Exploratory Case-control Study Research Articles

Exchangeable Copper Excess and Zinc Deficiency in the Serum of Patients with Colorectal Cancer.

Copper (Cu) and Zinc (Zn) are altered in colorectal cancer (CRC) but their association with the clinical classification of the tumor has not been fully explored. To examine the association of Cu and Zn homeostasis in the onset and severity of CRC, we performed an exploratory case-control study comparing the serum levels for Cu, the exchangeable component of Cu in serum (CuExc), Zn, the ratio between them (CuExc:Zn), ceruloplasmin [Cp, concentration (iCp) and its activity (eCp), Cp specific activity (eCp:iCp)], and the Cu:Cp, assessed in 31 consecutive CRC patients before surgical resection to those obtained from 37 healthy controls (CTRL). Additionally, we correlated the analyte levels with the indices of the pathological tumor, node, and metastasis (TNM) staging, namely tumor (T), node (N), and metastasis (M), evaluated at the histopathological examination. We found that Cu, CuExc, CuExc:Zn, iCp, eCp, eCp:iCp, and Cu:Cp ratios increased while Zn decreased in CRC patients. In addition, correlation analyses showed that CuExc and Zn levels confirmed the CRC diagnosis. Specifically, CuExc:Zn further increased the discrimination between the individuals of the two groups, providing an area under the curve (ROC AUC) = 0.94. Elevated CuExc was the strongest factor associated with CRC resulting in 15-fold increased odds. These data were confirmed through a multivariable regression model revealing an effect of Zn and CuExc on the CRC risk, with the CuExc resulting in 11-fold increased odds of having the disease. We also found that most of the Cu biological variables analyzed were associated with T, while the CuExc was associated with M. The current pilot study demonstrates that excess labile Cu pool, Zn deficiency, and even further their combination in the CuExc:Zn provide information about CRC in terms of diagnosis, risk of having CRC, and CRC disease stage.

Aberrance in default mode and executive network activity underlie working memory deficits in addictive disorders: A preliminary, exploratory case-control study

BackgroundAddiction can alter neural processes during rest and cognitive performance. Subjects with addictive disorders exhibit preoccupation and anticipation for the psychoactive substance when idle and cognitive deficits, during tasks. Methods128 channel EEG was recorded in sixty subjects (30, with alcohol, opioid and internet addiction; 30 controls) during rest and while performing working memory task to ascertain underlying differences in cortical activity between the groups while at rest and during performance of the task. Artifactually clean data was then subjected to source analysis using sLORETA software in both the groups. ResultsEEG cortical source analysis in subjects with addictive disorders showed significant activation of areas of Default Mode Network (DMN) and reduced activation in dorsolateral prefrontal cortices (DLPFC), an area known to be involved in executive function, during performance of task. However, control subjects demonstrated significantly reduced activation in areas of DMN; and increased activation of DLPFC during task performance. ConclusionInability to suppress DMN inhibits reallocation of neural resources to areas of executive functioning leading to working memory deficits in subjects with addictive disorder.

Exploratory case–control study on childhood cancer near the Mar Menor lagoon Region of Murcia (Spain) 2000 to 2018

The Mar Menor, Europe’s largest saltwater lagoon in the Mediterranean basin (Murcia, southeastern Spain), is an ecosystem facing severe pollution, anoxia events, and marine biodiversity loss. This exploratory study examines the association between residential proximity to the Mar Menor and childhood cancer incidence in Murcia from 2000 to 2018. In our case–control study of 594 cancer cases and 3564 controls, matched by birth year and sex, participants were categorized by proximity to the lagoon (G1 ≥ 20 km, G2 = 10–20 km, G3 = 2–10 km, G4 = ≤ 2 km). Odds ratios (ORs) and 95% confidence intervals (95%CI) were adjusted for sociodemographic and environmental covariates. Analysis of distance as a continuous variable indicated a decrease both in all types of cancer and lymphoid acute leukemia risk with greater distance (OR = 0.99; 95% CI 0.98–0.99), while as a categorical variable, it revealed a non-linear pattern. Specifically, the risk did not increase for those living within 2 km of the lagoon (OR = 0.87; 95% CI 0.52–1.37), whereas increased risks were observed in the 2–20 km range within Campo de Cartagena (G2; OR = 1.32; 95% CI 1.01–1.73 and G3; OR = 1.43; 95% CI 1.00–2.02). This suggests modulating factors near the lagoon may counterbalance risks from broader environmental contamination. These findings highlight the complexity of environmental health dynamics and the importance of detailed research to guide public health strategies and urban planning for environmental and child health protection.

Association between Coffee Consumption and Polycystic Ovary Syndrome: An Exploratory Case-Control Study.

Polycystic ovary syndrome (PCOS) is a leading cause of infertility, with an estimated worldwide prevalence between 5% and 15%. We conducted a case-control study with 121 PCOS patients and 155 controls to assess the association between coffee intake and the presence of having a diagnosis of PCOS in women in Murcia, Spain. The PCOS diagnosis was determined following Rotterdam criteria (the presence of two of the following three conditions: hyperandrogenism, oligo-anovulation, and/or polycystic ovarian morphology). Coffee consumption was assessed using a validated food frequency questionnaire. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multiple logistic regression. Coffee consumption was categorized into never, less than one cup per day, one cup per day, and two or more cups per day. We found a significant inverse linear trend: the higher the coffee consumption, the lower the probability of having PCOS in multivariable analysis (p-trend = 0.034). Women who presented with PCOS were less likely to drink one cup of coffee compared to those who had never drunk coffee (OR = 0.313, 95% CI: 0.141-0.69). The consumption of at least one cup of coffee per day may be associated with a decrease in PCOS symptoms.

An Exploratory Case-Control Study for Mitochondrial DNA G10398A in Bipolar I Disorder Patients with a Family History of Affective Disorders.

The mitochondrial DNA (mtDNA) G10398A polymorphism has been associated with bipolar disorder (BD). It leads to an amino acid substitution within NADH dehydrogenase subunit, thereby altering the mitochondrial complex I function. This exploratory case-control study assesses the association of mtDNA G10398A with the risk of BD and its relationship to clinical variables in Indian patients. Cases met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of BD-I in remission and had a family history of BD or recurrent unipolar disorder in biological relatives. The healthy controls (HC) had no known illness and were screened negative for Family Interview for Genetic Studies. Participants were assessed using Clinical Pro forma, NIMH-Life Chart Method and Alda lithium response scale. The mtDNA G10398A was assessed with real-time polymerase chain reaction using TaqMan assay. A total of 82 participants were recruited across cases and controls, with 42 patients (50% with maternal history) and 40 healthy individuals with similar demographic profiles. The mean age of onset was 25.16 (standard deviation [SD] 7.6) years, with illness for 11.59 years (SD: 7.18). Allele A was found in 50% of cases compared to 32.5% HC (odds ratio = 2.08; 95% confidence interval [CI]: 0.85-5.09). Findings remain non-significant for patients with maternal mood disorders (allele A: 38.9%; 21/42). Cases with allele G had significantly higher body mass index (BMI) (P = 0.008) than those with allele A. The study adds information on mtDNA 10398A amongst Indian patient samples and healthy individuals. No significant group difference was found with respect to mtDNA G10398A. The positive association of allele G with higher BMI has potential clinical relevance that can be further investigated in larger samples.

Increased CX3CL1 in cerebrospinal fluid and ictal serum t-tau elevations in migraine: results from a cross-sectional exploratory case-control study

BackgroundTo date, migraine is diagnosed exclusively based on clinical criteria, but fluid biomarkers are desirable to gain insight into pathophysiological processes and inform clinical management. We investigated the state-dependent profile of fluid biomarkers for neuroaxonal damage and microglial activation as two potentially relevant aspects in human migraine pathophysiology.MethodsThis exploratory study included serum and cerebrospinal fluid (CSF) samples of patients with migraine during the headache phase (ictally) (n = 23), between attacks (interictally) (n = 16), and age/sex-matched controls (n = 19). Total Tau (t-Tau) protein, glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and neurofilament light chain (NfL) were measured with the Neurology 4-plex kit on a Single Molecule Array SR-X Analyzer (Simoa® SR-X, Quanterix Corp., Lexington, MA). Markers of microglial activation, C-X3-C motif chemokine ligand 1 (CX3CL1) and soluble triggering receptor expressed on myeloid cells 2 (sTREM2), were assessed using an immunoassay.ResultsConcentrations of CX3CL1 but not sTREM2 were significantly increased both ictally and interictally in CSF but not in serum in comparison to the control cohort (p = 0.039). ROC curve analysis provided an AUC of 0.699 (95% CI 0.563 to 0.813, p = 0.007). T-Tau in serum but not in CSF was significantly increased in samples from patients taken during the headache phase, but not interictally (effect size: η2 = 0.121, p = 0.038). ROC analysis of t-Tau protein in serum between ictal and interictal collected samples provided an AUC of 0.729 (95% CI 0.558 to 0.861, p = 0.006). The other determined biomarkers for axonal damage were not significantly different between the cohorts in either serum or CSF.DiscussionCX3CL1 in CSF is a novel potential fluid biomarker of migraine that is unrelated to the headache status. Serum t-Tau is linked to the headache phase but not interictal migraine. These data need to be confirmed in a larger hypothesis-driven prospective study.

IJCM_270A: Neck circumference as a potential predictor of blood pressure: An exploratory Case Control Study

Background: Hypertension (HTN) poses a substantial health challenge globally, affecting nearly one billion people. Due to its silent nature, early detection is crucial to prevent end-organ damage. Recent studies suggest a correlation between hypertension and upper body subcutaneous fat accumulation, particularly in the neck circumference (NC). This anthropometric measure is proposed as practical surrogate for assessing visceral obesity, surpassing traditional measures like waist circumference. Objectives: To correlate Neck Circumference (NC) with blood pressure in adults and to correlate other risk factors of HTN with NC. Methodology: This Case Control Study was conducted at Government Wenlock Hospital, KMC Attavar, and KMC outreach clinics. The study population included hypertensive cases and non-hypertensive controls, with a sample size of 110 in each group. Participants above 25 years of age were included, and those with specific conditions were excluded. Mercury Sphygmomanometer, Stethoscope, Flexible measuring tape, and Weighing scale were used as study instruments. Results: Overall, 79.5% of individuals with NC > median consumed a non- vegetarian diet, and those with high salt intake were 1.42 times more likely to develop HTN. Although not statistically significant, 53% of those with a high cholesterol diet had NC greater than median. The study emphasizes the need for larger sample sizes for more conclusive results. Conclusion: The study establishes a positive correlation between blood pressure and NC, proposing NC as a practical and socially acceptable anthropometric marker. The non-invasive nature and simplicity of NC measurement make it a feasible tool for routine assessment, potentially impacting hypertension guidelines.

Risk Factors Associated with Malignant Lung Nodules in Smokers with Coal Worker’s Pneumoconiosis: An Exploratory Case-control Study

Background Benign lung nodules (LN) in coal worker’s pneumoconiosis (CWP) may be indistinguishable from lung cancer (LC) on radiography. There is a lack of validated LN risk calculators and LN management guidelines for CWP patients. Objective We sought to identify characteristics predictive of LC in LN detected in smokers with CWP. Methods An exploratory case-control study was conducted between 2015 to 2020. All adult ever-smokers with radiographic-proven CWP and LN, which were biopsied, were included. Multivariable logistic regression models were used to quantify adjusted associations between demographic and radiographic characteristics. Results Of the 29 eligible patients, 15 (52%) had biopsy-proven LC and 14 (48%) had benign LN. Solid LN increased the odds of LC by 21.6 times (p=0.17). Patients with radiographic emphysema were 2.21 times more likely to have a malignant LN (p=0.51). LN spiculation was associated with a higher risk of LC (OR=1.73, p=0.72), as was the presence of a solitary LN (OR=9.35, p=0.13). Multiple LN was found to be negatively associated with LC (OR=0.18, p=0.36). Family history of LC, pack-years of smoking, and exposure to silica and/or coal were not found to be predictive of malignancy (OR≤1, p>0.05). Conclusion Solid and spiculated LN associated with emphysema and multiple LN was found to be correlated with a higher risk for LC in CWP ever-smokers. No statistically significant association was found due to the small number of patients. This study highlights unique LN features conferring a higher risk of LC among smokers with CWP. Larger, prospective, multicentric studies should be conducted to confirm these findings. Clinical Trial Registration The clinical trial registration number approved by the Institutional Review Board, West Virginia University, was #2109411710.

The atorvastatin metabolite pattern in muscle tissue and blood plasma is associated with statin muscle side effects in patients with coronary heart disease; An exploratory case-control study

Background and aimsStatin-associated muscle symptoms (SAMS) is a prevalent cause of statin discontinuation. It is challenging and time-consuming for clinicians to assess whether symptoms are caused by the statin or not, and diagnostic biomarkers are requested. Atorvastatin metabolites have been associated with SAMS. We aimed to compare atorvastatin pharmacokinetics between coronary heart disease (CHD) patients with and without clinically statin intolerance and statin-dependent histopathological alterations in muscle tissue. Secondarily we aimed to assess genetic variants relevant for the observed pharmacokinetic variables. MethodsTwenty-eight patients with CHD and subjective SAMS were included in the exploratory MUSE biomarker study in 2020. Participants received atorvastatin 40 mg/day for seven weeks followed by no statins for eight weeks. Muscle biopsies and blood were collected at the end of each period. Four patients were categorized as clinically intolerant to ≥3 statins prior to study start whereas four patients had signs of muscle cell damage during treatment. ResultsWe found significantly lower levels of atorvastatin acids, and higher lactone/acid ratios in the statin intolerant, both in muscle and plasma. With optimal cut-off, the combination of 2-OH-atorvastatin acid and the 2-OH-atorvastatin lactone/acid ratio provided sensitivity, specificity, and predictive values of 100 %. Patients with variants in UGT1A1 and UGT1A3 had higher lactone metabolite levels than those with wild type, both in muscle and plasma. ConclusionAtorvastatin metabolites appear promising as biomarkers for the identification of clinical statin intolerance in patients with self-perceived SAMS, but the findings have to be confirmed in larger studies.

Seeing through a robot's eyes: A cross-sectional exploratory study in developing a robotic screening technology for autism.

The present exploratory cross-sectional case-control study sought to develop a reliable and scalable screening tool for autism using a social robot. The robot HUMANE, installed with computer vision and linked with recognition technology, detected the direction of eye gaze of children. Children aged 3-8 (M = 5.52; N = 199) participated, 87 of whom had been confirmed with autism, 55 of whom were suspected to have autism, and 57 of whom were not considered to cause any concern for having autism. Before a session, a human experimenter instructed HUMANE to narrate a story to a child. HUMANE prompted the child to return his/her eye gaze to the robot if the child looked away, and praised the child when it re-established its eye gaze quickly after a prompt. The reliability of eye gaze detection was checked across all pairs of human raters and HUMANE and reached 0.90, indicating excellent interrater agreement. Using the pre-specified reference standard (Autism Spectrum Quotient), the sensitivity and specificity of the index tests (i.e., the number of robot prompts and duration of inattentiveness) reached 0.88 or above and the Diagnostic Odds Ratios were beyond 190. These results show that social robots may detect atypical eye patterns, suggesting a potential future for screening autism using social robots.

Vitreous Biomarkers for Proliferative Vitreoretinopathy Prognostication in Patients Undergoing Primary Retinal Detachment Repair.

To compare baseline levels of exploratory biomarkers in the vitreous fluid of patients with primary retinal detachment who subsequently develop proliferative vitreoretinopathy (PVR) versus those who do not. In this exploratory case-control study, we evaluated the baseline protein biomarker levels from a biobank containing the vitreous fluid of patients who had undergone primary pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment. Undiluted samples were collected at the time of PPV and stored at -80°C. Samples from 13 patients who developed PVR within 6months (PVR group) and 13 age- and gender-matched controls who did not develop PVR (control group) were included. Protein abundance levels were evaluated using a proximity extension assay, and a confirmatory enzyme-linked immunosorbent assay (ELISA) was used to measure the concentration of vimentin. Baseline vimentin (Normalized Protein eXpression [NPX], 8.6 vs. 6.4, P < 0.0001) and heme oxygenase 1 (NPX 8.9 vs. 7.0, P < 0.001) levels were found to be elevated in vitreous fluid of patients who subsequently developed PVR compared to those who did not. Confirmatory analysis using ELISA demonstrated mean vimentin concentrations of 7254 vs. 2727 ng/mL in the PVR versus control groups (P = 0.0152). The odds ratio for developing PVR was 14 (confidence interval, 1.4-168; P = 0.03), assuming a baseline vimentin threshold of 7500 ng/mL. Vimentin is an intermediate filament protein expressed by retinal glial cells, and our data combined with prior evidence suggest that it may serve as an early vitreous biomarker for subsequent PVR formation and reactive gliosis. Furthermore, we found, for the first time, elevated baseline levels of heme oxygenase 1, a measurable indicator of oxidative stress. Our positive findings could impact clinical care for retinal detachment patients by facilitating risk stratification for targeted interventions or closer monitoring in those at the highest risk of developing PVR.

Paternal thrombophilia and recurrent implantation failure: an exploratory case-control study.

Many pieces of literature have reported that inherited and acquired thrombophilia might be a risk factor for recurrent implantation failure (RIF), however, most studies have only focused on RIF patients and not their male partners. We studied the possible association of paternal thrombophilia with RIF risk. Forty-two male partners aged 20-45 suffered from RIF compared with 42 males from couples with at least one successful pregnancy. All participants were investigated for thrombophilia markers. The prevalence of coagulation Factor V activity was significantly higher in the case group (42.9%) than in the control group (16.7%) (p=0.008) (OR=3.75; 95% CI, 1.38, 10.12). The prevalence of protein C and protein S deficiencies in RIF patients were 4.8% and 2.4%, respectively, and 0% in the controls. The prevalence of antithrombin III (ATIII) deficiency was significantly higher in the case group (19%) than in the control group (2.4%) (p=0.01). None of MTHFR C677T and MTHFR A1298C were statistically significant between the two groups. Combined thrombophilia was 45.2% in the men of the RIF group when compared with the control, 14.2% (p=0.001) (OR = 4.95; 95% CI, 1.75-13.86). Paternal thrombophilia may be related to recurrent implantation failure, so evaluation of this factor in RIF patients could be used to identify relevant risk groups and may help in the proper management of these cases to enhance the chance of implantation.

Evaluation of cardiovascular complaints in higher education students experiencing elevated level of situational anxiety during the martial law and peacetime.

Aim: To calculate the average score of situational anxiety level and compare the risk of developing cardiovascular complaints in higher education students from the country in the martial law and the country in peacetime according to the respondents' level of situational anxiety. To analyze the impact of place of residence on the frequency of complaints among students with an elevated level of situational anxiety in both countries. Materials and Methods: Descriptive and inferential statistics: cluster method, qualitative analysis method; exploratory observational analytical short-term case-control study. The State-Trait Anxiety Inventory (STAI) [1] questionnaire was used to calculate the situational anxiety level indicator. Calculations were conducted using Excel and MedStat software. Results: The research results demonstrated higher level of situational anxiety among students who belonged to higher educational institutions in the country under the martial law. The odds ratio is 0,42 (95% CІ 0,27-0,66), indicating that the elevated level of situational anxiety was encountered more frequently in the study group compared to the control group of students. Conclusions: The average score of situational anxiety level was found to be higher among students from a country where the martial law has been implemented. The presence of the martial law in the country was identified as a factor associated with an increased risk of complaints from the cardiovascular system among students. The risk of developing cardiovascular complaints in the context of elevated situational anxiety is confirmed.

Long-COVID in children: An exploratory case-control study from a bio-psycho-social perspective

ObjectiveThis study aimed to determine psychosocial differences between children with Long-COVID Syndrome (LCS) and two control groups (i.e., children who did not have COVID-19 and children who had previously had COVID-19 but did not develop LCS) from a bio-psycho-social and psychosomatic perspective. To classify children in these three groups, we examined the percentage of children meeting criteria for LCS, the type, frequency, perceived severity of symptoms, and their prevalence compared with children who never had SARS-CoV-2 infection. MethodsData were collected from 198 Italian mothers of children aged 4 to 13 years using a cross-sectional web-based case-control survey. Of these, 105 were mothers of children who had contracted SARS-CoV-2 and 94 were mothers of children who had previously had COVID-19. Information was collected on the type and frequency of symptoms commonly referred to as “Long-COVID symptoms” and psychosocial dimensions (i.e., maternal and child health anxiety, COVID-19 anxiety, adjustment, and child deprivation). Descriptive analyses, chi-square tests, Student's T-Test, and analyses of variance were performed. Results29 children (15% of the total sample) developed LCS, mostly in the neurological/neuropsychiatric domain (59%), and of mild intensity. Regarding psychosocial and psychological dimensions, maternal health anxiety, child deprivation, and fear of SARS-CoV-2 infection differed between groups, with the first two dimensions higher in children with LCS than in controls and the latter lower in children with LCS than in controls. ConclusionThis study sheds light on the need of integrating a psychosocial approach into the medical care of children with LCS and their caregivers.

Onchocerciasis-associated epilepsy: an explorative case-control study with viral metagenomic analyses on Onchocerca volvulus

Background A high prevalence of onchocerciasis-associated epilepsy (OAE) has been observed in onchocerciasis-endemic areas with high ongoing Onchocerca volvulus transmission. However, the pathogenesis of OAE remains to be elucidated. We hypothesise that the O. volvulus virome could be involved in inducing epilepsy. With this study, we aim to describe the O. volvulus virome and identify potential neurotropic viruses linked to OAE. Methods In Maridi County, an onchocerciasis endemic area in South Sudan with a high prevalence of OAE, we will conduct an exploratory case-control study enrolling 40 persons aged 12 years and above with palpable onchocerciasis nodules. Cases will be participants with OAE (n=20), who will be age- and village-matched with controls without epilepsy (n=20). For each study participant, two skin snips at the iliac crest will be obtained to collect O. volvulus microfilariae, and one nodulectomy will be performed to obtain adult worms. A viral metagenomic study will be conducted on microfilariae and adult worms, and the O. volvulus virome of persons with and without OAE will be compared. The number, size, and localisation of onchocerciasis nodules in persons with and without OAE will be described. Moreover, the pre- and post-nodulectomy frequency of seizures in persons with OAE will be compared. Ethics and dissemination The protocol has been approved by the Ethics Committee of the University of Antwerp and the Ministry of Health of South Sudan. Findings will be disseminated nationally and internationally via meetings and peer-reviewed publications. Registration ClinicalTrials.gov registration NCT05868551 (https://clinicaltrials.gov/study/NCT05868551). Protocol version 1.1, dated 09/05/2023.

Risk factors for development of pneumothorax in patients with COVID-19 at a government health facility in North India: An exploratory case-control study

Objective: To explore risk factors for the development of pneumothorax in patients with COVID-19 during the second COVID-19 wave at a northern Indian level 2 health facility. Methods: Patients suffering from SARS-CoV-2 infection during the second wave of the COVID-19 pandemic in India (January -June 2021) at a tertiary care teaching hospital and level 2 COVID care facility were included. Cases who suffered from SARS-CoV-2 infection but did not develop pneumothorax were selected as matched controls. All details regarding demographics, clinical presentation, treatment, and outcome were recorded in a semi-structured proforma. Results: Eleven patients with COVID-19 developed pneumothorax during the study period and 40 controls were included in the study. Five cases were smokers in comparison to only two in the control group. Type 2 diabetes mellitus was the most common comorbidity among both groups. Median change in C-reactive protein overall for cases and controls were around +14.0 and −41.9 and was statistically significant. Conclusions: Inflammatory markers like C-reactive protein have significant correlations with the development of pneumothorax in COVID-19-infected patients. There is no sex predisposition to develop pneumothorax among patients with COVID-19.

Context of substance initiation among urban Native Americans: an exploratory retrospective case-control study.

Addiction is a significant problem among many Native American groups but has rarely been examined in urban populations. In particular, little is known about the context in which urban Native Americans first use substances. This study compares cases (people with a history of addiction) to controls (people without a history of addiction) on demographics, substance use history, context of first substance use, and polysubstance use. In addition, this appears to be the first study to overcome the lack of Native American professionals by employing and training lay community members to identify criteria of substance use disorders in survey participants. Employing community members helped foster trust that enabled the revelation of sensitive and often illegal activity. As a result, the investigators were able to recruit participants who likely would not have engaged with traditional researchers. The trained Native American lay research assistants recruited community members and administered surveys. They first asked questions regarding the criteria for substance use disorders. Individuals who were determined to have met criteria for a substance use disorder in the past were classified as cases (n=38) and those who never met such criteria were classified as controls (n=42). They then asked demographic, substance use, and polysubstance use questions. Lastly, eight cases and eight controls were randomly selected for a second interview by a licensed drug and alcohol counselor (LDAC) who conducted a blinded assessment regarding the presence or absence of a history of a substance use disorder. Both groups reported a relatively young age of first substance use (age 16 years for cases and age 15 years for controls). Alcohol was the first substance most commonly used in both groups. Controls reported first benzodiazepine use at a younger age than cases but no other significant differences were found. Both groups reported first obtaining their first drug from family, friends, or at home (rather than a party, bar, or store). Most commonly, the location of their first use of drugs occurred at a friend's home, a party, a bar, or school rather than at their own home. Cases were marginally more likely to report that their first drug use occurred with a friend rather than with a family member when compared with controls. The majority of both groups reported that their first drug use occurred with other Native Americans rather than with non-Native Americans. Polysubstance use was common in both groups (43-45%). There were no significant differences between the groups regarding polysubstance use. The LDAC arrived at the same determination as the trained research assistants on all eight cases and eight controls.

THU314 Diagnosis Performance Of Insulin Surrogate Indices For Predicting Insulin Resistance In Young Men Defining As Reference The Matsuda Index - An Exploratory Case-Control Study Conducted In Latin America Population

Abstract Disclosure: V.M. Soriano: None. C. Espinel Pachon: None. Diagnosis performance of insulin surrogate indices for predicting insulin resistance in young men defining as reference the Matsuda index – An exploratory case-control study conducted in Latin America population Víctor Antonio Malagón – Soriano1, Álvaro Javier Burgos – Cárdenas1, Maria Fernanda Garcés2, Cristian Felipe Espinel – Pachon1, Roberto Franco – Vega3, Jorge Andres Rubio – Romero4, Sofia Alexandra Caminos – Cepeda5, Ezequiel Lacunza6, Ariel Iván Ruiz – Parra4, Jorge Eduardo Caminos2 1Department of Internal Medicine, 2Department of Physiology, 3Endocrinology Unit - Department of Internal Medicine, 4Department of Obstetrics &amp; Gynecology, School of Medicine Universidad Nacional de Colombia, Bogotá 11001, Colombia. 5School of Medicine, Universidad Pompeu Fabra; Barcelona 08002, Spain.6Centro de Investigaciones Inmunológicas Básicas y Aplicadas (CINIBA), Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata 1900, Argentina. Correspondence: Jorge Eduardo Caminos, MSc. PhD., Department of Physiology, School of Medicine, Universidad Nacional de Colombia, Carrera 30 No. 45-03, Edificio 471 Oficina 406, Bogotá, Colombia, E-mail: jecaminosp@unal.edu.coRunning title: Diagnosis performance of Insulin Surrogate Indices using as reference the Matsuda index. Key words: Insulin surrogate indices, diagnosis performance, Matsuda index, healthy and insulin resistant young men Abstract Insulin plays an essential role in glucose and lipid homeostasis. Changes in insulin sensitivity in adipose tissue, liver and muscle occur in the course of different metabolic disorders, and have been proposed to be a potential contributor to obesity and type 2 diabetes. The euglycemic-hyperinsulinemic clamp technique is the gold standard approach for assessing insulin sensitivity in humans, with the disadvantages of being expensive, labor intensive, and time consuming. Therefore, this study aimed to investigate the diagnosis performance of insulin surrogate indices using as reference the Matsuda index, in healthy and insulin resistant young men in Latin America population. Thus, the current cross-sectional study was conducted in healthy (n=48) and insulin resistant (n=45) young adult men (18–31 year old) using the Matsuda index cut-off value as reference to determine insulin sensitivity/resistance. Receivers operating characteristic curves (ROC) were used to determine the cut-off, sensitivity, and specificity values for QUICKI, HOMA-IR, TG/HDL-C, TyG, TyG-WC, TyG-BMI, LAP and VAI. TyG-WC (AUC=1.0) and TyG-BMI (AUC=1.0) indices showed the highest diagnostic performance with high sensitivity and specificity to predict insulin resistance in young men. In addition, TyG-BMI index showed a statistically significant stronger correlation with waist circumference (WC), when compared with HOMA-IR, Matsuda and QUICKY indices. In conclusion, we were able to diagnose insulin resistance with high sensitivity and specificity in young individuals -supposedly metabolically healthy- who do not meet the criteria for metabolic syndrome diagnosis, using widely available, low-cost, and reliable surrogate indices. Additionally, the TyG-WC and TyG-BMI indices were the better predictors of insulin resistance. The cut-off values used to define insulin resistance in our Latin America population studied were similar to recent studies in the United States population, despite clinical and racial/ethnic differences. Presentation: Thursday, June 15, 2023

Onchocerciasis-associated epilepsy: an explorative case-control study with viral metagenomic analyses on Onchocerca volvulus.

A high prevalence of onchocerciasis-associated epilepsy (OAE) has been observed in onchocerciasis-endemic areas with high ongoing Onchocerca volvulus transmission. However, the pathogenesis of OAE remains to be elucidated. We hypothesise that the O. volvulus virome could be involved in inducing epilepsy. With this study, we aim to describe the O. volvulus virome and identify potential neurotropic viruses linked to OAE. In Maridi County, an onchocerciasis endemic area in South Sudan with a high prevalence of OAE, we will conduct an exploratory case-control study enrolling 40 persons aged 12 years and above with palpable onchocerciasis nodules. Cases will be participants with OAE (n=20), who will be age- and village-matched with controls without epilepsy (n=20). For each study participant, two skin snips at the iliac crest will be obtained to collect O. volvulus microfilariae, and one nodulectomy will be performed to obtain adult worms. A viral metagenomic study will be conducted on microfilariae and adult worms, and the O. volvulus virome of persons with and without OAE will be compared. The number, size, and localisation of onchocerciasis nodules in persons with and without OAE will be described. Moreover, the pre- and post-nodulectomy frequency of seizures in persons with OAE will be compared. The protocol has been approved by the Ethics Committee of the University of Antwerp and the Ministry of Health of South Sudan. Findings will be disseminated nationally and internationally via meetings and peer-reviewed publications. ClinicalTrials.gov registration NCT05868551 ( https://clinicaltrials.gov/study/NCT05868551). 1.1, dated 09/05/2023.

Hearing Aids Reduce Self-Perceived Difficulties in Noise for Listeners With Normal Audiograms.

This study assessed hearing aid benefits for people with a normal audiogram but hearing-in-noise problems in everyday listening situations. Exploratory double-blinded case-control study whereby participants completed retrospective questionnaires, ecological momentary assessments, speech-in-noise testing, and mental effort testing with and without hearing aids. Twenty-seven adults reporting speech-in-noise problems but normal air conduction pure-tone audiometry took part in the study. They were randomly separated into an experimental group that trialed mild-gain hearing aids with advanced directional processing and a control group fitted with hearing aids with no gain or directionality. Self-reports showed mild-gain hearing aids reduce hearing-in-noise difficulties and provide a better hearing experience (i.e., improved understanding, participation, and mood). Despite the self-reported benefits, the laboratory tests did not reveal a benefit from the mild-gain hearing aids, with no group differences on speech-in-noise tests or mental effort measures. Further, participants found the elevated cost of hearing aids to be a barrier for their adoption. Hearing aids benefit the listening experience in some listening situations for people with normal audiogram who report hearing difficulties in noise. Decreasing the price of hearing aids may lead to greater accessibility to those seeking remediation for their communication needs.