms and factors leading to the pathology, the risk factors are described in terms of ‘Su-e-mizaj’ as per the concept of Tibb. So, it is considered in the context of Ziabetus which is described as a disease that develops due to Sue-mizaj haar (abnormal hot temperament). The symptoms mentioned in Unani medicine are increased frequency of micturition (ants and flies are attracted to urine), increased thirst, nocturia, dryness of mouth and whole body, fatigue, loss of weight, malaise, and cramps in lower extremities. The modern drug-based approach for the management of Intermediate Hyperglycaemia is associated with inherent drawbacks, including toxicity, tolerability, cost, and efficacy. Objective: The purpose of this review is to provide an in-depth understanding of prediabetes concerning the classical literature of Greek medicine based on the analysis of certain parameters like etiopathophysiology, current diagnostic criteria, risk factors, and evidence-based management strategies. By synthesizing findings from epidemiological studies, and clinical trials, this paper aims to enhance understanding of prediabetes and facilitate effective preventive measures and interventions. Keywords: Prediabetes, Intermediate hyperglycaemia, Impaired Glucose Tolerance, Impaired Fasting Glucose, Insulin Resistance.

Epidemiological Investigation of Goose Astrovirus in Hebei Province, China, 2019-2021.

The goose astrovirus (GAstV), a key pathogen causing visceral gout and high mortality in geese, has spread widely in China, with frequent outbreaks in recent years. Outbreaks and transmissions of this virus have been reported across China, causing considerable economic losses to the goose industry worldwide, with losses exceeding tens of billions in China alone. However, there is still no effective prevention strategy against this virus. Therefore, continuous monitoring of the genetic diversity of dominant GAstV strains is crucial for developing targeted vaccines and appropriate therapeutics. As a crucial region for goose breeding in China, Hebei Province has previously lacked reports on the epidemiology of GAstV. Hence, investigating the epidemiology of GAstV in Hebei Province is highly important. From January 2019 to December 2021, 474 samples suspected of having a GAstV infection were collected in Hebei Province in this study. Through detailed histological observations, pathological examinations, virus isolation and identification, and genetic diversity analysis, we found that GAstV-2 has become the predominant circulating genotype. However, the presence of GAstV-1 and mixed infections cannot be ignored and should receive increased attention. The findings of this study not only deepened our understanding of GAstV in waterfowl in China but also provided scientific evidence for developing effective prevention and control measures, thereby promoting the healthy development of the goose industry in China.

A Single-Step Method for Harvesting Influenza Viral Particles from MDCK Cell Culture Supernatant with High Yield and Effective Impurity Removal

A Single-Step Method for Harvesting Influenza Viral Particles from MDCK Cell Culture Supernatant with High Yield and Effective Impurity Removal

KNOWLEDGE AND AWARENESS OF STUDENTS ABOUT COVID-19: A CROSS-SECTIONAL STUDY

The COVID-19 outbreak has become an immediate public health threat. To contain the spread of the virus, the Kazakhstani government adopted emergency measures nationwide, including the closure of schools and universities, workplaces and subsequently lockdown. Objective. We aimed at studying knowledge and awareness about the sources, symptoms, and prevention measures of COVID-19 among students. Materials and methods. A cross-sectional study was conducted at al-Farabi KazNU, Almaty, Kazakhstan. Sample size was 5440 university students. A questionnaire was conducted on asking to assess the knowledge of students about COVID-19- related information, including questions on ways of spreading, symptoms, and vulnerable groups. In addition, preventive measures were evaluated. Results. Social media and media identified the most informative sources of information. The overall median knowledge score was 14 out of 19. Age and grade, studying at medical faculty, marital status and having children were associated with good knowledge about COVID-19. Moreover, according to students, practising a healthy lifestyle (60.1%), avoiding crowded places (59.4%), avoid touching your nose, mouth, and eyes with unwashed hands (58.5%) were effective preventive measures. Conclusion. Knowledge and awareness are essential tools in preventing disease. Students demonstrated fair good knowledge, although training programs for students about infectious diseases should be provided.

Prevalence of Neck Pain and Associated Disabilities among Students who Use Computers

Background: Neck pain is increasingly prevalent among computer users, leading to significant health concerns and impacting daily activities. Understanding the prevalence and associated disabilities of neck pain in this population is crucial for developing effective preventive measures and interventions. Objective: To investigate the prevalence of neck pain and associated disabilities among university students who use computers, and to identify the factors contributing to these conditions. Methods: This cross-sectional study was conducted over six months at Akhtar Saeed Medical and Dental College, Lahore. A sample of 144 students from DPT, MBBS, BDS, and Pharm-D programs, aged 20-28 years, was selected. Participants included both males and females who used computers for more than two hours daily and had no history of cervical trauma or underlying medical conditions. Data were collected using the Neck Disability Index (NDI) questionnaire and the Numeric Pain Rating Scale (NPRS). Ethical approval was obtained from the Institutional Review Board, and informed consent was secured from all participants. Data analysis was performed using SPSS version 25, with descriptive statistics summarizing demographic information and inferential statistics examining associations between neck pain and risk factors. Results: The study found that 29.2% of participants reported no pain, 20.8% had very mild pain, 45.8% had moderate pain, and 4.2% experienced severe pain. Weak correlations were observed between neck pain and disabilities, with 33.33% of participants able to care for themselves without pain, 62.50% able to care for themselves with extra pain, and 4.17% finding personal care difficult and slow. Regarding headaches, 16.67% reported no headaches, 20.83% had slight headaches infrequently, and 62.50% experienced moderate headaches frequently. Conclusion: The study concluded that a significant number of university students suffer from neck pain due to prolonged computer use, with most experiencing mild to moderate pain. Preventive measures, including ergonomic interventions and educational initiatives on proper posture and taking breaks, are essential to reduce the incidence of neck pain and improve the quality of life for computer users.

Prediction and causal inference of cardiovascular and cerebrovascular diseases based on lifestyle questionnaires

Cardiovascular and cerebrovascular diseases (CCVD) are prominent mortality causes in Japan, necessitating effective preventative measures, early diagnosis, and treatment to mitigate their impact. A diagnostic model was developed to identify patients with ischemic heart disease (IHD), stroke, or both, using specific health examination data. Lifestyle habits affecting CCVD development were analyzed using five causal inference methods. This study included 473,734 patients aged ≥ 40 years who underwent specific health examinations in Kanazawa, Japan between 2009 and 2018 to collect data on basic physical information, lifestyle habits, and laboratory parameters such as diabetes, lipid metabolism, renal function, and liver function. Four machine learning algorithms were used: Random Forest, Logistic regression, Light Gradient Boosting Machine, and eXtreme-Gradient-Boosting (XGBoost). The XGBoost model exhibited superior area under the curve (AUC), with mean values of 0.770 (± 0.003), 0.758 (± 0.003), and 0.845 (± 0.005) for stroke, IHD, and CCVD, respectively. The results of the five causal inference analyses were summarized, and lifestyle behavior changes were observed after the onset of CCVD. A causal relationship from ‘reduced mastication’ to ‘weight gain’ was found for all causal species theory methods. This prediction algorithm can screen for asymptomatic myocardial ischemia and stroke. By selecting high-risk patients suspected of having CCVD, resources can be used more efficiently for secondary testing.

Overexpression of an Integument Esterase Gene LbEST-inte4 Infers the Malathion Detoxification in Liposcelis bostrychophila (Psocoptera: Liposcelididae).

Liposcelis bostrychophila, commonly known as booklouse, is an important stored-product pest worldwide. Studies have demonstrated that booklices have developed resistance to several insecticides. In this study, an integument esterase gene, LbEST-inte4, with upregulated expression, was characterized in L. bostrychophila. Knockdown of LbEST-inte4 resulted in a substantial increase in the booklice susceptibility to malathion. Overexpression of LbEST-inte4 in Drosophila melanogaster significantly enhanced its malathion tolerance. Molecular modeling and docking analysis suggested potential interactions between LbEST-inte4 and malathion. When overexpressed LbEST-inte4 in Sf9 cells, a notable elevation in esterase activity and malathion tolerance was observed. HPLC analysis indicated that the LbEST-inte4 enzyme could effectively degrade malathion. Taken together, the upregulated LbEST-inte4 appears to contribute to malathion tolerance in L. bostrychophila by facilitating the depletion of malathion. This study elucidates the molecular mechanism underlying malathion detoxification and provides the foundations for the development of effective prevention and control measures against psocids.

Recycled mask polypropylene microfibers benefit tensile properties and prevent thermally induced spalling of high-strength engineered cementitious composite (HS-ECC)

The COVID-19 pandemic has led to a significant amount of waste medical masks being generated, which if not properly managed would pose a substantial risk to the natural environment. In this context, this study focuses on upcycling the waste medical mask propylene (PP) microfibers in high-strength engineered cementitious composites (HS-ECC) to mitigate its explosive spalling issue upon fire exposure. At ambient temperature, the compressive strength of Ref-ECC (without PP microfibers) reached 96.4 MPa, and the incorporation of recycled mask fibers (RMFs) up to 0.5 vol% had a negligible effect on it. The incorporation of low-cost RMFs benefited the uniaxial tensile properties of HS-ECC. For instance, at 25 °C, the incorporation of 0.5 vol% RMFs increased the tensile strain capacity and tensile strength of the HS-ECC to 2.60% and 7.9 MPa, from those of the Ref-ECC (2.03% and 7.1 MPa), respectively. The 0.5 vol% RMFs in the HS-ECC increased the tensile strain capacity to 3.80% at 60 °C, 4.50% at 90 °C and 5.23% at 120 °C notwithstanding their reduced tensile strength, respectively. The RMFs in the HS-ECC induced inner (sub)micron-sized cracks after thermal exposures, facilitating multi-cracking behavior. After 600 °C/2h heating, severe spalling occurred in the Ref-ECC cylinder specimens, demonstrating that polyethylene (PE) fibers alone (at 1.8 vol%) cannot prevent spalling upon fire exposure. However, the incorporation of RMFs (as little as 0.3 vol%) was proven as an effective preventive measure against the explosive spalling phenomenon in HS-ECC.

Hepatitis B Virus Infection: A Mini Review.

Hepatitis B and C viruses (HBV and HCV) are the leading causes of end-stage liver disease worldwide. Although there is a potent vaccine against HBV, many new infections are recorded annually, especially in poorly resourced places which have lax vaccination policies. Again, as HBV has no cure and chronic infection is lifelong, vaccines cannot help those already infected. Studies to thoroughly understand the HBV biology and pathogenesis are limited, leaving much yet to be understood about the genomic features and their role in establishing and maintaining infection. The current knowledge of the impact on disease progression and response to treatment, especially in hyperendemic regions, is inadequate. This calls for in-depth studies on viral biology, mainly for the purposes of coming up with better management strategies for infected people and more effective preventative measures for others. This information could also point us in the direction of a cure. Here, we discuss the progress made in understanding the genomic basis of viral activities leading to the complex interplay of the virus and the host, which determines the outcome of HBV infection as well as the impact of coinfections.

Abstract PO1-20-03: Acupuncture for Preventing Progression of Taxane-Induced PeripheralNeuropathy (ATP): A Phase II Randomized, Placebo Controlled Trial

Abstract Background: Chemotherapy-induced peripheral neuropathy (CIPN) from chemotherapy drugs such as taxanes can be detrimental to cancer survival, increasing the risk of falls and worsening physical functions. However, there is no effective treatment or preventative measure for CIPN. The current management of worsening and persistent CIPN during chemotherapy is dose reduction or discontinuation of chemotherapy. Our group previously completed a single-arm phase IIA pilot trial of women who developed National Cancer Institution Common Terminology Criteria for Adverse Events (NCI-CTCAE) grade 2 CIPN during weekly paclitaxel for stage I-III breast cancer. The result suggested an acupuncture intervention for grade 2 CIPN might slow CIPN progression during chemotherapy. However, the role of acupuncture still needs to be better defined. Trial design: The ATP trial is a two-arm, parallel, randomized controlled trial comparing weekly real acupuncture (RA) versus sham acupuncture (SA) during preplanned curative intent taxane containing regimens in patients with breast cancer. The study will include two phases: screening and intervention. In the screening phase, eligible patients will consent and receive CIPN screening each week. Patients who develop grade 1 CIPN or higher based on NCI-CTCAE version 5.0 will be consented to the intervention phase and randomized to receive either weekly RA or SA using a standardized, semi-fixed protocol developed in our preliminary studies to improve CIPN pain. Eligibility criteria for the screening phase: English or Spanish-proficient; aged ≥18 years; histological diagnoses of invasive carcinoma of the breast; and plan to receive curative intent chemotherapy regimen containing paclitaxel or nab-paclitaxel weekly or biweekly as standard of care. Eligibility criteria for the intervention phase: in additional to the screening phase eligibility criteria, developed CIPN grade ≥1 based on the NCI-CTCAE version 5.0, while receiving taxane; ≥ four weeks of paclitaxel or nab-paclitaxel weekly or biweekly planned, as standard of care and at treating physician’s discretion; willing to adhere to requirement that no new pain medication or dose changes be taken throughout the first 12 weeks of the study period; and willing to adhere to all study-related procedures, including randomization to one of the two possible acupuncture treatments. Specific aims: The primary aim is to evaluate the effectiveness of RA versus SA in preventing taxane-induced peripheral neuropathy progression as measured by Neuropathic Pain Scale (NPS) in patients with early-stage breast cancer who are receiving curative intent neurotoxic chemotherapy. The secondary aim is to evaluate the effectiveness of RA versus SA on chemotherapy relative dose intensity (RDI) and CIPN-related chemotherapy discontinuation. Statistical methods: We will randomize 80 patients, 40 to each arm. All randomized patients will be evaluable in the Intent to Treat (ITT) analyses because all will have completed the baseline assessment before randomization. We will use a linear mixed model (LMM) to compare the change in NPS between the arms from baseline to week 4. Based on our pilot data, a difference in CIPN grade from 1 to 2 corresponded to a difference in NPS from 12 to 22, a difference of ten points in 27 patients. The NPS standard deviation (SD) in patients with grade 1 CIPN was 17. With 80 patients we will have 80% power to detect a difference between arms as small as 10 points on the NPS, assuming a one-sided test, type I error of 5%, correlation between baseline and follow-up measurements of 0.5, SD of 17, and 15% attrition at week 4. Present accrual and target accrual: We accrued 20 participants in the intervention phase by the end of June 2023; the target accrual is 80 participants. Contact information for people with a specific interest in the trial: W. Iris Zhi, MD, PhD, zhiw@mskcc.org. ClinicalTrails.gov Identifier: NCT05458284. Citation Format: W. Iris Zhi, Lauren Taylor, Raymond Baser, Matthew Weitzman, Qing Li, Christina Seluzicki, Ting Bao, Jun Mao. Acupuncture for Preventing Progression of Taxane-Induced PeripheralNeuropathy (ATP): A Phase II Randomized, Placebo Controlled Trial [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-20-03.

Gastric cancer actionable genomic alterations across diverse populations worldwide and pharmacogenomics strategies based on precision oncology.

Introduction: Gastric cancer is one of the most prevalent types of cancer worldwide. The World Health Organization (WHO), the International Agency for Research on Cancer (IARC), and the Global Cancer Statistics (GLOBOCAN) reported an age standardized global incidence rate of 9.2 per 100,000 individuals for gastric cancer in 2022, with a mortality rate of 6.1. Despite considerable progress in precision oncology through the efforts of international consortia, understanding the genomic features and their influence on the effectiveness of anti-cancer treatments across diverse ethnic groups remains essential. Methods: Our study aimed to address this need by conducting integrated in silico analyses to identify actionable genomic alterations in gastric cancer driver genes, assess their impact using deleteriousness scores, and determine allele frequencies across nine global populations: European Finnish, European non-Finnish, Latino, East Asian, South Asian, African, Middle Eastern, Ashkenazi Jewish, and Amish. Furthermore, our goal was to prioritize targeted therapeutic strategies based on pharmacogenomics clinical guidelines, in silico drug prescriptions, and clinical trial data. Results: Our comprehensive analysis examined 275,634 variants within 60 gastric cancer driver genes from 730,947 exome sequences and 76,215 whole-genome sequences from unrelated individuals, identifying 13,542 annotated and predicted oncogenic variants. We prioritized the most prevalent and deleterious oncogenic variants for subsequent pharmacogenomics testing. Additionally, we discovered actionable genomic alterations in the ARID1A, ATM, BCOR, ERBB2, ERBB3, CDKN2A, KIT, PIK3CA, PTEN, NTRK3, TP53, and CDKN2A genes that could enhance the efficacy of anti-cancer therapies, as suggested by in silico drug prescription analyses, reviews of current pharmacogenomics clinical guidelines, and evaluations of phase III and IV clinical trials targeting gastric cancer driver proteins. Discussion: These findings underline the urgency of consolidating efforts to devise effective prevention measures, invest in genomic profiling for underrepresented populations, and ensure the inclusion of ethnic minorities in future clinical trials and cancer research in developed countries.

Spatial distribution of non-communicable diseases; a case of Ischaemic Heart Diseases, Cancer and Diabetes in Sri Lanka

The abstract provides a comprehensive overview of the global prevalence of non-communicable diseases (NCDs) and their impact on public health, emphasizing their leading role in morbidity and mortality worldwide. It highlights the specific burden of Ischaemic heart diseases, cancers, and diabetes, with a significant portion of premature deaths occurring in low- and middle-income countries. Transitioning to Sri Lanka, the abstract underscores the country's shift towards NCDs as the primary health concern, attributing over 80% of premature deaths to these diseases. The narrative emphasizes the influence of rapid lifestyle changes and socio-economic development on the rise of NCDs in Sri Lanka and emphasizes the urgent need for comprehensive research to understand trends, patterns, and contributing factors for effective preventive measures.