Health Issues Research Articles

Effect of calf separation on gut microbiome and fecal metabolome of mother in the captive Yangtze finless porpoise (Neophocaena asiaeorientalis asiaeorientalis).

Social separation, or the absence of social support, can cause physical and psychological health issues. Social separation is crucial for the welfare of the Yangtze finless porpoise (YFP) in captivity because they face many challenges like frequent social separation, noise from visitors, and animal replacement, which can cause psychological and physiological stress. This research is aimed at assessing the potential negative impacts of social separation on the gut microbiome and metabolome of captive YFP, focusing on the potential imbalances caused by mother-calf separation. The study found that social separation did not alter the alpha and beta diversity of the gut microbes but increased the abundance of disease-associated taxa such as Romboutsia, Terrisporobacter, and Clostridium_sensu_stricto_13 in the MC (mother-calf) group while increasing Paeniclostridium and Clostridium_sensu_stricto_1 associated with host health in the MS (mother-separated) group. The fecal metabolome underwent significant changes during social separation, with stress-associated metabolites like kainic acid, phenethylamine glucuronide, and paxilline upregulated in the MC group and host health-associated metabolites like butyric acid, 6-hydroxyhexanoic acid, and fosinopril downregulated in the MS group. In addition, there was a strong association between the fecal microbiome and the metabolome of captive YFPs. The study enhances our comprehension of the detrimental effects of social separation, which result in disruptions in the gut microbiome and fecal metabolome. The study is aimed at introducing a new method for assessing the health and welfare of endangered mammals in captivity.

Heat Index Levels and Heat – Related Risks in the Philippines

Using a systematic literature review, this study determined and establish the Health Index Levels and Heat – Related Health Risks in the Philippines.  Background. The heat index which is also called as the visible temperature is well-defined as a personalized, subjective experience of a person when comparative humidity is correlated with the temperature of the air. The incidence and intensity of life-threatening incidents especially escalated heat index are growing all around the world which ultimately poses a serious risk to the health of people.  Aim. The aim of this review was to explore and deliberate the relationship between the heat index, a measure that combines air temperature and relative humidity to approximate the apparent temperature, and the risk of heat-related health issues in the Philippines from published articles between 2019 – 2024.  Data Sources. A systematic search of primary articles on numerous electronic databases that included Google Scholar and other related engines. Grey literature was also connected based on the references available and bibliographies from the different articles were also included in the pooling of literature of data.  Method. The article included two (2) or more of the key search terms identified: heat exhaustion, heat stroke, health related risks, heat index , and lastly published from years 2019-2024.  Results. Analysis of the research articles were used to answer the effect of the heat index in the risk of heat exhaustion, the effect of the heat index in the risk of stroke and formulation of research - based recommendations on Heat Index Levels and Heat - Related Health Risks in the Philippines.  Acknowledgment: The authors of this systematic literature review thanks and recognize all the writers of the variety of references that were used in this review paper. The proponents these data sources used in this paper are both cited in the text and in the reference lists.  Disclaimer: The beliefs and point of view manifested in this paper are those of the authors and do necessarily indicate the official guidelines or stand of any affiliated institution, organization or agency of the authors.  Conflict of Interest: The authors have not anything to proclaim. This paper is a collaborative effort of the authors mentioned above.

Traumatic Brain Injury as a Public Health Issue: Epidemiology, Prognostic Factors and Useful Data from Forensic Practice

Traumatic brain injury (TBI) represents a major public health problem, being a leading cause of disability and mortality among young people in developed countries. Head trauma occurs across all age groups, each experiencing consistently high rates of mortality and disability. This review aims to present an overview of TBI epidemiology and its socioeconomic impact, alongside data valuable for prevention, clinical management, and research efforts. Methods: A narrative review of TBI was performed with a particular focus on forensic pathology and public health. In fact, this review highlighted the economic and epidemiological aspects of TBI, as well as autopsy, histology, immunohistochemistry, and miRNA. Results: These data, together with immunohistochemical markers, are crucial for histopathological diagnosis and to determine the timing of injury onset, a fundamental aspect in forensic pathology practice. There is compelling evidence that brain injury biomarkers may enhance predictive models for clinical and prognostic outcomes. By clarifying the cause of death and providing details on survival time after trauma, forensic tools offer valuable information to improve the clinical management of TBI and guide preventive interventions. Conclusions: TBI is one of the most common causes of death today, with high costs for health care spending. Knowing the different mechanisms of TBI, reduces health care costs and helps improve prognosis.

An amitraz-based miticide does not appear to affect the bacterial microbiota of Apis mellifera (Apidae: Hymenoptera, Linnaeus, 1758) or Varroa destructor (Acari: Varroidae, Anderson & Trueman, 2000)

ABSTRACT The use of pesticides in beehives constitutes an important health issue for honey bees (Apis mellifera). Miticide treatments are not lethal to bees but could still impose significant sublethal costs. This study examined the impacts of amitraz, a commonly used miticide, on the bacterial communities of the honey bee gut and Varroa destructor mites. We sequenced and compared gut 16S rDNA composition pre – and post-amitraz treatment. Amitraz did not significantly influence bacterial gut communities in either honey bees or mites during the first six weeks following treatment. The gut bacterial community of bees was mainly dominated by the commonly observed microbiota in bees, which included species in the genera Gilliamella, Snodgrassella, and Frischella. Deformed wing virus (DWV) loads were analysed but were also unaffected by amitraz treatment over the six-week period studied. The bacterial community of Varroa destructor mites was heavily dominated by Bartonella spp., in contrast to results observed elsewhere. Our results indicating that amitraz does not appear to affect honey bee microbiota should be helpful for beekeepers who rely on this pesticide for mite control.

Comorbidity Pattern and Autonomic Nervous System Dysfunction in Patients with Chronic Vulvar Discomfort

This study examines novel concepts of comorbidity in patients with chronic vulvar discomfort using data from the DATRIV (Diagnostic Accuracy of Three Rings Vulvoscopy) study, which involved 328 participants categorized into four groups: asymptomatic individuals with normal or impaired vulvar skin and patients with chronic vulvar discomfort, classified as either vulvodynia or vulvar dermatosis. Clinical data were collected through a structured questionnaire and analyzed using statistical software, including StatSoft (Dell, Austin, TX, USA), Statistica 12 (TIBCO®, Palo Alto, CA, USA), and SPSS 20 (IBM, Armonk, NY, USA). The study received approval from the Institutional Review Board of Polyclinic Harni, and all participants provided written informed consent. The findings reveal significantly higher comorbidity rates in patients with chronic vulvar discomfort compared to other groups (p = 0.0000). A substantial percentage of asymptomatic participants with both normal (63.4%) and impaired (70.7%) vulvar skin also reported comorbid conditions. Analysis of comorbidity curves revealed distinct patterns of symptom progression, with a gradual increase in frequency from asymptomatic individuals to patients with vulvodynia, followed by a decline in vulvar dermatosis cases. These patterns highlight the central role of autonomic nervous system (ANS) dysfunction, where sympathetic hyperactivity and parasympathetic depression contribute to separate comorbidity chains. These dysfunctions may act independently or concurrently, leading to various health issues. The elevated comorbidity rates and overlapping symptomatology suggest complex pathophysiology driven by ANS dysregulation. Further research on comorbidity clusters may unveil new therapeutic targets and guide the development of multifaceted treatment strategies.

Perancangan Motion Graphic Edukasi Kami Juga Manusia, Anxiety Disorder

Mental health, is a health issue that is no less important than physical health, but unfortunately public awareness of mental health issues is still very lacking. The lack of public awareness of mental health disorders is influenced by several factors, where one of the most influential factors is the low level of public knowledge about mental health, so that there is an error in the public's perspective on the survivors of mental health disorders themselves. This of course can lead to mistreatment of survivors of mental health disorders, potentially stigmatizing treatments. Based on these data, this study aims to use the right learning media to change the public's perspective on mental health disorders in order to reduce the existing stigmatization. The method used is the design thinking method which is a method of developing a product that begins with efforts to answer problems that exist in society. The results of this study a learning media in the form of video motion graphics with cartoon visual style and a way of delivering information with an emotional and rational approach has its own charm for the audience.

A case study on development of a spiral oral health curriculum for medical students.

Inadequate oral healthcare remains a critical public health issue in children and adults in the US affecting adverse social, psychological, economic, and health outcomes. Medical clinicians have a clear role in addressing oral health issues and improving outcomes. Oral health guidelines for health profession schools were developed by the Association of American Medical Colleges (AAMC) oral health core competencies, and the newer Center for Integration of Primary Care and Oral Health's (CIPCOH) Entrustable Professional Activities (EPAs). However, the majority of health professional school deans and residency directors in the US report they are not satisfied with the oral health knowledge and skills of their learners at graduation. To address this issue, faculty at the University of Massachusetts Chan Medical School (UMCMS) have worked for the past decade to develop and implement a true spiral curriculum building on lessons of knowledge, skills, and attitudes throughout the 4-year student experience. The current UMCMS curriculum involves most courses at the medical school, has community-based and interprofessional components, and is taught using multimedia. Most of the curriculum is mandatory with selective opportunities for those in specialty tracks or who are seeking more hands-on training. Our study evaluated the UMCMS curriculum using the AAMC and CIPCOH EPA guidelines. Findings show that all students receive training in 42 of 48 AAMC oral health competencies and seven of seven CIPCOH oral health EPAs with the opportunity to explore oral health further through elective courses. Assessments of students show they perform well and evaluation of the oral health curricula by students are positive. Although our oral health curriculum is robust, the next steps include expanding the evaluation of students to ensure they universally meet competencies. We expect that this case study can serve as a map for creating a generalizable, spiral curriculum for other medical schools.

The Role of Intersectional Stigma in Coronary Artery Disease Among Cisgender Women Aging with HIV

Cisgender women living with HIV experience elevated cardiovascular disease (CVD) risk that increases with age, a concern given extended life expectancies for people living with HIV. The CVD risk disparity among cisgender women aging with HIV is understudied and remains unclear. Taking a psychoneuroimmunology approach, given this group’s intersecting marginalized identities, one potential driver of the disparity is intersectional stigma. Yet not all women living with HIV have coronary artery disease (CAD). Resilience to stigma may serve as a protective factor to CAD, as observed in other health issues. This study aimed to explore the relationship between intersectional stigma, resilience, “traditional” CVD risk factors, and objective indicators of CAD among women aging with HIV. A diverse sample of cisgender women aging with HIV (aged ≥ 35, N = 48) completed a cross-sectional survey, clinical health interview, blood sample, blood pressure, anthropometric measurements, and computed tomography angiography (CTA). CART-based machine learning models assessed the statistical importance of traditional CVD risk factors, intersectional stigma, and resilience for classifying individuals with coronary artery stenosis, calcification, and inflammatory markers associated with CAD. Of the n = 31 who completed CTA, 74% had detectable calcification and 39% stenosis. Intersectional stigma was identified as an important variable for explaining calcification, but not stenosis, and for explaining sCD163, an inflammatory biomarker associated with CAD. Results show a potential psychoneuroimmunology pathway to the CAD disparity among this group. Future longitudinal research should investigate the mechanisms of this pathway and consider stigma as target for intervention to improve cardiovascular health among women aging with HIV.

Abstract 4134935: Impact of COVID-19 on Cardiology Fellows and Faculty in the United States: Two Years Later

Introduction: Recent data demonstrated that the COVID-19 pandemic adversely affected cardiovascular fellows in training (cFIT) and faculty in terms of educational disruption and search for job prospects, respectively. However, less is known about the pandemic's effect on cFIT and faculty in terms of general well-being, shifts in personal and professional priorities, quantitative measures of stress levels, and research productivity. Methods: A national survey targeting cFIT and faculty was developed to assess the effect of the pandemic two years later on these parameters. Fifty-four participants, including 21 cFIT and 33 faculty, responded to the survey. The survey was distributed between October 2021 and May 2022 to program directors of ACGME-accredited general cardiology fellowship programs in the United States. Results: 30% of cFITs perceived impaired clinical training during the pandemic; 36% of fellows experienced a decline in their clinical skills in the cardiac catheterization lab, while 27% experienced a decrease in their echocardiographic skills. Additionally, a significant percentage of cFIT reported negative interference in their competencies in nuclear cardiology (27%) and electrophysiology (12%). Most participants (76%), including faculty and fellows, reported several health issues such as sleep problems, low energy, changes in appetite, difficulty concentrating, and restlessness due to the pandemic. 43% of the faculty and 61% of cFIT reported high rates of impaired short-term productivity (Figure). Conclusion: In this national survey, we found that two years after the onset of the COVID-19 pandemic, cardiology fellows and faculty continued to experience significant concerns for decreased hands-on training and diminished research productivity. While faculty were not distressed regarding decreased clinical competencies, concerns about short-term and long-term research productivity persisted. Faculty and fellows all experienced increased stress levels and impaired productivity. Although limited by a small sample size, which can introduce bias, these results signal the importance of performing a follow-up study on the impact of COVID-19 on wellness as well as the impact on career.

A roadmap to reduce the incidence and mortality of breast cancer by rethinking our approach to women's health.

Despite progress, breast cancer remains the most feared disease among women. In the USA alone, the incidence is now almost 300,000 new cancers per year, a rate that has nearly doubled in the last 30years. Most women survive, but over 40,000 women a year still die of their disease National Cancer Institute [Internet]. [cited 2024 Nov 4]. Cancer of the Breast (Female) - Cancer Stat Facts. Available from: https://seer.cancer.gov/statfacts/html/breast.html. It is the most diagnosed cancer among women and the second leading cause of cancer death. Important disparities exist in breast cancer outcomes among African American women, where women die of breast cancer at higher rates, are diagnosed younger, and at a more advanced stage. We are proposing a radical shift in our thinking about breast cancer preventionwith an aspiration to dramatically lower breast cancerincidence. Most breast cancers are driven by steroid hormones. Throughout the life course, women are offered an array of hormonal treatments for menstrual cycle control, family planning, in vitro fertilization, postpartum weaning, and menopausal symptom management. There are mixed data on the extent to which each of these may contribute to increased or decreased risk for breast cancer. These endocrine manipulations could represent a great opportunity to potentially reduce breast cancer incidence and improve quality of life for survivors. To date, they have not been designed to explicitly reduce breast cancer risk. A new holistic approach will require scientists, drug developers, breast oncologists, obstetricians, gynecologists, endocrinologists,radiologists, and family medicine/internists to work together toward the common goal of reducing breast cancer risk while addressing othercritical issues in women's health.

Abstract 4134962: Association between Chronotype and Psychological Health in South Korean Adolescents

Background: Chronotype influences general health, with late chronotypes often linked to psychological problems. However, longitudinal studies on this topic are limited. This study assessed the association between chronotype and adolescent mental health, focusing on depression and somatic symptoms through cross-sectional and longitudinal analyses. Methods: This longitudinal study used data from the Korean Children and Youth Panel Survey (KCYPS), targeting middle school students aged 13. Participants were assessed annually over four years (2018-2021). Chronotype was determined by analyzing sleep onset and wake times. Depression and somatic symptoms were evaluated using preexisting questionnaires like the SCL-90. Multilevel linear regression analyses were conducted both concurrently and prospectively, with gender stratification. Covariates included sleep quality, physical activity, smartphone usage, breakfast and friendship. Results: The study included 1,882 students who completed all follow-ups. Students with a late chronotype, short sleep duration, and low sleep quality reported more mental health symptoms. Late chronotype was associated with higher levels of depression (β=0.062, p<.001) and somatic symptoms (β=0.056, p=.018) within the same year, and predicted somatic symptoms one year later (β=0.055, p=.019). For males, insufficient sleep worsened the effects of late chronotype on depression one year later (β=0.100, p=.042), and late chronotype predicted somatic symptoms one year later (β=0.072, p=.024). In females, late chronotype was associated with depression (β=0.061, p=.025) and somatic symptoms (β=0.075, p=.005) within the same year but did not predict future symptoms. Conclusions: Late chronotype negatively impacted depression and somatic symptoms and predicted future somatic symptoms. In females, late chronotype was related only to current mental health issues, whereas in males, it predicted future mental health problems, especially when combined with insufficient sleep. These findings highlight the impact of chronotype on adolescent mental health and suggest that its negative effects can be moderated by factors like sleep duration.

Abstract 4147606: The Risk of Cardiac Events Associated with Psychiatric Drugs in Patients with Long QT Syndrome.

Introduction: Long QT syndrome (LQTS) is a potentially life-threatening genetic heart disease. Patients with LQTS may also have co-existent mental health illnesses that may benefit from psychiatric medications. However, because many of these medications have QT-prolonging potential (www.crediblemeds.org), many of these patients receive suboptimal mental health care. Objective: To evaluate the frequency, management, and incidence of breakthrough cardiac events (BCEs) in patients with LQTS and concomitant mental health issues treated with psychiatric medications. Methods: A retrospective review was conducted on patients cared for in Mayo Clinic's Windland Smith Rice Genetic Heart Rhythm Clinic between 2000 and 2024 focusing on patients with LQTS and a concomitant psychiatric diagnosis requiring medication with known, possible or conditional risk of torsades de pointes (TdP). Electronic medical records were reviewed for data. BCEs were defined as LQTS-triggered syncope, seizures, appropriate ICD therapy, sudden cardiac arrest (SCA), or sudden cardiac death (SCD). Patients with missing information were excluded. Results: Overall, 195 /1899 LQTS patients [10%, 86 (43%) with LQT1, 83 (42%) with LQT2, and 16 (8%) with LQT3] had a concomitant psychiatric diagnosis requiring medication [150 female (76%), mean age at diagnosis 27 ± 18 years, median follow-up time 6.6 years (IQR 2.9-13)]. The most common psychiatric conditions were depression (71%), anxiety (62%), and ADHD (9%). The mean duration of therapy was 3.36 +/- 3.48 years and the most common medications used were fluoxetine (26%), sertraline (14%), and escitalopram (11%). There was no significant difference in QTc after starting the first psychiatric medication when compared to baseline (473 ± 33 vs 474 ± 35 ms, p=0.6). Prior to their LQTS diagnosis and while therefore untreated, 61/195 (31%) had at least 1 LQTS-associated cardiac event. This occurred in the setting of a psychiatric drug in 7 patients (11%). Following LQTS diagnosis and treatment, 14/195 patients (7%) have experienced a non-lethal BCE of which only 3/14 (21%) while on psychiatric medications. Conclusions: Although avoidance of medications with known QT-prolonging potential is prudent, attention to patient’s overall well-being besides just their LQTS must be given. After correct diagnosis and treatment, LQTS patients with concomitant mental health issues may be safely and effectively treated with medications known to prolong QTc.

Survivor Health Connection Project: Understanding Experiences of Accessing Health Care Among Those Affected by Intimate Partner Violence During the COVID-19 Pandemic.

Intimate partner violence (IPV) has short- and long-term health effects, including physical injuries and traumatic brain injury, as well as sexual, reproductive, and mental health issues. However, accessing necessary health care is often challenging for IPV survivors and became even more difficult during the COVID-19 pandemic. We examined access to health care among those affected by IPV during the COVID-19 pandemic to better connect survivors to health and social support services. The Health Resources and Services Administration's Office of Women's Health partnered with its Bureau of Primary Health Care, the Administration for Children and Families' Office of Family Violence Prevention and Services, and the National Domestic Violence Hotline (Hotline) on the 2-year Survivor Health Connection Project. The Hotline administered 2 surveys to its contacts: a 2-question postinteraction survey from March 29, 2021, through September 30, 2022, and a longer focused survey in 2021 and 2022 that measured barriers and restrictions to accessing health care, telehealth safety, and interactions with health care providers. Of 9918 respondents to the postinteraction survey, 6173 (62.2%) reported current health needs related to their abusive experience. Nearly half of 242 respondents to the 2021 survey (n = 106, 43.8%) indicated that the frequency or intensity of abuse increased during the COVID-19 pandemic, and 157 of 338 respondents to the 2022 survey (46.4%) reported that their partner had controlled and/or restricted their access to health care. Participants described barriers to accessing health care, including finances, health insurance coverage, and transportation. Findings illuminate opportunities to further support the health and social needs of those experiencing IPV, including continued coordination of efforts across health care and social service delivery partners.

Abstract 4136754: Psychoactive medication use in pediatric heart transplant recipients: An assessment of prevalence, risk factors, and outcomes

Background: There is increasing recognition of the mental health burden experienced by pediatric heart transplant (HTx) recipients. Mental health concerns can impact physical health and increase risk of poor health outcomes. Using the Pediatric Heart Transplant Society (PHTS) database, we assessed the use of psychoactive medications as a proxy for mental health issues. We assessed the prevalence of psychoactive medication usage, pre- and post HTx factors, and post HTx outcomes associated with psychoactive medication usage. Methods: We queried the PHTS database for patients >5 years of age at time of follow-up who underwent HTx between January 2015 and June 2023. Patients with use of any psychoactive medication were identified. Sub-analyses were performed for use of antianxiety/antidepressant and attention-deficit/hyperactivity disorder (ADHD) medications. Multivariate logistic regression models were utilized to assess risk factors and impact on outcomes, including graft survival, coronary artery vasculopathy (CAV), and rejection at 1, 3, and 5 years post-HTx. Results: Among 1792 patients older than 5 at 1 year post HTx, 301 (16.8%) were prescribed at least one psychoactive medication; 246 (13.7%) were prescribed medication for antianxiety/antidepressant medications and 59 (3.3%) for ADHD. Utilization of psychoactive medication decreased at 3 years (14.8%, N= 240 of 1629) and 5 years post HTx (11.3%, N=230 of 2029). Patients on psychoactive medications at 1 year post HTx tended to be older (OR=2.1, p<0.001), had higher priority listing status (OR=2.3, p<0.05), and longer bypass time (OR=1.6, p<0.05). Black patients were less likely to be prescribed psychoactive medication at 3-years post HTx than white patients (OR=0.57, p<0.05) or other races (OR=0.43, P <0.001). There was no association of psychoactive medication usage on graft survival, CAV, or rejection at 1 year post HTx. At 3 years post HTx psychoactive medication usage was associated with significantly higher prevalence of CAV (p<0.05). At 5 years post HTx graft loss (p<0.005) and CAV (p<0.05) were significantly increased in patients on psychoactive medications. Conclusions: A significant proportion of pediatric HTx patients take psychoactive medications. This population may be at risk for worse long-term outcomes. There is a need to assess the mental health burden of pediatric HTx and to identify modifiable factors to improve assessment and treatment of mental health issues and its impact on outcomes.

Effectiveness of autism training program introduction at primary health care (PHC) level

Background: Autism spectrum disorder (ASD) has become a public health issue in many countries especially in developing countries. Family members who have a toddler with ASD face significant physical, emotional, and financial challenges. Early detection is crucial to achieve improvement in children with ASD. Objectives: The aim of the current research is to study the implementation of a training program for Autism in 4 health care facilities and to evaluate its initial outcomes. Methodology: An interventional study conducted among 63 health care workers dealing with children 18-30 months in 4 health care facilities (2 urban health care facilities and 2 rural health care facilities) in Giza governorate. A tailored autism health education message as well as training on using the Arabic validated version of the Modified Checklist for Autism in Toddlers (M-CHAT) were provided to the HCWs. Results: 58.7% of participating primary health care workers (HCWs) had a satisfactory level of awareness about childhood autism prior to the intervention, and 71.4% had a satisfactory level of understanding following it. When comparing the study subjects' pre-intervention knowledge scores to their post-intervention knowledge scores, there was a statistically significant improvement in their knowledge about autism (p < 0.001). Conclusion: The study's findings validate the value of specialized training programs in raising healthcare workers' awareness of childhood autism. Recommendations: Incorporation of autism spectrum disorder (ASD) within the educational curriculum of medical and nursing schools and ongoing education and training in ASD for health care workers.

Breakthrough in Pediatric Atopic Dermatitis Therapy: The Role of Monoclonal Antibodies as a New Hope for Targeted Treatment in Children

Aims: Atopic dermatitis (AD) is a prevalent skin condition affecting children of all ages and ethnicities. The aim of this review paper is to explore emerging treatments for atopic dermatitis, with a focus on the latest advancements in monoclonal antibody therapy. By evaluating their benefits and potential risks, the review seeks to provide a comprehensive understanding of their efficacy and safety in managing moderate to severe AD. Highlighting recent progress in targeted therapies, this paper aims to encourage continued research into innovative, effective, and safer options that can significantly improve patients’ quality of life. Methods: A systematic review of scientific and medical literature was conducted using PubMed and Google Scholar databases. Researchers included only studies that mentioned monoclonal antibodies approved by EMA (European Medicines Agency) or that are being currently researched for use in pediatric population with AD. Results: AD is a debilitating health issue both for children and their caregivers. Advances in understanding its pathophysiology have introduced new treatment approaches. Monoclonal antibody therapies provide notable benefits for moderate to severe AD, though more pediatric-specific studies are necessary. Conclusions: Monoclonal antibody therapy appears to be a promising treatment for pediatric patients with moderate to severe AD, effectively reducing symptoms and enhancing quality of life. Despite the potential distress of injections for young children, their infrequency aids in management. Further research is required to confirm the safety and efficacy of these therapies in children. Ongoing development of new antibodies targeting various aspects of AD is crucial for improving management and outcomes.

Abstract Su706: New risk markers of sudden cardiac death in the young : insights from machine learning on EHR data

Background: Sudden Cardiac Death (SCD) in young adults is a significant public health issue, with survival rates often less than 15%. Effective prevention is critical as many SCD cases go undetected due to nonspecific symptoms and ineffective risk stratification methods, especially among the youth. Objective: To explore risk markers specific to SCD in younger populations using Artificial Intelligence (AI) trained on systematically collected Electronic Health Records (EHR) data, and to compare these markers with those in older populations. Methods: We conducted a retrospective cohort study using data from 46,060 participants in Paris and its inner suburbs, spanning 2011 to 2020. The cohort included 1,100 SCD cases and 1,100 controls aged 40 years or younger, and 21,930 SCD cases and 21,930 controls aged over 40. A machine learning model was developed, trained, and validated on these cohorts. We used the Catboost algorithm and evaluated model performance using AUC, sensitivity, and specificity. The SHAP algorithm was employed to elucidate the relationship between variables and predicted risk. Results: The model achieved on validation sets an AUC of 0.75 (95% CI 0.67-0.83) for the younger cohort and AUC of 0.82 (95% CI: 0.70-0.83), for the older cohort. Neuropsychiatric drugs were the most influential predictors for the younger cohort, whereas age and cardiovascular drugs were most predictive for the older cohort. The results indicate that traditional cardiovascular risk factors play a secondary role in predicting SCD among younger individuals. Conclusion: In analyzing predictors of sudden death in individuals under 40, we developed a personalized SCD prediction model using EHR data tailored to this demographic. Psychiatric medications, and possibly underlying psychiatric conditions, emerged as significant predictors. Our findings emphasize the need for a multidisciplinary approach to SCD prevention, integrating neuropsychiatric and cardiovascular considerations.

Systematic Review and Meta-Analysis of Sclerocarya birrea on Metabolic Disorders: Evidence from Preclinical Studies

Background/Objectives: Metabolic disorders, including diabetes, obesity, and cardiovascular diseases, are significant global health issues. Nutraceuticals, such as Sclerocarya birrea (SB), known for its high polyphenol content, are increasingly explored for managing these conditions. This study aims to evaluate the antihyperglycemic, hypolipidemic, and antihypertensive effects of SB in animal models to understand its potential as a natural intervention for metabolic diseases. Methods: A systematic review and meta-analysis were conducted according to PRISMA guidelines. Searches across databases like PubMed, Web of Science, Embase, and Scopus identified studies using SB in animal models of metabolic disorders. Inclusion criteria were studies with SB intervention, control groups, and quantitative measures of metabolic parameters. The study was registered with INPLASY (INPLASY2024100031). Results: The meta-analysis revealed that SB significantly reduces blood glucose levels in diabetic animal models. Acute administration of SB showed a pooled standardized mean difference (SMD) of −7.13 (95% CI: −11.44 to −2.83) at 1 h and −9.75 (95% CI: −15.92 to −3.59) at 2–4 h post-administration. Chronic administration indicated a non-significant reduction in glucose levels (SMD: −5.69, 95% CI: −16.38 to 5.01). Conclusions: SB appears to have the potential for reducing blood glucose levels and may offer benefits for other cardiometabolic risk factors, including lipid profiles and oxidative stress. However, variability in the results underscores the need for further research, including standardized animal studies and clinical trials, to confirm these effects and clarify the mechanisms by which SB may impact metabolic disorders.

Abstract 4118402: National Burden, Trends, and Racial Disparities in Cardiovascular Mortality Among Incarcerated Individuals in the United States from 2000-2019

Background: Cardiovascular disease is the leading cause of death in the U.S. Mass incarceration is a national public health issue, with the US having the highest incarceration rate in the world. However, there is a paucity of data on cardiovascular mortality among incarcerated individuals, or how the racialization of mass incarceration contributes to cardiovascular health inequities. The aim of this study was to evaluate the burden of cardiovascular mortality, trends in cardiovascular deaths, as well as racial differences in cardiovascular death and receipt of care among those incarcerated in U.S. state prisons from 2001-2019. Methods: We utilized the database “Mortality in Correctional Institutions: ICD-10 Diagnosis Codes for Natural Deaths Occurring in State Prison or Local Jail Custody, 2000-2019” from the United States Bureau of Justice Statistics. This database collects inmate death records from each of the nation’s 50 state prison systems. We extracted all deaths related to cardiovascular causes to evaluate the epidemiology of individuals with cardiovascular death, trends in cardiovascular death rates, and differences between racial groups. Results: From 2000-2019, there were a total of 18227 (28.0%) deaths secondary to cardiovascular causes among those incarcerated in US state prisons. The rate of CV death increased from 71.3 per 100,000 persons in 2001 to 94 per 100,000 persons in 2019. Black individuals who died while incarcerated had higher rates of death related to a cardiovascular cause than White individuals (30.9% vs. 27.8%, p<0.0001). Black individuals had higher rates of death due to ischemic heart disease (23.2% vs 21.9%) and hypertensive-related cardiovascular deaths (3.71% vs. 2.96%) as compared to white counterparts (p<0.001). Black incarcerated individuals who died from a cardiovascular cause were less likely to be evaluated by a medical provider in prison (78.6% vs. 81.9%; p<0.0001), were less likely to have a diagnostic test performed (65.3% vs. 69%, p<0.0001), were less likely to receive medications (68.1% vs 72.6%, p<0.001), as well as treatment other than medications (49.1% vs 52.8%, p <0.0001) for the condition which caused death as compared to White counterparts. Conclusions: Deaths due to cardiovascular causes are high among patients incarcerated in US state prisons. Combined with decarceral efforts to address mass incarceration, strategies to ensure quality and equitable cardiovascular care for this population are needed.

KOMUNIKASI, INFORMASI, EDUKASI PENYAKIT HIPERTENSI SEBAGAI STRATEGI UNTUK MENINGKATKAN PENGETAHUAN MASYARAKAT DI KELURAHAN PAKANSARI CIBINONG, KABUPATEN BOGOR

Hypertension is a significant health issue in Indonesia, with a prevalence of 30.8%. This community service activity aims to enhance the knowledge of residents in Pakansari Village regarding hypertension and its management through education on dietary patterns and using fruits and vegetables. The methods employed in this activity include Information and Education Activities, which consist of presentations, discussions, practical sessions on making healthy juices from local ingredients, and counseling. The results indicate an improvement in participants' knowledge, with an average post-test score reaching 95%, compared to a pre-test score of 88%. Additionally, participants successfully practiced making healthy beverages that can be incorporated into their daily routines to help control blood pressure. This activity will positively impact community health and encourage healthier lifestyle changes.