Higher Intensity Scores Research Articles

Management of postpartum anoestrus in Vechur cows by hormonal methods

The study aimed to evaluate suitable hormonal treatment regimen for inducing oestrus in postpartum anoestrus Vechur cows and its reproductive outcome. The efficiency of Ovsynch and Ovsynch + progesterone protocols in 12 anoestrus cows was studied. Six anoestrus cows were kept as untreated control and they were observed for a period of 180 days postpartum. Both treatment protocols resulted in a complete oestrus induction response of 100 per cent. The interval from treatment to induced oestrus was significantly lower in the Ovsynch group (50.10 ± 1.44 h) than in the Ovsynch + progesterone (54.40 ± 0.48 h) group. In comparison to the control group, treatment group animals displayed a high intensity score for oestrus. The duration of oestrus in the Ovsynch group (26.41 ± 0.53 h) was significantly longer than the control (24.45 ± 0.46 h) group and the Ovsynch + progesterone group (24.13 ± 0.42 h). The overall conception rate for three consecutive AI in Ovsynch, Ovsynch + progesterone and control group were 66.67, 83.33 and 33.33 per cent, respectively. The calving to conception intervals were significantly (p<0.001) shorter in Ovsynch (118.33 ± 9.71 d) and Ovsynch + progesterone (106.67 ± 8.12 d) groups than the control (191.5 ± 5.36 d). It is concluded that hormonal treatment is effective in inducing postpartum oestrus and reducing the calving to conception interval in Vechur cows. Keywords: Ovsynch, postpartum anoestrus, progesterone, Vechur

Improved Tomato Breeding Lines Adapted to Organic Farming Systems Have Enhanced Flavor, Yield, and Disease Resistance

Most of the tomato (Solanum lycopersicum) varieties currently used in organic farming were bred for conventional farming, often characterized by high-input use. These varieties do not perform as well in low-input organic systems, generating the need to develop varieties that are adapted to organic management systems. This project focused on improving flavor, disease resistance, and yield, all identified as key traits by organic tomato farmers in the Upper Midwest, USA. Ten advanced tomato breeding lines and two check varieties were developed and evaluated for 16 traits in organic high tunnel systems in 2020 and 2021. The line CSDE-F6.47 averaged 6.32 kg/plant and obtained high flavor intensity and overall flavor scores (3.78 and 3.69 out of 5, respectively). The line JBDE-F5.31 was another outstanding line, with a yield of 5.18 kg/plant, with good flavor intensity (3.32) and overall flavor (2.92) scores. Broad-sense heritability of marketable weight per plant was high (0.91), and the genetic variance was also high, which shows the opportunity to continue to increase the marketable weight in lines with excellent flavor. A significant positive correlation was found between overall flavor and °Brix (0.56), and titratable acidity (0.70), indicating that both measurements can be good predictors of overall flavor. The most promising lines will be further evaluated on-farm to evaluate their potential as releasable varieties.

Evaluation of the Vascular Endothelial Growth Factor and Smooth Muscle Actin Expression With Microvessel Density and Morphometric Analysis of Endometrial Vessels in Patients With Abnormal Uterine Bleeding.

Abnormal uterine bleeding (AUB) that occurs in a structurally normal uterus with regular menstrual cycles and without other identifiable etiology is often caused by a primary endometrial disorder (AUB-E). Altered vascular morphological changes and expression of markers of angiogenesis have been implicated as an underlying cause in these cases. The study was conducted to investigate the expression of vascular endothelial growth factor (VEGF) and smooth muscle actin-alpha (SMA-α), and to perform microvessel density (MVD), andmorphometric evaluation of endometrial vessels in patients with AUB-E. Endometrial biopsies and hysterectomy specimens of 40 patients clinically diagnosed with AUB-E were included in the study with 40 age-matched controls. Immunohistochemistry (IHC) with VEGFandSMA-αwas performed, and the expression and staining pattern was recorded as the number of positive vessels per 10 high power fields and intensity scores. Morphometric analysis was performed on CD34 stained sections using Leica Application Suite, version 4.4.0 software (Leica Microsystems, Wetzlar, Germany). MVDwas calculated by the vascular hotspot method. A statistically significant increase in VEGF vessel count (p-value<0.001) and a decline in SMA-α expression (p-value=0.23) was seen in cases as compared to the control group.There was a statistically significant increase in microvessel caliber (p-value=0.01) and MVD (p-value <0.001) in cases as compared to controls. These findings support aberrant vascular proliferation and impaired vessel maturation, contributing to the pathology of AUB-E. Alterations in angiogenesis in these patients reveal potential therapeutic targets for AUB.

Pengembangan Video Pembelajaran Menggunakan Aplikasi CapCut Pada Mata Pelajaran Pendidikan Agama Islam Kelas 8 SMP/MTS Tentang Sujud

In the learning process, the existence of media is an absolute must. But until now, many educational institutions still need to maximize learning media. This study aimed to determine the level of product validity in the form of learning videos that the researchers had made. This research uses the Research and Development (R&amp;D) method and applies the 4D development model; define, design, development and dissemination. The validation test data concluded that: 1) the percentage obtained from material expert validation 1 was 87% with high-intensity score criteria. In comparison, the material expert validation test 2 was 78% and received high score criteria. 2) the percentage of the results of the media expert validation test 1 is 90.2%, with the criteria for a high-intensity score. In comparison, the media expert validation test 2 gets a percentage of 98%, with the criteria for a high-intensity score. Based on the results of the module and media validation tests, it can be concluded that the learning video media for prostration material for class 8 semester 2 is feasible to use

Effect of intramuscular fat content on the sensory characteristics and dynamic flavor attributes of Japanese black cattle beef.

The intramuscular fat (IMF) in beef affects its flavor intensity and attributes, which have a significant impact on palatability. We conducted a sensory evaluation by descriptive analysis, Temporal Check-All-That-Apply, and a chemical analysis of 40 ribeye steaks from Japanese Black cattle to determine the relationship among IMF% and sensory characteristics including dynamic flavor attributes. The increased IMF% of Japanese Black cattle beef had intensified sweet and grilled/roasted flavors and reduced off-flavor, whereas excessive IMF% resulted in a decrease in water-soluble precursors of volatile and taste compounds including free amino acid and reducing sugars and weakened the flavor intensities. Beef with IMF% of approximately 40% exhibited strong and long-lasting sweet and grilled/roasted flavors represented by butter- and roasted nut-like, respectively, and a low perception of off-flavors represented by gamey, bloody, and grassy. These flavor attributes may be responsible for its high flavor intensity and overall evaluation score, whereas an IMF% of >55% lowered these scores. The excessive IMF% of beef may induce the less palatable sensory characteristics.

434. Healthcare Personnel Interactive Pathogen Exposure Response System

Abstract Background Infectious disease exposure investigations in the hospital are labor-intensive for the infection prevention and control (IPC) team and vulnerable to healthcare personnel (HCP) recall bias. We developed an electronic health record (EHR) algorithm to identify and rank patient-HCP interactions based on the likelihood and intensity of exposure. Methods We compared conventional and EHR-based findings from seven exposure investigations conducted between November 1, 2020 and February 1, 2022 at The Johns Hopkins Hospital (JHH), a 1095 bed academic tertiary center in Baltimore, MD. Conventional exposure investigations were conducted for hospitalized patients who tested positive for SARS-CoV-2 while not in COVID-19 isolation precautions. IPC contacted department managers to identify and report potentially exposed HCPs to occupational health. The EHR-based method identified HCP-patient interactions based on clinical data such as documentation in the flowsheet, medication administration, etc. A score was calculated for each HCP based on the estimated duration and intensity of the contact. Genomic sequencing of available samples was performed to investigate transmission events. Results Overall, the EHR-based system identified 75% (59/79) of the HCPs identified by conventional exposure investigations and 100% of those who document in the EHR. In contrast, it was unable to identify any potentially exposed individuals who do not document in the EHR (Table 1). All patient-HCP COVID-19 transmissions identified by conventional investigation and confirmed through genomic sequencing were identified by the EHR-based system, and all had high-intensity scores (i.e., top quartile of the list of exposed individuals). Table 1.Comparison of Conventional and EHR Based COVID-19 Exposure Investigations Conclusion We found clinical EHR data was highly sensitive and specific in identifying potentially exposed HCPs compared with conventional exposure investigations. The inability to detect interactions with support staff or others who do not document in the EHR was a limitation and suggests that EHR data can augment but not replace conventional exposure investigations. The system’s speed, ease, and lower resource requirements make it a promising tool to more efficiently complete exposure investigations in healthcare settings. Disclosures Sara E. Cosgrove, MD, Basilea: Member of Infection Adjudication Committee.

The Role of Immediate Post-Procedural Cone-Beam Computed Tomography (CBCT) in Predicting the Early Radiologic Response of Hepatocellular Carcinoma (HCC) Nodules to Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE).

The purpose of this study was to evaluate the efficacy of unenhanced cone-beam computed tomography (CBCT) performed at the end of drug-eluting bead transarterial chemoembolization (DEB-TACE) in predicting HCC nodules’ early radiologic response to treatment, assessed using mRECIST criteria with a 30−60 day four-phase contrast-enhanced CT follow-up. Fifty-nine patients (81 lesions) subjected to DEB-TACE as exclusive treatment for HCC lesions (naive/relapse) between February 2020 and October 2021 were prospectively enrolled. In a post-interventional unenhanced CBCT procedure, two experienced radiologists evaluated for each lesion the overall intensity of the contrast media deposit, the homogeneity of the enhancement, and the presence of smooth and complete margins. The univariate analysis found that lesions with complete response (CR+) had a significantly higher incidence of clear and complete margins than CR− lesions (76.9% vs. 17.2%, p = 0.003) and a higher intensity score (67.3% vs. 27.6%, p = 0.0009). A Dmax <30 mm was significantly more common among CR+ than CR− lesions (92.3% vs. 69%, p = 0.01). These features were confirmed as significant predictors for CR+ by multivariate binary logistic regression. The homogeneity of the enhancement did not affect the DEB-TACE outcome. Post-interventional unenhanced CBCT is effective in predicting early radiological response to DEB-TACE, since the presence of an intense contrast media deposit with clear and complete margins in treated HCC lesions is associated with CR.

Association of Stathmin (Op18) with TNM Staging and Grading of Oral Squamous Cell Carcinoma and Its Role in Tumor Progression

The purpose of the study was to evaluate the expression of stathmin in different histological grades and tumor, node, metastasis (TNM) staging of Oral carcinoma and various grades of oral dysplasia. The study also aims at observing the stathmin expression with respect to lymph node metastasis. A total of 90 histopathologically confirmed tissue sections were acquired, of which 30 sections of oral dysplasia, 30 oral squamous cell carcinoma (OSCC) and 30 normal tissue sections were stained immunohistochemically with stathmin. The tissue sections, were categorized into different grades of oral dysplasia and OSCC based on histopathological examination. For estimation of stathmin expression, manual examination of 300 cells was done in a minimum of five different areas of tissue section and a mean proportion of positive-stained cells were determined. The statistical analysis of the results was done using ANOVA test. A statistically significant increase in mean staining scores of stathmin in OSCC group compared to dysplasia and control groups. A statistically significant difference was observed in different grades of dysplasia and OSCC groups. Stage III and stage IV OSCC tissue sections showed high intensity staining scores of stathmin expression. An increased expression of stathmin was detected in various grades of OSCC and also with respect to staging of oral cancer. Half the cases of OSCC with lymph node metastasis showed high intensity scores of stathmin. Based on the above facts, stathmin expression was indicated as a potential tool for predicting the outcome of oral cancer patients with lymph node metastasis and its expression was increased in the group with poor prognosis. Any damage/mutation to stathmin can result in defects in cell division resulting in aneuploidy and in turn cancers. In this study, the results showed that there is a differential expression of stathmin in the early and the advanced grades and different TNM stages of OSCC. A high expression of stathmin was observed in all the cases with lymph node metastasis. These observations prove that stathmin has an important role in the progression, tumorigenicity, and prognosis of the oral cancer.

Occludin and claudin-1 are potential prognostic biomarkers in patients with oral squamous cell carcinomas: An observational study

The objective of this study was to evaluate the expression of several cell membrane markers in oral squamous cell carcinomas (OSCC) and to examine their prognostic influence. We analyzed the immunohistochemical expression of claudin-1 (CLDN-1), claudin-4 (CLDN-4), claudin-5 (CLDN-5), claudin-7 (CLDN-7), occludin (OCLN), and E-cadherin (CDHE) in 60 patients with OSCC treated in a central hospital Center of Oporto. The prognostic significance of these biomarkers in cancer-specific survival and recurrence-free survival were evaluated using multivariate analysis. Claudin-1 was observed in the membrane of tumor cells in 51 cases (89.5%), CLDN-4 in 36 cases (63.2%), and CLDN-7 in 48 cases (80%). Claudin-5 was detected in the cytoplasm of tumor cells in 46 cases (78%) and OCLN in 40 cases (70.2%). In a multivariate analysis, the combined evaluation of OCLN and CLDN-1 revealed a significant and independent association with cancer-specific survival and recurrence-free survival. We found a low extent score for OCLN and a high intensity score for CLDN-1, presenting the hazard ratios of 15.48 (P=.014) and 9.446 (P=.012), respectively. The CLDN-1 and OCLN proteins could be involved in tumor progression of OSCC. Their combined deregulated expression showed an adverse effect on survival and therefore they could be regarded as important prognostic biomarkers in OSCC.

Rho Kinase Expression in Giant Cell Arteritis: Validating Phosphorylated Ezrin/Radixin/Moesin Intensity Score to Increase Sensitivity of Temporal Artery Biopsy.

Aberrant Rho-associated protein kinase (ROCK) activity is implicated in several vascular and immunologic disorders. We previously demonstrated increased ROCK activity in histopathologically negative temporal artery biopsies (TABs) in subjects with clinical giant cell arteritis (GCA) compared to those without GCA. This current study aimed to examine ROCK activity in a larger cohort of biopsy-negative GCA subjects and to validate the prior findings. Based on clinical data 6 months after TAB, subjects were categorized into 2 groups: biopsy-negative GCA and controls without GCA. Paraffin-embedded TABs were stained for phosphorylated ezrin/radixin/ moesin (pERM), a surrogate of ROCK activity, and scored by 2 pathologists blinded to clinical diagnosis using a previously derived scoring system measuring staining intensity in 3 areas of the vessel. Thirty-six subjects with biopsy-negative GCA and 43 controls were analyzed. The mean (SD) pERM intensity score in non-GCA subjects was 3.9 (1.4), compared to 5.0 (1.4) in those with GCA (P = 0.002). Using the predetermined cut-off of 4 to define high pERM intensity, subjects with GCA were significantly more likely to have a high pERM intensity score compared to non-GCA (odds ratio 3.67, 95% CI 1.19-11.36; P = 0.02. The sensitivity of high pERM intensity score for diagnosis of GCA in histologically negative TABs was 86% (95% CI 70-95). In this well-characterized cohort, those with biopsy-negative GCA had significantly higher pERM intensity scores compared to subjects without GCA. pERM staining has diagnostic significance in enhancing the sensitivity of TAB and may help to define the clinically important group of biopsy-negative GCA.

Validity of the alcohol purchase task with United States military personnel.

Alcohol use is common among military personnel. However, alcohol use and problems are challenging to measure because military personnel do not have similar levels of confidentiality as civilians and can face sanctions for reporting illegal behavior (e.g., underage drinking) or for drinking during prohibited times (e.g., during basic training). The current study aimed to determine if the use of the alcohol purchase task (APT), which has previously been associated with alcohol use and alcohol-related problems in civilian populations, is a valid measure of alcohol-related risk in the military when asking about alcohol consumption is less feasible. Participants were 26,231 Air Force airmen who completed surveys including questions about sensation seeking, alcohol expectancies, perception of peer drinking, intent to drink, and family history of alcohol misuse, which are known predictors of alcohol use, and the APT, from which demand indices of intensity and Omax were derived. Individuals who were single, male, White, and had a high school diploma/GED had higher intensity and Omax scores, and non-Hispanic individuals had higher intensity scores. Age was negatively correlated with intensity and Omax. Regressions were used to determine if intensity and Omax were associated with known predictors of alcohol use and risk. Intensity and Omax showed significant but small associations with all included predictors of alcohol consumption and alcohol risk. Effect sizes were larger for individuals ages 21+ compared to individuals under 21. Thus, this study provides initial support for the validity of the APT as an index of alcohol-related risk among military personnel. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

How to improve O-RADS MRI score for rating adnexal masses with cystic component?

To test the performance of the Ovarian-Adnexal Reporting Data System (O-RADS) MRI in characterizing adnexal masses with cystic components and to test new specific MRI features related to cystic components to improve the ability of the O-RADS MRI score to stratify lesions according to their risk of malignancy. The EURopean ADnexal study (EURAD) database was retrospectively queried to identify adnexal masses with a cystic component. One junior and 13 radiologists independently reviewed cases blinded to the pathological diagnosis. For each lesion, the size of the whole lesion, morphological appearance, number of loculi, presence of a thickened wall, thickened septae, signal intensity of the cystic components on T1-weighted/T2-weighted/diffusion weighted, mean value of the apparent diffusion coefficient, and O-RADS MRI score were reported. Univariate and multivariate logistic regression analysis was performed to determine significant features to predict malignancy. The final cohort consisted of 585 patients with 779 pelvic masses who underwent pelvic MRI to characterize an adnexal mass(es). Histology served as the standard of reference. The diagnostic performance of the O-RADS MRI score was 0.944, 95%CI [0.922-0.961]. Significant criteria associated with malignancy included an O-RADS MRI score ≥ 4, ADCmean of cystic component > 1.69, number of loculi > 3, lesion size > 75 mm, the presence of a thick wall, and a low T1-weighted, a high T2-weighted, and a low diffusion-weighted signal intensity of the cystic component. Multivariate analysis demonstrated that an O-RADS MRI score ≥ combined with an ADC mean of the cystic component > 1.69, size > 75 mm, and low diffusion-weighted signal of the cystic component significantly improved the diagnostic performance up to 0.958, 95%CI [0.938-0.973]. Cystic component analysis may improve the diagnosis performance of the O-RADS MRI score in adnexal cystic masses. • O-RADS MRI score combined with specific cystic features (area under the receiving operating curve, AUROC = 0.958) improves the diagnostic performance of the O-RADS MRI score (AUROC = 0.944) for predicting malignancy in this cohort. • Cystic features that improve the prediction of malignancy are ADC mean > 1.69 (OR = 7); number of loculi ≥ 3 (OR = 5.16); lesion size > 75 mm (OR = 4.40); the presence of a thick wall (OR = 3.59); a high T2-weighted signal intensity score 4 or 5 (OR = 3.30); a low T1-weighted signal intensity score 1, 2, or 3 (OR = 3.45); and a low diffusion-weighted signal intensity (OR = 2.12). • An adnexal lesion with a cystic component rated O-RADS MRI score 4 and an ADC value of the cystic component < 1.69 associated with a low diffusion-weighted signal, has virtually a 0% risk of malignancy.

Clinical Comorbidity Phenotype in Knee Osteoarthritis is Associated With Higher Intensity Scores

Knee osteoarthritis (OA) is a common osteoarticular disease. Its prevalence increases with age, as well as the coexistence of other chronic diseases. Recent research has revealed an association between OA and cardiovascular diseases. However, the association between knee OA and comorbidities has not been fully studied. Therefore, the purpose of this study was to investigate the association between knee OA and comorbidities. In this cross-sectional study, patients with knee OA were enrolled. Sociodemographic data, as well as comorbidities, were collected. Grading of knee OA was performed using the Kellgren-Lawrence (KL) grading system. The functional impact of knee OA was assessed by KOOS-Physical Function Shortform (KOOS-PS). This study assessed 104 patients with knee OA (10 men and 94 women). The mean age was 65.83±11.08 years. Mean VAS pain was 6.56±1.72. Mean KOOS-PS was 15.58±6.73. Up to 81 patients (77.9%) had severe knee OA, according to the KL grading system. Comorbidity was noted in 92 cases (88%). The most frequent comorbidities were obesity (62.5%), hypertension (61.5%), and dyslipidemia (43.3%). Comorbidities in knee OA were associated with age (P=0.04), axial deviation in the sagittal plane (P=0.01), neuropathic pain component (P=0.02), and VAS pain (P=0.04). Our study also showed a significant correlation between comorbidities and structural grading of knee OA (P=0.04). However, comorbidities were not correlated with the KOOS-PS score (P=0.06). The accumulation of comorbidities is significantly associated with higher intensity scores in knee OA. Physicians should additionally pay close attention to the prevention and treatment of comorbidities in the routine management of OA.

Maternal Antenatal Attachment Scale (MAAS) reference values at different stages of pregnancy and their possible associations with major obstetric and demographic characteristics

ABSTRACT The study was aimed to explore the values of maternal-fetal attachment (MFA) at different stages of pregnancy using Maternal Antenatal Attachment Scale (MAAS) with the construction of reference percentile curves and to examine possible associations between the measures of MFA and major demographic and obstetric characteristics. The study covered 530 pregnant women aged 18 through 50 years, gestational age 4 through 41 weeks. Reference percentile curves were constructed. No associations were found between gestational age and the values of the MAAS subscales. Primigravida had higher intensity and MAAS total scores; women having previous abortions had lower intensity and MAAS total scores; primipara had higher intensity score, and women with intended pregnancy had higher values on the quality, intensity and MAAS total scores. Early evaluation of MFA is appropriate for most pregnant women and may be useful indicator for early clinical and psychological intervention.

The association between the expression of PD-L1 and CMTM6 in undifferentiated pleomorphic sarcoma.

Undifferentiated pleomorphic sarcoma (UPS) is a sarcoma with a poor prognosis. A clinical trial, SARC028, revealed that treatment with anti-PD-1 drugs was effective against UPS. Studies have reported that UPS expresses PD-L1, sometimes strongly (≥ 50%). However, the mechanism of PD-L1 expression in UPS has remained unclear. CKLF-like MARVEL transmembrane domain containing 6 (CMTM6) was identified as a novel regulator of PD-L1 expression. The positive relationship between PD-L1 and CMTM6 has been reported in several studies. The aim of this study was thus to examine CMTM6 expression in UPS and evaluate the relationship between PD-L1 and CMTM6 in this disease. Fifty-one primary UPS samples were subjected to CMTM6 and PD-L1 immunostaining. CMTM6 expression was assessed using proportion and intensity scores. CMTM6 gene copy number was also evaluated using a real-time PCR-based copy number assay. We also analyzed the mRNA expression and copy number variation of PD-L1 and CMTM6 in The Cancer Genome Atlas (TCGA) data. TCGA data indicated that the mRNAs encoded by genes located around 3p22 were coexpressed with CMTM6 mRNA in UPS. Both proportion and intensity scores of CMTM6 positively correlated with strong PD-L1 expression (≥ 50%) (both p = 0.023). CMTM6 copy number gain increased CMTM6 expression. Patients with UPS with a high CMTM6 intensity score had a worse prognosis for overall survival. UPS showed variation in CMTM6 copy number and CMTM6 expression. CMTM6 expression was significantly correlated with PD-L1 expression, especially with strong PD-L1 expression.

Adults with Loeys-Dietz syndrome and vascular Ehlers-Danlos syndrome: a cross-sectional study of patient experiences with physical activity

Purpose To study patient experiences with physical activity among persons with Loeys-Dietz- or vascular Ehlers-Danlos syndrome. Materials and methods A postal questionnaire survey in 2018. Seventy adults with molecularly verified Loeys-Dietz syndrome types 1-4, or vascular Ehlers-Danlos syndrome recruited through a National Resource Centre for Rare Disorders in Norway. Results The response rate was 74%, (Loeys-Dietz n = 34, vascular Ehlers-Danlos n = 18), aged 18 to 68 years, 58% women. In total, 88.5% reported they had received advice regarding physical activity and most (77%) had modified their habits. Fifty percent had an appropriate- and 40% a low mean physical activity sum score. Another 10% had too high physical activity levels due to high intensity scores. Lower scores with the Fatigue Severity Scale (p = 0.033) and the anxiety subscale of the Hospital Anxiety and Depression Scale (p = 0.021), were associated with high physical activity levels. About a third reported unmet rehabilitation needs. Conclusion Many adults with Loeys-Dietz- or vascular Ehlers-Danlos syndrome may have a potential to reach more favorable physical activity levels by increasing the frequency and duration of activities. Future directions should include evaluation of effects of professional-led practical and safe physical activity sessions as well as customized multidisciplinary rehabilitation programs for these patient groups.

Concerns about Suicide among Asian Americans: The Need for Outreach?

Suicide was the ninth leading cause of death for Asian Americans in 2017. The growth of Asian American populations has led to more discussions about suicide prevention efforts. A 128-item needs assessment survey was administered at cultural events in 10 predominantly immigrant Asian communities. In five years, 1,840 respondents (61 percent response rate) filled out the survey anonymously to express their health and mental health concerns. This study aims to identify factors and help-seeking behaviors associated with having suicidal concerns among Asian Americans in various subgroups. Among the respondents, 1,314 rated the intensity of their concerns about suicide with an average of 0.74 (SD = 1.11) on a four-point rating scale in that 13.7 percent rated their concerns as severe. Taiwanese respondents expressed the highest intensity score (1.09) compared with other ethnic groups (from 0.29 to 1.04). A logistic regression analysis found that each unit of health concerns on a four-point rating scale significantly increases the likelihood of suicide concerns by 46 times among Asian Americans. Consistent with previous studies, immigrants were likely to share mental health problems with friends and physicians. Effective suicide prevention requires mental health awareness programming for the Asian American community.

HSR19-087: Intensity of Symptom Management After Palliative Care Referral Not Associated With Reduced Imaging Intensity for Cancer Patients During the End-of-Life Period

Purpose: For patients with advanced cancer, palliative care (PC) referral itself results in improved quality of life and lower total health care costs. While our earlier research suggests that PC referral alone does not appear to affect imaging utilization, the effect of the intensity of services for PC symptom management on utilization of imaging services is unknown. We sought to evaluate whether an association exists between the intensity of PC symptom management services and utilization of high-cost imaging at the end-of-life. Methods/Materials: Adult cancer patients who died between January 1, 2012–May 31, 2015 were identified. A PC symptom management intensity score was determined for each patient during the last year of life based upon the number of inpatient and outpatient PC service visits and the number of problems addressed within the 8 defined domains for palliative care. Frequency of utilization of nonemergent oncologic imaging was determined for the last 3 months and the last month of life. Using chi-square and Wilcoxon-rank sum tests, effects of low (&lt;20th percentile) and high (&gt;80th percentile) PC symptom management intensity score on the proportion of patients imaged and mean number of studies per patient (mean imaging intensity [MII]) were compared for the last 3 months and last month of life. Results: 3,772 decedents were included, with 3,523 (93.4%) never referred to PC and 249 (6.6%) referred to PC, largely before the last month of life (70.3%). Within the last 3 months and last month of life, the proportion of patients imaged was significantly greater (P&lt;.001) in patients with high PC symptom management intensity scores when compared to those with low PC symptom management intensity scores. There was no significant difference in the mean number of imaging studies received by either group in the last 1 month or 3 months of life. (P&gt;.05). Conclusions: The intensity of PC symptom management in end-of-life oncologic care was not associated with decreased use of nonemergent, high-cost cancer imaging in our cohort. This may suggest an opportunity for reduced high-cost imaging through further clarification of the goals of care with both patients and oncologists, although the role of imaging in the setting of PC during the end-of-life period warrants further study as well.

Association between PD-L1 expression and lymph node metastasis in cutaneous squamous cell carcinoma.

To clarify the relationship between programmed cell death ligand 1 (PD-L1) expression in cutaneous squamous cell carcinoma (cSCC) and clinicopathological variables. We examined PD-L1 expression in tumor cells (TCs) and tumor infiltrating immune cells (ICs) in 46 cases of cSCC by immunohistochemistry. In each case, we employed two methods-intensity and proportion scores-to evaluate PD-L1 expression in TCs. For the evaluation of PD-L1 expression in ICs, only the proportion score was used. Association between PD-L1 expression and clinicopathological variables was analyzed using Fisher's exact test. High intensity scores in TCs were observed in 18 of the 46 cases (39.1%) and low intensity scores were observed in 28 cases (60.9%). Applying the proportions, using cut-off values of ≥1% and 50%, positive scores in TCs were observed in 36 (78.3%) and 20 cases (43.5%), respectively. PD-L1-positive ICs were observed in 29 (63%) and seven cases (15.2%), using cut-off values of ≥1% and 10%, respectively. The high intensity scores in TCs correlated with lymph node metastasis (P=0.008) and female gender (P=0.017), although positive proportions in TCs or ICs were not significantly related to lymph node metastasis. A multivariate analysis showed that high intensity of PD-L1 expression in TCs was an independent risk factor for lymph node metastasis. The results suggested that high intensity of PD-L1 expression in TCs is associated with lymph node metastasis in cSCC.

Objectives of community policies and programs associated with more healthful dietary intakes among children: findings from the Healthy Communities Study.

Rational planning of community policies and programs (CPPs) to prevent obesity requires an understanding of CPP objectives associated with dietary behaviours. The objective of the study is to identify objectives of CPPs associated with healthful dietary behaviours. An observational study identified 4026 nutrition CPPs occurring in 130 communities in the prior 6years. Dietary intakes of fruits and vegetables, added sugar and sugar-sweetened beverages, among others, were reported among 5138 children 4-15years of age from the communities, using a Dietary Screener Questionnaire with children age 9 years and older (parent assisted) or parent proxies for younger children. CPPs were documented through key informant interviews and characterized by their intensity, count, and objectives including target dietary behaviour and food environment change strategy. Associations between dietary intakes and CPP objectives were assessed using hierarchical statistical models. CPPs with the highest intensity scores that targeted fast food or fat intake or provided smaller portions were associated with greater fruit and vegetable intake (0.21, 0.19, 0.23 cup equivalents/day respectively with p values <0.01, 0.04, 0.03). CPPs with the highest intensity scores that restricted the availability of less healthful foods were associated with lower child intakes of total added sugar (-1.08 tsp/day, p<0.01) and sugar from sugar-sweetened beverages (-1.63 tsp/day, p=0.04). Similar associations were observed between CPP count and dietary outcomes. No other significant associations were found between CPP target behaviours or environmental strategies and dietary intakes/behaviours. CPPs that targeted decreases in intakes of less healthful foods and/or aimed to modify the availability of less healthful foods and portions were associated with healthier child dietary behaviours.