Interest Groups Research Articles

6951 European survey of diagnosis and management of the polycystic ovary syndrome: full report on the ESE PCOS Special Interest Group’s 2023 Questionnaire

Abstract Disclosure: S. Livadas: None. B.O. Yildiz: None. G. Mastorakos: None. A. Gambineri: None. D.L. Pignatelli: None. F. Giorgino: None. M. Andersen: None. B.M. Obermayer-Pietsch: None. D.P. Macut: None. Background: Although polycystic ovary syndrome (PCOS) constitutes a common endocrinopathy, there are several issues which confuse clinicians during everyday practice.Objective: To define the current status of knowledge of the full spectrum of PCOS among European endocrinologists. Methods: A detailed questionnaire comprising 41 items covering various aspects of diagnosis and management of women with PCOS was shared via web among members of European Society of Endocrinology. Results: 505 European endocrinologists (64% females), with a mean age of 47±11.6 years answered the questionnaire. Rotterdam criteria were used by 85% of endocrinologists. The most frequent age at referral was between 20-40 years (87.1%). A quarter of doctors have access to mass spectrometry for the evaluation of androgen levels. Extended metabolic profile was part of workup by the vast majority, but there was significant uncertainty regarding the diagnosis of chronic anovulation. Diabetes, gestational or type 2, was considered a major consequence for women with PCOS and screening is carried out regardless of BMI status. Lifestyle modification and metformin are considered a standard approach of all participants and oral contraceptives are a standard therapeutic modality, but there is significant discrepancy on the duration of treatment.Conclusions: Rotterdam diagnostic criteria are currently an established diagnostic approach within the European endocrine community. This updated survey showed an advance in using steroid profiling for diagnosis and strong position on recognizing PCOS as a metabolic condition with potential broader consequences. Therapeutic aspects are currently changed into the need for more lifestyle intervention involvement and the use of metabolic therapies either as monotherapy or in combination with standard hormonal compounds. Presentation: 6/3/2024

6951 European survey of diagnosis and management of the polycystic ovary syndrome: full report on the ESE PCOS Special Interest Group’s 2023 Questionnaire

Abstract Disclosure: S. Livadas: None. B.O. Yildiz: None. G. Mastorakos: None. A. Gambineri: None. D.L. Pignatelli: None. F. Giorgino: None. M. Andersen: None. B.M. Obermayer-Pietsch: None. D.P. Macut: None. Background: Although polycystic ovary syndrome (PCOS) constitutes a common endocrinopathy, there are several issues which confuse clinicians during everyday practice.Objective: To define the current status of knowledge of the full spectrum of PCOS among European endocrinologists. Methods: A detailed questionnaire comprising 41 items covering various aspects of diagnosis and management of women with PCOS was shared via web among members of European Society of Endocrinology. Results: 505 European endocrinologists (64% females), with a mean age of 47±11.6 years answered the questionnaire. Rotterdam criteria were used by 85% of endocrinologists. The most frequent age at referral was between 20-40 years (87.1%). A quarter of doctors have access to mass spectrometry for the evaluation of androgen levels. Extended metabolic profile was part of workup by the vast majority, but there was significant uncertainty regarding the diagnosis of chronic anovulation. Diabetes, gestational or type 2, was considered a major consequence for women with PCOS and screening is carried out regardless of BMI status. Lifestyle modification and metformin are considered a standard approach of all participants and oral contraceptives are a standard therapeutic modality, but there is significant discrepancy on the duration of treatment.Conclusions: Rotterdam diagnostic criteria are currently an established diagnostic approach within the European endocrine community. This updated survey showed an advance in using steroid profiling for diagnosis and strong position on recognizing PCOS as a metabolic condition with potential broader consequences. Therapeutic aspects are currently changed into the need for more lifestyle intervention involvement and the use of metabolic therapies either as monotherapy or in combination with standard hormonal compounds. Presentation: 6/3/2024

The Latvian Lost Cause: Veterans of the Waffen-SS Latvian Legion and Post-war Mythogenesis

During World War II, tens of thousands of Latvians served in German-led military formations, primarily in the Waffen-SS Latvian Legion. After the war, around 25,000 former Legionnaires transitioned from prisoner of war camps run by the Western Allies to civilian life in a variety of Western countries. They created veterans’ organisations — such as Daugavas Vanagi (‘Hawks of the Daugava’) — which also functioned as political advocacy groups and heritage organisations for the Latvian diaspora. These post-war organisations and platforms then allowed former Latvian Legionnaires to shape public memory of the war. In writings after 1945, a cohort of veterans crafted a narrative of the war that (1) presents their military service as representing a righteous cause defeated either by forms of betrayal or by the overwhelming might of the Soviet Union, (2) develops a cult of the fallen soldier, and (3) mystifies German war aims and the relationship of Latvian Legionnaires to them. Through analysis of memoirs and periodical publications by veterans along with forms of public commemoration, I argue that these materials and practices collectively constitute a ‘Lost Cause’ narrative, which, similar to the Lost Cause of the Confederacy — developed in the U.S. South after the American Civil War — became predominant among the Latvian diaspora before spreading to Latvia itself. This framework allows for productive comparisons with other European countries that experienced traumatic military defeats, representing a new approach to this controversial subject with potential application to similar cases in Ukraine and Estonia.

The relationship between positive end-expiratory pressure (PEEP) and intra-abdominal pressure (IAP) in mechanically ventilated patients: A prospective observational study.

Positive end-expiratory pressure is a crucial mechanical breathing parameter. Intra-abdominal hypertension is well defined as a sustained increase in the intra-abdominal pressure ≥12 mmHg. There are still controversies about mechanical ventilation's effect and use of positive end-expiratory pressure on intra-abdominal pressure. We aimed to delineate the relationship between positive end-expiratory pressure and intra-abdominal pressure in mechanically ventilated patients admitted to the intensive care units of a large tertiary hospital in Upper Egypt. This study was a prospective observational study. The study was conducted at a university hospital from October 2023 to February 2024. The enrolled adult patients were allocated into two groups based on their positive end-expiratory pressure: group I, low pressure (<8 cm H2O) and group II, high pressure (8-10 cm H2O). A total of 120 patients were enrolled, 60 patients in each group. The most commonly encountered diagnoses were pneumonia (32/120, 26.7%) and acute respiratory distress syndrome (ARDS) (31/120, 25.8%), respectively. There was a significant difference between the intra-abdominal pressure mean values of the two patient groups, 18.9 ± 3.3 versus 24.4 ± 5.9 mmHg in the group of low versus high pressure (correlation value of .454, p < .001), respectively. There were highly significant correlations between intra-abdominal pressure categories and the patient groups (correlation value of .495, p < .001). There were 24 (40%) versus 0 (0%) patients of high pressure versus low pressure within the category IV group of intra-abdominal hypertension (>25 mmHg). We observed a significant relationship between positive end-expiratory pressure and intra-abdominal pressure in mechanically ventilated patients. The patient group with high pressure had higher mean values compared with the group with low pressure. The study highlights the importance of closely monitoring intra-abdominal pressure in mechanically ventilated patients who receive positive end-expiratory pressure. Further studies are warranted. The relationship between positive end-expiratory pressure and intra-abdominal pressure is an essential issue in daily critical care nursing clinical practice. Considering the occurrence of multiple organ dysfunction as a result of a non-detected increase in intra-abdominal pressure, critical care nurses should pay attention to measuring this pressure to maintain intra-abdominal pressures that are safe for mechanically ventilated and critically ill intensive care unit patients, thereby preventing these undue effects.

Muslim Political Dynamics Post-Tahkim: A Case Study of the Shiffin War

The Shiffin War, a battle that took place between the Ali bin Abi Talib group and the Mu'awiyah, was a war whose negative impact was felt by Muslims. In fact, in the view of historians, it has resulted in divisions among large groups of Muslims. Although it ended with him which was intended as an attempt to arbitrate between Muslims who were in conflict, it turned out that the effort just stared at the dissatisfaction between them, so three religious-political groups emerged that are still suspected to exist today as a continuation of the phenomenon of division at that time. The rise of Shi'a, Khawarij, and Sunni groups is understood by historians as the impact of the war. Because the awareness of ukhuwah among Muslims has not yet flourished, the division is still felt and there are no significant enough signs to subside, let alone leading to the awakening of ukhuwah consciousness which is marked by the desire to build a dialogue that is built with awareness to bridge the rift that occurs among Muslims, especially from their leaders. Especially for interest groups who see that the tension between Muslims will give them political benefits. In fact, with the right spirit of ukhuwwah, the problem of division between Muslims can be solved.

Answering the call for better science: an update on SAVIR’s efforts to advance antiracism in injury and violence research

In response to the call for better science that the Society for Advancement of Violence and Injury Research (SAVIR) put out 4 years ago, SAVIR established its Anti-racism Interest Group...

Commercial determinants of health and cancer prevention in South Africa

Aim Commercial determinants, encompassing marketing strategies, corporate social responsibility, and lobbying, significantly contribute to avoidable cancer deaths globally. In South Africa, 30-50% of cancers are preventable, but SA focuses mainly on tobacco control, ignoring major causes of cancer such as alcohol, obesity, and ultra-processed foods. This paper highlights the role of these commercial determinants in contributing to cancer in SA. It outlines strategies and barriers in addressing these determinants. Approach While conventional approaches focus on individual responsibility relating to risk factors like tobacco, alcohol, and unhealthy diets, the role of industries in promoting these risk factors remains inadequately addressed. The paper explores the marketing and non-marketing methods employed by industries, such as tobacco, alcohol, and ultra-processed products, to maximise profits while neglecting public health consequences. Findings The article sheds light on industry tactics, including strategic partnerships, sponsorship, and diversionary narratives during crises, aimed at safeguarding profits. It emphasises the less-explored realm of non-marketing strategies, such as political lobbying, industry-funded research, and the ‘revolving door’ phenomenon where industry insiders become policymakers. Conclusions The article advocates for a paradigm shift in cancer prevention policies, urging the government to implement a comprehensive suite of measures that include increased taxation on harmful products, strict restrictions on marketing, enhanced product labelling, and eliminating conflict of interest in health research and policies. Addressing the commercial determinants necessitates not only recognising their impact but also adopting a multi-level governance approach that prioritises public health over corporate profits. The paper concludes by emphasising the urgency of recognising the links between alcohol, food regulation, and cancer prevention. The overarching goal is to shift power relations, fostering governance for the collective good and ensuring equitable access to preventive measures, especially for vulnerable populations.

Optimization of ray-tracing simulations to confirm performance of the GP-SANS instrument at the High-Flux Isotope Reactor

The CG-2 beamline at the High Flux Isotope Reactor (HFIR) exhibits a notable discrepancy between observed count rates and the count rates we would expect based on a Monte-Carlo neutron ray-trace simulation. These simulations consistently predict count rates approximately five times greater than those observed in four separate experimental runs involving different instrument configurations. This discrepancy suggests that certain factors are causing losses in measurements that are not adequately accounted for in the simulation, in particular guide reflectivity or misalignment.To investigate these discrepancies, a high-dimensional simulation parameter approach is applied in order to understand the losses. Region of Interest (ROI) groups along the instrument are assigned to different surfaces of the guide components within the simulation. This allows the parameters of those guide components to be varied as a group to minimize the complexity of the search space. The result is an optimization of simulation parameters using an iterative scheme that aims to minimize the difference between experimentally measured count rates and simulated count rates across all tested collimator combinations.This proposed methodology holds the potential to reveal previously unrecognized sources of intensity loss in the CG-2 beamline at HFIR and improve the accuracy of simulations, leading to enhanced understanding and performance of the beamline for various scientific applications.

Toward a public outreach and community engagement strategy on cancer in Newfoundland and Labrador: an initial road map and recommendations

Abstract Background: The province of Newfoundland and Labrador has one of the highest incidence and mortality rates for cancer among the Canadian provinces. Sharing accessible knowledge on cancer is an important part of cancer control and population health efforts. However, bringing useful health information and knowledge exchange events to residents requires an efficient and accessible system. Objectives: We aimed to create a road map and recommendations for effective public outreach and community engagement on cancer in Newfoundland and Labrador. Methods: We used the following information, experience, or public engagement tools to gather information to inform our work: discussions with the members of the Public Interest Group on Cancer Research, researchers' experiences with recruitment and knowledge translation activities, feedback provided to 2 public conferences delivered (Public Conference on Genetics delivered in 2020 and Public Conference on Cancer delivered in 2022—where the target audience was general public), and 2 public town halls (one in-person, one virtual) and 2 individual consultation sessions with key stakeholders. Information gathered was then summarized. Results: We identified a rich set of cancer-related topics for which to organize public events on cancer. In addition, a large number of public outreach and engagement options were identified, emphasizing the fragmented, inefficient, and resource-intensive nature of public outreach and community engagement efforts in the province. Based on the information collected, we developed an initial road map and recommendations to inform future public engagement activities and strategies. In addition, our group has started to implement the road map for our current and future public engagement activities. Conclusions: We present key cancer-related topics that are of public interest and issues and opportunities for recruitment and delivery of knowledge and events to residents of Newfoundland and Labrador. This information can be useful for researchers, organizations, and the health care system in the province. However, more inclusive consultations, larger collaborations, funding, and systematic data collection are needed to build a province-wide public outreach network on cancer and to identify more comprehensive public engagement options. The work presented here can potentially guide these efforts. Our work is also expected to inspire other provinces, states, and communities to assess their public outreach status and help develop road maps co-led by patients to progress their public engagement efforts in cancer.

Lower Extremity Trauma is Associated with an Increased Rate of New Mental Disorder Diagnosis and Suicide Attempt.

To evaluate the risk of developing a new mental disorder diagnosis within two years of lower extremity fracture. Design: Retrospective cohort study. National insurance claims database. Included were patients between the ages of 18 and 65 with lower extremity, pelvis and acetabular fractures without prior mental disorders as defined with ICD-9 and ICD-10 diagnosis codes. Mental disorders evaluated included alcohol use disorder, generalized anxiety disorder, bipolar disorder, major depressive disorder, drug use disorder, panic disorder, post-traumatic stress disorder, and suicide attempt.Outcome Measures and Comparisons: The individual lower extremity fracture cohorts were matched 1:4 with non-fracture controls. The specific groups of interest were pelvis fractures, acetabulum fractures, proximal femur fractures, femoral shaft fractures, distal femur fractures, patella fractures, tibia plateau fractures, tibia shaft fractures, ankle fractures, pilon fractures, calcaneus fractures, and Lisfranc fractures. Rates of mental disorders after primary lower extremity fractures within two years were compared using multivariable logistic regression. Overall, the 263,988 patient fracture group was 57.2% female with an average age of 46.6 years. Compared to controls with no fracture, patients who sustained pelvis, acetabulum, proximal femur, femoral shaft, distal femur, patella, tibia plateau, tibia shaft, pilon, calcaneus, or Lisfranc fracture had a statistically significant increased risk of being diagnosed with a queried mental disorder within two years of fracture. When comparing all fracture patients by location, those suffering from fractures proximal to the knee joint, including pelvis fractures (OR: 1.51, 95% CI: 1.39-1.64) and proximal femur fractures (OR: 1.36, 95% CI: 1.26-1.47), demonstrated greater risk of developing any of the queried mental disorders compared fractures distal to the knee, including ankle fractures (OR: 0.99, 95% CI: 0.95-1.03) and pilon fractures (OR: 1.05, 95% CI: 0.81-1.36). When comparing specific fracture patients to patients without fracture by mental disorder, patients demonstrated an increased risk of suicide attempt following fracture of the pelvis, acetabulum, femoral shaft, distal femur, and calcaneus, as well as patients suffering a Lisfranc fracture. There is an increased risk of being diagnosed with a new mental disorder following lower extremity trauma in patients without prior mental disorder diagnosis compared to matched individuals without a lower extremity fracture. Among the fractures studied, those that were more proximal, such as pelvis and proximal femur fractures, carried the greatest risk compared to more distal fracture sites, including ankle and pilon fractures. Patients who experienced certain lower extremity fractures had a significantly higher rate of suicide attempt compared to patients without fracture. Physicians should consider increased mental health screening and potential referral for mental health evaluation for patients following lower extremity trauma. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Teaching Linked Data Principles through Virtual Wikidata Edit‐a‐thons

ABSTRACTCataloging and metadata professionals in libraries have an interest in learning about the Semantic Web and Linked Data technologies. However, with limited release time and funding for continuing education, professional development opportunities need to be designed with learner needs in mind: free, flexible, and fun. Our regional Linked Data interest group approached this challenge by developing an annual program in the form of a five‐day edit‐a‐thon, providing training and hands‐on experience in creating and editing Wikidata. The flexible format makes use of synchronous video conferencing, detailed online documentation, independent editing days for hands‐on learning, and opt‐in community discussion via Slack. Individual and project progress was tracked with the Wikimedia Event Dashboard. This poster proposes the Wikidata edit‐a‐thon as an ideal method to fulfill a professional development need of library staff by introducing participants to the principles of Linked Data through this flexible and interactive event.

Everyday Ethics or Deference to Expertise: Experiences of Pediatric Palliative Care Teams with Ethics Consultancy.

Background: Little is known about the extent to which pediatric palliative care (PPC) clinicians are engaged in ethics consults or how they perceive interactions with ethics consultants. Objective: Describe the extent to which PPC team members serve in pediatric health care ethics (PHCE) consultancy roles and to describe their experiences interacting with pediatric ethic consultant services. Design: Online survey distributed to members of the American Academy of Pediatrics and American Academy of Hospice and Palliative Care pediatric and ethics section and special interest groups in the United States. Results: Eighty-six responses were obtained (response rate 45%) from PPC teams in 70 different children's hospitals located in 34 states. Almost all (97%) reported a functional ethics consult service such that PPC is not expected to meet the ethics need of the institution. A person involved on the PPC team also performed ethics consults in half (49%) of the settings, predominantly the PPC physician. Most respondents who perceive PPC teams engage in ethics-relevant work as part of their everyday PPC work. Formal ethics training was lacking among PPC members involved in ethics consults with few ethics degrees (15%), certifications (6%), or fellowships (2%). Discord (67%), conflict (49%), limitations to treatment (48%), and distress (41%) were cited as the most frequent reasons for which PPC teams consult ethics. PPC respondents identified role clarity, coordinated engagement, timely presence, and open communication as strong PHCE consultant practices. Conclusions: PPC team members performing ethics consults may benefit from additional ethics education and training. Further research is warranted to delineate scope of ethics consultancy relevant to PPC and role clarity.

Cardiac diffusion-weighted and tensor imaging: a Society for Cardiovascular Magnetic Resonance (SCMR) special interest group consensus statement

Thanks to recent developments in Cardiovascular magnetic resonance (CMR), cardiac diffusion-weighted magnetic resonance is fast emerging in a range of clinical applications. Cardiac diffusion-weighted imaging (cDWI) and diffusion tensor imaging (cDTI) now enable investigators and clinicians to assess and quantify the 3D microstructure of the heart. Free-contrast DWI is uniquely sensitized to the presence and displacement of water molecules within the myocardial tissue, including the intra-cellular, extra-cellular and intra-vascular spaces. CMR can determine changes in microstructure by quantifying: a) mean diffusivity (MD) –measuring the magnitude of diffusion; b) fractional anisotropy (FA) – specifying the directionality of diffusion; c) helix angle (HA) and transverse angle (TA) –indicating the orientation of the cardiomyocytes; d) E2A and E2A mobility – measuring the alignment and systolic-diastolic mobility of the sheetlets, respectively.This document provides recommendations for both clinical and research cDWI and cDTI, based on published evidence when available and expert consensus when not. It introduces the cardiac microstructure focusing on the cardiomyocytes and their role in cardiac physiology and pathophysiology. It highlights methods, observations and recommendations in terminology, acquisition schemes, post-processing pipelines, data analysis and interpretation of the different biomarkers. Despite the ongoing challenges discussed in the document and the need for ongoing technical improvements, it is clear that cDTI is indeed feasible, can be accurately and reproducibly performed and, most importantly, can provide unique insights into myocardial pathophysiology.

Research on irregular sponge layout system based on heuristic algorithms

Abstract A layout optimization method that integrates No-Fit Polygons (NFP) positioning and a genetic algorithm is proposed for the two-dimensional irregular sponge packing problem. Firstly, according to the geometric characteristics of the parts, they are classified and encoded to calculate the NFP between part classes, avoiding redundant NFP calculations. Simultaneously, heuristic rules aimed at minimizing the packing height are introduced to provide a comprehensive evaluation function for part positioning strategies, thus improving packing efficiency. Secondly, in the optimization of part sorting, a genetic algorithm is introduced to optimize the sponge packing algorithm. Finally, several standard cases provided by the European Special Interest Group on Cutting and Packing (ESICUP) are used to test the proposed packing method. The results show that compared to the traditional Bottom-Left algorithm, the computational efficiency of the proposed packing method is improved by 4.20% to 22.73%.

Knowledge Organization Systems and Provenance: Experiences and Challenges

ABSTRACTThis panel is situated at the intersections of Knowledge Organization Systems (KOS) and provenance research. In this panel, we will share experiences and challenges in documenting the changes of a KOS The panelists will provide real‐world examples drawn from their research and practice. These examples range from KOSs used in LIS, such as the Dewey Decimal Classifications, Homosaurus, and Library of Congress Subject Headings; to extended information science research fields, such as digital preservation metadata standards, biodiversity taxonomies, and ontologies. Currently, the models and practices for documenting changes in KOSs fall short in supporting even simple provenance queries like “who made the change?”“what are the reasons for the change?”or“when was the change made?” The panelists will collectively discuss examples of queries we have faced, as well as the implications for provenance for KOS research and practice.This panel is sponsored by Classification &amp; Metadata Research Special Interest Group (SIG‐CMR).

Patient Preferences for Attributes of Androgen Deprivation Therapies in Prostate Cancer: A Discrete Choice Experiment with Latent Class Analysis.

Medical androgen deprivation therapy (ADT) options have expanded for patients with advanced prostate cancer (PC). Historically, ADT was primarily available in long-acting injectable formulations. In 2020, the first oral formulation was US Food and Drug Administration-approved for adults with advanced PC. This study's aim was to assess patient preferences for attributes of medical ADT, including mode of administration, side effects, impact on sexual interest, and out-of-pocket (OOP) costs, and to segment respondents into distinct groups based on their treatment choice patterns. A cross-sectional survey was conducted among US residents aged > 40years with PC, employing a discrete choice experiment to assess preferences for ADT attributes. For each choice task, respondents were asked to select the hypothetical treatment profile that they preferred out of two presented. Latent class analysis (LCA) was conducted to estimate attribute-level preference weights and calculate attribute relative importance for groups of respondents with similar treatment preferences. A total of 304 respondents completed the survey (mean age 64.4years). LCA identified four preference groups, named according to the attribute each group considered most important: Sexual interest, Cost-sensitive, Favors daily pill, and Favors injection. Most respondents in the Sexual interest group were < 65years, while the Cost-sensitive group was mostly ≥ 65years. Favors daily pill had the highest proportion of ADT-naïve individuals. On average, respondents in these groups preferred an oral medication. Favors injection, which had the highest proportion of ADT-experienced individuals, preferred infrequent intramuscular injections, lower chance of post-ADT testosterone recovery, and lower OOP cost. Respondents differed in their preferences regarding ADT attributes, highlighting the need for patient involvement in their treatment decisions. Effective communication between healthcare providers and patients about the benefits and risks of available therapies should be encouraged to ensure that patients receive the PC treatment that best meets their needs.

A review of the 21st Annual Meeting of the Neuropsychological Rehabilitation Special Interest Group of the World Federation of Neuro-rehabilitation (NR-SIG WFNR) in Coimbra, Portugal, 30 June–1 July 2024: ‘Music to the Brain’

A review of the 21st Annual Meeting of the Neuropsychological Rehabilitation Special Interest Group of the World Federation of Neuro-rehabilitation (NR-SIG WFNR) in Coimbra, Portugal, 30 June–1 July 2024: ‘Music to the Brain’

Advanced Practice Providers in Cellular Therapy: Survey Results from the ASTCT APP Special Interest Group Exploring Clinical Roles, Compensation, and Job Satisfaction

BackgroundAdvanced practice providers (APPs), which include physician assistants/associates and advanced practice nurses, are critical members of the transplant and cellular therapy (TCT) care team. Despite broad utilization in transplant centers, there is little published literature on the clinical roles and responsibilities, staffing models, compensation structure, and job satisfaction of TCT APPs. This study represents the results of a national survey administered by the APP Special Interest Group to better characterize the TCT APP workforce. ObjectiveTo characterize the TCT APP workforce by investigating clinical roles and responsibilities, compensation and institutional support, and job satisfaction. MethodsA 25-item web-based survey addressing four domains (transplant center data, APP roles and responsibilities, compensation and institutional support, and job satisfaction). Surveys were sent to participants through a chain-referral sampling method. Data were analyzed using descriptive statistics and multinomial logistic regression. ResultsA total of 198 responses were analyzed, representing 64 transplant centers of varying size from 29 states. APPs report working in inpatient and outpatient settings and performing a broad array of TCT-associated procedures including bone marrow biopsy (78%), lumbar puncture (43.2%), intrathecal chemotherapy (47.0%), and cellular infusions (45.9%). Median salary of respondents was $110,000-$119,000 and was significantly associated with geographic location of transplant center and years of experience. A minority of respondents reported no funding (4.2%) or time (9.8%) supporting continuing education. A majority of APPs (55.1%) do not feel they are appropriately paid. A majority (54.3%) did not feel that their center supported a good work-life balance. Nearly 35.4% of respondents did not feel valued in their role. ConclusionsThis survey represents the first to characterize the TCT APP workforce in the United States. APPs are highly integrated into the TCT care team and can serve as means to improve patient access to TCT therapies given a worsening physician shortage. However, the lack of satisfaction with compensation and work-life balance could represent barriers to recruitment and retention of TCT APPs and warrant future studies to better characterize.

Virtual/Mobile Overdose Response in Canada: A Social Return on Investment Analysis

The overdose epidemic continues to be one of the leading causes of death in North America and continues to contribute to high healthcare costs. While harm reduction initiatives have significantly reduced the aforementioned costs, there is a dearth of evidence regarding overdose response hotlines and applications. We aim to evaluate the social return on investment (SROI) from a payer perspective of one such overdose response hotline, Canada's National Overdose Response Service, and its implications for service users, service operators, the Canadian healthcare system, and program funders. Outcome variables determined from theory of change models were developed in consultation with the aforementioned vested interest groups. Proxy values were attributed to each variable identified through values present within existing literature and databases. These values were then compared to operational costs accounting for deadweight, attribution, and displacement to determine a final SROI ratio. A discount rate was then applied based on the influence of risk on the outcome achieved. The ratio illustrating the value created for all stakeholders, resulting from the $1,592,00 investment made over two years, is $15.84 per single dollar invested. The value generated stems primarily from overdose prevention, mental health support, staff employment, reductions in emergency service utilization, service referrals, and volunteer well-being, which outweigh costs including operational funding, work-related stressors, compassion fatigue, and false calls. The results of our study demonstrate that the National Overdose Response Service provides a social value that far outweighs the costs attributed to the program's operation.

Side-effects of Phytotherapeutics in Cancer Care - A Review of Inconsistencies in National and International Databases.

The interest in phytotherapy in patients with cancer is immensely high. When using herbal medicine, knowledge of potential side-effects is essential as part of counselling the patient. The aim of this study was therefore to collect information on the side-effects of popular medicinal plants and to compare different official and the most popular sources of information reporting the side-effects of phytotherapeutics. Four different databases were reviewed from 09 February 2021 to 01 March 2022. These were the German monographs of the German Federal Institute for Drugs and Medical Devices, the European monographs of the European Medicines Agency, the website About Herbs (https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine/herbs) and the German Red List. A total of 171 medicinal plants were chosen from the German monographs. These plants were relevant for supportive cancer treatment, targeting symptoms e.g. pain, nausea, vomiting, mucositis or fatigue. Out of the 171 selected plants, only 20 were found in all four sources. The compilation of the data showed there to be a huge disparity in the number of plants listed by each database and the type and frequency of the side-effects described. The reasons for this are manifold: Lack of interest, different interest groups, different origins (Europe versus America) and no standardized terminology. Physicians should not rely exclusively on one source to inform themselves about potential side-effects of phytotherapeutics but should use several sources to ensure the best possible safety of the patient. Since there seems to be too few data on certain medicinal plants for which no side-effects have been documented, more clinical studies are needed.