Full Survey Research Articles

Slitless spectrophotometry with forward modelling: Principles and application to measuring atmospheric transmission

Context. In the next decade, many optical surveys will aim to answer the question of the nature of dark energy by measuring its equation-of-state parameter at the per mill level. This requires trusting the photometric calibration of the survey with a precision never reached so far on many sources of systematic uncertainties. The measurement of the on-site atmospheric transmission for each exposure, or for each season or for the full survey on average, can help reach the per mill precision for the magnitudes. Aims. This work aims at proving the ability to use slitless spectroscopy for standard-star spectrophotometry and its use to monitor on-site atmospheric transmission as needed, for example, by the Vera C. Rubin Observatory Legacy Survey of Space and Time supernova cosmology program. We fully deal with the case of a disperser in the filter wheel, which is the configuration chosen in the Rubin Auxiliary Telescope. Methods. The theoretical basis of slitless spectrophotometry is at the heart of our forward-model approach to extract spectroscopic information from slitless data. We developed a publicly available software called Spectractor, which implements each ingredient of the model and finally performs a fit of a spectrogram model directly on image data to obtain the spectrum. Results. We show through simulations that our model allows us to understand the structure of spectrophotometric exposures. We also demonstrate its use on real data by solving specific issues and illustrating that our procedure allows the improvement of the model describing the data. Finally, we discuss how this approach can be used to directly extract atmospheric transmission parameters from the data and thus provide the base for on-site atmosphere monitoring. We show the efficiency of the procedure in simulations and test it on the limited available data set.

Tree species diversity mapping from spaceborne optical images: The effects of spectral and spatial resolution

AbstractIncreasingly available spaceborne sensors provide unprecedented opportunities for large‐scale, timely and continuous tree species diversity (TSD) monitoring. However, given differences in spectral and spatial resolutions, the choice of sensor is not always straightforward. In this work, we investigated the effects of spatial and spectral resolutions for four spaceborne sensors (RapidEye, Landsat‐8, Sentinel‐2 and PlanetScope) on TSD mapping in an area of approximately 4000 km2 within the Black Forest, Germany. We employed a random forest (RF) regression model to predict Shannon–Wiener diversity based on seven types of spectral heterogeneity metrics (texture, coefficient of variation, Rao's Q, convex hull volume, spectral angle mapper, convex hull area and spectral species diversity) and a full survey dataset from 135 one‐ha sample plots. We compared the RF model's performance across sensors and spatial resolutions. Our results demonstrated that the Sentinel‐2‐based TSD model achieved the highest accuracy (mean R2: 0.477, mean root‐mean‐square error (RMSE): 0.274). The RapidEye‐based TSD model produced lower accuracy (mean R2: 0.346, mean RMSE: 0.303), but it was better than the PlanetScope‐ and Landsat‐based TSD models. The 10 m (for Sentinel‐2 and RapidEye) and 15 m (for PlanetScope) were the best spatial resolutions for predicting TSD. The NIR band was the most favourable spectral band for predicting TSD. Texture metrics and Rao's Q outperformed the other spectral heterogeneity metrics. Our results highlighted that spaceborne optical imagery (especially Sentinel‐2) can be successfully used for large‐scale TSD mapping but that the choice of sensors can significantly affect the resulting mapping accuracy in temperate montane forests.

Irony in Storytelling of Two Short Stories, "Rip Van Winkle" and "The Story of an Hour"

This paper is wholly designed to discuss the use of Irony in two famous classic short stories: Rip Van Winkle and The Story of an Hour. The two stories used Irony as a literary device in many positions to add a sense of humor and surprise in the reader's perception. Irony could take three shapes, as literature usually explains. Irony could be verbal, situational, or dramatic. Two types of these appeared in the two stories as literary devices and added a sense of weirdness and humor as expected when using Irony. Irony is widely applied as a useful literary device. This paper stresses the point that the two short stories, The Story of an Hour and Rip Van Winkle, use irony as a literary device. The paper used discourse analysis as a means to study Irony in the two stories. This paper depends on making a full survey of uses of irony in through different aspects. Subtitles are used separately to explain how examples of irony appeared in each short story. Content analysis was made to define each position of irony in the two stories. The conclusion explained that irony was used as a literary device and defined different positions of different types of irony in the two stories. Irony added a sense of humor and weirdness to the two stories and created excitement in Storytelling to prove its effectiveness as a literary device.

A budget impact analysis of a powered hybrid mattress to prevent pressure ulcers in the Austrian inpatient setting: An original research.

Pressure ulcer is a considerable health problem and is associated with an increased hospital length of stay (LOS), nursing effort, costs, and reduced quality of life. The aim of this analysis is to compare the economic, clinical, and nursing benefit after the implementation of the powered hybrid mattress Dyna-Form Mercury Advance SMARTcare® in 2019 with the situation in 2017 (rental systems Arjo BariAir® and Arjo TheraKair Visio®, and purchased foam mattresses Arjo Simuflex®) using a single center. In the framework of a budget impact analysis, a difference-in-difference approach was used to compare pre-implementation longitudinal data (2017) with post-implementation data (2019). The longitudinal data comprise the mattress resource use, patient characteristics, and LOS. The care effort was gathered based on a full survey of all 75 members of the nursing staff using the online tool "LimeSurvey." In this survey, the resource use of the different mattress systems was identified in terms of time (minutes or days). This analysis was performed from the hospital perspective and included direct costs of mattress systems, Austrian diagnostic-related group costs for the hospital stay and nursing staff costs for 2019. Based on 1253 patients "at-risk," the total yearly costs implementing the powered hybrid mattress amounts to 654,248€ compared with 901,469€ when using Arjo products. The budget impact shows a cost advantage of 247,221€. Furthermore, the powered hybrid mattress system leads to fewer nursing-staff time in minutes per year (-1,031,097 min [1,993,204 vs. 3,024,302]); 242€ are saved per patient. Compared with the Arjo products, fewer inpatient cases of pressure ulcers (-44 cases [0 vs. 44]) were documented. Despite the higher total outlay of costs associated with the powered hybrid mattress, the long-term savings potential showed a significant cost advantage per annum for the single center. Therefore, the use of the hybrid mattress leads to considerable economic, clinical, and nursing benefits.

WALLABY pilot survey: an ‘almost’ dark cloud near the Hydra cluster

ABSTRACT We explore the properties of an ‘almost’ dark cloud of neutral hydrogen (H i) using data from the Widefield ASKAP L-band Legacy All-sky Survey (WALLABY). Until recently, WALLABY J103508 − 283427 (also known as H1032 − 2819 or LEDA 2793457) was not known to have an optical counterpart, but we have identified an extremely faint optical counterpart in the Dark Energy Spectroscopic Instrument (DESI) Legacy Imaging Survey Data Release 10. We measured the mean g-band surface brightness to be 27.0 ± 0.3 mag arcsec−2. The WALLABY data revealed the cloud to be closely associated with the interacting group Klemola 13 (also known as HIPASS J1034 − 28 and the Tol 9 group), which itself is associated with the Hydra cluster. In addition to WALLABY J103508 − 283427/H1032 − 2819, Klemola 13 contains 10 known significant galaxies and almost half of the total H i gas is beyond the optical limits of the galaxies. By combining the new WALLABY data with archival data from the Australia Telescope Compact Array, we investigate the H i distribution and kinematics of the system. We discuss the relative role of tidal interactions and ram pressure stripping in the formation of the cloud and the evolution of the system. The ease of detection of this cloud and intragroup gas is due to the sensitivity, resolution, and wide field of view of WALLABY, and showcases the potential of the full WALLABY survey to detect many more examples.

Spectroscopic identification of rapidly rotating red giant stars in APOKASC-3 and APOGEE DR16

ABSTRACT Rotationally enhanced red giant stars are astrophysically interesting but rare. In this paper, we present a catalogue of 3217 active red giant candidates in the APOGEE DR16 (Apache Point Observatory Galactic Evolution Experiment – Data Release 16) survey. We use a control sample in the well-studied Kepler fields to demonstrate a strong relationship between rotation and anomalies in the spectroscopic solution relative to typical giants. Stars in the full survey with similar solutions are identified as candidates. We use vsini measurements to confirm that 50 ± 1.2 per cent of our DR16 candidates are rotationally enhanced (vsini > 5 km s−1), compared to 4.9 ± 0.2 per cent in the Kepler control sample. In both, the Kepler control sample and a control sample from DR16, we find that there are 3–4 times as many giants rotating with intermediate velocities of 5 < vsini < 10 km s−1 compared to velocities of vsini > 10 km s−1, the traditional threshold for rapid rotation for red giants. The vast majority of intermediate rotators are not spectroscopically anomalous. We use binary diagnostics from APOGEE and Gaia to infer a binary fraction of 73 ± 2.4 per cent among the confirmed rotationally enhanced giants in DR16. We identify a significant bias in the reported metallicity for DR16 candidates with complete spectroscopic solutions, with a median offset of −0.37 dex in [M/H] from a control sample. As such, up to 10 per cent of stars with reported [M/H]<−1 are not truly metal poor. Finally, we use Gaia data to identify a subpopulation of main-sequence photometric binaries erroneously classified as giants.

Probing cosmology via the clustering of critical points

ABSTRACT Exclusion zones in the cross-correlations between critical points (peak-void, peak-wall, filament-wall, and filament-void) of the density field define quasi-standard rulers that can be used to constrain dark matter and dark energy cosmological parameters. The average size of the exclusion zone is found to scale linearly with the typical distance between extrema. The latter changes as a function of the matter content of the universe in a predictable manner, but its comoving size remains essentially constant in the linear regime of structure growth on large scales, unless the incorrect cosmology is assumed in the redshift–distance relation. This can be used to constrain the dark energy parameters when considering a survey that scans a range of redshifts. The precision of the parameter estimation is assessed using a set of cosmological simulations, and is found to be a 4σ detection of a change in matter content of 5 per cent, or about 3.8σ detection of 50 per cent shift in the dark energy parameter using a full sky survey up to redshift 0.5.

A cross-sectional study of the psychosocial and occupational impact of COVID-19 among NHS staff: findings from a Northwest London cohort during the second wave

Background: Evidence of the deleterious mental health impact of COVID-19 on healthcare workers shows the priority need to support their psychological wellbeing. We assessed the nature, prevalence and factors associated with the psychosocial and occupational impact of COVID-19 among NHS staff during the pandemic. Methods: A cross-sectional online survey was sent to all NHS provider organisations in Northwest London in January 2021. Results: Of 1,065 participants completing the survey, 906 (85%) provided responses to the full survey. Over half (54.1%; n=543) exceeded the cut-off score for probable mental disorders, 31.1% (n=222) for probable burnout, and similarly for PTSD (28.5%; n=210). 28.6% (n=214) had experienced suicidal thoughts. 58% (n=429) scored >5 out of 10 for emotional and physical exhaustion. Over 30% (n=328) of respondents reported using some kind of staff support service. Staff in pay bands 4-6 were more likely to have common mental disorders (CMD) (OR 2.42 [1.20,4.88]) and PTSD symptoms (OR 4.18 [1.44,12.14]) than lower banded staff. Staff working in acute care settings were more likely to experience CMD (OR 1.50 [1.08,2.07]) and PTSD (OR 1.57 [1.03,2.41]) than in non-acute settings. Low social connectedness and perceived delivery of poor-quality care were highly associated with risk of all mental health problems, apart from alcohol misuse (OR range 1.56-18.34). Conclusions: Psychosocial morbidity and adverse occupational impacts on NHS staff in the second wave of the COVID-19 pandemic echoed that reported in the first wave. Social connection and perception of delivering good care were important, potentially modifiable, mitigating factors.

Physicians' beliefs and perceived importance of traumatic brain injury-associated agitation in critically ill patients: a survey of Canadian intensivists.

Agitation is a common behavioural problem following traumatic brain injury (TBI). Intensive care unit (ICU) physicians' perspectives regarding TBI-associated agitation are unknown. Our objective was to describe physicians' beliefs and perceived importance of TBI-associated agitation in critically ill patients. Following current standard guidance, we built an electronic, self-administrated, 42-item survey, pretested it for reliability and validity, and distributed it to 219 physicians working in 18 ICU level-1 trauma centres in Canada. We report the results using descriptive statistics. The overall response rate was 93/219 (42%), and 76/93 (82%) respondents completed the full survey. Most respondents were men with ten or more years of experience. Respondents believed that pre-existing dementia (90%) and regular recreational drug use (86%) are risk factors for agitation. Concerning management, 91% believed that the use of physical restraints could worsen agitation, 90% believed that having family at the bedside reduces agitation, and 72% believed that alpha-2 adrenergic agonists are efficacious for managing TBI agitation. Variability was observed in beliefs on epidemiology, sex, gender, age, socioeconomic status, and other pharmacologic options. Respondents considered TBI agitation frequent enough to justify the implementation of management protocols (87%), perceived the current level of clinical evidence on TBI agitation management to be insufficient (84%), and expressed concerns about acute and long-term detrimental outcomes and burden to patients, health care professionals, and relatives (85%). Traumatic brain injury-associated agitation in critically ill patients was perceived as an important issue for most ICU physicians. Physicians agreed on multiple approaches to manage TBI-associated agitation although agreement on epidemiology and risk factors was variable.

Decoding the molecular complexity of the solar-type protostar NGC 1333 IRAS 4A

ABSTRACT The characterization of the molecular inventory of solar-type protostars is of crucial importance for a deep understanding of the chemical complexity underlying our cosmic origins. In this context, we present here the full millimetre line survey of the Class 0 protostellar object NGC 1333 IRAS 4A in the spectral bands at 3, 2, and 1.3 mm. In recognition of the powerful tool that unbiased spectral studies provide for investigating the chemistry and physics of star-forming regions, we provide a detailed description of the survey and the results of the analysis. We describe the identification of 1474 spectral lines belonging to 97 different molecular species, including complex organic molecules, which together cover the most ubiquitous chemical elements of life on Earth, namely carbon, hydrogen, nitrogen, oxygen, phosphorus, and sulphur. The abundances obtained herein are compared with the Class 0 protostellar objects L483 and L1527, and selected molecular ratios are used as tracers of physicochemical properties of the sources. Particularly, the dominance of oxygen-bearing species and the presence of distinct excitation temperature regimes support the attribution of NGC 1333 IRAS 4A as a hot corino featuring three physical components with distinguished and diverse chemical composition.

Use of Questionnaire-Based Research in Hand Surgery

Introduction Questionnaire-based research is ubiquitous, and careful survey design is paramount to obtaining meaningful results. This study characterizes the use of questionnaire-based studies in the current hand surgery literature. Methods We conducted a systematic review of questionnaire-based studies published between 2010 and 2020 in 4 major American journals. We included studies in which questionnaire results represented a primary outcome. Validation status of the survey instruments was assessed, and topics of study were categorized. Nonvalidated instruments were assessed for reporting of parameters to limit bias. Results Three hundred fifty-four studies were identified, including 186 (52.5%) using validated instruments, 98 (27.7%) using nonvalidated instruments, 64 (18.1%) using a combination, and 6 (1.7%) that sought to validate an instrument. Of the studies that used validated instruments, 84.9% focused on patient-reported outcomes and 15.1% focused on other patient-centered topics. In contrast, of studies that used nonvalidated instruments, 44.9% focused on physician practice, 30.6% were patient centered, and 13.3% focused on education. Among nonvalidated questionnaires, 74.5% did not report predistribution testing, 49.0% did not publish full survey questions, and 33.3% did not report response rates. Conclusions Survey research is common in the hand surgery literature. Forty-six percent of examined studies included at least some nonvalidated elements. Techniques to limit bias in the design and reporting of studies based on nonvalidated surveys were not uniformly disclosed. Identified areas for improvement include (1) pilot testing to assess for question clarity; (2) publication of full texts to improve transparency; and (3) better reporting on sample selection, respondents, and nonrespondents.

Successful Incorporation of Electronic Patient Reported Outcomes Using Promis-29 into Standard of Care after Hematopoietic Stem Cell Transplant and Chimeric Antigen Receptor T Cell Therapy

Background: Cellular therapies including hematopoietic stem cell transplant (HCT) and CAR T are mainstays of treatment for hematologic malignancies, but can have significant and prolonged side effects. Patient reported outcome (PRO) measures are instruments which allow a patient to self-report symptoms to their care team and have been shown to be more comprehensive and reliable than provider assessment. Using our center's electronic platform, we aimed to integrate PRO collection into standard of care to improve the clinical experience after HCT and CAR T. Methods: Patients received the PROMIS-29 survey through the patient portal. Baseline surveys were automatically generated by a chemotherapy order, and follow-up surveys on Day 0 (infusion), weekly for the first month, monthly for the first year, and every 3 months for the second year were generated off the cell infusion order. Patients were manually censored from further surveys at time of relapse or progression of disease. Survey responses in pre-identified severe ranges prompted instructions to call the clinician's office and for the clinical team to call the patient. Results: From May 2019 to December 2022, 1025 patients underwent a cell therapy at MSK (323 allo HCT, 450 allo HCT, 228 commercial CAR T, 24 with both HCT and CAR T) with overall median age of 63 (range 20 -85), 44% female. HCT patients had leukemia (22%), myelodysplastic syndrome (10%), myeloproliferative neoplasm (3%), non-Hodgkin lymphoma (NHL, 18%), Hodgkin lymphoma (5%), plasma cell disorders (40%), or other diseases (1%); while CAR T cell patients had NHL (85%), multiple myeloma (12%), or leukemia (3%). Seventy-eight percent answered at least one survey over the two years, with response rates at baseline, Day 0, week 1, week 2, week 3, and week 4 of 51%, 27%, 26%, 26%, 29% and 29%, respectively (Figure 1). PROMIS-29 physical health summary scores at at baseline, Day 0, week 1, week 2, week 3, and week 4 were 49 [21 - 59], 45 [22 - 59], 43 [21 - 59], 41 [21 - 59], and 42 [21 - 59], respectively (Figure 2). Mental health summary scores were 51 [30 - 64], 49 [29 - 64], 48 [29 - 64], 47 [26 - 64], 48 [24-64] and 49 [30 - 64], respectively. Conclusions: We demonstrate the feasibility of incorporating patient reported outcomes into standard of care practice after HCT and CAR T cell therapy. Missing surveys were more common while inpatient, which may be due to toxicity or less use of the patient portal while admitted. Additional work is ongoing to improve the response rates at all time points. Importantly, the electronic system allowed us to capture later timepoints when patients have less frequent visits and may be followed locally. Full survey results will be presented.

Provider beliefs and practices regarding the management of obesity in lung transplant recipients

Obesity at the time of lung transplant is associated with decreased survival. How providers manage obesity after lung transplantation is unknown. We performed an international survey of lung transplant providers to assess beliefs and practices regarding post-transplant obesity management. Eighty-one providers initiated the survey and 73 (90%) completed the full survey. Respondents were primarily North American-based pulmonary physicians. Nearly all providers believe treating obesity improves quality of life (99%) and survival (95%) after lung transplantation, but that only 41% of patients attempting weight loss are successful. While respondents nearly always recommend diet (96%), exercise (92%), and dietician consultation (89%), they less frequently recommend prescription weight loss medications (29%) or bariatric surgery (11%). Lung transplant providers are motivated to treat obesity in transplant recipients. However, there is a gap between general obesity treatment guidelines and lung transplant practice. Additional training, education, and trials in this population could address this gap.

Supporting clinical decision making in the emergency department for paediatric patients using machine learning: A scoping review protocol.

Machine learning as a clinical decision support system tool has the potential to assist clinicians who must make complex and accurate medical decisions in fast paced environments such as the emergency department. This paper presents a protocol for a scoping review, with the objective of summarising the existing research on machine learning clinical decision support system tools in the emergency department, focusing on models that can be used for paediatric patients, where a knowledge gap exists. The methodology used will follow the scoping study framework of Arksey and O'Malley, along with other guidelines. Machine learning clinical decision support system tools for any outcome and population (paediatric/adult/mixed) for use in the emergency department will be included. Articles such as grey literature, letters, pre-prints, editorials, scoping/literature/narrative reviews, non-English full text papers, protocols, surveys, abstract or full text not available and models based on synthesised data will be excluded. Articles from the last five years will be included. Four databases will be searched: Medline (EBSCO), CINAHL (EBSCO), EMBASE and Cochrane Central. Independent reviewers will perform the screening in two sequential stages (stage 1: clinician expertise and stage 2: computer science expertise), disagreements will be resolved by discussion. Data relevant to the research question will be collected. Quantitative analysis will be performed to generate the results. The study results will summarise the existing research on machine learning clinical decision support tools in the emergency department, focusing on models that can be used for paediatric patients. This holds the promise to identify opportunities to both incorporate models in clinical practice and to develop future models by utilising reviewers from diverse backgrounds and relevant expertise.

Frequency of resuscitation attempts with dying nursing home residents. A full survey in an urban district in Germany based on registry data from 2018–2021

AimThe realities of emergency care and resuscitation research involving nursing home (NH) residents suggest an overuse of resuscitation attempts in NHs. A complete analysis of all NH resident deaths is needed to provide a complementary perspective of potential underuse. The present research investigated whether residents of different NH homes died at the NH during attempted resuscitation or after transfer to hospital. MethodsA full survey of resuscitation attempts and deaths among NH residents, via retrospective analysis of data from the death registry and the German Resuscitation Registry for the years 2018 to 2021. ResultsOver the 4-year study period, 14,598 individuals died, of whom 3,288 (22.5%) were residents of 31 different NHs. The mean age of the deceased NH residents was 87 years (±8.6); 2,196 (66.8%) were female, 118 (3.6%) underwent a resuscitation attempt, and 58.5% died at the NH. NH averages were as follows: deaths per NH: 106 (±51; min–max: 36–292); number of beds: 102 (±39; 34–210); deaths per bed per year 0.27 (±0.07; 0.15–0.51); resuscitation attempts per 1,000 beds per year: 9.5 (±5.5; 0–21.1); and ratio of futile resuscitation attempts to deaths: 6.0% (0–12.5%). Considering the entire study region before and during the COVID-19 pandemic, a slight underuse of resuscitation attempts with female NH residents emerged. On a facility level, substantial disparities and opposing trends were found. The incidence of deaths and resuscitation attempts, as well as the place of death and the ratio of futile resuscitation attempts to deaths, varied considerably. ConclusionResuscitation attempts are rarely administered to dying NH residents. However, their frequency varies considerably between NHs.

The MidPIC study: Midwives’ knowledge, perspectives and learning needs regarding preconception and interconception care

Preconception and interconception care improves health outcomes of women and communities. Little is known about how prepared and willing Australian midwives are to provide preconception and interconception care. The aim of this study was to explore midwives’ knowledge, perspectives and learning needs, and barriers and enablers to delivering preconception and interconception care. We conducted a cross-sectional exploratory study of midwives working in any Australian maternity setting. An online survey measured midwives’ self-rated knowledge; education needs and preferences; attitudes towards pre and interconception care; and views on barriers, enablers; and, future service and workforce planning. Quantitative data were analysed descriptively and demographic characteristics (e.g., years of experience, model of care) associated with knowledge and attitudes regarding pre- and interconception care were examined using univariate logistic regression analysis. Qualitative data were captured through open-ended questions and analysed using inductive content analysis. We collected responses from (n = 338) midwives working across all models of care (full survey completion rate 96%). Most participants (n = 290; 85%) rated their overall knowledge about pre and interconception health as excellent, above average or average. Participants with over 11 years of experience were more likely to report above average to excellent knowledge (OR 3.11; 95% CI 1.09, 8.85). Online e-learning was the most preferred format for education on this topic (n = 244; 72%). Most (n = 257; 76%) reported interest in providing pre and interconception care more regularly and that this is within the midwifery scope of practice (n = 292; 87%). Low prioritisation in service planning was the most frequently selected barrier to providing preconception and interconception care, whereas continuity models and hybrid child health settings were reported as enablers of pre and interconception care provision. Findings revealed that midwives are prepared and willing to provide preconception and interconception care. Pre and post registration professional development; service and funding reform; and policy development are critical to enable Australian midwives’ provision of pre and interconception care.

The MAGPI survey: effects of spiral arms on different tracers of the interstellar medium and stellar populations at z ∼ 0.3

ABSTRACT Spiral structures are important drivers of the secular evolution of disc galaxies, however, the origin of spiral arms and their effects on the development of galaxies remain mysterious. In this work, we present two three-armed spiral galaxies at z ∼ 0.3 in the Middle Age Galaxy Properties with Integral Field Spectroscopy (MAGPI) survey. Taking advantage of the high spatial resolution (∼0.6 arcsec) of the Multi-Unit Spectroscopic Explorer (MUSE), we investigate the two-dimensional (2D) distributions of different spectral parameters: Hα, gas-phase metallicity, and D4000. We notice significant offsets in Hα (∼0.2 dex) and gas-phase metallicities (∼0.05 dex) among the spiral arms, downstream and upstream of MAGPI 1202197197 (SG 1202). This observational signature suggests the spiral structure in SG 1202 is consistent with arising from density wave theory. No azimuthal variation in Hα or gas-phase metallicities is observed in MAGPI 1204198199 (SG 1204), which can be attributed to the tighter spiral arms in SG 1204 than SG 1202, coming with stronger mixing effects in the disc. The absence of azimuthal D4000 variation in both galaxies suggests the stars at different ages are well mixed between the spiral arms and distributed around the disc regions. The different azimuthal distributions in Hα and D4000 highlight the importance of time-scales traced by various spectral parameters when studying 2D distributions in spiral galaxies. This work demonstrates the feasibility of constraining spiral structures by tracing interstellar medium (ISM) and stellar population at z ∼ 0.3, with a plan to expand the study to the full MAGPI survey.

Clinician preferences on treatment of smoldering myeloma: a cross-sectional survey

Smoldering myeloma (SMM) is an asymptomatic precursor condition to multiple myeloma (MM) with a variable risk of progression. The management of high-risk SMM (HR-SMM) remains controversial, particularly with changes in diagnostic criteria that led to reclassifying of some patients with SMM to MM. This study aimed to assess clinician preferences for whether to treat patients with HR-SMM and/or patients with MM diagnosed solely by SLiM criteria (free light chain ratio >100, bone marrow plasma cell percentage >60, greater than two focal marrow lesions on MRI) through an electronic survey. This was a cross-sectional survey of clinicians, conducted via an anonymous online REDCap survey from May 16th to July 5th, 2023. The survey included questions on demographics, SMM surveillance practices, and management preferences for two clinical scenarios (HR-SMM and MM based solely on the free light chain ratio >100 criterion). Data was analysed descriptively via Microsoft Excel. A total of 146 clinicians completed the full survey, with 92% recommending against routine treatment for a patient with HR-SMM based on a single time point assessment, instead preferring active surveillance. For patients with MM diagnosed solely on the basis of a free light chain ratio >100, 61% recommended active treatment, while 37% recommended active surveillance. The most common reasons recommending against treatment of HR-SMM were toxicity, lack of demonstrated overall survival benefit, and low MM-defining event rates in clinical trials. The survey indicates that most clinicians recommend against routine treatment for HR-SMM. Active surveillance is the prevailing standard of care and it is therefore an appropriate control arm in future SMM trials. More randomised trials are needed to determine if early treatment of modern-era SMM offers a net benefit to patients. None.

Post-conflict acute stress reactions in Kazakhstan in the aftermath of January 2022 unrests: A national survey

BackgroundIn January 2022 Kazakhstan experienced unprecedented nationwide protests that quickly turned to violent riots. Although the number of individuals affected physically by the disturbances were cited, the emotional toll of the events remains undetermined. The aim of this study was to evaluate the comparative rates of acute stress reactions in Kazakhstan in the aftermath of the unrests. MethodsA cross-sectional, population-based online survey was conducted one month after the start of the disturbances. The study questionnaire were completed anonymously and included the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) and the General Anxiety Disorder-7 (GAD-7), as well as socio-demographic and event exposure information. ResultsOf the 7021 people who initially agreed to participate, 6510 were able to complete the full survey. For a cut-off of ≥3 on the PC-PTSD-5, 14.8 % of the study participants exhibited symptoms. With a cut-off of ≥4, this percentage reduced to 4.6 %. Participants from Almaty city and Almaty region who experienced the most extensive disturbances showed a doubled prevalence compared to the national level (30.0 % for a cut-off of ≥3, and 10.1 % for a cut-off of ≥4). At the national level, the prevalence of anxiety symptoms, defined as a score of ≥10 on the GAD-7, stood at 10.9 %. This prevalence decreased to 4.2 % when considering a cut-off of ≥15. ConclusionHealth authorities of riot-affected areas ought to be aware of the population level mental health impact of the civil conflict and consider provision of targeted interventions to mitigate the long-term consequence of these lifespan disorders, while also seeking for the peaceful resolution of the ensuing conflicts.

SAT559 Challenges Involved in Managing a Paraplegic Patient with Metastatic Papillary Thyroid Cancer Requiring Radioactive Iodine Therapy

Abstract Disclosure: G. Al-Naqeeb: None. E. Munger: None. P. Veeraraghavan: None. C. Cochran: None. P. Bernaldez: None. P. Wong: None. N. Devaraj: None. T. Fisher: None. K. Lee: None. O. Owoade: None. I. Jones: None. S. Gubbi: None. J. Klubo-Gwiezdzinska: None. Background: High radioactive iodine (RAI) therapy doses utilized for treating thyroid cancer patients require a 24-48-hour radiation isolation period until the total effective dose equivalent exposure (TEDE) to the general population does not exceed 5mSv. We present a unique scenario of a paraplegic patient with metastatic papillary thyroid cancer (PTC) requiring RAI therapy and the radiation precaution strategies implemented by our team to reduce radiation exposure risk to the medical staff.A 69-year-old female with RAI-refractory tall cell-variant PTC (pT4aN1bM1; BRAF V600E pathogenic variant) with pulmonary metastases, paraplegia due to a motor vehicle accident with neurogenic bowel and bladder, was referred to our center for management of PTC. Laboratory data revealed a serum thyroglobulin of 2313 ng/mL (normal=1.6-59.9), and anatomical imaging showed numerous pulmonary nodules that had increased in size and number compared to prior imaging from 6 months ago. Due to disease progression, re-differentiation therapy with dabrafenib was initiated. After 3-months of dabrafenib therapy, a diagnostic thyroid hormone withdrawal-aided 131I scan with dosimetry revealed a significant re-induction of RAI uptake in pulmonary lesions and it was determined that therapy with an RAI dose of 200 mCi would not exceed a safe radiation exposure to the bone marrow of 200 rads. A multi-step mitigation strategy was developed based on a multidisciplinary team meeting and appropriate mock sessions. Stay times were estimated for individuals based on historical TEDE following the care of non-paralyzed patients receiving similarly prescribed activity. To minimize exposure to nursing staff, the patient’s Foley catheter was shielded with lead lining and bowels were emptied the night before RAI with a laxative. For each entry, posted safety sheets were updated with one-foot and one-meter isodose lines and on-contact exposure rates. Two nurses and one radiation safety staff member donned full personal protective equipment (PPE; full body suit, double gloves, booties, face covering) in the staging area and entered via lane one. While nursing provided direct care needs, radiation safety staff emptied the shielded catheter, organized clutter and packaged radioactive waste containers. Upon completion of duties, staff exited via lane two, removed PPE, and performed a full personnel contamination survey in the staging area. The patient successfully underwent RAI therapy with 200 mCi. Six months later the serum thyroglobulin had reduced to 48.4ng/ml with a substantial reduction in pulmonary metastatic tumor burden on imaging studies. Conclusion: Post-RAI therapy care of paralyzed patients during radiation isolation poses a unique challenge to medical staff warranting modifications in routine care practices, which can be achieved safely through optimal planning and enhanced training. Presentation Date: Saturday, June 17, 2023