High Occupancy Research Articles

Psychological distress is more common in some occupations and increases with job tenure: a thirty-seven year panel study in the United States

BackgroundWorkers in certain occupations may have elevated risks of psychological distress. However, research is limited. For example, researchers often measure distress that may have existed before occupational exposures. We studied occupations and the development of psychological distress using national data from the United States.MethodsWe reviewed relevant research to identify occupations with low and high risks of mental health problems. We confirmed those individual low and high risk occupations using 1981–2017 data from the Panel Study of Income Dynamics (n = 24,789). We measured new cases of distress using the Screening Scale for Psychological Distress (Kessler K6) and compared distress in the low and high risk groups, adjusted for factors associated with occupational selection and non-occupational distress risks. A subset of participants described their jobs (n = 1,484), including factors such as job demands, social support, and control over work. We examined associations of those factors with psychological distress.ResultsWorkers in high risk occupations had 20% higher adjusted odds of developing distress than those in low risk occupations (odds ratio, OR 1.20, 95% confidence interval, CI 1.13–1.28). Distress increased with time in a high risk occupation: ≥5 years OR 1.38 (CI 1.18–1.62), ≥ 10 years OR 1.46 (CI 1.07–1.99), and ≥ 15 years OR 1.77 (CI 1.08–2.90; p-trend = 0.0145). The most common positive participant descriptions of their jobs indicated social support (34%), sense of accomplishment (17%), and control over work (15%). Participants reporting such descriptions were significantly less likely to have a high risk occupation (OR 0.66, CI 0.46–0.94, p = 0.0195). The most common negative descriptions were excessive job demands (43%), low social support (27%), and lack of control (14%). Participants reporting such descriptions were significantly more likely to have a high risk occupation (OR 1.49, CI 1.03–2.14, p = 0.0331).ConclusionCertain occupations may have high risks of psychological distress, which may be due to characteristics of the occupations rather than employee characteristics, or in addition to them. Results were consistent with theoretical models of psychosocial work environments. Providers of health care and social services should ask patients or clients about work-related distress.

First evidence of microplastics in freshwater from fish farms in Rondônia state, Brazil

The main aimed of this study was to provide information on microplastics present in the freshwater of fish farm ponds. In addition, the study showes a relationship between the seasonal, spatial distribution and the amount of microplastics found. This study was conducted in 35 fish farms located in the Rondônia state, Brazil, the sample collects were carried out in the two Amazonian hydrological seasons (dry and rainy). The study was developed in a completely randomized factorial scheme 35 × 3 x 3 (35 fish farms, 3 ponds and 3 repetitions per ponds). Microplastic sampling was performed following a modified method based on National Oceanic and Atmospheric Administration (NOAA). Samples of 250 mL freshwater collected, which were deionized and pre-filtered through 6.0 mm mesh granulometric sieves. The average abundances of the different hydrological seasons were compared by Student's t-test, with differences statistically significant at p < 0.05. The microplastics were morphological categorized into fibers and colors blue, red or transparent. Microplastic contamination was confirmed in freshwater of 9 fish farming, with greater abundance of blue fibers and greater quantification in the rainy season. Fish farms P3, P4 and P6 had the highest quantifications of blue fiber in the two seasons (6 and 43, 19 and 56, 11 and 88 items mL−1, respectively). Almost all fish farms had a higher abundance of microplastics in the rainy season. It is important to highlight the prominence of microplastics in the blue fiber rainy season (286 items mL−1) compared to the dry season (58 items mL−1). Fish farms P3, P4 and P6 showed a strong positive correlation between the factors distance from the nearest urban area (r = 0.94, 0.79 and 0.97, respectively) and seasonality (r = 0.98, 0.77 and 0.96, respectively). Rainfall variations influenced the abundance of microplastics, especially of blue fibers. Fish farms are supplied with fresh water by rivers or streams, so it is possible that microplastics originate outside the fish farm, perhaps they were introduced due to high soil occupation, although surface runoff (of water contaminated by sewage) caused by heavy rains the most important factor. Therefore, one factor must be considered, surface runoff and groundwater contaminated by urban, agricultural and urban effluents may have contaminated rivers and streams and then contaminated the water in the fish farm ponds.

Occult intraocular aluminium foreign body causing rhegmatogenous retinal detachment: a case report

BackgroundOcular trauma is complex and varied, and some occult intraocular foreign bodies (IOFBs) can lead to uncommon symptoms and signs. We report a case of rhegmatogenous retinal detachment (no obvious wound, no pain, no intraocular infection or other symptoms) caused by an occult intraocular aluminium foreign body, which could have been easily missed.Case presentationA 42-year-old male presented to the outpatient department of our hospital complaining of fluttering black dots and decreased vision in his left eye that began 3 months earlier. He was diagnosed with "floaters" at a community hospital. He denied a history of ocular trauma or previous surgery. The cornea and lens of the left eye were clear. A small patch of pigmentation was noted in the temporal sclera. Fundoscopy revealed macula-off retinal detachment. After mydriasis, elliptical holes were seen in the peripheral retina at 2:30, and a suspicious hyperreflective strip was found under the anterior lip of the retina by Goldmann three-mirror contact lens examination; the strip was confirmed to be an IOFB by orbital CT. The IOFB was removed through pars plana vitrectomy without any complications.ConclusionUnlike iron and copper IOFBs, aluminium IOFBs are more inert and more likely to be missed. For people with special occupations (construction workers, mechanics, etc.), when abnormal pigmentation of the sclera is found, the possibility of foreign bodies in the eye should be considered. In the process of disease diagnosis and treatment, it is necessary to ask for a detailed history, including occupation history and practice, and perform careful physical and targeted examinations. Such comprehensive analysis regarding the above information will minimize the chance of missed diagnosis.Awareness of occult IOFB in high risk occupations and prompt referral to a retinal surgeon is of outmost importance.

Artificial intelligence-based prediction of indoor bioaerosol concentrations from indoor air quality sensor data

Exposure to bioaerosols in indoor environments, especially public venues that have a high occupancy and poor ventilation, is a serious public health concern. However, it remains challenging to monitor and determine real-time or predict near-future concentrations of airborne biological matter. In this study, we developed artificial intelligence (AI) models using physical and chemical data from indoor air quality sensors and physical data from ultraviolet light-induced fluorescence observations of bioaerosols. This enabled us to effectively estimate the bioaerosol (bacteria-, fungi- and pollen-like particle) and 2.5-µm and 10-µm particulate matter (PM2.5 and PM10) on a real-time and near-future (≤60 min) basis. Seven AI models were developed and evaluated using measured data from an occupied commercial office and a shopping mall. A long short-term memory model required a relatively short training time and gave the highest prediction accuracy of ∼ 60 %–80 % for bioaerosols and ∼ 90 % for PM on the testing and time series datasets from the two venues. This work demonstrates how AI-based methods can leverage bioaerosol monitoring into predictive scenarios that building operators can use for improving indoor environmental quality in near real-time.

Jellybean Quantum Dots in Silicon for Qubit Coupling and On-Chip Quantum Chemistry.

The small size and excellent integrability of silicon metal-oxide-semiconductor (SiMOS) quantum dot spin qubits make them an attractive system for mass-manufacturable, scaled-up quantum processors. Furthermore, classical control electronics can be integrated on-chip, in-between the qubits, if an architecture with sparse arrays of qubits is chosen. In such an architecture qubits are either transported across the chip via shuttling or coupled via mediating quantum systems over short-to-intermediate distances. This paper investigates the charge and spin characteristics of an elongated quantum dot-a so-called jellybean quantum dot-for the prospects of acting as a qubit-qubit coupler. Charge transport, charge sensing, and magneto-spectroscopy measurements are performed on a SiMOS quantum dot device at mK temperature and compared to Hartree-Fock multi-electron simulations. At low electron occupancies where disorder effects and strong electron-electron interaction dominate over the electrostatic confinement potential, the data reveals the formation of three coupled dots, akin to a tunable, artificial molecule. One dot is formed centrally under the gate and two are formed at the edges. At high electron occupancies, these dots merge into one large dot with well-defined spin states, verifying that jellybean dots have the potential to be used as qubit couplers in future quantum computingarchitectures.

Gender Stereotypes Selectively Affect the Remembering of Highly Valued Professions

This study includes two experiments designed to assess the effects of occupational gender-related stereotypes on information processing and memory performance. These two experiments were conducted in two separate cohorts of undergraduate students (N = 107 and N = 96, respectively). In each of them, we assessed (and confirmed) the presence of an implicit association preferentially linking high status attributes to men using the Implicit Association Test (IAT). We also assessed the effective incorporation of this association into gender-schemata and its consequences for information processing with a memory task that involved remembering the feminine and masculine forms of high or low status professional occupations. Results indicated that, independently of their gender, participants were more likely to forget and less likely to falsely recall the feminine forms of high status professions, whereas the opposite was true for the masculine forms of high status professions. The magnitude of these memory biases was correlated with the IAT scores. Moreover, in agreement with the predictions of gender-schemata theory, these memory biases (and their correlations with IAT scores) were predominantly observed when participants were not adverted that their recall would be evaluated later on (incidental-encoding memory task; Experiment 1), but less so when participants were explicitly instructed to memorize the same feminine and masculine forms of high or low status professional occupations (intentional encoding memory task; Experiment 2). Taken together, these results call into question the notion that gender stereotypes about professional occupations are declining, and they highlight a “men-high-status” association as a major component of these occupational stereotypes.

Periodic X-ray sources in the massive globular cluster 47 Tucanae: Evidence for dynamically formed cataclysmic variables

ABSTRACT We present a systematic study of periodic X-ray sources in the massive globular cluster 47 Tuc, utilizing deep archival Chandra observations that resolve the cluster core and recently available eROSITA observations that cover the cluster outskirt. By applying the Gregory-Loredo algorithm, we detect 20 periodic signals among 18 X-ray sources, ranging between 205–95731 s. Fourteen periods are newly discovered in the X-ray band. We classify these periodic sources into four quiescent low-mass X-ray binaries, 1 ms pulsar, two coronally-active binaries, and eleven cataclysmic variables (CVs) based on their X-ray temporal and spectral properties, as well as multiband information. Despite a small sample subject to potential selection bias against faint and non-magnetic CVs, the 11 CVs together define an orbital period distribution significantly different from that of the CVs previously found in the solar neighbourhood and the Galactic bulge. In particular, there exists in 47 Tuc an apparent paucity of short-period CVs below the period gap, which might be attributed to a high occupation fraction of non-magnetic CVs. Also characteristic of the 47 Tuc CVs are an overabundance of long-period CVs with a subgiant donor, a substantial fraction of CVs within the period gap, and a steep radial surface density profile. These are best understood as a group of CVs having recently formed via dynamical interactions in the dense cluster core. Despite sufficient sensitivity of the X-ray data, only one periodic source is found between one-third of the half-light radius and the tidal radius, the nature of which is unclear.

Preferences for zero-emission vehicle attributes: Comparing early adopters with mainstream consumers in California

Ambitious zero-emission vehicle (ZEV) adoption goals have been proposed to decarbonize the transportation sector, while the current market share pales in comparison. Although the distinct socio-economic characteristics of ZEV early adopters relative to mainstream car buyers are well understood, the two groups' preferences for ZEV attributes are not clear. This knowledge gap hinders the development of effective policies to achieve mass ZEV penetration goals. This paper examines consumers’ preferences and willingness to pay for ZEV attributes based on 755 early adopters and 3493 mainstream consumers from the 2019 California vehicle survey data. Results show that early adopters are more sensitive to battery range, acceleration performance, home charging availability, and high occupancy vehicle lane access, while mainstream consumers attach greater importance to cost attributes (e.g., fuel and maintenance costs) and charging time. Moreover, the effects of monetary incentives are found to be significant for both groups, whereas neither early adopters nor mainstream consumers value the availability of public charging stations. The findings of this study inform targeted ZEV policymaking and marketing strategies in different adoption stages.

An efficient method for mining high occupancy itemsets based on equivalence class and early pruning

Many researchers have been investigating and applying a new trend of data mining, namely high occupancy itemset mining. Frequent itemset mining often returns a large set of itemsets, but businesses need a smaller set of inputs to investigate or send into a recommendation system to quickly make decisions. Applying an occupancy measure to a support-based mining framework will thus bring many benefits for decision support systems, while managers will benefit by having a new method to visualize reports and analyze data more efficiently. Similar to frequent itemset mining, mining high occupancy itemsets can be applied on any transaction database. In this research, we apply additional conditions to eliminate unqualified itemsets and integrate the property of equivalence class to reduce the runtime of the k-itemsets generation process. Moreover, a new theorem is stated and applied to a specific class of databases so that it is not necessary to calculate the upper-bound occupancy, and this speeds up the process as well as reduces memory requirements with regard to generating high occupancy itemsets. We develop two new algorithms, fast high occupancy itemset mining (FHOI) and depth first search (DFS) for high occupancy itemset mining (DFHOI) to solve the problem. Our new algorithms are examined experimentally using different databases to evaluate its performance in term of runtime and memory usage.

Identifikasi Soil Transmitted Helminths Pada Tanah Peternakan Domba di Desa Manggis Kecamatan Serbajadi Kabupaten Serdang Bedagai

Background. More than one and a half million of whole world population are infected by Soil Transmitted Helminths. The most common types of Soil Transmitted Helminths found in human are Ascaris lumbricoides, Trichuris trichiura and Hookworm (Necator americanus and Ancylostoma duodenale). Soil Transmitted Helminths infections are usually found on individuals with poor personal hygiene, low socioeconomic status, and high risk occupations, such as sheep farmer. Sheep farming in Indonesia is generally a small-scale farm with modest technology. Livestock herding on the pasture may cause the livestock to consume Soil Transmitted Helminths-contaminated grass. Soil is the medium for the maturing of Soil Transmitted Helminths fertilized egg into infective form. Modest handling aspect and poor sanitation allow Soil Transmitted Helminths to be found in farm soil. Aim. To identify Soil Transmitted Helminths in the soil of a sheep farm in Manggis Village, Serbajadi District, Serdang Bedagai Regency. Method. This observational descriptive study was conducted with cross-sectional approach. 100 of soil samples were collected per 8 square meters through quota sampling from a sheep farm in Manggis Village, Serbajadi District, Serdang Bedagai Regency. The data was collected by carrying out flotation technique in laboratory. Result. Findings showed that Soil Transmitted Helminths eggs were discovered in 17 (17%) out of 100 samples. Hookworm eggs were found in 14 samples (14%), Ascaris lumbricoides eggs were found in 5 (5%) samples, which 2 (2%) samples of both were double findings of Hookworm and Ascaris lumbricoides. Conclusion. There are Soil Transmitted Helminths in soil of the sheep farm in in Manggis Village, Serbajadi District, Serdang Bedagai Regency.

Schools of struggle: social movement learning in the Brazilian high school student occupations (Primavera secundarista, 2015–2016)

ABSTRACT Over 2015–2016, high school students in Brazil occupied hundreds of schools across the country. Students fought to keep public schools open, funded, and functional, against outsourcing and privatisation, and in solidarity with teachers’ trade unions and strikes. The ‘primavera secundarista’ (‘student spring’) was the most significant school student movement since the struggles against the military dictatorship (1964–1988). This paper firstly addresses the political dynamics of the primavera secundarista. Secondly, it discusses the movement’s educational practices, which flourished in the months that students occupied their schools. Thirdly, it discusses the forms of community and solidarity that students built with other social actors and how they each learnt from this. In doing so, the paper builds on the work of Aziz Choudry and other scholars of social movement learning to argue that such student movements are prime sites of counter-hegemonic knowledge production and dissemination. Shown through the Brazilian high school occupations, the paper highlights how student movements are unusual in being situated in formal epistemic institutions, and yet are not widely recognised, especially in high schools, as blending formal and informal learning to produce and share knowledge-from-below.

Competitiveness and Phylogenetic Relationship of Rhizobial Strains with Different Symbiotic Efficiency in Trifolium repens: Conversion of Parasitic into Non-Parasitic Rhizobia by Natural Symbiotic Gene Transfer

In Uruguayan soils, populations of native and naturalized rhizobia nodulate white clover. These populations include efficient rhizobia but also parasitic strains, which compete for nodule occupancy and hinder optimal nitrogen fixation by the grassland. Nodulation competitiveness assays using gusA-tagged strains proved a high nodule occupancy by the inoculant strain U204, but this was lower than the strains with intermediate efficiencies, U268 and U1116. Clover biomass production only decreased when the parasitic strain UP3 was in a 99:1 ratio with U204, but not when UP3 was at equal or lower numbers than U204. Based on phylogenetic analyses, strains with different efficiencies did not cluster together, and U1116 grouped with the parasitic strains. Our results suggest symbiotic gene transfer from an effective strain to U1116, thereby improving its symbiotic efficiency. Genome sequencing of U268 and U204 strains allowed us to assign them to species Rhizobium redzepovicii, the first report of this species nodulating clover, and Rhizobium leguminosarun, respectively. We also report the presence of hrrP- and sapA-like genes in the genomes of WSM597, U204, and U268 strains, which are related to symbiotic efficiency in rhizobia. Interestingly, we report here chromosomally located hrrP-like genes.

IMPACT OF MARKET PATRONAGE ON THE TRAFFIC SITUATION IN BENIN METROPOLIS, NIGERIA

This paper examines the influence of market patronage on the traffic situation in Benin City, Nigeria. Nine market routes were studied, and a well-structured questionnaire administered randomly and systematically was used to collect data from 407 respondents. Descriptive and correlation techniques were used to analyse the responses. Most of the markets were found to be situated along transit routes, and operated every day, resulting in street trading and parking which contributed 76.2 percent to the traffic situation in Benin metropolis. It is suggested that traffic laws prohibiting street trading and parking be enacted and enforced. The marketplaces should be restructured to accommodate motor parks, and alternative routes to bypass market areas for non-market trips should be considered as well as the provision of priority lanes for High Occupancy Vehicles (HOV).

EEG-based detection of modality-specific visual and auditory sensory processing

Objective. A passive brain–computer interface (pBCI) is a system that enhances a human–machine interaction by monitoring the mental state of the user and, based on this implicit information, making appropriate modifications to the interaction. Key to the development of such a system is the ability to reliably detect the mental state of interest via neural signals. Many different mental states have been investigated, including fatigue, attention and various emotions, however one of the most commonly studied states is mental workload, i.e. the amount of attentional resources required to perform a task. The emphasis of mental workload studies to date has been almost exclusively on detecting and predicting the ‘level’ of cognitive resources required (e.g. high vs. low), but we argue that having information regarding the specific ‘type’ of resources (e.g. visual or auditory) would allow the pBCI to apply more suitable adaption techniques than would be possible knowing just the overall workload level. Approach. 15 participants performed carefully designed visual and auditory tasks while electroencephalography (EEG) data was recorded. The tasks were designed to be as similar as possible to one another except for the type of attentional resources required. The tasks were performed at two different levels of demand. Using traditional machine learning algorithms, we investigated, firstly, if EEG can be used to distinguish between auditory and visual processing tasks and, secondly, what effect level of sensory processing demand has on the ability to distinguish between auditory and visual processing tasks. Main results. The results show that at the high level of demand, the auditory vs. visual processing tasks could be distinguished with an accuracy of 77.1% on average. However, in the low demand condition in this experiment, the tasks were not classified with an accuracy exceeding chance. Significance. These results support the feasibility of developing a pBCI for detecting not only the level, but also the type, of attentional resources being required of the user at a given time. Further research is required to determine if there is a threshold of demand under which the type of sensory processing cannot be detected, but even if that is the case, these results are still promising since it is the high end of demand that is of most concern in safety critical scenarios. Such a BCI could help improve safety in high risk occupations by initiating the most effective and efficient possible adaptation strategies when high workload conditions are detected.

Urban Air Pollution and Greenness in Relation to Public Health.

Air pollution is the result of economic growth and urbanization. Air pollution has been progressively recognized as a serious problem for cities, through widespread effects on health and well-being. There is less concern from stakeholders about greenness and air pollution mitigating factors in an urban area. This research targeted to indicate the spatial dissemination of greenery, air quality levels (PM2.5, PM10, CO2, and AQI), and exposure to air quality-related health risks for the people in the urban area. The data were collected by measuring air quality at transportation stations and manufacturing industries with Air visual pro, then observing and mapping greenness in the city within the administrative boundary by GIS (street greenery, forest, availability of greenness in the manufacturing industry), and lastly questionnaire and interview were employed for air quality-related health issues. Then, the air quality data were analyzed by using USAQI standards and health messages. Both quantitative and qualitative research approach had employed to explore air pollution levels, availability of greenness, and air quality-related health issues. Moreover, Health questionnaires and greenness were correlated with air quality levels by a simple linear regression model. The result indicated that there was unhealthy air quality in the transportation and manufacturing industries. The measured air quality showed in a range of 50.13-96.84 μg/m3 of PM2.5, 645-1764 ppm of CO2, and 137-179 Air quality index (AQI). The highest mean of PM2.5 and air quality concentrations at Addis Ababa transportation stations and manufacturing sites ranged between 63.46 and 104.45 μg/m3 and 179-326, respectively. It was observed with less street greenery and greenness available in residential, commercial areas, and manufacturing industries. The pollution level was beyond the limit of WHO standards. The result has shown a health risk to the public in the city, particularly for drivers, street vendors, and manufacturing industry employees. Among 480 respondents, 57.92% experienced health risks due to air pollution by medical evidence. High health risks due to industries and old motor vehicles in the city need to be reduced by introducing policies and strategies for low-carbon, minimizing traveling distance, encouraging high occupancy vehicles, and promoting a green legacy in the street network and green building.

Synthesis, Molecular Dynamics Simulation, and In-vitro Antitumor Activity of Quinazoline-2,4,6-triamine Derivatives as Novel EGFR Tyrosine Kinase Inhibitors.

Developing a potent and safe scaffold is challenging in anti-cancer drug discovery. The study focused on developing novel series of compounds based on the inhibition of epidermal growth factor receptor tyrosine kinase (EGFR-TK) as one of the most promising compounds in cancer therapy. In this study, a novel series of quinazoline-2,4,6-triamine derivatives were designed and synthesized through intramolecular C-H activation reaction of para-nitro aniline, trichloroacetonitrile, and isocyanides employing a one-pot reaction. The in-vitro antitumor activities of the compounds which showed acceptable inhibitory effects were investigated against breast (MCF-7), lung (A-549), and colon (HT-29) cancer cell lines by employing MTT assay. All compounds had the most negligible cytotoxicity toward normal fibroblast human cell lines. Based on structural and thermodynamics analysis results, it was found that Met 769 is a key residue in interaction with all inhibitors through the formation of hydrogen bonds with high occupancies with the amine group on the quinazoline ring of inhibitors. Also, there was a good consistency between calculated ΔG binding and experimental IC50 values of compounds 10d, 10e, and erlotinib. Compound 10e had an extensive range of antitumor activity on three diverse cell lines comparable with erlotinib and doxorubicin reference drugs. Also, compound 10d showed selective cytotoxicity against cancerous lung cells (A-549). On the other side, computational studies confirmed that Met 769 is a crucial residue in interaction with all inhibitors.

In silico approach to identify novel allosteric intracellular antagonist for blocking the interleukin-8/CXCR2 receptor signaling pathway

The role of interleukin-8 (IL-8) and its receptor CXCR2 in inflammatory responses and tumor development and progression has been well documented. Our study aims to discover novel compounds as CXCR2 antagonists to block the IL-8 signaling pathway using an in silico drug design. Herein, a structure-based pharmacophore model was developed based on the crystal structure of inactive CXCR2 in a complex with an allosteric inhibitor. This model was validated and refined, followed by virtual screening with the ZINC15 database. Subsequent molecular docking allows for predicting the best pose of a ligand inside a receptor binding site. We found that the 35 top-ranked hits exhibited docking scores from −30.81 to −25.28 kJ/mol and better interaction potential comparing the reference inhibitor. Analysis of ADME and toxicity properties revealed the efficacy and safety of the selected seven compounds. To validate the stability of the protein-ligand complex structure MD simulations approach has also been performed and confirmed via the critical parameters. The MD results explained that the CXCR2 receptor bound with two best-proposed molecules, including ZINC77105530 and ZINC93176465, was quite stable states as observed from low RMSD, RMSF, Rg, SASA values, and high occupancy of the interaction types. Finally, our data identified that these compounds play as potential inhibitors of IL-8 signaling pathways with the MM/GBSA binding free energies of −41.77 ± 6.45 kcal/mol and −38.84 ± 6.16 kcal/mol, respectively. Communicated by Ramaswamy H. Sarma

SDI-118, a novel procognitive SV2A modulator: First-in-human randomized controlled trial including PET/fMRI assessment of target engagement.

Background: Current treatments for progressive neurodegenerative disorders characterized by cognitive impairment either have limited efficacy or are lacking altogether. SDI-118 is a small molecule which modulates the activity of synaptic vesicle glycoprotein 2A (SV2A) in the brain and shows cognitive enhancing effects in a range of animal models of cognitive deficit. Methods: This first-in-human study evaluated safety, tolerability, and pharmacokinetics/pharmacodynamics of SDI-118 in single ascending oral doses up to 80mg administered to 32 healthy male subjects. Brain target occupancy was measured in eight subjects using positron emission tomography with PET-ligand [11C]-UCB-J. Food effect was assessed in seven subjects. Mood state was regularly evaluated using standardized questionnaires, and resting state fMRI data were analyzed as exploratory objectives. Key Results: At all doses tested, SDI-118 was well tolerated and appeared safe. Adverse events were mainly dizziness, hypersomnia, and somnolence. All were mild in intensity and increased in frequency with increasing administered dose. No dose-limiting adverse reactions were observed at any dose. SDI-118 displayed a linear pharmacokinetic profile with no significant food effect. Brain penetration and target engagement were demonstrated by a dose-proportional SV2A occupancy. Conclusion: Single oral doses of SDI-118 up to 80mg were very well tolerated in healthy male subjects. Dose-proportional SV2A occupancy in the brain was demonstrated with brain imaging. Adverse effects in humans mainly occurred in higher dose ranges, with high occupancy levels, and were all mild and self-limiting. These data support further clinical exploration of the compound in patients with cognitive disorders. Clinical Trial Registration: https://clinicaltrials.gov/, identifier NCT05486195.

1255 IMPROVING COMMUNICATION BETWEEN NEXT OF KIN AND MEDICAL STAFF FOR OUR MOST VULNERABLE PATIENTS: A QUALITY IMPROVEMENT PROJECT

Abstract Background This project was completed by a team of junior doctors working across two general medical wards at Queen Alexandra Hospital. Introduction Due to persistently high bed occupancy, patients are increasingly subject to multiple moves, increasing the risk of missed or delayed communication (Toye C et al, Clin interv aging, 2019, 14, 2223-2237). Importantly, families who receive good communication from staff are more likely to feel satisfied with the care of their loved one (Ersek M et al, J pain symptom manage, 2021, 62(2), 213–222). Our aim was to increase the occurrence and comprehensiveness of documented discussions between next of kin (NOK) and the medical team, especially in vulnerable patients who may be unable to advocate for themselves. Methods We conducted a retrospective, cross-sectional analysis of patient notes across two PDSA cycles. NICE guidelines NG27, NG97 and NG96 provided an audit standard. Patients were identified as at-risk of poor communication if diagnosed with dementia, cognitive impairment, addiction, learning difficulties or needing an interpreter. Targeted intervention prior to re-audit included education of the medical team and introduction of a written prompt within the patient’s notes. Results 25/55 patients were identified as at-risk in cycle one, with 39/71 patients at-risk in cycle two. Post-intervention, the number of at-risk patients with a documented NOK discussion increased from 74% to 82%. Patient treatment plan discussions increased from 81% to 97%. Discussions, where applicable, regarding escalation of care, Deprivation of Liberty Safeguards (DoLS), capacity and Mental Health Act (MHA) slightly decreased. Conversations regarding patient consent for data sharing were rarely documented. Conclusion Our intervention increased the proportion of documented patient discussions; however, it did highlight the need to improve the frequency of documented conversations surrounding escalation of care, DoLS, capacity and MHA. This has provided impetus for further improvement projects.

Neonatal intensive care unit occupancy rate and probability of discharge of very preterm infants.

To assess the association of NICU occupancy with probability of discharge and length of stay (LOS) among infants born <33 weeks gestational age (GA). Retrospective study of 3388 infants born 23-32 weeks GA, admitted to five Level 3/4 NICUs (2014-2018) and discharged alive. Standardized ratios of observed-to-expected number of discharges were calculated for each quintile of unit occupancy. Multivariable linear regression models were used to assess the association between occupancy and LOS. At the lowest unit occupancy quintiles (Q1 and Q2), infants were 12% and 11% less likely to be discharged compared to the expected number. At the highest unit occupancy quintile (Q5), infants were 20% more likely to be discharged. Highest occupancy (Q5) was also associated with a 4.7-day (95% CI 1.7, 7.7) reduction in LOS compared Q1. NICU occupancy was associated with likelihood of discharge and LOS among infants born <33 weeks GA.