Medical Areas Research Articles

Hepatic Cirrhosis and its Management via Electro-Homoeopathic Practices

Hepatic cirrhosis is known by the development of regenerative nodules in liver parenchyma surrounded by fibrous septa resultant to chronic liver damage. Cirrhosis happens due to necrosis of liver cells followed by fibrosis and nodule formation. The liver organization come to be abnormal and interferes with liver blood flow and function, and eventually pointers to portal hypertension followed by hepatocytic dysfunction. Chronic liver diseases signify a remarkable health problem across the world with liver cirrhosis. The exact prevalence of cirrhosis worldwide was ambiguous due to the clinical continuum ranging from apathetic, asymptomatic to whole liver decompensation. Therefore, recurrent inputs via a series of research in view of various conventional and definite earlier techniques in background, along this thrust medical area, directed an emerging and medically most precise an alternate technique, namely, Electro-Homoeopathic Medical Science that has been presently in practice by a number of practitioners in India and southeast Asian countries enlightening attractive outcome without any significant post therapeutic physiological and/or biochemical side effect concomitant with risk factor. Various clinical practices and survey provide new insights into the development and establishment of an increasingly advanced form of the electro-homeopathic system for a defined diagnosis enlightening a definite root cause and efficient management of Liver Disease as well as its perception.

Chronic Renal Failure-Etiology, Pathophysiology, Symptoms, Diagnosis and its Management through Electro-Homeopathy: An Overview

Chronic Renal Failure (CRF), a progressive, irreversible deterioration in renal function in which the body’s ability to sustain metabolic and fluid and electrolyte balance fails, resulting in uremia or azotemia, is a global public health problem that tends to take dimensions of epidemic and has severe impact on quality of patient’s life. Chronic kidney diseases represent a noteworthy health problem across the globe with CRF. The clear-cut prevalence of CRF worldwide was obscure due to the clinical continuum ranging from indolent, asymptomatic to complete renal decompensation. Thus, continual inputs through a series of research considering various conventional and certain earlier techniques in background, along this thrust medical area, led an emerging and medically most precise technique, namely, Electro-homeopathic therapy that has been currently in practice by a number of practitioners in India revealing fascinating outcome without any significant post therapeutic physiological and/or biochemical side effect as well as risk factor. The efficacy of the Electro-homoeopathy treatment for chronic kidney disease has been successfully monitored over a period of 30-60 and 30-80 days, respectively, in the case of GFR and renal lithiasis, based on improvement in the subjective parameters and blood investigations. Nevertheless, paralysis of bladder cases was cured within 30 to 60 days of treatment. The outcome of this overview provides new insights into developing and establishing more and more advanced account of Electro-Homeopathic system for accurate diagnosis enlightening specific root cause/origin (Etiology) and smooth-running management of ‘Chronic Renal Failure’ as well as its manifestation.

Clinical Impact of a Local Triage System Using the Emergent Large Vessel Occlusion Screen with a Rotation System of Thrombectomy-Capable Hospitals.

Early intervention with mechanical thrombectomy (MT) is expected to improve the functional outcome in patients with large vessel occlusion (LVO); however, a method for the effective detection of these patients in a prehospital setting and early transport to MT-capable hospitals has not been established. This study aimed to analyze the clinical impact and diagnostic performance of the emergent large vessel occlusion (ELVO) screen and its influence on the transportation time. The emergency medical services (EMS) in one of the secondary medical areas in Akita, Japan, introduced a prehospital triage system employing an ELVO screen and a rotation system of three MT-capable hospitals on December 1, 2021. Patients who were transferred to each of the three hospitals involved in the rotation system according to a predefined priority list from December 2021 to November 2022 were included in the triage group. Patients who underwent MT in the three hospitals before the introduction of the triage system were assigned to the pre-triage group. We compared the transportation time parameters between the two groups and analyzed the performance of the ELVO screen for the diagnosis of LVOs. This study was approved by the institutional review boards of all three hospitals. Time parameters were compared between the 37 and 42 patients who underwent MT and had detailed data in the triage (n = 351) and pre-triage (n = 43) groups, respectively. The time from door to puncture tended to decrease in the triage group in all hospitals, with one hospital showing a statistically significant shortening of 14 min (p = 0.018). In the triage group, 209 ELVO screen-positive patients were present, with 60 (28.7%) of these having LVO. The sensitivity, specificity, positive and negative predictive values, and area under the curve of the ELVO screen to detect LVO under the present triage system were 87.0%, 47.2%, 28.7%, 93.7%, and 0.671, respectively. The present study demonstrated that the introduction of a triage system may have shortened the time required for MT. ELVO screen may be considered a useful marker for screening LVO in prehospital settings in terms of the sensitivity and negative predictive value; however, further improvement may be necessary to reduce the rate of false positive results.

대한민국 의료이용 형평성에 관한 고찰

This study is to examine the current situation in which people's right to health is secured based on equity in health service utilization in Korea. Health service utilization was analyzed by focusing on the consumer perspective, which is equity in medical use. Since the relationship between health care and its contribution to improving the health level of the population is not clear, it is meaningful to focus on the use of medical institutions at the individual level to improve health.
 In the health service utilization in Korea, there were regional inequalities in medical resources, inequalities in medical use by income, and inequalities due to changes in government policy. Securing health service utilization is a service that must be provided by the government as part of the right to health. There is a need to improve structural factors that take underprivileged groups into consideration so that medical benefits can be distributed evenly to all citizens.
 In a medical area dominated by private hospitals, there is a need for the plan to improve equity in health service utilization by government resources. A comprehensive medical delivery system must be established. We must lay the foundation for long-term use of the responses that were useful in the COVID-19 pandemic situation. We must utilize technological advancements to prepare all to receive essential medical care and seek ways to minimize inequality by strengthening the health literacy of the population.

The Influence of Interpersonal Skills, Salesmanship Skills, and Work Environment on Medical Representative Performance

Interpersonal skills, salesmanship skills, and work environment are some of the factors that influence employee performance. For pharmaceutical companies, the performance of the Medical Representative (MR) is a very important factor for the company in achieving its business goals. Therefore, pharmaceutical companies must ensure that their MRs have good interpersonal skills to be able to establish good relationships with other medical professionals, effective salesmanship skills to market pharmaceutical products, and a conducive work environment to motivate MRs to work. This study aims to describe and test how much influence partially and simultaneously the interpersonal skills, salesmanship skills, and work environment variables have on the performance of the Asahan Labuhanbatu medical representative area, as well as being an input for pharmaceutical companies on how to improve the performance of Medical Representative employees. This type of research is a quantitative descriptive study with a total of 30 respondents. The results of the research show that both partially and simultaneously, the interpersonal skills, salesman skills, and work environment variables have a positive and significant effect on the performance of the Medical Representative Area Asahan - Labuhanbatu.

Electrochemical Sensors for Detection of Glucose based on Electrochemically Reduced Graphene Oxide: Optimization of pH and Number of Cycles

Glucose determination method had gain significant interest from the industry for a fast and efficient response especially in the medical area for diabetes patient. Reduced graphene oxide (RGO) had been reported to help and improve the sensitivity of a sensor. The investigation for the optimum pH concentrations using FESEM, EDX, XRD analysis and Raman spectroscopy indicate that the pH 9 was suited to be deposited on the SPGE. In addition to that, different number of cycles during electrodeposition process was employed. Electrochemical impedance spectroscopy (EIS) was used to investigate the charge transfer resistance for each cycle. All the deposited RGO on screen-printed gold electrode (SPGE) was being compared to the bare SPGE to confirmed that the electrodeposition of RGO could decrease the charge transfer resistance. For the detection of glucose, cyclic voltammetry (CV) and differential pulse voltammetry (DPV) was used. 10 cycles deposition of RGO shows the highest sensitivity of 1.0525 μA·mM−1·cm−2 in the detection of glucose compared to the other cycles. The ease of use and scalability of the electrodeposition technique may make it easier to build upon the results of this work and produce glucose sensors that are more widely available and less expensive.

Chemical Characteristics and Biotechnological Potentials of Mumio

Mumio is a valuable substance that ranges in color from pale brown to blackish-brown and is obtained from rock layers in various mountain ranges worldwide, particularly in the Tien Shan ranges of Kyrgyzstan. It is also a natural chemical found largely in the Himalayas, created over ages by the progressive degradation of particular plants by bacteria. Mumio is essentially a nutraceutical product with considerable human health advantages. To fully appreciate the predicted impact of mumio use in the medical area, particularly in neurological sciences, more research at both the fundamental biology level and through well-designed clinical trials is required. This involves a thorough examination of the various organic and inorganic elements that contribute to Mumio's therapeutic efficacy.The paper also dives into the results of Mumio's comprehensive biological and biotechnological analyses. These scientific research have revealed the mechanisms of action of this natural chemical and confirmed its medicinal claims. The article seeks to offer a full review of Mumio by merging traditional medicine knowledge, chemical analysis, and scientific assessments, stressing its relevance in traditional medicine and its potential for life science activities.

Prednosti virtualne stvarnosti u prevenciji padova kod starijih odraslih

Introduction. The aging of the human organism brings with it a decrease in bodily functions, both motor and cognitive, and the probability of developing numerous diseases and conditions increases. The most common difficulties faced by the elderly are reduced ability to control balance and control gait due to muscle weakness and reduced coordination. The consequences of falls in elderly population are increase in mortality and morbidity and effects on quality of life, and work is needed to prevent falls in this population. Over the past few decades, the integration of information and communication technology (ICT) into healthcare has given rise to a novel research field. One prominent aspect within this field is the widespread adoption of virtual reality (VR) and/or exergaming in various medical areas. This study aims to explore the potential usability of virtual reality and exergames as a preventive measure against falls in older adults. Methods. A search of literature was conducted through PubMed and Scopus databases, using search strings and inclusion and exclusion criteria. Results. A total of 330 papers were identified through databases search, and after study selection process, 8 studies were included in this review. Conclusion. The use of these interventions has a promising effect on improving the balance, gait, motor, and cognitive functions of the older adults, which are all factors that are correlated with a reduction in the risk of falls in the studied population.

Battling the "Imposter": Our Experience in the Development of an Advance Practice Provider Fellowship.

In the face of ever-evolving shifts in health care, the demand for advanced practice providers (APPs), including nurse practitioners and physician assistants, continues to grow as the nation faces provider shortages and increased patient complexity. Because of different educational backgrounds and previous professional experience, there is a gap in readiness for practice following completion of academic programs, leading to high rates of turnover and financial implications for health care institutions. The creation of APP fellowship programs is a strategy many health institutions implement to provide enhanced support for new graduate APPs. These programs offer fully licensed and credentialed nurse practitioners and physician assistants additional experience within medical specialty areas. The establishment and operational cost associated with an APP fellowship program is a significant barrier health systems face. This article discusses how Saint Luke's Health System developed an APP fellowship program to address these barriers. The model addresses specific fellow needs and has contributed to improved employee retention rates, increased clinical competency, and overall provider satisfaction within Saint Luke's Health System. The evolution of the model, successes, barriers, and opportunities for future program growth are discussed within this article.

AgNPs incorporated in Eu(III)-doped hydroxyapatite biomaterial: Spectroscopic, cytotoxicity, and antimicrobial investigation

This study aimed to synthesize and to characterize hydroxyapatite with antimicrobial action. For the synthesis, the precursors calcium nitrate and phosphoric acid were employed; europium(III), 1 % w/w in relation to calcium(II), was used as spectroscopic probe, to investigate structural alterations. Silver nanoparticles, as antimicrobial agents, were added to the resulting material. Formation of the hydroxyapatite phase was confirmed by X-ray diffraction and vibrational spectroscopy in the infrared region. Incorporation of silver nanoparticles in the material was confirmed by electronic absorption spectroscopy in the ultraviolet–visible region, through the absorption band at approximately 400 nm. Scanning electron microscopy revealed that the material had adequate morphology to induce bone formation. The excitation, emission, and lifetime measurements of the structural probe, europium(III), showed that the hydroxyapatite unit cell had two symmetry sites. Cytotoxicity evaluation in human cells showed that the material was toxic at concentrations above 1250 μg/mL. At 2000 ppm, the material displayed antimicrobial activity against E. coli, but the maximum evaluated concentration was insufficient to verify activity against S. aureus. Therefore, hydroxyapatite bearing silver nanoparticles is a promising material for application in the medical area.

ChatGPT in the development of medical questionnaires. The example of the low back pain.

In the last year, Chat Generative Pre-Trained Transformer (ChatGPT), a web software based on artificial intelligence has been showing high potential in every field of knowledge. In the medical area, its possible application is an object of many studies with promising results. We performed the current study to investigate the possible usefulness of ChatGPT in assessing low back pain. We asked ChatGPT to generate a questionnaire about this clinical condition and we compared the obtained questions and results with the ones obtained by other validated questionnaires: Oswestry Disability Index, Quebec Back Pain Disability Scale, Roland-Morris Disability Questionnaire, and Numeric Rating Scale for pain. We enrolled 20 subjects with low back pain and we found important consistencies among the validated questionnaires. The ChatGPT questionnaire showed an acceptable significant correlation only with Oswestry Disability Index and Quebec Back Pain Disability Scale. ChatGPT showed some peculiarities, especially in the assessment of quality of life and medical consultation and treatments. Our study shows that ChatGPT can help evaluate patients, including multilevel perspectives. However, its power is limited, and further research and validation are required.

Haitian State Hospital Orthopedic Grand Rounds Series: A Virtual Curriculum to Address Global Surgery Needs.

Orthopedic Relief Services International (ORSI), in partnership with the Foundation for Orthopedic Trauma and the department of Orthopedic Surgery of La Paix University Hospital in Haiti, has developed a year-round Orthopedic Grand Round series. This series is moderated by Haitian faculty, features presentations by American orthopedic surgeons, and is broadcast to major state hospitals in Haiti for residents and attendings. To introduce clinical concepts and increase knowledge in an area that is medically underserved, especially in the field of orthopedics, through lectures that tailor to the educational needs of Haiti. Topics for lecture series are requested by Haitian attending orthopedic surgeons and residents in collaboration with American orthopedic surgeons to meet the educational needs of the residents in Haiti. These lectures reflect the case mix typically seen at state hospitals in Haiti and consider the infrastructural capacity of participating centers. Grand rounds are held an average of twice per month for an hour each, encompassing an educational lesson followed by an open forum for questions and case discussion. Feedback is taken from Haitian residents to ensure the sessions are beneficial to their learning. To date 95 sessions hosted by 32 lecturers have been completed over Zoom between the US and Haiti. The fourth year of the lecture series is currently ongoing with an expansion of topics. In an underserved medical area such as Haiti, programs that educate local surgeons are crucial to continuing the growth and development of the medical community. Programs like this have the potential to contribute to the educational infrastructure of countries in need, regardless of the specialty. The model of this program can be used to produce similar curricula in various specialties and areas around the world.

Abstract A097: Assessing patterns of cancer screening uptake, healthcare access, health status, and the county-level Social Vulnerability Index in Louisiana

Abstract Background The Social Vulnerability Index (SVI) was originally developed to identify areas of high need prior to a disaster but it can also be used to identify medical underserved communities and areas of shortages of medical care. There are four major themes that contribute to SVI: 1) socioeconomic status, 2) household characteristics, 3) racial and ethnic minority status, and 4) housing type/transportation which can be used to examine cancer screening uptake in communities as their socioeconomic makeup contributes to the ability of individuals to access cancer screening. Cancer screenings are essential and highly effective tools when diagnosing cancer early which significantly improves chances of cancer survival and decreases chances of morbidity. This study aims to examine the association of county-level cancer screening uptake and SVI patterns in Louisiana while adjusting for healthcare utilization and self-reported health status. Methods 2020 county level age-adjusted cancer screening rates for breast, cervical, and colorectal, healthcare utilization rates, and health status rates for Louisiana were obtained from CDC’s PLACES website and SVI were obtained from CDC ATSDR. The county-level SVI was recoded into four categories: very low (0-.2499), low (0.2500-0.4999), high (0.5000-0.7499), and very high (0.7500-1.000) with high SVI implying least amount of resources. Linear regressions were used to assess the associations between screening rates and SVI quartiles while adjusting for healthcare utilization and health status variables. Results Of the 64 counties in Louisiana, the mean for county-level cancer screening rate were 1) breast cancer at 74.93% (range, 70.40%-79.90%), 2) colorectal cancer at 68.60% (range, 62.60%-75.10%), and cervical cancer at 81.57% (range, 77.4%-85.60%). The multivariable regression models showed very high SVI was associated with low cancer screening rates. When comparing very high SVI and very low SVI, the unadjusted odds ratio (OR) for cervical cancer screening, 0.25 (95% CI, 0.11-0.54) and colorectal cancer screening, 0.59 (95% CI, 0.18-0.59) showed significance. After adjusting for healthcare utilization and health status among very high SVI and very low SVI, all three breast, cervical, and colorectal cancer screening showed statistically significant associations. For uninsured rates, unadj. OR for breast, 8.95 (95% CI, 3.32-24.18) cervical, 5.16 (95% CI, 1.90-14.05) and colorectal, 7.12 (95% CI, 2.44-20.76) showed significance. For general health status, unadj. OR for breast, 9.42 (95% CI, 3.60 - 24.63) cervical, 6.64 (95% CI, 2.68 - 16.44) and colorectal, 9.94 (95% CI, 3.46 - 28.58) showed significance. Conclusions This study found that areas with very high SVI had low rates of cancer screening rates, low healthcare utilization, and high levels of self-reported fair/poor general, mental, and physical health status. These areas may benefit from community level interventions to address barriers to care and better dialogues of the importance of keeping up with routine checkup including cancer screenings. Citation Format: Malesa Pereira, Bilikisu Elewonibi. Assessing patterns of cancer screening uptake, healthcare access, health status, and the county-level Social Vulnerability Index in Louisiana [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A097.

HPR199 To Operationalize the VBHC in the Medical Device Area – An Italian Experience

HPR199 To Operationalize the VBHC in the Medical Device Area – An Italian Experience

Synthesis and specific biomedical applications of polymer brushes

The modification of surfaces with various polymer chains through interactions involving strong covalent bonds is a current focal point. The relevance of this subject lies in the diversification of polymeric structures, particularly applicable in biomedical engineering and medicine. Presently, designs for drug carrier systems have reached an advanced stage, and novel polymer-based materials have been successfully synthesized. Polymeric brushes find applications in crucial medical areas such as artificial tissue engineering, implants, and biosensors. The advantages of polymeric brushes include their sensitivity to stimuli, a variety of polymer types and synthesis methods, tunability, and high biocompatibility. This study comparatively examines grafting approaches and polymerization techniques frequently encountered in the literature, highlighting their primary medical applications.

Highly Sensitive Temperature Sensor Based on Vernier Effect Using a Sturdy Double-cavity Fiber Fabry-Perot Interferometer.

Temperature measuring is a daily procedure carried out worldwide in practically all environments of human activity, but it takes particular relevance in industrial, scientific, medical, and food processing and production areas. The characteristics and performance of the temperature sensors required for such a large universe of applications have opened the opportunity for a comprehensive range of technologies and architectures capable of fulfilling the sensitivity, resolution, dynamic range, and response time demanded. In this work, a highly sensitive fiber optic temperature sensor based on a double-cavity Fabry-Perot interferometer (DCFPI) is proposed and demonstrated. Taking advantage of the Vernier effect, we demonstrate that it is possible to improve the temperature sensitivity exhibited by the polymer-capped fiber Fabry-Perot interferometer (PCFPI) up to 39.8 nm/°C. The DCFPI is sturdy, reconfigured, and simple to fabricate, consisting of a semi-spherical polymer cap added to the surface of the ferrule of a commercial single-mode fiber connector (SMF FC/PC) placed in front of a mirror at a proper distance. The length of the air cavity (Lair) was adjusted to equal the thickness of the polymer cap (Lpol) plus a distance δ to generate the most convenient Vernier effect spectrum. The DCFPI was packaged in a machined, movable mount that allows the adjustment of the air cavity length easily but also protects the polymer cap and simplifies the manipulation of the sensor head.

A systematic review and meta-analysis on ChatGPT and its utilization in medical and dental research

BackgroundSince its release, ChatGPT has taken the world by storm with its utilization in various fields of life. This review's main goal was to offer a thorough and fact-based evaluation of ChatGPT's potential as a tool for medical and dental research, which could direct subsequent research and influence clinical practices. Methods: Different online databases were scoured for relevant articles that were in accordance with the study objectives. A team of reviewers was assembled to devise a proper methodological framework for inclusion of articles and meta-analysis. Results: 11 descriptive studies were considered for this review that evaluated the accuracy of ChatGPT in answering medical queries related to different domains such as systematic reviews, cancer, liver diseases, diagnostic imaging, education, and COVID-19 vaccination. The studies reported different accuracy ranges, from 18.3 % to 100 %, across various datasets and specialties. The meta-analysis showed an odds ratio (OR) of 2.25 and a relative risk (RR) of 1.47 with a 95 % confidence interval (CI), indicating that the accuracy of ChatGPT in providing correct responses was significantly higher compared to the total responses for queries. However, significant heterogeneity was present among the studies, suggesting considerable variability in the effect sizes across the included studies. Conclusion: The observations indicate that ChatGPT has the ability to provide appropriate solutions to questions in the medical and dentistry areas, but researchers and doctors should cautiously assess its responses because they might not always be dependable. Overall, the importance of this study rests in shedding light on ChatGPT's accuracy in the medical and dentistry fields and emphasizing the need for additional investigation to enhance its performance.© 2017 Elsevier Inc. All rights reserved.

1245. Knowledge, Attitudes, and Practices of Healthcare Workers towards Antimicrobial Stewardship in Dr. Paulino J. Garcia Memorial Research and Medical Center: A Cross Sectional Study

Abstract Background Antimicrobial resistance, a challenge faced by the public health sector, occurs when pathogens are no longer susceptible to common medicines used to treat them. Several studies have shown that reduction in antibiotic prescription could be done successfully through behavioral intervention. It is important to ensure that antimicrobials are prudently used to preserve its efficacy and enable maximum therapeutic effect. This study assessed the knowledge, attitudes, and practices of healthcare workers towards antimicrobial stewardship at Dr. Paulino J. Garcia Memorial Research and Medical Center in Nueva Ecija, Philippines. Methods Cross-sectional design was used in this study. Stratified random sampling and proportional allocation to each stratum was used. Healthcare workers including physicians who routinely prescribed antibiotics; nurses assigned at the wards, and pharmacists were included. Questionnaires were self-administered. Kruskal-Wallis H Test and Dwass-Steel-Critchlow-Fligner pairwise comparisons were used in data analysis. Results There were a total of 142 participants. Significant differences were noted on actual knowledge between physicians and nurses, on hand hygiene between physicians and nurses and nurses and pharmacists, on perceived knowledge between surgical area and family medicine and medical area and family medicine. There was also a significant difference between physicians and nurses on attitudes towards antimicrobial stewardship. There were no significant differences noted in the practices of healthcare workers. Conclusion Healthcare workers are essential in the fight against antimicrobial resistance. Physicians, nurses, and pharmacists had overall good knowledge, attitudes, and practices towards antimicrobial stewardship but despite this, attention must be given to subsets of the study garnering a poor or moderate level of knowledge. This must be addressed by reinforcing previous known concepts and conducting regular trainings and seminars. Factors affecting the knowledge and practice of antimicrobial stewardship program must also be explored. Disclosures All Authors: No reported disclosures

Photodynamic Eradication of Pseudomonas aeruginosa with Ru-Photosensitizers Encapsulated in Enzyme Degradable Nanocarriers.

The development of new approaches for the treatment of the increasingly antibiotic-resistant pathogen Pseudomonas aeruginosa was targeted by enhancing the effect of local antimicrobial photodynamic therapy (aPDT) using poly(ethylene glycol)-block-poly(lactic acid) (PEG114-block-PLAx) nanocarriers that were loaded with a ruthenium-based photosensitizer (PS). The action of tris(1,10-phenanthroline) ruthenium (II) bis(hexafluorophosphate) (RuPhen3) encapsulated in PEG114-block-PLAx micelles and vesicles was shown to result in an appreciable aPDT inactivation efficiency against planktonic Pseudomonas aeruginosa. In particular, the encapsulation of the PS, its release, and the efficiency of singlet oxygen (1O2) generation upon irradiation with blue light were studied spectroscopically. The antimicrobial effect was analyzed with two strains of Pseudomonas aeruginosa. Compared with PS-loaded micelles, formulations of the PS-loaded vesicles showed 10 times enhanced activity with a strong photodynamic inactivation effect of at least a 4.7 log reduction against both a Pseudomonas aeruginosa lab strain and a clinical isolate collected from the lung of a cystic fibrosis (CF) patient. This work lays the foundation for the targeted eradication of Pseudomonas aeruginosa using aPDT in various medical application areas.

659. Geographical Clustering of the Likelihood of Treatment in Histologically Diagnosed Helicobacter pylori in the BOSTON-HP Cohort

Abstract Background The BIDMC Optimization & Standardization for Treatment Outcomes in New England for Helicobacter Pylori (BOSTON-HP) study included 1002 patients with confirmed Helicobacter pylori (HP) via gastric histopathology from 2016-2022 to evaluate the effects of a Multidisciplinary Division Wide Program. Our previous data showed that demographic factors, such as race/ethnicity and preferred language, are associated with treatment, test-of-cure, and eradication outcomes. We hypothesize that given an unlikely even geographic distribution of demographic factors, HP outcomes may cluster geographically. Methods The BOSTON-HP cohort patient addresses were transformed to georeferenced coordinates which were mapped using QGIS (3.30 's-Hertogenbosch) onto OpenStreetMap. We calculated the maximum Euclidean distance matrix to assign heatmap weights for each outcome, and calculated global spatial autocorrelation to evaluate the extent of spatial clustering. Results Eight hundred and sixty-eight patients (86.6%) received treatment with confirmed eradication in 416 (47.9%) of them. A statistically significant positive spatial autocorrelation of clusters (Moran’s I = 0.080, p =0.003, z=2.787) was observed for the likelihood of treatment. Layering transportation and healthcare units revealed key clustering patterns (see Figures 1. & 2.). Clusters in the vicinity of Longwood Medical Area (LMA), and South Cove Medical Center (SCMC) were more likely to receive treatment, while those in the Brighton collegiate area (BCA) and along the Red Line Axis in Roxbury-Dorchester (RLRD) were less likely to receive treatment. Test-of-cure and eradication success were not statistically significant for clustering (Moran’s I = 0.007, p =0.388, z=0.284) (Moran’s I = 0.006, p =0.441, z=0.149), respectively.Figure 1. BOSTON-HP Treatment Cohort.Figure 2. Untreated in the BOSTON-HP Cohort. Conclusion A moderate and significant spatial correlation existed between the likelihood of HP treatment and the geographic location of the patient’s residence. Identification of groups for targeted quality improvement interventions (RLRD) and models of success within the system (SCMC) can help improve treatment outcomes and reduce geographic disparities. Disclosures Javier Villafuerte-Gálvez, MD, Milky Way Biosciences: Partial Research Support.