Jonckheere-Terpstra Trend Test Research Articles

Prevalence and trends of Chlamydia trachomatis infection in female sex workers and men who have sex with men in China: a systematic review and meta-analysis

IntroductionChlamydia trachomatis infection can cause a significant disease burden in high-risk populations. This study aimed to assess the overall prevalence of C. trachomatis infection, and determine the long-term trends and geographic distribution of this infection among female sex workers (FSWs) and men who have sex with men (MSM) in China.MethodsThe PubMed, Web of Science, CNKI, Wanfang Data and VIP databases were searched from 1 January 1990 through 30 April 2023. Publications in which C. trachomatis infection was detected using nucleic acid amplification tests (NAATs) were included. The Q test and I2 statistics were used to assess the heterogeneity between studies. A random-effect model was used to estimate the pooled prevalence of C. trachomatis infection. Subgroup, meta-regression, and sensitivity analyses were performed to explore the sources of heterogeneity. Publication bias was evaluated using Egger’s test. Trend analysis of the prevalence was performed using the Jonckheere-Terpstra trend test method.ResultsSixty-one studies were eligible for inclusion (including 38 for FSWs and 23 for MSM). The pooled prevalence of C. trachomatis infection was 19.5% (95% CI: 16.4, 23.0) among FSWs and 12.7% (95% CI: 9.2, 17.7) in the rectum, 6.4% (95% CI: 5.3, 7.8) in the urethra and 1.3% (95% CI: 0.8, 2.1) in the oropharynx from MSM in China. The subgroup analyses showed that the sample size, study period, study region, specimen collection type, molecular diagnosis method, and recruitment site could explain some heterogeneity among studies of FSWs, and the publication language, study period, study region, molecular diagnosis method, and specimen collection anatomical site could explain some heterogeneity among studies of MSM. From 1998 to 2004, 2005 to 2009, 2010 to 2015, and 2016 to 2021, the pooled prevalence of C. trachomatis infection among FSWs were 30.3%, 19.9%, 21.4%, and 11.3%, respectively. For MSM, the pooled prevalence from 2003 to 2009, 2010 to 2015, and 2016 to 2022 were 7.8%, 4.7%, and 6.5%, respectively. However, no overall decline in the prevalence of C. trachomatis infection was observed among FSWs (z = -1.51, P = 0.13) or MSM (z = -0.71, P = 0.48) in China.ConclusionsThe prevalence of C. trachomatis infection was high in these two high-risk populations in China. The findings of this study provide evidence for the formulation of effective surveillance and screening strategies for the prevention and control of C. trachomatis infection among these two specific populations.

Shared comorbidity of depression, migraine, insomnia, and fibromyalgia in a population-based sample

BackgroundDepression, migraine, insomnia, and fibromyalgia are reportedly comorbidities. Nevertheless, no study has evaluated the comorbidity of all four of these disorders. This study aimed to investigate the comorbidity of these four disorders. MethodsCross-sectional analyses were performed using data of the Circannual Change in Headache and Sleep study, an online nationwide population-based survey. Validated questionnaires were used to diagnose the disorders and measure quality of life. The change of clinical characteristics by addition of any comorbidity was analyzed using the Jonckheere–Terpstra trend test. ResultsThe prevalence rates of depression, migraine, insomnia, and fibromyalgia were 7.2 %, 5.6 %, 13.3 %, and 5.8 %, respectively. Among the 3030 included participants, 494 (16.3 %), 164 (5.4 %), 40 (1.3 %), and 6 (0.2 %) had one, two, three, and four of these conditions, respectively. The number of headache days per 30 days (Jonckheere–Terpstra trend test, p = 0.011) and migraine-related disability (migraine disability assessment score, p = 0.021) increased with an increase in the number of comorbidities but not with the intensity of headache (visual analog scale, p = 0.225) among participants with migraine. The severity of insomnia (Insomnia Severity Index, p < 0.001) and fibromyalgia (fibromyalgia severity score, p = 0.002) increased with additional comorbidities; however, depression (Patient Health Questionnaire-9, p = 0.384) did not show such an increase. LimitationsThe diagnoses of conditions were based on self-reported questionnaires. ConclusionsThe findings confirmed significant comorbidity between depression, migraine, insomnia, and fibromyalgia. Health professionals should be aware of the probable comorbidity of depression, migraine, insomnia, and fibromyalgia when caring for individuals with any of these four disorders.

Comparative estrogen exposure from compounded transdermal estradiol creams and Food and Drug Administration-approved transdermal estradiol gels and patches.

The aim of this study was to evaluate the amount of estrogen exposure associated with the use of compounded transdermal estradiol (E2) creams and compare it with estrogen exposure associated with the use of Food and Drug Administration (FDA)-approved transdermal E2 patches and gels. This was a retrospective cohort study that used clinical laboratory data collected from January 1, 2016, to December 31, 2019. Participants were first divided into three groups: postmenopausal women on no menopausal hormone therapy (n = 8,720); postmenopausal women using either a transdermal E2 patch, gel, or cream (n = 1,062); and premenopausal women on no hormonal therapy (n = 16,308). The postmenopausal menopausal hormone therapy group was further subdivided by formulation (patch [n = 777], gel [n = 132], or cream [n = 153]) and dose range (low, mid, or high). The Jonckheere-Terpstra trend test was used to determine if there was a dose-dependent trend in urinary E2 with increasing dose of compounded E2 cream (dose categories for E2 cream subanalysis, <0.5 mg [n = 49], ≥0.5-≤1.0 mg [n = 50], ≥1.0-≤1.5 mg [n = 58], and >1.5-≤3.0 mg [n = 46]). Urinary E2 and other characteristics were compared across formulations (within each dose range) using Kruskal-Wallis one-way analysis of variance. A dose-dependent, ordered trend existed for urinary E2 with increasing doses of compounded E2 cream (urinary E2 medians [ng/mg-Cr], 0.80 for <0.5 mg, 0.73 for ≥0.5-≤1.0 mg, 1.39 for ≥1.0-≤1.5 mg, and 1.74 for >1.5-≤3.0 mg; Jonckheere-Terpstra trend test, P < 0.001). Significant differences in urinary E2 concentrations were observed in all three dose ranges (Kruskal-Wallis one-way analysis of variance, P = 0.013 for low dose, P < 0.001 for mid dose, P = 0.009 for high dose). Comparison of E2 concentrations of compounded creams to E2 concentrations obtained with similar doses of FDA-approved patches and gels showed that the creams had significantly lower values than the patches and gels. Estrogen exposure from compounded transdermal E2 creams increases in a dose-dependent manner; however, the amount of estrogen exposure associated with compounded creams is significantly lower than estrogen exposure associated with FDA-approved transdermal E2 patches and gels. Clinicians should be aware of the direction and magnitude of these potential differences in estrogen exposure when encountering women who have either previously used or are currently using compounded E2 creams.

Comprehensive assessment of cortisol and cortisol metabolites provides insight into the complex relationship between HPA axis function and BMI

Aims/objectivesAlthough considerable effort, both experimental and theoretical, has been directed towards understanding the relationship between the HPA axis and weight regulation, no true consensus exists in the literature as to the nature of the relationship. The aim of this study was to explore potential correlations between BMI and measures of cortisol and cortisol metabolites using dried urine and saliva sampling in a large sample of individuals with BMIs ranging from underweight to obese. Materials and methodsA cohort of patients with data available from urinary and/or salivary measures of cortisol and cortisol metabolites who met inclusion criteria was extracted from the database of a commercial clinical laboratory. Pearson correlation coefficients were used to determine associations between variables; Student's t-test and one-way ANOVA were used to examine differences between groups, and the Jonckheere-Terpstra trend test was used to assess for trends by BMI category. A multivariable linear regression model was created to determine which variables explained the largest amounts of variance in BMI. ResultsA significant correlation was observed between the urinary cortisol metabolites and BMI (P < 0.0001). In addition, cortisol metabolites were associated with changes in BMI over time. No significant correlation was observed between urinary free cortisol and BMI, and correlations observed between BMI and other variables, with the exception of age, were either weak or not statistically significant. ConclusionsThe data presented in this study suggest that cortisol metabolism is a key component of weight regulation and that cortisol metabolite concentrations may potentially serve as informative biomarkers to characterize the relationship between the HPA axis and changes in BMI. The implications of this affect both clinical practice and the research and development of both prevention and treatment strategies aimed at either decreasing or increasing BMI.

Clinical impact of postoperative malnutrition after pancreaticoduodenectomy: prediction based on estimated functional remnant pancreatic volume, prognostic nutritional index, and body mass index

BackgroundThe present study aimed to evaluate the association between estimated functional remnant pancreatic volume (eFRPV) and postoperative malnutrition after pancreaticoduodenectomy (PD). MethodsThe medical records of 131 patients who underwent PD and preoperative computed tomography were retrospectively reviewed. Onodera’s prognostic nutritional index (PNI) was assessed 6-months after PD. Patients with PNI values of at least 45 were included in the non-malnutrition group, while those with values <45 and <40 were included in the mild and severe malnutrition groups, respectively. Associations between eFRPV and postoperative nutritional status were evaluated to identify factors predictive of severe malnutrition after PD. ResultsFifty-three patients (40%) were included in the non-malnutrition group, while 38 (29%) and 40 (31%) were included in the mild and severe malnutrition groups, respectively. Overall survival was significantly shorter in the severe malnutrition group (p < 0.001). The eFRPV was significantly lower in the severe malnutrition group (p = 0.003; Jonckheere–Terpstra trend test, p < 0.001). In the multivariate analysis, eFRPV ≤55.2 mL·HU (odds ratio [OR] = 5.20; p = 0.004), preoperative PNI ≤41.9 (OR = 6.37; p = 0.010), and body mass index ≤19.1 kg/m2 (OR = 3.43; p = 0.031) were independent predictors of severe malnutrition after PD. ConclusionThe current results indicate that eFRPV may predict low PNI values after PD.

MP43-04 EFFECTS OF AGE ON TESTICULAR FUNCTION AND THE SPERM RETRIEVAL RATE IN MEN WITH NONOBSTRUCTIVE AZOOSPERMIA

You have accessJournal of UrologyCME1 Apr 2023MP43-04 EFFECTS OF AGE ON TESTICULAR FUNCTION AND THE SPERM RETRIEVAL RATE IN MEN WITH NONOBSTRUCTIVE AZOOSPERMIA Shoichiro Iwatsuki, Yukihiro Umemoto, Takumi Kito, Tomoki Takeda, Satoshi Nozaki, and Takahiro Yasui Shoichiro IwatsukiShoichiro Iwatsuki More articles by this author , Yukihiro UmemotoYukihiro Umemoto More articles by this author , Takumi KitoTakumi Kito More articles by this author , Tomoki TakedaTomoki Takeda More articles by this author , Satoshi NozakiSatoshi Nozaki More articles by this author , and Takahiro YasuiTakahiro Yasui More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003289.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We previously reported an increase in the age of men with nonobstructive azoospermia (NOA) (AUA Annual Meeting 2020). It is important to determine age-induced effects on testicular function in men with NOA. We investigated age-induced changes in testicular endocrine function and the sperm retrieval rate (SRR) during microdissection testicular sperm extraction in men with NOA. METHODS: We investigated 323 men with idiopathic NOA. Patients were categorized into the following age-based groups: 20 s (20–30 years, n=64), 30 s (30–40 years, n=201), and >40 s (>40 years, n=58). We retrospectively recorded testicular volume, serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (TT), and anti-Mullerian hormone (AMH) levels, and SRRs. RESULTS: Testicular volumes in groups 20 s, 30 s, and >40 s were 9.5±4.3 vs. 9.1±4.0 vs. 7.9±3.9 mL, p<0.05 (Jonckheere-Terpstra trend test). Although we observed no intergroup differences in serum LH and TT levels, FSH levels significantly increased with age (22.4±13.3 vs. 26.9±13.2 vs. 26.8±15.3 mIU/mL, p<0.05) as did serum AMH levels (4.4±4.3 vs. 7.9±6.3 vs. 9.2±7.0 ng/mL, p<0.01). SRRs in the 20 s, 30 s, and 40 s groups were 12.5 vs. 28.4 vs. 36.2%, p<0.05 (Cochran-Armitage trend test). CONCLUSIONS: We observed age-induced testicular atrophy and increased serum FSH and AMH levels, which highlight age-induced testicular function decline in men with NOA and suggest that NOA may be progressive despite favorable SRRs in older men. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e602 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shoichiro Iwatsuki More articles by this author Yukihiro Umemoto More articles by this author Takumi Kito More articles by this author Tomoki Takeda More articles by this author Satoshi Nozaki More articles by this author Takahiro Yasui More articles by this author Expand All Advertisement PDF downloadLoading ...

A nonparametric alternative to the Cochran-Armitage trend test in genetic case-control association studies: The Jonckheere-Terpstra trend test.

Identifications of novel genetic signals conferring susceptibility to human complex diseases is pivotal to the disease diagnosis, prevention, and treatment. Genetic association study is a powerful tool to discover candidate genetic signals that contribute to diseases, through statistical tests for correlation between the disease status and genetic variations in study samples. In such studies with a case-control design, a standard practice is to perform the Cochran-Armitage (CA) trend test under an additive genetic model, which suffers from power loss when the model assumption is wrong. The Jonckheere-Terpstra (JT) trend test is an alternative method to evaluate association in a nonparametric way. This study compares the power of the JT trend test and the CA trend test in various scenarios, including different sample sizes (200-2000), minor allele frequencies (0.05-0.4), and underlying modes of inheritance (dominant genetic model to recessive genetic model). By simulation and real data analysis, it is shown that in general the JT trend test has higher, similar, and lower power than the CA trend test when the underlying mode of inheritance is dominant, additive, and recessive, respectively; when the sample size is small and the minor allele frequency is low, the JT trend test outperforms the CA trend test across the spectrum of genetic models. In sum, the JT trend test is a valuable alternative to the CA trend test under certain circumstances with higher statistical power, which could lead to better detection of genetic signals to human diseases and finer dissection of their genetic architecture.

PS-C35-6: NATIONWIDE TREND ANALYSIS OF ADDING SALT TO MEALS IN JAPAN: COOKPAD DATA, 2010–2014

Objective: Numerous studies have revealed that dietary salt intake is associated with blood pressure and mortality. Adding salt to food as a seasoning is deeply rooted in Japanese culture, which results in that the amount of salt in the diet in Japan remains high. Cookpad is one of the popular cooking-recipe sharing websites globally, where the amount of seasonings can be quantitatively extracted. This epidemiological study aimed to investigate a nationwide trend of adding salt to meals using real-world data in Japan. Design and method: This is a large-scale retrospective study using Cookpad data from January 2010 to December 2014, provided by Informatics Research Data Repository, National Institute of Informatics. The amount of salt added as the seasoning was calculated in each recipe. The “Salt Seasoning Rate” was defined as the percentage of recipes that contained salt as an ingredient out of all recipes. We also expressed the “Low-sodium Ingredient Rate” as the percentage of all recipes that contains low sodium food or ingredient. Additionally, the salt added per person per meal was used as “Salt Seasoning Amount” to quantify the amount of salt added as a seasoning. Year-to-year differences in salt seasoning rate and the amount of salt seasoning per person per meal from 2010 to 2014 were analyzed using the Cochrane-Armitage test for percentage trends and the Jonckheere-Terpstra trend test for salt amount. Results: Overall, 1,119,555 recipes were identified from January 2010 to December 2014 and stratified by the year of publication. A total of 494,216 recipes (44.1%) containing salt as an ingredient were extracted. The Salt Seasoning Rate trended upward from 85,466/219,549 (38.9%) in 2010 to 74,950/212,162 (35.3%) in 2014 (p-trend &lt; .001). The Low-sodium Seasoning Rate showed a statistically higher trend from 0.07% (144/219,549) in 2010 to 0.18% (375/212,162) in 2014 (p-trend &lt; .001). Furthermore, the Salt Seasoning Amount showed a gradual downward trend, from 0.86 g in 2010 to 0.81 g in 2014 (p-trend &lt; .01). Conclusions: This study showed that the frequency and amount of adding salt to meals as seasonings had decreased gradually, and that of using low sodium ingredients has increased, which could reflect the increasing trend of a low-sodium diet and low-sodium food taking behavior.

Current Trends in Pancreatoduodenectomy: A NSQIP Study

Introduction: Pancreaticoduodenectomy (PD) remains one of the most challenging and complex surgical procedures, with high morbidity rates, prolonged hospital length of stay (LOS), and high resource use. With continued evolution in treatment and peri-operative care plans, this study aimed to evaluate trends in preoperative and operative factors and postoperative surgical outcomes after PD over a 7-year period (2014-2020). Methods: The American College of Surgeons NSQIP pancreas-targeted database was queried to identify patients with pancreatic malignancy who underwent PD from 2014 to 2020. Trends in patient demographics, operative factors, and postoperative outcomes were computed and analyzed using the Jonckheere-Terpstra trend test. Results: A total of 13,933 pancreatic cancer patients who underwent PD were included. From 2014 to 2020, patients older than 65 years increased from 56.0% to 60.6%, non-White patients increased by 2.54% (mainly in Asian patients), and the rate of neoadjuvant chemotherapy increased by 26.6%(p < 0.001). Significant trends in operative factors include an increase in minimally invasive surgery (MIS) approach from 6.4% to 9.4% (p < 0.001) and vascular resection from 22.1% to 26.3% (p < 0.001). Postoperative early discharge (<5 days) increased from 10.4% to 24.0% (p < 0.001), while the rates of pancreatic fistula and complication of any type decreased from 12.7% to 6.9% and 40.9% to 35.7% respectively (p < 0.001). Conclusion: Over this recent 7-year period evaluated time, significant changes have occurred in demographics, operative factors, and outcomes of patients undergoing PD for pancreatic cancer. Understanding the evolving nature of PD conduct and outcome is relevant to comprehending this population’s needs, characteristics, and perioperative planning.

Predicting relapse from the time to remission during the acute treatment of depression: A re-analysis of the STAR*D data

BackgroundPredicting relapse during maintenance treatment for depression is challenging. The objective of this analysis was to investigate the association between the time taken to achieve remission in the acute phase, and the subsequent relapse rate or time to relapse using the Sequenced Treatment Alternatives to Relieve Depression dataset. MethodData of 1296 outpatients with nonpsychotic depression who entered a 12-month naturalistic follow-up period after achieving remission with citalopram for up to 14 weeks were analyzed. One-way analysis of variance and the Jonckheere-Terpstra trend test were performed to compare the relapse rates and days to relapse during the follow-up period among those who achieved remission at weeks 2, 4, 6, 9, 12, and 14. Remission and relapse were defined as scores of ≤5 and ≥11, respectively, on the 16-Item Quick Inventory of Depressive Symptomatology and Self-Report. ResultsThe relapse rates were significantly different among those who achieved remission each week (F(5, 1087) = 4.995, p < 0.001). The lowest and highest relapse rates were observed in those who achieved remission at weeks 4 (25.7 %) and 12 (42.4 %), respectively, with a significant difference (p = 0.006). There was also a significant negative trend between the weeks taken to achieve remission and the days to relapse (z = −6.13, p < 0.001). ConclusionsPatients with depression who show a faster response to antidepressant treatment are more likely to maintain remission in the long term. This finding suggests that, to prevent relapse, close attention should be paid to patients who require a relatively long time to achieve remission.

Palliative care journal publications by country as a metric for palliative care development level

ObjectiveThere is a growing interest in developing a scientific research metric to assess the level of palliative care (PC) development in countries. This study assesses a metric based on publishing...

The predictive value of Thromboelastography (TEG) parameters in vascular complications in patients with type 2 diabetes mellitus

AimsThe purpose of this research was to explore the association of TEG parameters (Reaction time, R; Clot kinetics, K; Alpha angle, α-angle; Maximum amplitude, MA) with vascular complications of type 2 diabetes mellitus (T2DM), and assess whether TEG parameters could predict T2DM patients with vascular complications. MethodsA total of 68 healthy controls (HC), 57 T2DM patients without vascular complications (NC), 18 T2DM patients with only microvascular complications (MIC), 196 T2DM patients with only macrovascular complications (MAC), and 94 T2DM patients with both microvascular and macrovascular complications (MIC+MAC) were recruited in this study. Participants' clinical information and TEG parameters were recorded. TEG parameters were analyzed by the Jonckheere-Terpstra trend test, assuming the vascular complication was progressing from HC → NC → MIC → MIC+MAC or HC → NC → MAC → MIC+MAC. Receiver operating characteristic (ROC) was performed to explore the diagnostic accuracy of TEG parameters in T2DM with vascular complications. ResultsShorter TEGK, higher TEG-α-angle, and higher TEG-MA were found in T2DM patients with both microvascular and macrovascular complications (MIC+MAC) group compared with healthy controls (HC) group and T2DM patients without vascular complications (NC) group (P < 0.05). Trend analysis showed that TEG-R/K decreased, but TEG-α-angle/MA increased gradually as the vascular complication progressed (P < 0.001). With stratification of urine microalbumin/creatinine ratio (UACR), diabetic nephropathy with macroalbuminuria (grade A3) behaves shorter TEGK, higher TEG-α-angle/MA compared with normal to mildly increased albuminuria (grade A1) and microalbuminuria (grade A2) (P < 0.05). ROC curves implied that TEGK, TEG-α-angle, and TEG-MA have moderate diagnostic values in T2DM without vascular complications (K-AUC: 0.780, α-angle-AUC: 0.773, and MA-AUC: 0.740) as well as T2DM with both microvascular and macrovascular complications (K-AUC: 0.778, α-angle-AUC: 0.757, and MA-AUC: 0.800). ConclusionTEG parameters are associated with the progression of vascular complications in T2DM, and it could be a diagnostic indicator for T2DM without vascular complications or with advanced vascular complications.

Abstract 5703: Quantification of DNA methylation for carcinogenic risk estimation in patients with non-alcoholic steatohepatitis

Abstract Background: In recent years, non-alcoholic steatohepatitis (NASH) has become the main cause of hepatocellular carcinoma (HCC). As a means of improving the treatment of NASH-related HCCs based on early detection, this study investigated the feasibility of carcinogenic risk estimation in patients with NASH. Results: Normal liver tissue (NLT), non-cancerous liver tissue (N) showing histological findings compatible with non-alcoholic fatty liver (NAFL) from patients without HCC (NAFL-O), N showing NASH from patients without HCC (NASH-O), N showing NAFL from patients with HCC (NAFL-W), N showing NASH from patients with HCC (NASH-W) and NASH-related HCC (T) were analyzed. An initial cohort of 171 tissue samples and a validation cohort of 55 tissue samples (226 samples in total) were used. Genome-wide DNA methylation screening using the Infinium HumanMethylation450 BeadChip and DNA methylation quantification using high-performance liquid chromatography (HPLC) with a newly developed anion-exchange column were performed. Based on the Infinium assay, 4,050 CpG sites showed significant alterations of DNA methylation in 22 NASH-W samples relative to 36 NLT samples in the initial cohort, indicating that DNA methylation alterations had occurred in the NASH-W samples. On 3,234 of the 4,050 CpG sites, DNA methylation alterations in NASH-W samples relative to NLT samples were inherited by or strengthened in 22 T samples (Jonckheere-Terpstra trend test). Among the 3,234 CpG sites, receiver operating characteristic curve analysis identified 415 CpG sites discriminating NASH-W from NLT samples with area under the curve values of more than 0.95. Among the 415 CpG sites, we focused on 21 CpG sites showing more than 85% specificity, even for discrimination of NASH-W from 91 NASH-O samples. The DNA methylation status of these 21 CpG sites was able to predict the coincidence of HCC independently from histopathological findings such as ballooning and fibrosis stage (Brunt classification). The methylation status of 5 candidate marker CpG sites was assessed using a HPLC-based system, which will be easily introduced into clinical laboratories, and for 3 of them sufficient sensitivity and specificity was successfully validated in the validation cohort. By combining these 3 CpG sites including the ZC3H3 gene, of which expression alternation may affect the post-transcriptional regulation of various tumor-related genes, 10 NAFL-W and 11 NASH-W samples from which HCCs had already arisen were confirmed to show carcinogenic risk with 95% sensitivity in the validation cohort. Conclusions: After a further prospective validation study using a larger cohort, carcinogenic risk estimation in liver biopsy specimens of patients with NASH may become clinically applicable using this HPLC-based system for quantification of DNA methylation. Citation Format: Junko Kuramoto, Eri Arai, Mao Fujimoto, Ying Tian, Yuriko Yamada, Takuya Yotani, Satomi Makiuchi, Noboru Tsuda, Hidenori Ojima, Moto Fukai, Yosuke Seki, Kazunori Kasama, Nobuaki Funahashi, Haruhide Udagawa, Takao Nammo, Kazuki Yasuda, Akinobu Taketomi, Tatsuya Kanto, Yae Kanai. Quantification of DNA methylation for carcinogenic risk estimation in patients with non-alcoholic steatohepatitis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5703.

Abstract 13751: Association Between Demographics of Cardiovascular Disease Fellowship Program Directors and Fellow Recruitment: Insights From Association of American Medical Colleges Database

Introduction: We sought to investigate trends in cardiovascular (CV) disease fellows’ demographic characteristics over the past decade, and the association between fellow recruitment and demographics of fellowship program directors (PD). Methods: We procured de-identified demographic data pertaining to first-year CV fellows and fellowship PDs from the Association of American Medical Colleges from 2010-2019 and 2019/2020. In the cross-sectional study, we analyzed trends in demographics of fellow recruitment using the Jonckheere-Terpstra trend test, and the association between demographics of fellows and PDs using multivariate logistic regression. We used fellow characteristics such as age, gender, medical school, US citizenship, fellowship program location, and PD gender in the multivariate model. Results: We included 9,153 fellows from 243 fellowship programs from 2010 to 2019. The characteristics of demographics of fellows and their trends are extrapolated in Figure . We found an increasing trend of female fellows (p=0.003), and fellows with non-US citizenship (p=0.021), and a declining trend of fellows with Asian ethnicity (p for trend 0.033) without a change in trends for other races. There was an association between race of PD and fellow recruitment [White: adjusted odds ratio (aOR) (95% confidence interval (CI)): 1.30 (1.19-1.43), p&lt;0.001; Black: aOR (95% CI): 2.03 (1.22-3.39), p=0.007; Asian: aOR (95% CI): 1.29 (1.17-1.42), p&lt;0.001; Hispanic: aOR (95% CI): 4.14 (3.18-5.39), p&lt;0.001]. Conclusions: Over ten years in CV fellowship recruitment, fellows’ demographic profiles have changed; however, the racial profile has remained constant. We found an association between the race of fellowship PDs and their respective fellow recruitment, irrespective of the type of race/ethnicity.

The Association between Decreased Kidney Function and FIB-4 Index Value, as Indirect Liver Fibrosis Indicator, in Middle-Aged and Older Subjects.

Liver fibrosis might be linked to the prevalence of chronic kidney disease (CKD). However, there is little information about the association between liver fibrosis and decreased kidney function in middle-aged and older subjects. We aimed to evaluate the influence of liver fibrosis on the incidence or prevalence of CKD stage 3–5 in a retrospective cross-sectional study (Study 1, n = 806) and a 6-year longitudinal study (Study 2, n = 380) of middle-aged and older subjects. We evaluated liver fibrosis using the Fibrosis-4 (FIB-4) index and kidney function using the estimated glomerular filtration rate (eGFR) of all subjects. All subjects were divided into four groups on the basis of their FIB-4 score quartiles (low to high). In the Jonckheere–Terpstra trend test of Study 1, the eGFR decreased significantly from the lowest group to the highest group (p < 0.001). The Kaplan–Meier survival curve in Study 2 showed that the cumulative prevalence of CKD stage 3–5 was higher in the third quartile than the other quartiles. Our results suggest that liver fibrosis could be a useful indicator for the prevalence of CKD, even within a relatively healthy population, although liver fibrosis was not an independent risk factor.

Program Expansion of a Day Hospital Dedicated to Manage Sickle Cell Pain

Background: Vaso-occlusive crisis (VOC) is the hallmark complication of sickle cell disease (SCD). The majority of SCD-related healthcare costs in the United States, estimated at $2.4 billion annually, is attributed to frequent emergency room (ER) visits and hospitalizations due to recurrent VOC (1-3). A day hospital (DH) dedicated to manage uncomplicated VOC reduces admission rates, decreases length of stay (LOS) for inpatient admissions, and saves hospital costs (4 , 5). Most DH programs have hours of operation from 9 am to 5 pm, and programs with extended hours are limited. The impact of extended hours of DH programs on patient care is less clear.Methods: The Comprehensive Sickle Cell Center at the University of Illinois at Chicago (UIC) started a DH program to manage uncomplicated VOC in 2009 that was open from 8 am-5 pm Monday through Friday. To improve patient access and decrease the burden on the ER, the hours of operation were increased to 8 am-11 pm in February, 2014. Data on VOC-related patient visits to the DH and ER and admissions to the inpatient floors for calendar years 2012- 2016 were collected from the electronic medical record and evaluated. Descriptive statistics, the Cochrane trend test and Jonckheere-Terpstra trend test were used for data analysis.Results: The number of the DH visits increased from 208 visits in to 1058 visits in 2016. The proportion of the DH visits compared to the ER visits during the same time period showed a trend of significant increase (p<0.0001; Figure 1A). The numbers of unique patients served in the DH (66 in 2012 to 164 in 2016) also had a greater progressive increase compared to in the ER (115 in 2012 to 185 in 2016) (p=0.0012; Figure 1B). With increasing utilization of the DH, the inpatient admission rate from the DH over the 5-year span decreased (24% in 2012 to 14% in 2016; p<0.0001) (Figure 2A). The LOS for inpatient admissions from either the ER or DH due to a VOC also significantly decreased after program expansion (p<0.0001) (Figure 2B).Summary: Here we show that expanding the operation hours of a DH program increased its utilization by SCD patients by almost 5-fold. This was accompanied by a decreased hospital admission rate from the DH and a decrease in LOS for inpatient admissions, which may represent significant cost savings. A major advertising campaign to promote the UIC Comprehensive Sickle Cell center during the same time period may also contribute to the increasing patient visits in both DH and ER, but the incremental increase in the DH utilization over the ED most likely reflects the impact of expanded hours in the DH. Further expansion of the DH program may offer more benefits to patients with SCD.Reference:1. K. L. Hassell, Am J Prev Med38, S512 (Apr, 2010).2. S. Lanzkron, C. P. Carroll, C. Haywood, Jr., Am J Hematol85, 797 (Oct, 2010).3. T. L. Kauf, T. D. Coates, L. Huazhi, N. Mody-Patel, A. G. Hartzema, Am J Hematol84, 323 (Jun, 2009).4. L. J. Benjamin, G. I. Swinson, R. L. Nagel, Blood95, 1130 (Feb 15, 2000).5. A. H. Adewoye, V. Nolan, L. McMahon, Q. Ma, M. H. Steinberg, Haematologica92, 854 (Jun, 2007). [Display omitted] DisclosuresHsu:AstraZeneca: Other: steering committee for HESTIA trial; Emmi: Other: consultant for Emmi. Gordeuk:Emmaus Life Sciences: Consultancy.

Validation and clinical evaluation of a Polish translation of the Wisconsin Upper Respiratory Symptom Survey for Kids (WURSS-K)

BackgroundThe Wisconsin Upper Respiratory Symptom Survey for Kids (WURSS-K) is a self-administered questionnaire developed to evaluate the severity of the common cold. It is a patient-oriented instrument that evaluates quality of life in an illness-specific manner to be used in children aged 10 years. The purpose of this study was to validate the Polish version of the Wisconsin Upper Respiratory Symptom Survey for Kids.MethodsThe validation process consisted of five stages: forward translation, backward translation, cognitive debriefing, a pilot study (Study A and Study B), and statistical analysis. The first study (Study A, n = 10, aged 5–13) was conducted in the Emergency Room and an Outpatient Clinic of the Pediatric University Hospital in Warsaw. The purpose of the study was to obtain data for testing the convergent validity of the questionnaire. The second study (Study B, n = 56), consisted of children aged four to six enrolled in three kindergartens in the Warsaw suburbs. The obtained data were subjected to detailed statistical analysis.ResultsThe WURSS Kids Polish showed excellent reliability. The Cronbach’s alpha of the 13 items was 0.791 for the six symptom items and 0.854 for the seven functional items. The Jonckheere–Terpstra trend test was used to evaluate criterion validity. Compliance of the measurement performed independently by the examined person and the doctor on the first day was high (convergent validity). Each particular item was characterized by a different sensitivity to clinical change. The Guyatt’s Responsiveness index ranged from 0.083 to 0.464.ConclusionThe internal consistency of the measurements and cross-cultural adaptation of the Polish version of WURSS Kids was satisfactory. The WURSS Kids Polish is a reliable, valid, and responsive disease-specific questionnaire for assessing symptoms and QOL in Polish patients in the pediatric population with the common cold. It may be used both in clinical practice and for research among Polish children with URTI.

Hot-water bathing before bedtime and shorter sleep onset latency are accompanied by a higher distal-proximal skin temperature gradient in older adults.

Passive body heating in controlled settings could shorten sleep onset latency (SOL). The hypothesized mechanism is vasodilation-induced heat loss before bedtime. However, this evidence is based on small sample-sized studies in specific populations. Thus, we analyzed the association of hot-water bathing and its before-bedtime timing with SOL and heat loss in a large study population of older adults. We conducted a longitudinal analysis using repeated measurements of hot-water bathing and sleep among 1,094 older adults (mean age, 72.0 years). SOL was recorded using actigraphy and self-reported sleep estimates and was categorized into conditions (intervals of 1-60, 61-120, 121-180, and > 181 minutes between hot bath and bedtime) and compared with the control condition of no bathing. The heat-loss indicator, distal-proximal skin temperature gradient, was examined in the same categorization. Mixed-effects linear regression models suggested that the bathing conditions of 61-120 minutes and 121-180 minutes showed significantly shorter log-transformed actigraphic SOL by 0.23 log-minutes (95% confidence interval (CI), 0.03-0.42) and 0.32 log-minutes (95% CI, 0.09-0.56), shorter self-reported SOL by 0.16 log-minutes (95% CI, 0.02-0.30) and 0.18 log-minutes (95% CI, 0.01-0.35), and higher distal-proximal skin temperature gradient for 30 minutes before bedtime by 0.49°C (95% CI, 0.22-0.75) and 0.51°C (95% CI, 0.20-0.83), respectively, independent of potential confounders. Hot-water bathing before bedtime is significantly associated with shorter SOL and higher distal-proximal skin temperature gradient among the large-scale older population. This finding could enhance the generalizability of hot-water bathing habits for ameliorating sleep initiation difficulty.

Self-Assessment of Digital Competenciees among Employees and Non-Working People of Generation Z in the Economy 4.0

Purpose: The objective of this article is to identify and analyse self-assessment of digital competencies among employees, soldiers and Generation Z people who are not in employment, as well as its correlations with gender, generation, personality, place of residence, professional status, interest in professional military service, motivation, feeling of satisfaction of their expectations concerning employment/military service, as well as capacity to work in Economy 4.0. Design/Methodology/Approach: The sample was based on random selection of 23 out of 28 powiats and questionnaires handed out during the obligatory military entrance processing by Military Draft Offices. Non-parametric tests were used for data analysis. Correlations between the variables were tested by chi-square test for variables on nominal scale. For analysing correlations between the numerical and categorical variables, U-Mann-Whitney test (for two groups) or Kruskal-Wallis test (for more than two groups) were applied. In the case of two numerical variables, Spearman's linear correlation coefficient was applied. Furthermore, in the case of more than two groups, the author applied Jonckheere-Terpstra trend test and post hoc analysis with Dunn test with Bonferroni's correction for tied ranks. Findings: Empirical research indicates that the level of the studied digital competencies is not high in respondents' self-assessment. Respondents of Generation Y declared the highest self-assessment of the competencies. The level of digital competencies varied depending on the place of residence and it was the lowest among respondents living in countryside. It turned out that soldiers have significantly higher digital competencies than civilians. No significant differences in digital competencies were found with respect to gender and position held. However, a series of significant correlations were found between digital competencies and other variables. Practical Implications: Practical business implications concern mainly necessity of broader development of digital competencies in organisations, and in Economy 4.0. Originality/value: The article describes a diagnosed competency gap in the area of digital competences in employees, soldiers and non-working representatives of generation Z. It has also been established that the increase in their digital competences increases their motivation to work, their willingness to operate their own business, leads to a higher sense of fulfilment of expectations concerning employment/military service, higher interest in professional military service and higher capacity to work in Economy 4.0.

Accuracy Improvement of Intraoral Scanning and Buccal Bite Registration Using Healing Abutment as Landmarks: An In Vitro Study

This study aimed to determine the influence of the healing abutment (HA), placed at the implant placement site, on the accuracy of intraoral scanning and buccal bite registration in quadrant maxillary and mandibular models when using three types of intraoral scanner (IOS) and elucidate the distribution of arch distortion. Six experimental groups based on whether the HA was connected and the location of missing teeth were digitized using one laboratory scanner (Identica T500) and three IOSs (Trios 3, CS3600, and i500). Three-way ANOVA was used to analyze the effects of the scanner, location and number of missing teeth, and HA using Tukey investigation analyses for multiple comparisons (α = 0.05). Linear distances between hemispheres from the upper and lower arches were analyzed using the Jonckheere–Terpstra trend test to investigate the tendency of distortion from anterior to posterior tooth positions (α = 0.05). The accuracy of IOSs in groups with HAs was found significantly more accurate than groups without HAs. There was a significant trend in distortion from anterior to posterior tooth positions when using the Trios 3 and i500 IOSs. The scanning accuracy was affected by the presence of an HA, and the distortion along with the arch span may vary with the IOS utilized.