Large Institutions Research Articles

Professional cultural institutions and the community? Lessons from the first community production of the Barcelona opera house

ABSTRACT Large cultural institutions have been given goals that go well beyond their conventional artistic endeavours. Opera houses are no exception. One strategy they attempt is to stage community productions, but how does this activity match with institutions that seek “artistic excellence”? We focus on a case study of the Gran Teatre del Liceu, Barcelona, and firstly see to what extent productions staged by large cultural institutions can be considered community-based programmes. Secondly, we analyse if these programmes are realistic in terms of reaching their target population. Lastly, we study the degree of participation achieved. In order to do so, we review the concepts of access and participation to build our own analytical framework. We also follow a qualitative and quantitative methodology, performing interviews and fielding a questionnaire to participants. We think that our research and results are relevant from both an analytical point of view and an empirical perspective: in terms of access, the Liceu worked towards correcting the underrepresentation of minority groups in artistic forms that obtain public funding, but these efforts were limited; regarding participation, the opera was developed for, with and by the community depending on the action analysed, and it combined crowd-sourcing, co-creation and audience-as-artist actions.

Abstract 4134345: Diastolic Dysfunction And The Risk Of Stroke And Major Bleeding

Background: Diastolic dysfunction (DD) is associated with adverse cardiovascular outcomes including atrial fibrillation. Whether DD is independently associated with incident ischemic stroke/transient ischemic attack (TIA) and with bleeding events is not well established. Aims: To examine the association of presence and severity of DD with the risk of incident ischemic stroke/TIA and major bleeding. Methods: A total of 219,667 patients who underwent at least one echocardiogram between 2010 and 2022 at a large academic institution and were followed for at least 3 months were included. Patients with prior history of stroke or TIA (n=21,505, 10%) were excluded. Smart key-phrase search was applied to echocardiographic reports to classify patients into 4 groups, based on the most severe DD assessment: Normal (n=113,265), grade I (n=21,981), grade II (n=7,215), and grade III (n=1,627). Patients in whom the presence of DD could not be determined (n=54,074) were excluded. The final study cohort (n=144,088) was followed to the endpoint of hospital admission for ischemic stroke/TIA or for major bleeding. Results: Over a median follow-up of 3.4 years, 3482 (2.4%) patients were hospitalized for stroke/TIA and 6994 (4.9%) for major bleeding. After adjusting for several confounding variables (Table), DD remained a strong predictor of incident stroke/TIA (hazard ratio (HR)=1.34 per grade increase in DD, p<0.001, Figure) and of major bleeding (HR=1.32 per grade increase in DD, p<0.001, Figure). These results were similar in patients with (n=11,508, 8%) or without prior history of atrial fibrillation. Conclusions: Patients with DD have a heightened risk of ischemic cerebrovascular accidents and major bleeding independent of the presence of atrial fibrillation. These risks escalate with the severity of DD. DD should be considered when counseling patients regarding their risk profile and management options.

Abstract 4137587: Need for Testing Standardization and Improved Treatment of Elevated Lipoprotein(a) at a Large Urban Academic Medical Center

Background: Lipoprotein(a) [Lp(a)] is causally linked to ASCVD events and aortic stenosis. Some guidelines now recommend screening of Lp(a) at least once in an adult’s lifetime. Currently, there is inconsistency in measurement modality (mg/dL vs. nmol/L), but most guidelines recommending testing in nmol/L due to less variability and improved standardization. We sought to determine the Lp(a) measurement practices, including testing modality and downstream interventions, at a large academic medical institution. Methods: We evaluated all patient encounter data at UT Southwestern Medical Center (UTSW) between January 1, 2017 to December 31, 2021 for any Lp(a) measurement. High Lp(a) was defined as >50mg/dL or >125 nmol/L. Aggregate data were used to summarize patient demographics, relevant ASCVD co-morbidities, and lipid lowering prescriptions. Chart-review was conducted on patients with high Lp(a) to assess referrals to specialty clinics. Results: From 2017 to 2021, there were 1,065 Lp(a) measurements among 938 patients, representing fewer than 0.1% of all patients with labs at UTSW. Most were ordered by cardiologists (71%). Lp(a) tests ordered by cardiologists increased 69% annually but remained stagnant for other specialties (figure 1, lines). Median Lp(a) levels across all tests were 17mg/dL and 43nmol/L. Lp(a) was high in 30% of all initial tests. A higher proportion of tests ordered in 2021 by cardiologists (84%) were in nmol/L, the recommended standard, compared with other specialties (55%) (figure 1, bars). Patients with high Lp(a) found by a non-cardiologist were infrequently referred to cardiology (16%), and 53% of patients with high Lp(a) were prescribed lipid lowering therapy within 3 months. Conclusion: Lp(a) testing at a major academic medical center was rare and only marginally increased during the 5-year study period. Measurement frequency and assay varied widely between specialties, and there were potential opportunities for downstream interventions. In addition to improving awareness of Lp(a), there is an opportunity to standardize practice patterns regarding its measurement and implications.

Understanding faculty perspectives on health equity curriculum implementation in graduate medical education: a qualitative study.

Despite increased awareness of persistent healthcare disparities, integrating health equity education into medical residency curricula needs urgent expansion. The Accreditation Council for Graduate Medical Education (ACGME) mandates addressing healthcare disparities and social determinants of health, but implementation remains insufficient due to pervasive barriers. To explore residency faculty perspectives at one institution surrounding implementing a health equity curriculum within their programs. Between November 2022 and April 2023, qualitative interviews and focus groups were conducted with residency faculty participants (n = 13) from a large academic medical institution. Participants were recruited via an internal email list directory of program directors. Semi-structured sessions explored faculty perspectives on health equity curriculum implementation. Data analysis utilized template analysis and thematic coding. Faculty perceived barriers included limited time for teaching health equity, challenges in prioritizing health equity content within the curriculum, lack of formal training and expertise, discomfort in leading discussions, and institutional barriers such as resource allocation and lack of buy-in. Findings underscored the need for institutionally supported faculty development and protected learning time for health equity education. Despite participant recruitment and representation limitations, the study provides valuable insights for addressing curricular challenges. This study highlights critical areas for improving health equity curriculum implementation in graduate medical education. Addressing these faculty barriers can enhance resident competency in identifying and addressing healthcare disparities. The study received approval from the Thomas Jefferson Institutional Review Board (IRB #22E.762).

Data Organization Patterns in Data Mesh: Optimizing Data Management for the Modern Enterprise

This article explores the implementation of Data Mesh principles through a structured layered approach to data organization, addressing the challenges of managing large-scale, diverse data ecosystems in modern enterprises. As global data creation surges towards 181 zettabytes by 2025, traditional centralized data architectures are proving inadequate. We propose a four-layer methodology—Raw, Work, Gold, and Publish—that aligns with Data Mesh philosophy while providing clear delineation of data processing stages. Through case studies across various industries, we demonstrate how this approach leads to significant improvements in data quality, time-to-insight, and incident resolution. A large financial institution achieved a 40% reduction in time-to-insight, while a global manufacturer reported a 30% improvement in data quality. The article also discusses the challenges of implementation, including cultural shifts and skill gaps. Our findings suggest that combining Data Mesh principles with a layered organizational structure can transform enterprise data landscapes, enhancing agility, cross-functional collaboration, and alignment of data assets with business objectives. This article contributes to the evolving field of decentralized data architectures and provides practical insights for organizations seeking to optimize their data management strategies in the face of exponential data growth.

Current Practices for Delivering New Diagnosis Education at Children's Oncology Group Institutions: A Report From the Children's Oncology Group.

The Children's Oncology Group (COG) Nursing Discipline developed expert consensus recommendations and resources to guide the delivery of new diagnosis education across its member institutions. Current new diagnosis education practices across COG member institutions are unknown. To understand current new diagnosis education practices across COG member institutions. We conducted a cross-sectional survey of COG nurses between July and October 2023 to elicit current practices to deliver new diagnosis education to families across COG institutions. Data were collected and managed using REDCap electronic data capture tools. Individual responses from single institutions were averaged as a single institution-level response. Respondents included 146/227 (64.3%) COG institutions across 5 countries. Advanced practice nurses and nurse educators have primary responsibility for new diagnosis education at 28.1% and 26.7% of institutions, respectively. Less than half (42.4%) of institutions have a clearly defined process for delivering new diagnosis patient/family education. Almost all (88.2%) institutions use the COG Family Handbook; 64.7% use the COG New Diagnosis Guide, and 41.9% use the COG KidsCare app to support the delivery of new diagnosis education. More than half (61.5%) of institutions use checklists to facilitate the delivery of new diagnosis education, with 81.6% of large institutions versus 44.1% of small institutions reporting the use of checklists ( P = .004). There is variability in current new diagnosis education practices across COG institutions. These findings highlight opportunities for implementing standardized approaches aligned with expert consensus recommendations for the delivery of new diagnosis education.

Disparities in Patient Portal Activation and Usage at a Large Pediatric Academic Institution.

Access to personal medical information promotes patient understanding of health issues and enables patient self-advocacy of healthcare needs. The advent of electronic medical record systems and the 2016 21st Century CURES Act promoted and encouraged patient access to personal medical information, yet technology-dependent modalities have often disadvantaged certain communities. We sought to evaluate whether disparities existed in access to patient portals at our institution, the main pediatric care provider in an area serving one million children. We evaluated the activation of patient portal accounts at our institution over the past decade (2010-2021). Portal activation data were analyzed by ethnic background and language preference and income information available based on primary home access location. Further, we evaluated portal activation rates over time and across institutional interventions. A logistic regression model was used to identify important demographic associations with portal account status. Over 1 million patients were served at our pediatric institution over the study period with 47.7% having ever activated their patient portals. Univariate analyses and ultimately logistic regression modeling demonstrated significant differences in portal activation by ethnicity (odds ratio (confidence interval):1.36 (1.34, 1.37)), language preference (1.39 (1.37, 1.40)), and median household income (1.00001 (1.00001, 1.00001)). Interim interventions were successful in improving portal activation rates. Overall, electronic medical record portal activation was less prevalent among Hispanic, non-English speakers, and patients living in communities with lower median household income. Opportunities for interventions exist to reduce healthcare disparities in these underserved communities.

Impact of Artificial Intelligence-Based Autosegmentation of Organs at Risk in Low- and Middle-Income Countries

Radiation therapy (RT) processes require significant human resources and expertise, creating a barrier to rapid RT deployment in low- and middle-income countries (LMICs). Accurate segmentation of tumor targets and organs at risk (OARs) is crucial for optimal RT. This study assessed the impact of artificial intelligence (AI)-based autosegmentation of OARs in 2 LMICs. Ten patients, comprising 5 head and neck (HN) cancer patients and 5 prostate cancer patients, were randomly selected. Planning computed tomography images were subjected to autosegmentation using an Food and Drug Administration-approved AI software tool and manual segmentation by experienced radiation oncologists from 2 LMIC RT clinics. The control data, obtained from a large academic institution in the United States, consisted of contours obtained by an experienced radiation oncologist. The segmentation time, DICE similarity coefficient (DSC), Hausdorff distance, and mean surface distance were evaluated. AI significantly reduced segmentation time, averaging 2 minutes per patient, compared with 57 to 84 minutes for manual contouring in LMICs. Compared with the control data, the AI pelvic contours provided better agreement than did the LMIC manual contours (mean DSC of 0.834 vs 0.807 in LMIC1 and 0.844 vs 0.801 in LMIC2). For HN contours, AI provided better agreement for the majority of OAR contours than manual contours in LMIC1 (mean DSC: 0.823 vs 0.821) or LMIC2 (mean DSC: 0.792 vs 0.748). Neither the AI nor LMIC manual contours had good agreement with the control data (DSC < 0.600) for the optic nerves, chiasm, and cochlea. AI-based autosegmentation generates OAR contours of comparable quality to manual segmentation for both pelvic and HN cancer patients in LMICs, with substantial time savings.

Grab the Mic: Connecting theory and practice within an undergraduate sport communication course

Experiential learning within sport management classrooms provides valuable industry experience to complement theoretical knowledge. Content creation is a valuable skill for sport management students, particularly those who are looking to work within media and marketing spaces after graduation. Therefore, sport communication undergraduate students at a large research-intensive institution in the Midwest of the United States participated in a podcast creation project for their sport communication class. The experiential learning opportunity provided students with the opportunity to collaborate with a classmate to write, record, and edit a podcast episode under the umbrella of the department's podcast show. This gave the students valuable experience in creating content for professional consumption. The project received positive feedback from students on skill development and the benefits of collaboration, while also discussing the challenges associated with the time demands of the project.

Burnout in neurosurgery in the post-pandemic era

ObjectiveBurnout syndrome impacts one of two neurosurgeons and negatively impacts both the individual and institution. The impact of burnout on neurosurgeons may have increased due to the SARS-COV-2 pandemic. Characteristics of burnout may differ among neurosurgeons and non-neurosurgeon physicians, and this may better target wellness initiatives designed to alleviate burnout. MethodsValidated burnout inventories (Maslach Burnout Inventory; MBI) were provided to physicians, including neurosurgeons, at a single, large academic institution. Rates of burnout and specific characteristics of burnout were compared. Free-response answers describing specific characteristics of burnout were also collected for neurosurgeons. ResultsA total of 294 physicians responded to the survey, including 40 neurosurgeons. The rate of burnout between neurosurgeons and non-neurosurgeons did not differ (39% vs 34%; p=0.631), but there were notable differences in the characteristics of burnout. Neurosurgery respondents were more likely to report depersonalization (p<0.001), and an additional 42.5% of neurosurgeon respondents reported a “period of hardship,” which may lead to subsequent burnout. Neurosurgeons also more frequently reported higher feelings of personal accomplishment (p<0.001). Targeted wellness interventions specific to neurosurgeons may alleviate and prevent burnout. ConclusionsWe show that although the rate of burnout does not differ for neurosurgeons, the characteristics of burnout may. This may represent the key to providing specialty-specific targeted interventions to alleviate burnout. Further, there is a significant proportion of neurosurgeons at risk for subsequent burnout for which additional importance must be placed to prevent progression to burnout.

Marfan syndrome in children: large, single centre experience on management and outcome

Abstract Introduction Beta-blockers (BBs) and angiotensin receptor blockers (ARBs) have been proved to decrease the growth rate of the aortic root in Marfan patients, we describe our single centre experience at a large tertiary paediatric institution. Methods This is a retrospective longitudinal study of a large, paediatric only, Marfan cohort through review of medical notes for clinical data and treatment and assessment of serial echocardiograms. Results 167 patients were included, mean age at first assessment was 4.05 ± 3.12 years, 86 (51.50%) were males. 41 pts (24.55%) had a de novo FBN1 mutation. A 35.32% had a cysteine loss mutation. Median follow up was 9.54±4.37 years. 2 patients had a clinical and molecular diagnosis of early-onset Marfan, they both underwent mitral valve surgery in infancy and one of them died at 7 years old. No other deaths or acute aortic events in our cohort until transition to adult services at 18 years old. Of the entire study population 12 pts (7.2%) underwent aortic surgery at a median age of 13±7.02 years, 1 patient had a mitral valve repair. Chemoprophylaxis (currently only evaluated in a subgroup of our youngest 65 patients) was offered to all patients, 27.69% declined medicines. The remining 47 subjects are on treatment which was started at a mean age of 4.88 ±2.96 years, surveillance data available for a mean follow up of 2.75±2.41 years. 50 received BB (58.50% atenolol [average dose 0.79 mg/kg/day] and 19.15% bisoprolol [average dose 0.087 mg/kg/day]), 5 (8.51%) losartan [average dose 0.763 mg/kg/day], and 10 (15.38%) double therapy with BB and ARBs. The Sinus of Valsalva (SOV) z-scores, as assessed on echocardiograms and normalised according to Lopez dataset, showed a reduction over time in children treated with chemoprophylaxis (see figure 1). SOV mean z-score at starting treatment was 3.38 ± 2.06 which reduced to 2.79± 1.81, however, differences were not statistically significant (paired T-student p-value 0.078). In non-treated patients, initial SOV z-score was 1.89 ± 1.05. When comparing evolution there was a trend towards decreased average SOV z-score over the years in the treated group, not seen in the non-treated patients (see figure 2). No statistical differences in the SOV z-score reduction change were found when comparing different treatment groups (ANOVA p-value 0.851), but a tendency to more profound decrease in the losartan groups was observed. Reduction in blood pressure or heart rate did not differ amongst the treatment groups. Conclusions We present one of the largest single centre reviews on management of paediatric Marfan patients. Our data confirm a decrease in SOV z-score with chemoprophylaxis in a real-world cohort. This is in line with current evidence and corroborates clinical practice.SOV Z-SCORE EVOLUTION AFTER TREATMENTSOV Z-SCORE GROUP AVERAGE CHANGE

Integration of investor behavioral perspective and climate change in reinforcement learning for portfolio optimization

Addressing environmental impact is increasingly imperative for individual investors and large financial institutions, making it a key objective of socially responsible investing. However, there is a noticeable gap in research on integrating sustainability and low-carbon considerations into machine learning-based portfolio optimization. To meet this challenge, this study introduces a Portfolio Emissions Sentiment Attention Aware Reinforcement Learning (PESAARL) model based on the Proximal Policy Optimization (PPO) algorithm to optimize a portfolio of Dow Jones Industrial Average (DJIA) stocks. PESAARL uniquely integrates environmental impact considerations, specifically carbon footprint using the firm level scope 1 and scope 2 emissions data, alongside firm-level investor sentiment and attention, into the investment decision-making process. Through multiple experiments, PESAARL demonstrates significant advantages, in terms of financial and environmental performance, over the benchmarks.

Based on sustainable development of skating sports training new ecological and environmental protection measures

In recent years, under the background of exam-oriented physical education reform, the government has issued a lot of physical education documents and policies. As a result, many schools have made fundamental changes in physical education activities. These policies are mainly aimed at getting young people to be more active and autonomous in school sports. This requires physical education training teachers must adhere to the people-oriented, student-oriented, so as to highlight the subject status of students. Based on this, students should establish a good sports values and ethics and form a good habit of lifelong sports, so as to further promote the sustainable development of youth sports activities. Based on the ecological theory of sustainable development as the background, this study constructs a unified theory of Unified Theory of Acceptance and Use of Technology (UTAUT) model for the sustainable training and development of youth skating sports training institutions. This study selects the youth skating sports training institutions in Beijing, China as the investigation object, covering small, medium and large institutions of different sizes, and analyzes based on the statistical data in 2023 and the results of field research. The results show that the application of this model not only increases the willingness of youth skating training institutions to continue to participate by 3.66%, but also promotes the diversified development of youth skating training. In addition, this study also discusses the environmental protection measures implemented in the process of skating training to ensure that the training activities are sustainable while reducing the impact on the environment, so as to build a sustainable development of the new ecology of skating sports training.

Reserves Were Not so Ample After All

Abstract We show that the likelihood of a liquidity crunch in wholesale US dollar funding markets depends on levels of reserve balances at the financial institutions that are the most active intermediaries of these markets. Heightened risk of an imminent liquidity crunch is signaled by significant delays in intra-day payments to these large financial institutions over the prior two weeks. Our study contributes to the broader dialogue surrounding the Federal Reserve’s ongoing quantitative tightening (QT).

Second Look Opportunity for Radiation Oncology Medical Residency During Virtual Interview Season

PurposeDespite easing of COVID-19 travel restrictions and social distancing, medical radiation oncology (RO) residency interviews for the 2023 Match remained exclusively virtual. Virtual interviews can be limited in providing program atmosphere, resident camaraderie, and city culture. Our institution offered a voluntary in-person second look (SL) to address these concerns and supplement the virtual interview. Methods and MaterialA voluntary in-person SL across 3 dates was offered to all applicants who successfully interviewed with the RO department for the 2023 Match (n=54). Attendees of the SLs (n=38) were invited to complete a voluntary 10-question anonymous survey after Match Day regarding their perspectives on this opportunity including motivations for attending, financial burden, and perceived benefits of SLs. Results38 individuals (70%) attended one of the departmental SLs with 19 participants (50%) completing the survey. 16 out of 19 (84%) participants traveled >200 miles to attend. All surveyed applicants were grateful for the in-person SL opportunity and agreed such opportunities should continually be offered with exclusively virtual residency interviews. All participants reported that their decision to attend the SL was affected by departmental financial support. Two applicants felt pressured to attend the SL to remain competitive to the program. Majority of applicants agreed that they achieved a better “feel” for the program culture and the larger institution, resident camaraderie, and the surrounding city from this in-person SL encounter, compared to virtual interview alone (18, 94%). ConclusionThese in-person second look opportunities were well-attended, well-received, and offered insights and experiences to RO resident applicants in the setting of exclusively virtual interviews. The cost of attendance may be a limiting factor when applicants are deciding to attend in-person SLs. Caution is needed to ensure applicants do not feel obligated to attend and SLs are not used as a platform for inappropriate post interview communication.

Group virtual reality simulation in the adult nursing curriculum: student and lecturer experiences.

Virtual reality (VR) simulation technology was rapidly integrated into pre-registration adult nursing programmes in response to the pandemic and a reduction in clinical placements. The UK's regulatory body for nursing has recognised its value in nursing education by increasing the possible number of simulated practice hours that can replace clinical placements to 600 hours. This article reports on an evaluation study of a novel approach using screen-based VR simulations for groups of students in a classroom setting. This study aims to evaluate student and lecturer experiences of screen-based VR with the aim of informing and sharing insights from this approach. Students and lecturers responded to an evaluation survey comprising both closed- and open-ended questions. A large approved education institute in the East of England. Pre-registration adult nursing master's students and adult nursing lecturers who had experience of screen-based VR with groups. Quantitative data were analysed using descriptive methods, and qualitative data using thematic analysis. Student and lecturer experiences of screen-based VR were overwhelmingly positive, overcoming many challenges of simulation documented in the literature. The group-working approach promoted development of non-technical or essential 'soft' skills such as communication, decision-making and teamwork. Screen-based VR for classroombased learning offers an effective, engaging and cost-effective method of incorporating VR simulation scenarios in adult nursing education. Thoughtful consideration of pedagogical aspects are key to its successful and effective integration into the pre-registration adult nursing curriculum.

Student–Faculty Interaction and Academic Self-Concept: Gender as a Moderator

This study examines the moderating effect of gender on the relationship between student–faculty interaction and academic self-concept. Using data from a large public Hispanic-serving institution (HSI) in Southern California, the analysis suggests that although student–faculty interaction positively impacts academic self-concept for all students, the effect is stronger for female students. Despite these gains, a persistent gender gap remains, with female students reporting lower academic self-concept than male students. These findings emphasize the importance of tailored initiatives to improve student–faculty interaction and academic self-concept, especially for female students.

The impact of maturation sutures on false passage formation in pediatric tracheostomy

IntroductionFalse passage (FP) after tracheostomy is an infrequent but potentially life-threatening complication. The practice of tracheal stomal maturation at the time of tracheostomy is variable amongst surgeons in pediatric patients, and it remains unknown whether or not maturation sutures decrease the risk of FP. Our objective was to evaluate the impact of maturation sutures on the incidence of FP after pediatric tracheostomy. Materials and methodsA retrospective review of children who underwent tracheostomy (2001–2024) was performed. Records were reviewed for demographics and procedural details including use of maturation sutures. Outcomes included incidence of FP, time to FP and associated complications resulting from FP. ResultsOne-hundred and twenty-five children met study criteria [median (IQR) age 0.5 (0.2–3.2) years]. Fifty-five children (44.0 %) received maturation sutures, with 31 (56.4 %) of these being four-point sutures, 10 (18.2 %) being two-point sutures (70 % of which were placed inferiorly), and 14 (25.5 %) being unrecorded. Four out of 125 (3.2 %) patients developed FP at a median (IQR) of 12.8 (4.6–13.5) days following tracheostomy insertion, and they all occurred within the first two tracheostomy changes. None of the patients who developed FP had maturation sutures. Of the four children who developed FP, three (75 %) had no further complications, and one (25 %) developed subcutaneous emphysema and pneumomediastinum. No deaths associated with FP were identified. ConclusionThis large single institution study evaluating the relationship between maturation sutures and FP in children undergoing tracheostomy suggests that maturation sutures may help prevent FP; however, ongoing work is required to validate these findings and guide clinical practice. Level of evidence3.

Recent Advances in Intraoral Scanners.

Intraoral scanners (IOSs) have emerged as a cornerstone technology in digital dentistry. This article examines the recent advancements and multifaceted applications of IOSs, highlighting their benefits in patient care and addressing their current limitations. The IOS market has seen a competitive surge. Modern IOSs, featuring continuous image capture and advanced software for seamless image stitching, have made the scanning process more efficient. Patient comfort with IOS procedures is favorable, mitigating the discomfort associated with conventional impression taking. There has been a shift toward open data interfaces, notably enhancing interoperability. However, the integration of IOSs into large dental institutions is slow, facing challenges such as compatibility with existing health record systems and extensive data storage management. IOSs now extend beyond their use in computer-aided design and manufacturing, with software solutions transforming them into platforms for diagnostics, patient communication, and treatment planning. Several IOSs are equipped with tools for caries detection, employing fluorescence technologies or near-infrared imaging to identify carious lesions. IOSs facilitate quantitative monitoring of tooth wear and soft-tissue dimensions. For precise tooth segmentation in intraoral scans, essential for orthodontic applications, developers are leveraging innovative deep neural network-based approaches. The clinical performance of restorations fabricated based on intraoral scans has proven to be comparable to those obtained using conventional impressions, substantiating the reliability of IOSs in restorative dentistry. In oral and maxillofacial surgery, IOSs enhance airway safety during impression taking and aid in treating conditions such as cleft lip and palate, among other congenital craniofacial disorders, across diverse age groups. While IOSs have improved various aspects of dental care, ongoing enhancements in usability, diagnostic accuracy, and image segmentation are crucial to exploit the potential of this technology in optimizing patient care.

7147 A Retrospective Evaluation of Biochemical and Clinical Criteria of Permanent Hypoparathyroidism After Total Thyroidectomy and Their Associated Outcomes

Abstract Disclosure: D.G. Su: None. S. Tsou: None. W. Shen: None. Q. Duh: None. C. Graves: None. I. Suh: None. Background: Postoperative hypoparathyroidism (hypoPT) is the most common complication of total thyroidectomy and carries long-term morbidity. However, reported incidences vary widely due to nonstandardized measurement practices and absence of a universally accepted definition. This study aims to evaluate various definitions of hypoPT and to identify influencing factors such as diagnosis and operative duration. Methods: We performed a retrospective analysis of patients with a diagnosis of hypoPT (ICD-9: E20, E20.0, E20.8, E20.9, E89.2) between January 2012 and January 2019 at a single large academic institution, and only included those who had underwent a total thyroidectomy six months prior. Definitions based on low parathyroid hormone (PTH) values (PTH &amp;lt; 10 pg/mL), low calcium levels (corrected calcium [Ca] &amp;lt; 8.5 mg/dL or ionized Ca [iCa] &amp;lt; 1.1 mmol/L), and postoperative supplementation (elemental calcium or vitamin D) were evaluated at 6 and 12 months postoperatively. Postoperative hypocalcemic symptoms were graded by disease severity (based on the presence of numbness/paresthesia, muscle spasms/aches, and Chvostek/Trousseau signs). Patient demographics, operative and pathological characteristics, and use of parathyroid autotransplantation were recorded. Results: Of 879 patients with hypoPT ICD-9 diagnoses, 124 (14%) underwent a total thyroidectomy and were included. Our cohort was 64% female with a median age of 52.9 years. Fifty-one patients (41%) had low PTH levels, 49 (39%) had low calcium levels, and only 26 (21%) had both low PTH and calcium. Of 94 patients (76%) with hypocalcemic symptoms, 68 (73%) required long-term calcium or vitamin D supplementation. Twenty-eight (22.6%) patients had either an ED visit or readmission for hypocalcemia postoperatively. One hundred seven patients (86%) had a pathologic diagnosis of malignancy, of which 37% had extrathyroidal extension, 25% vascular invasion, and 36% positive margins. Those who underwent parathyroid autotransplantation (33%) were less likely to meet biochemical definition of hypoPT (p = 0.0312). Dosage of calcium/vitamin D supplementation did not correlate with symptom grade. Conclusions: Postoperative hypocalcemic symptoms and long-term calcium/vitamin D supplementation were the most common characteristics found in our permanent hypoPT cohort. However, substantial heterogeneity in defining postoperative hypoPT exists, with no definition capturing the full spectrum of affected patients. Further research is necessary to develop reliable diagnostic criteria or biomarkers for hypoPT prediction and management. Presentation: 6/2/2024