Initial Intake Research Articles

0658 Is Evaluating for Dreams and Nightmares during Clinically Indicated Polysomnography Useful?

Abstract Introduction The incidence of nightmares and dreams during clinically indicated polysomnography (PSG) is rarely reported. We sought to (1) describe the incidence of nightmares and dreams during PSG, (2) PSG characteristics of nightmares and dreams, and (3) identify clinical correlates. Methods Ninety-three patients undergoing an initial clinically indicated PSG had a post-PSG and initial intake questionnaire reviewed. Questionnaires included Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI) and Nightmare Disorder Index (NDI), as well as a structured post-PSG dreams and nightmares questionnaire. Dreams were self-reported, and a nightmare was differentiated from a bad dream if the former caused a patient-reported awakening. Results Overall, 87.1% were Active Duty and 89.2% reported the presence or absence of dreams. In total, 50.5% (47) reported no dreams, 22.6% (21) reported a dream, 2.2% (2) a bad dream, and 14% (13) a nightmare with 12/13 reporting details of their nightmare. The mean total NDI differed significantly between groups (6 ± 5 vs. 7 ± 6 vs. 12 ± 0 vs. 11 ± 5, respectively) (p=0.029). The groups were not significantly different based on sex, age, BMI, diagnosis of depression, anxiety, PTSD, TBI, chronic pain, being prescribed a sleep aid or psychoactive medication, or their ESS and ISI values. PSG characteristics including REM percentage did not differ significantly between groups. Of those reporting a nightmare 75% (9) reported associated autonomic symptoms and 5 (41.7%) reported a trauma related nightmare (TRN). Of those with a TRN, one was related to combat, one sexual assault, two an accident, and one related to death. Two patients with TRN reported their nightmare was an accurate replay of the trauma, 2 reported a mix of replay/non-replay events, and one did not answer. Conclusion Despite rare reports of nightmare capture in sleep labs, our cohort uniquely demonstrated that at least half of first time PSG patients at a military sleep center experience a dream or nightmare during their PSG. Higher NDI scores may predict who is more likely to suffer from a bad dream or nightmare in the sleep lab. Assessing for the occurrence of dreams or nightmares during PSG is likely indicated. Support (if any)

Reducing mitochondrial ribosomal gene expression does not alter metabolic health or lifespan in mice

Maintaining mitochondrial function is critical to an improved healthspan and lifespan. Introducing mild stress by inhibiting mitochondrial translation invokes the mitochondrial unfolded protein response (UPRmt) and increases lifespan in several animal models. Notably, lower mitochondrial ribosomal protein (MRP) expression also correlates with increased lifespan in a reference population of mice. In this study, we tested whether partially reducing the gene expression of a critical MRP, Mrpl54, reduced mitochondrial DNA-encoded protein content, induced the UPRmt, and affected lifespan or metabolic health using germline heterozygous Mrpl54 mice. Despite reduced Mrpl54 expression in multiple organs and a reduction in mitochondrial-encoded protein expression in myoblasts, we identified few significant differences between male or female Mrpl54+/− and wild type mice in initial body composition, respiratory parameters, energy intake and expenditure, or ambulatory motion. We also observed no differences in glucose or insulin tolerance, treadmill endurance, cold tolerance, heart rate, or blood pressure. There were no differences in median life expectancy or maximum lifespan. Overall, we demonstrate that genetic manipulation of Mrpl54 expression reduces mitochondrial-encoded protein content but is not sufficient to improve healthspan in otherwise healthy and unstressed mice.

68 Titration of GLA supplementation is linearly related to incorporation of DGLA into equine red blood cells

The omega-6 fatty acid gamma-linolenic acid (GLA) has received considerable research attention in other species for its anti-inflammatory properties, largely attributed to the conversion of dietary GLA to dihomo-gamma-linolenic acid (DGLA). However, there is little to no published research on supplementing GLA to horses. The objective of this study was to determine how varied levels of supplemental GLA influence the equine blood fatty acid profile. Twenty Thoroughbred horses (9.9 ± 3.7 yr; 605 ± 58 kg BW; mean ± SD) were used in a longitudinal design for 6 mo including 3 mo of supplementation and 3 mo post-supplementation. Horses were stratified into 5 groups balanced primarily for age, BW, and initial grain intake and randomly assigned to one of 5 GLA oil treatments (n = 4): 0 (control), 1.9, 3.7, 7.3, or 9.7 g/d GLA top-dressed on similar low-starch commercial concentrates (1 to 5 kg/d). Fatty acid composition of plasma and red blood cells (RBCs) was measured every 28 d using gas chromatography at a commercial laboratory. Data were analyzed using linear regression and repeated measures ANOVA (GraphPad Prism). There was a strong positive linear relationship (R2 = 0.87; [% DGLA in RBC = 0.053(g/d of GLA intake) + 0.243]) between GLA intake and RBC DGLA incorporationafter 3 mo of supplementation, indicating horses can effectively convert GLA to DGLA in a dose-responsive manner. As GLA intake increased, more DGLA was incorporated into RBCs at a faster rate. Between baseline and 3 mo of supplementation, RBC DGLA did not change at 0 g/d GLA (0.26 to 0.23; P = 0.41) but increased 164% (0.28 to 0.74; P < 0.01) at 9.7 g/d GLA. At 1.9 g/d GLA, RBC DGLA did not differ (P > 0.05) from baseline until 3 mo of supplementation and returned after one month of washout. At 7.3 and 9.7 g/d GLA, RBC DGLA was different (P < 0.05) from baseline within one month of supplementation and remained elevated after 3 mo of washout. Results indicate that higher levels of supplementation respond faster, but take longer to peak and more time to wash out. More research is needed to determine if there is an upper limit to the dose response of GLA. Although an optimal equine blood fatty acid profile has not been delineated, these results provide novel data on the impact GLA supplementation has on the equine blood fatty acid profile.

161 Texas 4-H program initiates a tangible opportunity to help at-risk horses

Texas continues to have the highest number of horses at approximately 767,100, according to the American Horse Council (2017). This coupled with the ever-growing population of at-risk horses, sometimes referred to as “unwanted” horses, puts Texas in a unique position to develop initiatives to mitigate the abuse, neglect, and abandonment of horses. The grant-funded, Texas 4-H Homes for Horses program launched in 2021 to provide Texas 4-H youth the opportunity to actively help reduce the number of horses at-risk in Texas. 4-H youth were competitively selected to participate with an at-risk horse provided by a select group of Texas adoption partners with guidance of American Society for the Prevention of Cruelty to Animals (ASPCA) Right Horse Initiative. Before program start, participants completed a pre-survey and data was analyzed for 2021 and 2022 (n = 24) for descriptive statistics using the means and frequency procedures in SAS 9.4 (Cary, NC). Participants reported that 91% currently owned horses with an average ownership of 4.57 horses and average monthly cost of $276.25 per horse. Program participants were allotted a stipend of $1,000 from the grant to help cover project horse expenses for the duration of the program. Participants reported that the horse expense stipend had little to no influence on their decision to participate in the program (49.5%), whereas 12.5% reported it influenced them a great deal.Overall, 79.5% of the participants reported that they were somewhat to very likely to permanently adopt their project horse following the conclusion of the program, whereas 18.8% actually did adopt their horse at the conclusion of the program in 2021. Four horses were permanently adopted by their 4-H youth and 5 horses were adopted to new homes at the Texas State 4-H Horse Show program finale. Seven horses were returned to adoption partners where on average it took 22.8 d for them to be adopted into a new home, whereas according to the Equine Welfare Data Collective (2022), the average length of stay for horses at adoption facilities across the United States is significantly longer at 210 d. The Humane Society of North Texas (HSNT) reported the initial intake of a horse costs $426 and subsequent care costs $250–400 per horse per month. An annual savings of $44,000–70,400 was perceived by adoption partners by supplying horses for the program. The initiation of this program successfully connected 4-H youth with at-risk horses to demonstrate how youth can be actively involved in helping at-risk horses in Texas while simultaneously helping adoption agencies with the financial burden of intake and care of this population of horses.

Covid-19 Era in the Coastal Areas: The Cookies Formulation Gonad of Diadema setosum and its Impacts on Malnutrition During Infection

Infection with Salmonella typhi bacteria during the COVID-19 era has the potential to worsen malnutrition in children in low- and middle-income nations, particularly around the coast. Recent studies have demonstrated that one of the best strategies for preventing malnutrition is consuming local food sources from the sea, which are easy to acquire, inexpensive, and high in nutrients. In this study, 15 male mice were used as the test subjects. They were split into two groups: the intervention group and the control group, both before and after intraperitoneal injection of Salmonella typhi. The intervention group was given dosages of cookies containing Diadema setosum gonad (0.40 mg/kg of body weight), whereas the control group received only a natural diet. The blood samples were then analyzed to measure their hemoglobin levels using the Sahli haemometer method, and serum albumin concentrations were determined using the bromocresol green method. The results show that the treatment with Diadema setosum gonad cookies had a significant effect on the levels of albumin and hemoglobin (Hb), as well as the body weights of the intervened mice, with a statistically significant increase (p&lt;0.05). Conversely, BALB/c mice in the control group demonstrated a decrease in their initial food intakes, resulting in a significant reduction in body weight, albumin, and hemoglobin (Hb). This finding implies that the cookie formula with Diadema setosum gonad as the principal ingredient has potential benefits in lowering the incidence of malnutrition for children.

Change in Metabolomic Profile Associated with an Average Increase in Plain Water Intake of >+ 1 L/Day, Sustained Over 4 Weeks, in Healthy Young Men with Initial Total Water Intake Below 2 L/Day.

Cells adapt to chronic extracellular hypotonicity by altering metabolism. Corresponding effects of sustained hypotonic exposure at the whole-person level remain to be confirmed and characterized in clinical and population-based studies. This analysis aimed to 1) describe changes in urine and serum metabolomic profiles associated with four weeks of sustained > +1 L/d drinking water in healthy, normal weight, young men, 2) identify metabolic pathways potentially impacted by chronic hypotonicity, and 3) explore if effects of chronic hypotonicity differ by type of specimen and/or acute hydration condition. Untargeted metabolomic assays were completed for specimen stored from Week 1 and Week 6 of the Adapt Study for four men (20-25 years) who changed hydration classification during that period. Each week, first-morning urine was collected after overnight food and water restriction, and urine (t+60 min) and serum (t+90 min) were collected after a 750 mL bolus of drinking water. Metaboanalyst 5.0 was used to compare metabolomic profiles. In association with four weeks of > + 1 L/d drinking water, urine osmolality decreased below 800 mOsm/kg H2O and saliva osmolality decreased below 100 mOsm/kg H2O. Between Week 1 and Week 6, 325 of 562 metabolic features in serum changed by 2-fold or more relative to creatinine. Based on hypergeometric test p-value <0.05 or Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway impact factor >0.2, the sustained > + 1 L/d of drinking water was associated with concurrent changes in carbohydrate, protein, lipid, and micronutrient metabolism, a metabolomic pattern of carbohydrate oxidation via the tricarboxylic acid (TCA) cycle, instead of glycolysis to lactate, and a reduction of chronic disease risk factors in Week 6. Similar metabolic pathways appeared potentially impacted in urine, but the directions of impact differed by specimen type. In healthy, normal weight, young men with initial total water intake below 2 L/d, sustained > + 1 L/d drinking water was associated with profound changes in serum and urine metabolomic profile, which suggested normalization of an aestivation-like metabolic pattern and a switch away from a Warburg-like pattern. Further research is warranted to pursue whole-body effects of chronic hypotonicity that reflect cell-level effects and potential beneficial effects of drinking water on chronic disease risk.

Performance of growing rabbit bucks and does fed diets supplemented with brewers dried grains

The study was conducted to at the rabbitry unit of the National Animal Production Research Institute/Ahmadu Bello University, Shika-Zaria to evaluate the performance of growing rabbit bucks and does fed diets supplemented with brewers dried grain (BDG). Forty rabbits growing rabbits aged between 6 to 7 weeks of age, with initial average weight of 0.75Kg were randomly assigned to four dietary treatments (0%, 20%, 30% and 40% BDG) in a completely randomized design (CRD) with five rabbits in each treatment. The experimental diet and clean drinking water were supplied ad libtum during the experiment, which lasted for a period of 8 weeks. The following growth parameters were measured included, daily feed intake and weight changes, initial weight, final weight, total weight gain, average daily gain and feed conversion ratio. Data generated was subjected to statistical analysis of SAS. In growing rabbit bucks, initial weight, average daily feed intake, final weight and average daily gain showed no significant difference (P &gt; 0.05). Feed conversion ratio was significantly differences (P &lt; 0.05) with the control having the best feed efficiency while 20% level of inclusion had the least value. For the does, there were no significant differences (P&gt;0.05) in initial weight and average daily feed intake. There were significant differences (P&lt;0.05) in final weight, average daily gain and feed conversion ratio. Final weight and average daily gain had a similar pattern with the control (0%) and treatment 2 recording the highest and lowest values respectively. Feed conversion ratio had different pattern as treatments 2 (20%), 3 (30%) and 4 (40%) were significantly higher than the control. It can be concluded that, inclusion of BDG in the diet of growing rabbits have no effect on growth performance but if efficiently utilized.

The incidence of adding Gingko biloba and Curcumin extracts in drinking water on Body growth, hematological and immune statues of New Zealand White rabbit

This study was performed to investigate the effect of adding ginkgo biloba (GB) and curcumin extracts in rabbit drinking water, as growth promoter, serum biochemistry, antioxidant enzyme activities and immunoglobin statues. A total of 40 New Zealand White rabbit (NZW) at 5 weeks of age assigned to 4 treatments with four replicates. Gingko biloba (T2) and Curcumin extracts (T3) and their mix (T4) had no significantly differences among all treatments in initial weight, feed and water intake, also in body temperature. While, body weight and body weight gain had significantly (P≤0.05) increased in the all groups of water additive compared with control (T1). As well as FCR (feed conversion ratio) had significantly (P≤0.05) improved in the treatments T2, T3 and T4, compared with the control group T1. Otherwise, the heart rate (beat) was significantly (P≤0.01) decreased in the treatments respectively compared with the control T1. Quite good results were achieved that approve the curcumin and ginkgo biloba extract has a direct influence on the production and blood parameter, improve immunoglobins and antioxidant enzymes concentrations in blood serum.&#x0D; &#x0D;

Current parenteral nutrition practice and clinical outcomes of term and late preterm infants: A retrospective study

Limited studies have described parenteral nutrition (PN) practices and clinical outcomes in term and late preterm infants. The aim of this study was to describe the current practice of PN in term and late preterm infants and their short-term clinical outcomes. We conducted a retrospective study in a tertiary NICU between October 2018 and September 2019. Infants (gestation ≥34 weeks) admitted on the day of birth or the following day and received PN were included. We collected data on patient characteristics, daily nutrition, clinical and biochemical outcomes until discharge. A total of 124 infants [mean (SD) gestation: 38 (1.92) weeks] were included; 115 (93%) and 77 (77%) commenced on parenteral amino acids and lipids, respectively, by day 2 of admission. The mean parenteral amino acid and lipid intake on day 1 of admission was 1.0 (0.7) g/kg/day and 0.8 (0.6) g/kg/day respectively and increased to 1.5 (1.0) g/kg/day and 2.1 (0.7) g/kg/day by day 5, respectively. Eight (6.5%) infants accounted for 9 episodes of hospital-acquired infections. The mean z-scores for anthropometrics at discharge were significantly lower than at birth (Weight:-0.72 (1.13) vs - 0.04 (1.11); p<0.001; Head circumference:-0.14 (1.17) vs 0.34 (1.05); p<0.001; Length:-0.17 (1.69) vs 0.22 (1.34); p<0.001). A total of 28 (22.6%) and 16 (12.9%) infants had mild and moderate postnatal growth restriction (PNGR), respectively. None had severe PNGR. Thirteen infants (11%) experienced hypoglycaemia, whereas 53 (43%) experienced hyperglycaemia. The intakes of parenteral amino acids and lipids in term and late preterm infants were at the lower end of the currently recommended doses, especially in the first five days of admission. One third of the study population had mild to moderate PNGR. Randomised trials investigating the impact of initial PN intakes on clinical, growth and developmental outcomes are recommended.

Barriers to recovery for medical professionals: Assessing financial support through a survey of Physician Health Programs.

There is increasing focus on physician burnout, psychiatric problems, and substance use disorders. Costs of recovery for physicians enrolled in Physician Health Programs (PHPs) remain unexamined with little known regarding funding resources. We sought to elucidate perceived costs of recovery from impairing conditions and highlight resources for financial strain. This survey study was distributed by the Federation of State Physician Health Organizations via e-mail to 50 PHPs in 2021. Questions assessed perceptions of costs and ability to pay for recommended evaluation, treatment, and monitoring. Questions also assessed limitation of engagement due to financial concerns, and availability of financial resources. Complete responses were received from 40 of 50 eligible PHPs. The majority (78%) of responding PHPs assessed ability to pay at initial intake evaluation. There is notable financial strain on physicians, particularly those earliest in training, to pay for services. PHPs are vital to physicians, especially physicians-in-training, as "safe haven programs."Methods to financially assist through PHPs included fee deferrals, sliding scale fees, and fee forgiveness. Health insurance, medical schools, and hospitals were able to provide additional assistance. Because burnout, mental health, and substance use disorders are high stakes amongst physicians, it is critical that access toPHPs is available, destigmatized, and affordable.Our paper focuses specifically on the financial cost of recovery, the financial burden placed on PHP participants, a topic lacking in the literature, and highlights remedies and vulnerable populations.

Supplementation with calcium + vitamin D enhances the beneficial effect of weight loss on plasma lipid and lipoprotein concentrations

Background: Adequate calcium intake can have a favorable effect on some metabolic variables.Objective: The objective of the study was to determine the effects of daily calcium intake and of supplementation with calcium and vitamin D (calcium+D) during a weight-loss intervention on blood pressures, plasma lipid and lipoprotein concentrations, and glucose and insulin concentrations in low calcium consumers.Design: Healthy, overweight or obese women (n = 63) with a daily calcium intake of <800 mg/d were randomly assigned in a double-blind manner to 1 of 2 groups: the group consuming 2 tablets/d of a calcium + vitamin D supplement (600 mg elemental calcium and 200 IU vitamin D/tablet) or the group consuming placebo; both groups observed a 700 kcal/d energy restriction. These 63 women then completed a 15-wk weight-loss intervention.Results: Initial daily calcium intake was significantly correlated with plasma HDL cholesterol (r = 0.41, P < 0.001) and with 2-h postload glycemia (r = −0.29, P < 0.05) during an oral-glucose-tolerance test, independent of fat mass and waist circumference. After the 15-wk intervention, significantly greater decreases in total:LDL and LDL:HDL (P < 0.01 for both) and of LDL cholesterol (P < 0.05) were observed in the calcium+D group than in the placebo group. The differences in total:HDL and LDL:HDL were independent of changes in fat mass and in waist circumference. A tendency for more beneficial changes in HDL cholesterol, triacylglycerol, and total cholesterol was also observed in the calcium+D group (P = 0.08).Conclusion: Consumption of calcium+D during a weight-loss intervention enhanced the beneficial effect of body weight loss on the lipid and lipoprotein profile in overweight or obese women with usual low daily calcium intake.

Abstract P2-02-07: Patients’ selection of daily timing of oral intake of adjuvant hormonotherapy (HT) and everolimus (EVE) for high risk early breast cancer in the UCBG-UNIRAD phase III trial

Abstract Background: Everolimus (EVE) addition to adjuvant hormonotherapy (HT) for high-risk early breast cancer (BC) did not improve 3-year disease-free survival (DFS) compared with ET alone in the randomized UNIRAD trial (NCT01805271) (1). Most patients (pts) withdrew from EVE for adverse events nearly midway before the expected treatment duration of 2 years. The main EVE target involves m-TOR-induced S6 protein phosphorylation, which is controlled by the molecular circadian clock in mice and cells. Toward the analysis of possible circadian time-dependencies in EVE toxicities and efficacy, we first determine the actual distribution of the daily times chosen by the patients for both oral EVE and HT intakes. Patients and methods: The registered pts were asked to record the clock hours they chose for both HT and EVE or placebo (PLAC) intakes within four possible daily 6-h slots, i.e. from 06:00 to 11:59 (morning), 12:00 to 17:59 (midtime), 18:00 to 23:59 (evening), or 24:00 to 05:59, (night) in a daily diary throughout their participation in the trial. Modifications in times of drugs intake were reported. Comparisons between groups involved Kruskal-Wallis sum test and Pearson’s Chi-squared and Fisher’s exact tests. Results: Out of 1,278 randomized patients, 1063 (83,1 %) recorded the times of EVE or PLAC intakes, 852 recorded those for HT intakes. Only 10 pts reported night EVE/PLAC intakes and were not considered here. Of the 1053 evaluated pts; 549 pts took EVE/PLAC in the morning, 82 pts at midtime and 422 in the evening. As compared with evening intakes, morning or midtime intakes of EVE or PLAC were significantly associated with an older age, and post-menopausal status, whilst younger and premenopausal women preferentially chose evening intakes (p&amp;lt; 0.001 for both). Consistently, HT with aromatase inhibitors (AI) were mostly taken in the morning or at midtime, whereas tamoxifene (TAM) was mostly taken the evening (p = 0.001). Tumor size, lymph nodes involvement, histological grade, hormonal receptors status, and EVE initial dose were similarly distributed among the three time slots (Table 1). A similar distribution of oral intake times as in the whole timing study population was found according to age, menopausal status and HT type in the EVE arm (N=508 pts), and in the HT population (+/- EVE or PLAC) (N=852 pts). Initial oral timing intake was modified for EVE by 50 of 508 pts (10%) and for HT by 10 of 852 pts (1%). Conclusion: To the best of our knowledge, it is the first time that the patients’ spontaneous selection of daily times for oral intakes of a targeted agent (EVE) and HT is reported in a large series of early breast cancer pts. Age and menopausal status were important determinants of patient-selected daily timing intakes of both EVE and HT, as well as HT types. These findings will be carefully considered in the analyses of possible EVE and HT timing effects on adverse events and efficacy of the current adjuvant regimens. 1) Bachelot T et al, J Clin Oncol. 2022 May 23 Citation Format: Sylvie Giacchetti, Anne-Sophie Hamy, Thomas Bachelot, Jérôme Lemonnier, Fabrice Andre, David A. Cameron, Judith Bliss, Sylvie Chabaud, Anne-Claire Hardy-Bessard, Magali Lacroix-Triki, Jean-Luc Canon, Hervé R. Bonnefoi, Mario Campone, Paul Cottu, Florence Dalenc, Annabelle Ballesta, Francis Lévi, Enora Laas. Patients’ selection of daily timing of oral intake of adjuvant hormonotherapy (HT) and everolimus (EVE) for high risk early breast cancer in the UCBG-UNIRAD phase III trial. [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-02-07.

Examining the role of attention problems in motor stereotypy in children with autism spectrum disorder

BackgroundMotor Stereotypy has a similar presentation in individuals with and without autism. Attention dysfunction is common in those with motor stereotypy who do not have autism spectrum disorder (ASD). A possible link between attention dysfunction and motor stereotypy in ASD remains to be examined. We hypothesize a positive relationship between attention problems and motor stereotypy in individuals with ASD and that attention problems account for changes in stereotypy over time. MethodWe examined the relationship between attention problems and motor stereotypy concurrently and over time in a sample of youth with ASD from the Simons Simplex Collection (N = 2568). Caregiver reported measures including the Child Behavior Checklist, Repetitive Behavior Scale-Revised, and Social Responsiveness Scales were used to measure attention problems, motor stereotypy, and autistic traits, respectively. ResultsA hierarchical regression controlling for age, sex, intelligence quotient (IQ), and autistic traits indicated attention problems were significantly associated with motor stereotypy at Time 1 (participant’s initial date intake) for the full sample and at Time 2 (participant’s second data intake) for a follow-up subsample of youth (N = 233). The follow up sample is the subsample of participants with data from a second timepoint. Hierarchical regression with the follow-up sample controlling for age, sex, IQ, autistic traits, and motor stereotypy at Time 1 revealed that the motor stereotypy did not predict change in attention problems over time. ConclusionsFurther investigation into the relationship between attention dysfunction and motor stereotypy could provide insight into developmental challenges indicated by motor stereotypy.

β-sitosterol as an alternative to oxytetracycline: Effect on growth performance, feed intake and utilization efficiency and viscera macromorphometry of Cobb 500 broiler chickens

Antibiotics are used to fortify broiler chicken feeds as growth promoters. Chronic antibiotic use pollutes the environment and causes the development of antibiotic resistance. Natural alternatives that mimic the properties of antibiotics, without causing health and environmental challenges are required. β-sitosterol has antimicrobial, antioxidant, digestive and immune system modulating and growth stimulating activities. We evaluated its potential to replace oxytetracycline as a growth-promoter in broiler chicken feeds. Two hundred and forty, one-day-old Cobb 500 broiler chicks were randomly allocated to four diets where β-sitosterol replaced oxytetracycline at 0 mg/kg (control; fortified with 50 mg/kg oxytetracycline), 500 mg/kg, 1000 mg/kg and 1500 mg/kg (w/w) feed and fed for 6 weeks: 2 weeks for each growth phase. Each diet was replicated thrice with 20 chicks per replicate. Initial, weekly and terminal body mass (TBM) and daily feed intake (FI) were measured. Body mass gain (BMG), average daily gain (ADG) and feed conversion ratio were computed. Terminally, the chickens were fasted for 4 h then slaughtered and dressed. Gastrointestinal tract (GIT) and GIT accessory viscera masses and small and large intestine lengths were measured. Dietary fortification with β-sitosterol had similar effects (P > 0.05) to oxytetracycline on the chickens’ TBM, BMG, ADG, FI and utilisation efficiency and GIT organ macromorphometry. In conclusion, β-sitosterol can replace oxytetracycline in Cobb 500 broiler chicken feeds without compromising growth performance, feed intake and utilisation efficiency and GIT organ growth and development.

Comparison of COVID-19-Related Suicidal Ideation Prevalence in SMI and Non-SMI Psychiatric Populations

This study investigates differences in the prevalence of COVID-19-associated suicidal ideation in individuals with psychiatric diagnoses at opposite ends of the DSM diagnostic severity spectrum. These opposite poles were represented by Adjustment Disorder (AjD) at one end and disorders categorized as Serious Mental Illness (SMI) at the other. The study hypothesized that persons with SMI disorders would be more likely to report Covid-19-related suicidal ideation compared to individuals with non-SMI disorders. Methods: An observational, cross-sectional model was used to collect data from new client intake forms completed between April 2020 and December 2020. Participants were 24 male and 26 female U.S. citizens (mean age = 32) diagnosed with either SMI or Adjustment Disorder. COVID- related suicidal ideation was assessed by a licensed behavioral health professional during the initial 50-minute client intake interview. Clients were placed in one of two categories: ‘suicidal ideation reported’ or ‘suicidal ideation denied’. Results: A total of 5 (18.5%) of the 27 patients diagnosed with serious mental illness reported COVID-19-associated suicidal ideation compared to only one (4.3%) of the 23 patients with a diagnosis of Adjustment Disorder. Due to the small sample of patients with suicidal ideation, a Fisher's exact test was required in lieu of a chi-square test. The difference was not statistically significant (p = .199). Conclusion: The results of this current study are best considered inconclusive. The fact that persons in the SMI group were 4.3 times more likely to report suicidal ideation compared to persons in the Adjustment Disorder group, yet this difference did not meet statistical significance is discussed. An alternate explanation is offered that the sample size was too small for statistical significance to be accurately measured. The need for the study to be replicated using a larger sample size is discussed and recommended.

362. Association of Eosinophilia with Parasites in Rhode Island Refugees, 2015 - 2020

Abstract Background There are sparse data reporting the rates of potentially pathogenic parasites in asymptomatic, newly arrived refugees to the United States. Untreated parasitic infections can have significant health consequences including anemia, malnutrition, infertility, urinary tract malignancy, and death, among others. Eosinophilia may serve as a biomarker for certain parasites, but its reliability is debated. We hypothesized that detection of eosinophilia in refugees to Rhode Island would be useful for guiding management in this vulnerable population. Methods A retrospective chart review was performed on all adult and pediatric refugees who had their initial refugee intake clinic visit at Lifespan’s Center for Primary Care Refugee Clinic, Hasbro Children Hospital’s Refugee Clinic, or Medicine-Pediatrics Refugee Clinic, all in Rhode Island, from January 2015 to December 2020. Patients who had delayed intakes or were originally evaluated in other states were not eligible. Data were systematically collated in RedCap and descriptive statistics were performed. Results Charts of 955 refugees were reviewed retrospectively, of which 143 did not meet eligibility criteria and were excluded. Overall, 505 (62.2%) patients were from Africa, 242 (29.8%) from Asia, 32 (3.9%) from the Americas, 32 (3.9%) from Europe, and 1 (0.1%) from Australia. Among the 812 individuals included, 147 (18.1%) patients had eosinophil counts &amp;gt; 500/uL, of whom 113 (76.9%) had mild (450-1499/uL), 30 (20.4%) had moderate (1500-4999/uL), and 4 (2.7%) had severe eosinophilia (⪰ 5000/uL). The majority of patients with or without eosinophilia originated from Africa. Prevalence of symptoms (Table 1) ranged from 0% (bloody stools) to 17.6% (abdominal pain). Overall, &amp;gt; 50% of refugees tested positive for a parasite by various methods (Table 2). Serology did not distinguish between acute or past infection. One patient (0.7%) was diagnosed with Plasmodium falciparum malaria. Table 1.Symptoms at Initial Encounter Among Patients With Eosinophilia (n=68)Table 2.Lab Values Among Patients with Eosinophilia (n=147) Conclusion Eosinophilia was common in both adult and pediatric asymptomatic refugees in Rhode Island who had parasites detected by various tests. Therefore, we conclude that routine testing for eosinophilia may inform treatment of potentially dangerous parasites in the absence of symptoms. Disclosures All Authors: No reported disclosures.

Gamma Radioactivity Detection Limits and Associated Radionuclide Intakes Study in Artificial Human Urine Using Sodium-iodide and High-purity Germanium Detectors.

The performance of several gamma detectors was investigated for emergency urine bioassay screening of two radionuclides of concern: 131 I and 137 Cs. Unspiked artificial urine samples were measured for 10 min each on four different gamma detectors: 80% relative efficiency high-purity Ge detector in standard shielding, 102% low-background high-purity Ge detector equipped with top muon shield, 78% high-purity Ge well detector in standard shielding, and 4″ × 4″ NaI well detector in standard shielding. The measured gamma spectra were analyzed in two ways: (1) for the 364-keV peak region of 131 I and 662-keV peak region of 137 Cs and (2) for the total counts in the full energy spectrum (50-2,048 keV). The results were analyzed using the principles of signal detection theory according to the Currie's formalism extended by a complete uncertainty propagation. This enabled calculation of the detection capability in terms of detection limit (Bq L -1 ) of urine, the latter referred to as minimum detectable activity. The NaI well detector had the lowest minimum detectable activities for total spectra, whereas the high-purity Ge well detector had the lowest peak minimum detectable activity values. Minimum detectable inhalation and ingestion intakes from urine bioassay were calculated from the minimum detectable activity values for urine collection 1 d, 1 wk, and 1 mo past the initial intake. The calculated intakes were compared with annual limits on intake. The results are interpreted with respect to a large-scale radiological emergency response.

Dysphagia Evaluation in a Multidisciplinary VA Cognitive Care Clinic.

The VA Cognitive Care Clinic (CCC) provides comprehensive evaluation and longitudinal treatment for older Veterans with neurocognitive disorders and their caregivers through multidisciplinary care including geriatrics, palliative medicine, neuropsychology, and social work. Speech-language pathology (SLP) was recently incorporated into the CCC team in response to calls for more proactive approaches to diagnosis and management of dysphagia (swallowing dysfunction) in persons with dementia. While dysphagia is estimated to be highly prevalent in this population, prior work has been limited by inadequate dementia characterization. The purpose of this novel quality improvement project was to provide descriptive information regarding the occurrence of dysphagia in persons with dementia seen in CCC. CCC patients underwent comprehensive neuropsychological and geriatrics assessments that led to a multidisciplinary determination of dementia diagnosis and subtype. Validated dysphagia-specific clinical evaluation tools included the Eating Assessment Tool (EAT-10; dysphagia-specific patient-reported outcome measure), the 3-ounce water swallow test to assess swallowing safety (aspiration risk), and the Test of Masticating and Swallowing Solids (TOMASS) to assess swallowing efficiency. A REDCap database was constructed to track CCC evaluation results and patient-specific variables derived from the electronic health record. Descriptive statistics were calculated for dementia diagnosis, subtype, and dysphagia measures. 124 patients were seen in CCC between 2017 and 2021. Eighty-eight patients (73%) received a dementia diagnosis with the majority meeting criteria for Alzheimer's disease (53%) or mixed etiology (24%). Sixty-eight (55%) of these patients were evaluated by an SLP during their initial intake appointment. Twenty of 59 patients (39%) scored 3 or higher on the EAT-10, indicating concern for dysphagia. Twenty-six of 64 patients (41%) failed the 3-ounce water swallow test. Thirty-one of 62 patients (50%) demonstrated inefficient mastication based on length of total masticatory time on the TOMASS. Findings from this initial cohort indicate that approximately one-half of patients with dementia assessed by a SLP demonstrated clinical signs of swallowing safety or efficiency impairment. Patient report of dysphagia-related symptoms occurred at a significantly lower rate, supporting the need for SLP services in multidisciplinary memory and geriatrics clinics to facilitate early identification of dysphagia and avoid serious dysphagia-related consequences, including pneumonia and malnutrition.

Waco COVID Survey: A Community-Based SARS-CoV-2 Serological Surveillance Study in Central Texas.

In early-2020, the epidemiology of the SARS-CoV-2 virus was still in discovery and initial reports about the role of asymptomatic individuals were developing. The Waco COVID Survey was implemented in mid-2020 with targeted serological surveillance to assess relationships among risk factors and asymptomatic transmission in McLennan County, Texas, USA. Because large-scale random sampling of the population was not feasible, a targeted and repeated sampling of specific clustered groups of asymptomatic individuals was employed. This included four waves (initial intake [n = 495], two follow-ups separated by a month [n = 348; n = 287], and a final follow-up one year later [n = 313]) of sampling participants in different risk categories: (a) healthcare workers (e.g., physicians, nurses, etc.) and first responders, (b) essential service employees (e.g., convenience and grocery stores, restaurants focused on delivery and carry-out), (c) employees whose businesses began reopening on May 1 (e.g., dine-in restaurants, churches, etc.) including church attendees, and (d) individuals that practiced intensive isolation. The survey collected information on demographics, compliance with public health recommendations, satisfaction with government responses, health history, attitudes regarding the SARS-CoV-2 virus and COVID-19 disease, health behaviors, personality, stress, and general affect. Results illustrate pandemic fatigue over time, the influence of political leniency on opinions and behaviors, the importance of face coverings in preventing infection, and the positive impact of vaccination in the community. This project remains one of the largest longitudinal SARS-CoV-2 antibody seroprevalence surveys in the US, and details for successful implementation and community involvement are discussed.

The Entry-Into School Health History Intake: The Starting Point for Care Coordination.

Many students enter school with a previously diagnosed chronic health condition necessitating school nurse management during the school day. Common pediatric chronic health conditions include asthma, diabetes, seizure disorder, and severe allergy to name a few. In addition, students might present with a less common health condition or an injury or short-term illness requiring school nursing services. Identification of student health conditions originate from a variety of sources, chief among them being school and sport physicals. Yet, primary healthcare provider information may not be provided for all students and, when provided, may not contain a complete health history. Thus, school nurses should establish a consistent method of collecting an initial entry-into school health history intake and periodic updates for all students, along with developing a system to distinguish between parent and healthcare provider reporting of health conditions. This is no small task. The purpose of this article is to discuss principles surrounding identifying students with health conditions, along with providing a sample intake form developed in one state that is adaptable for both paper and electronic formatting collection of data.