MET Score Research Articles

OGC SO28 - Predictors of Pulmonary Complications Following Thoracoscopic Oesophagectomy

Abstract Background Thoracoscopic oesophagectomy, a minimally invasive technique, is associated with less postoperative pain and reduced pulmonary dysfunction. There is a correlation between preoperative cardiopulmonary fitness and postoperative outcomes, with certain variables linked to a higher risk of complications following oesophagogastric cancer surgery. This review aims to identify variables that correlate with pulmonary complications after oesophagectomy. Method A retrospective review of patients undergoing thoracoscopic oesophagectomy between 2014 -2022 at a single oesophagogastric unit was performed. 96 patients were identified and separated into two groups (19 with serious complications (SC) (greater than Clavien Dindo 3b), and 77 without serious complications (Clavien Dindo 3a and below)(NC). The primary outcomes measured included FEV1, FVC, VE/VCO2, VO2 Peak, anaerobic threshold, Estimated Met Score (EMS). Secondary outcomes measured preexisting pulmonary complications, smoking status and operating (chest time, one lung ventilation time (OLVT)). Results Groups were similar in age, gender, BMI, ASA, and clinical stage. SC had a significantly less number of smokers (p=0.004) and less individuals with pulmonary disease (p=0.019). AT was higher in NC (14.15 vs 13.50, p=0.355) and VE/VCO2 was significantly greater in SC (28 vs 32, p=0.018). SC had a significantly lower FEV1 and FVC (2.12 vs 2.81, p=0.009 and 3.11 vs 3.80, p=0.010) and a trend towards a lower EMS (6.95 vs 7.25, p=0.245). There was no significant difference in chest time between NC and SC (295min vs 265min, p=0.151) and OLVT (270min vs 245min, p=0.381) in both groups. Conclusion VE/VCO2 ratio in thoracoscopic oesophagectomy patients is a significant predictor of postoperative complications and has increasing links to adverse outcomes. Smoking status and pulmonary history do not significantly correlate with pulmonary complications in our cohort. Lower EMS, FEV1, and FVC are significantly associated with complications. Although preoperative inspiratory muscle training has not broadly impacted postoperative outcomes, it may benefit specific groups. These variables are crucial for clinicians to consider when counselling patients and planning prehabilitation.

Retrospective Correlation of the Circulation Time of Test Bolus Injections in MR Angiography and Cardiac Function

This retrospective study examines 248 test bolus examinations preceding contrast-enhanced magnetic resonance angiography (CE-MRA) to extract clinically relevant data for critical limb ischemia (CLI) management. The method involved a retrospective review of test bolus exams, analysing 60 graphs for time to peak (TTP), full-width half-maximum (FWHM) time, and time to continual rise in signal intensity. These values were correlated with heart function parameters (ejection fraction, ASA classification, Lee index, and MET score). The results indicate a mean TTP of 31.2 ± 7.3 s, showing a correlation between the ejection fraction and ASA classification. Patients with atrial fibrillation exhibited prolonged TTP compared to those without. Despite population heterogeneity, these findings facilitate risk stratification for limb-saving interventions in CLI. TTP emerges as a potential clinical cardiovascular parameter and a risk factor for vascular interventions. Given the variation in injection protocols across centres, this study underscores the importance of precise bolus arrival time documentation for future multicentre studies.

The health-related physical fitness of university female students with and without generalized joint hypermobility: A case-control study

Objective: To evaluate the effect of generalized joint hypermobility (GJH) on health-related physical fitness. Participants: Female university students between the ages of 18-23. Methods: Cardiorespiratory fitness ((maximal cycling ergometer tests, six-minute walking tests (6MW)), respiratory function tests, respiratory muscle strength (maximal inspiratory and expiratory pressure), body composition (bioelectrical impedance analyses), flexibility (sit and reach tests (SRT), muscle strength and endurance (isometric and isokinetic tests) were evaluated for health-related physical fitness. Results: The mean VO2max (23.6 vs. 21.8, p=.049), MET (6.7 vs. 6.3, p=0.049), W/kg (1.6 vs. 1.5, p=0.035), and SRT scores (23.3 vs. 18.7, p=0.016) were higher in 39 students with asymptomatic GJH compared to 42 non-GJH students. No significant differences found between groups for 6MW, FVC, FEV1, MIP, MEP, body composition, muscle strength, and endurance (p>.05). Conclusion: Females with generalized joint hypermobility have the same or even higher levels of physical fitness capacity as those without the hypermobility.

Comparison of the effects of esketamine, sufentanil, or lidocaine combined with propofol on tussis reflection during upper gastrointestinal endoscopy: study protocol for a randomised, two centre, three-blind, controlled trial

BackgroundTussis, which increases the incidence of airway spasm, aspiration, nausea, and vomiting, is a common complication faced during upper gastrointestinal (GI) endoscopy. However, sedatives and analgesics exhibit inhibitory actions against airway reflexes to different degrees. Our assumption is a combination of propofol and small doses of sufentanil, esketamine, or lidocaine, especially the combination of propofol and esketamine, might reduce tussis incidence.MethodThe study will be performed as a randomised controlled three-blind, two-centre trial. Patients undergoing upper GI endoscopy, ≥ 18 years old, with American Society of Anesthesiologists (ASA) classification I–III will be randomised to four groups: P group (single administration of propofol), P + S group (administration of propofol and sufentanil in combination), P + K group (administration of propofol and esketamine in combination), and P + L group (administration of propofol and lidocaine in combination) (N = 100 per group). The primary endpoints include the frequency of tussis, nausea and vomiting, and/or body movements observed at the insertion of the endoscope into the pharyngeal cavity or within 5 min of endoscope insertion. Secondary outcomes are recovery assessment, patients’ and endoscopists’ satisfaction with the procedure, MMSE scores, MET scores, sleep condition, and the number of sedation-related events. Data on sedation-related events are collected by recording of vital signs. Satisfaction parameters and mental states are collected by means of questionnaires and evaluation scales before and after the procedure and on different following days.DiscussionEsketamine can reduce tussis occurrence with good tolerability and relax the bronchus and also provides high clearance rates and low possibility of adverse reactions. We aim to demonstrate that the combination of esketamine with propofol for sedation in patients subjected to upper GI procedure is nevertheless superior to only administration of propofol or a combination of propofol with other anaesthetics, such as opioids or lidocaine.Trial registrationClinicalTrials.gov. NCT05497492, Registered 09 August 2022.

Fatigue and physical activity levels in poles living in Poland and the United Kingdom in the further year of the COVID-19 pandemic: a pilot study

SummaryObjectivesThe aim of this study was to conduct a preliminary assessment of the prevalence of fatigue and level of physical activity, as well as the relationship between fatigue and physical activity among Poles living in Poland and the United Kingdom (UK) in the further year in the COVID-19 pandemic.MethodsA web-based online survey was conducted among Poles living permanently in Poland and the UK in January 2023. Responses were obtained from 200 respondents aged 18–69 years. The level of fatigue was assessed by the Modified Fatigue Impact Scale (MFIS). The level of physical activity was measured by the International Physical Activity Questionnaire (IPAQ).ResultsThe median for the total fatigue score was equal to 17 points out of a possible 105. 13.5% of the subjects had a low level of physical activity, the average MET for high-intensity activity was 1294.55 METs, for moderate activity 714.44 METs, and for walking 631 METs. As age and number of COVID-19 cases increased, scores on the MFIS questionnaire scale also increased. With an increase in the number of COVID-19 cases, high-intensity MET scores decreased.ConclusionsThe level of fatigue, in contrast to the level of physical activity, was low in the study population. There were few statistically significant differences in fatigue between people living in Poland and the UK. Further experimental studies on the physiological mechanism of differences in fatigue and physical activity are needed.

Analysis of the Relationship between Physical Activity and the Factors Related to Weight Management of Bariatric Surgery Patients.

We aimed to analyze the relationship between physical activity and the factors related to the weight management of bariatric surgery patients. This descriptive-correlational study was conducted on 87 participants, who underwent bariatric surgery in Cyprus between May and Oct 2020. The International Physical Activity Questionnaire and a questionnaire on socio-demographic and obesity characteristics were used to collect data. Mean age of the participants was 34.7±8.43 and 65.5% were female. A statistically significant difference was found between physical activity levels and weight loss (P=0.021). Post-bariatric surgery physical activity level was low active for 65.5% of the participants. There was a statistically significant difference between the MET scores of the participants according to their gender, and the scores of men were higher than women (2256.9; 1110.9 respectively). Although most of the participants in the study were females, women lost less weight than males (45.5; 54.2 respectively). Being female, married, and having chronic diseases caused less weight loss after bariatric surgery. As the physical activity levels of the patients increased, their weight loss increased. In line with these results, people undergone bariatric surgery and are at risk of regaining weight should be followed closely after surgery and appropriate physical activities should be planned.

Assessment of dyspnoea and physical activity levels among Poles living in Poland and the United Kingdom in the third year of the COVID-19 pandemic – a pilot study

Objectives. The aim of this study was to assess the extent of dyspnoea and the relationship between dyspnoea and physical activity among Poles living in Poland and the United Kingdom (UK) in the third year of the COVID-19 pandemic. Methods. The pilot study was conducted in January 2023. The study authors received 200 questionnaires from respondents aged 18-69 years (104 from Poland and 96 from the UK). The level of dyspnoea was assessed using the Medical Research Council Dyspnoea Scale (MRC) questionnaire. Level of physical activity was measured using the International Physical Activity Questionnaire (IPAQ). Results. In the majority of cases, dyspnoea occurred only during heavy physical exertion and increased with age and more cases of COVID-19. A trend towards increasing dyspnoea with decreasing MET scores for moderate physical activity was observed. Respondents’ country of residence was not correlated with dyspnoea level. Conclusions. The introduction of regular physical activity may have an impact on reducing dyspnoea. Dyspnoea is a factor that influences the reduction of physical activity and leads to a change to a sedentary lifestyle.

Decoding the metastatic potential and optimal postoperative adjuvant therapy of melanoma based on metastasis score

Metastasis is a formidable challenge in the prognosis of melanoma. Accurately predicting the metastatic potential of non-metastatic melanoma (NMM) and determining effective postoperative adjuvant treatments for inhibiting metastasis remain uncertain. In this study, we conducted comprehensive analyses of melanoma metastases using bulk and single-cell RNA sequencing data, enabling the construction of a metastasis score (MET score) through diverse machine-learning algorithms. The reliability and robustness of the MET score were validated using various in vitro assays and in vivo models. Our findings revealed a distinct molecular landscape in metastatic melanoma characterized by the enrichment of metastasis-related pathways, intricate cell–cell communication, and heightened infiltration of pro-angiogenic tumor-associated macrophages compared to NMM. Importantly, patients in the high MET score group exhibited poorer prognoses and an immunosuppressive microenvironment, featuring increased infiltration of regulatory T cells and decreased infiltration of CD8+ T cells, compared to the low MET score patient group. Expression of PD-1 was markedly higher in patients with low MET scores. Anti-PD-1 (aPD-1) therapy profoundly affected antitumor immunity activation and metastasis inhibition in these patients. In summary, our study demonstrates the effectiveness of the MET score in predicting melanoma metastatic potential. For patients with low MET scores, aPD-1 therapy may be a potential treatment strategy to inhibit metastasis. Patients with high MET scores may benefit from combination therapies.

Peripheral neuropathy and lifestyle factors in women with breast cancer receiving taxane-based chemotherapy: Pathway analysis

PurposePeripheral neuropathy adversely affects the treatment process of cancer, and thus it is important to reveal the factors leading to peripheral neuropathy and to take the necessary precautions to avoid it. This study was conducted to investigate the relationship between chemotherapy-induced peripheral neuropathy (CIPN) and lifestyle factors (nutrition, physical activity and sleep quality). MethodsThis descriptive and correlational study was conducted with 108 individuals who were treated in the chemotherapy unit of a hospital between April 2021 and April 2022 in Turkey. Data were collected using the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (CIPNAT), the International Physical Activity Questionnaire (IPAQ), the Mini Nutritional Assessment Test (MNA), and the sleep level Visual Analog Scale. Number, percentages, means, and standard deviations were calculated, and multiple linear regression analysis and path analysis were conducted to analyze the data. ResultsThe results indicate that the total MET score significantly and positively predicted the sleep scale score (β = 0.24, p < 0.01), while it negatively and significantly predicted the CIPNAT score (β = −0.30, p < 0.001). In addition, both the MNA screening score and the sleep scale score significantly and negatively predicted the CIPNAT score (β = −0.25, p < 0.01, β = −0.29, p < 0.001, respectively). ConclusionsLifestyle factors (exercise, nutrition, sleep) were found to have an effect on peripheral neuropathy. It is thought that increasing the level of exercise improves sleep quality, and regular nutrition, quality sleep and increased physical activity may be effective in reducing peripheral neuropathy.

ADOLESAN SPORCULARIN ERGOJENİK DESTEK KULLANIMINDA, FİZİKSEL VE MENTAL YORGUNLUK DÜZEYİNİN YORDAYICILIĞI

Being involved in the developmental period of adolescent athletes may cause more energy and fatigue levels. At this point, the correct and appropriate use of ergogenic supports can contribute to athletes. The study aims to reveal the predictors of fatigue and physical activity levels in adolescent athletes' use of ergogenic support. 171 (female: 98, male: 73) licensed athletes from the Provincial Directorate of Youth and Sports participated in the research voluntarily. Demographic information questionnaire, International Physical Activity Questionnaire-short form (IPAQ-SF), and Chalder Fatigue Scale were used in the research. The data collected in the study were analyzed in the Jamovi (2.0.0) statistical program at a 95% confidence interval and 0.05 significance level. In the analysis of the data, frequency (N), mean (x̄), standard deviation (ss), percentage (%), minimum (Min.), and maximum (Max.) values, Pearson's correlation and binomial logistic regression analysis were used. According to the findings of the study, most of athletes do not prefer to use ergogenic support. Those who use ergogenic support mostly use sports drinks, fish oil, and protein powder. Fatigue and total MET levels do not predict the use of ergogenic support by athletes. As a result, it can be said that adolescent athletes do not prefer to use ergogenic support and although their total MET scores are high, their fatigue levels are at a normal level.

A three-month physical training program improves cardiovascular autonomic function in patients with metabolic syndrome with and without diabetes - a pilot study.

Vascular complications and neuropathy may develop in the presence of metabolic syndrome. The aim of our study was to measure the cardiovascular autonomic function following physical training in patients with metabolic syndrome with and without diabetes. 56 patients with metabolic syndrome (32 men/24 women, 40 non-diabetic patients (NDMetS)/16 diabetic patients (DMetS) [mean ± SD]: age: 50.35 ± 8.03 vs. 56.8 ± 9.30 years, p=0.023; baseline BMI: 32.2 ± 7.03 vs. 32.8 ± 5.94 kg/m2, p=0.739) were involved in our study. All tests and measurements were carried out before and following a 3-month physical training period. Autonomic function was assessed by means of five standard cardiovascular reflex tests. ECG repolarization parameters, including short-term QT variability and stress-ECG were also measured. In the whole population, Valsalva-ratio (VR) and the autonomic score (AS) improved following training (VR: 1.49 ± 0.24 vs. 1.64 ± 0.34, p=0.001; AS: 2.05 ± 1.73 vs. 1.41 ± 1.36, p=0.015) accompanied by the significant decrease of the systolic (150.3 ± 16.12 vs. 134.1 ± 16.67 mmHg, p<0.001) and diastolic (90.64 ± 12.8 vs. 82.79 ± 11.1 mmHg, p<0.001) blood pressure. An improvement in VR was detected in NDMetS patients following training (1.51 ± 0.24 vs. 1.67 ± 0.31, p= 0.002). No significant changes could be detected in autonomic tests' results in the DMetS patient group following training. The applied exercise training program did not lead to significant changes in ECG repolarization. The stress-ECG test in the whole study population yielded a significant increase in the test duration (12.9 ± 3.76 vs. 15.1 ± 2.96min, p<0.001) and in the test load (10.5 ± 2.78 vs. 11.6 ± 2.39 MET, p<0.001). The load capability improved significantly in both subgroups: 11.1 ± 2.04 vs. 12.1 ± 1.82, (p<0.001) and 9.0 ± 3.64 vs. 10.4 ± 3.05, (p=0.033) in subpopulations of NDMetS and DMetS, respectively. The DMetS patients achieved a significantly lower MET score at baseline (p=0.039) and following training (p=0.044) in comparison to the NDMetS patients. The three-month exercise program improved the Valsalva-ratio and the AN score in the MetS patients, that is potentially protective against cardiovascular events. The training had some beneficial effect on blood pressure and the results of the stress-ECG tests in both groups. The absence of significant change in the reflex tests in DMetS group reflects an impaired adaptation compared to the NDMestS group.

Prevalence and correlates of premenstrual syndrome and premenstrual dysphoric disorder among women aged 18-25 in Turkey.

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are experienced in the luteal phase among women of reproductive age and affect the quality of life. This study sought to determine the prevalence and correlates of PMS and PMDD in women aged 18-25. A cross-sectional study was conducted between December 2022 and May 2023, which recruited 1125 female college students. A personal information form, the International Physical Activity Questionnaire, and the Premenstrual Syndrome Scale (PMSS) were administered. Participants who met the criteria for PMS during three consecutive menstrual cycles based on the ACOG and PMSS scores were diagnosed as having PMS. Participants who met the criteria for PMDD during three consecutive menstrual cycles based on the DSM-V were diagnosed as having PMDD. Logistic regression analysis was used to determine independent correlates of PMS and PMDD. PMS was found in 49.2% and PMDD in 48.0% of the participants. Women having a B blood group compared to those with A blood group were more likely to have PMS (OR = 151.80, 95% = 54.50-422.57). In addition, women with PMS were less likely to be physically active based on the metabolic equivalent of task score (OR = 0.99,95% = 0.98-0.99). Menstrual cycle duration was also longer among those with PMDD (OR = 1.47, 95% = 1.25-1.72), as was daily caffeine intake (OR = 1.01,95% = 1.00-1.01). PMSS score was also found to be associated with MDD (OR = 1.06,95% = 1.05-1.07). PMS and PMDD are associated with blood groups, MET scores, and other clinical characteristics that may help clinicians to identify these conditions among young women in Turkey.

Hip resurfacing arthroplasty in women: A novel ceramic device enables near normal gait function

BackgroundGait function improves after Total Hip Arthroplasty (THA) but is not restored to normal levels. Metal-on-metal Resurfacing Arthroplasty (MoM-HRA) is an alternative to THA and has shown to restore normal levels gait function and physical activity but has been restricted to men owing to problems of metal-ion release. Ceramic HRA (cHRA) removes the cobalt-chrome bearing surfaces, thereby eliminating these specific metal-ion concerns and aiming to be safe for females. Research questionIs there a difference in gait function of female cHRA patients compared to female THA using subjective and objective measures? MethodsFifteen unilateral cHRA and 15 unilateral THA, age and BMI matched, completed patient reported outcome measures (PROMs) (Oxford Hip Score, EQ5d and MET score) and underwent gait analysis using an instrumented treadmill pre- (2–10 weeks) and post-operatively (52–74 weeks). Maximum walking speed (MWS), Vertical GRF of the stance phase, GRF symmetry index (SI) and spatiotemporal gait measures were recorded. Patients were compared to age, gender and BMI healthy controls (CON). ResultsThere were no differences in PROMs or gait function between groups pre-operatively. Post- operatively, cHRA had a higher MET score (11.2 vs 7.1, p = 0.02) and a higher MWS (6.2 vs 6.8 km/hr, p = 0.003) compared to THA. cHRA had a similar GRF profile to CON, whereas THA had a reduced push-off force at 70–77 % of the stance phase compared to CON. At faster walking speeds of 6 km/hr walking speed, THA displayed an asymmetric GRF profile (SI<4.4 %) whereas the cHRA patients continued to display a symmetrical gait profile. cHRA was able to increase step length from pre-op levels (63 vs 66 cm, p = 0.02) and produced a larger step length compared to THA (73 vs 79 cm, p = 0.02). SignificanceFemale cHRA returned to levels of gait function and activity similar to healthy controls unlike female THA.

An Individualized Prognostic Model in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma Based on Serum Metabolomic Profiling.

This study aims to evaluate the value of a serum metabolomics-based metabolic signature for locoregionally advanced nasopharyngeal carcinoma (LA-NPC) patients, thereby assisting clinical decisions. In this retrospective study, a total of 320 LA-NPC patients were randomly divided into a training set (ca. 70%; n = 224) and a validation set (ca. 30%; n = 96). Serum samples were analyzed using widely targeted metabolomics. Univariate and multivariate Cox regression analyses were used to identify candidate metabolites related to progression-free survival (PFS). Patients were categorized into high-risk and low-risk groups based on the median metabolic risk score (Met score), and the PFS difference between the two groups was compared using Kaplan-Meier curves. The predictive performance of the metabolic signature was evaluated using the concordance index (C-index) and the time-dependent receiver operating characteristic (ROC), and a comprehensive nomogram was constructed using the Met score and other clinical factors. Nine metabolites were screened to build the metabolic signature and generate the Met score, which effectively separated patients into low- and high-risk groups. The C-index in the training and validation sets was 0.71 and 0.73, respectively. The 5-year PFS was 53.7% (95% CI, 45.12-63.86) in the high-risk group and 83.0% (95%CI, 76.31-90.26) in the low-risk group. During the construction of the nomogram, Met score, clinical stage, pre-treatment EBV DNA level, and gender were identified as independent prognostic factors for PFS. The predictive performance of the comprehensive model was better than that of the traditional model. The metabolic signature developed through serum metabolomics is a reliable prognostic indicator of PFS in LA-NPC patients and has important clinical significance.

ASSESSMENT OF PHYSICAL ACTIVITY IN MEDICAL STUDENTS IN A CITY, A CROSS SECTIONAL STUDY

Background:Physical inactivity and the associated health problems pose a current and growing threat to public health. Todays medical student is a future physician. There is an increase in morbidity and mortality among doctors due to noncommunicable diseases. Physical activity plays an important in the prevention of non-communicable diseases, including obesity, diabetes, cardiovascular diseases and stroke. Metabolic equivalent task is used as a means of expressing the intensity of physical activitiy. Aims and Objective:To assess physical activity in MBBS students in a medical college. Material and Methods:It was a cross-sectional study conducted on 200 medical students (129 males and 71 females) aged between 18-25 years. Physical activity of MBBS students was assessed in detail with respect to the time, type and quality of activity. IPAQ (short) questionnaire was used and information was asked about three specific types of activity such as walking, moderate-intensity activities, and vigorous-intensity activities and calculation of MET was done. Results: The MET score was calculated from IPAQ and it was found that 28.5%, 45.5%, and 26% of students fall in low, moderate, and high physical activity groups, respectively. Conclusion:It was observed that nearly a quarter of medical students had low physical activity as calculated by MET. Follow up study in students in the academic period is needed to identify the trend of physical activity among them.

Gene-environment interaction explains a part of missing heritability in human body mass index

Gene-environment (G×E) interaction could partially explain missing heritability in traits; however, the magnitudes of G×E interaction effects remain unclear. Here, we estimate the heritability of G×E interaction for body mass index (BMI) by subjecting genome-wide interaction study data of 331,282 participants in the UK Biobank to linkage disequilibrium score regression (LDSC) and linkage disequilibrium adjusted kinships–software for estimating SNP heritability from summary statistics (LDAK-SumHer) analyses. Among 14 obesity-related lifestyle factors, MET score, pack years of smoking, and alcohol intake frequency significantly interact with genetic factors in both analyses, accounting for the partial variance of BMI. The G×E interaction heritability (%) and standard error of these factors by LDSC and LDAK-SumHer are as follows: MET score, 0.45% (0.12) and 0.65% (0.24); pack years of smoking, 0.52% (0.13) and 0.93% (0.26); and alcohol intake frequency, 0.32% (0.10) and 0.80% (0.17), respectively. Moreover, these three factors are partially validated for their interactions with genetic factors in other obesity-related traits, including waist circumference, hip circumference, waist-to-hip ratio adjusted with BMI, and body fat percentage. Our results suggest that G×E interaction may partly explain the missing heritability in BMI, and two G×E interaction loci identified could help in understanding the genetic architecture of obesity.

Prostate cancer extracellular vesicle digital scoring assay – a rapid noninvasive approach for quantification of disease-relevant mRNAs

Optimizing outcomes in prostate cancer (PCa) requires precision in characterization of disease status. This effort was directed at developing a PCa extracellular vesicle (EV) Digital Scoring Assay (DSA) for detecting metastasis and monitoring progression of PCa. PCa EV DSA is comprised of an EV purification device (i.e., EV Click Chip) and reverse-transcription droplet digital PCR that quantifies 11 PCa-relevant mRNA in purified PCa-derived EVs. A Met score was computed for each plasma sample based on the expression of the 11-gene panel using the weighted Z score method. Under optimized conditions, the EV Click Chips outperformed the ultracentrifugation or precipitation method of purifying PCa-derived EVs from artificial plasma samples. Using PCa EV DSA, the Met score distinguished metastatic (n = 20) from localized PCa (n = 20) with an area under the receiver operating characteristic curve of 0.88 (95% CI:0.78–0.98). Furthermore, longitudinal analysis of three PCa patients showed the dynamics of the Met scores reflected clinical behavior even when disease was undetectable by imaging. Overall, a sensitive PCa EV DSA was developed to identify metastatic PCa and reveal dynamic disease states noninvasively. This assay may complement current imaging tools and blood-based tests for timely detection of metastatic progression that can improve care for PCa patients.

EFEITOS DO TREINAMENTO COM CARGAS PROGRESSIVAS NA RESISTÊNCIA CARDIORRESPIRATÓRIA DE VELOCISTAS

ABSTRACT Introduction: The most evident change during exercise is the increase in oxygen demand, and prolonged high-intensity exercises may impact this even more on this demand. Physical training with progressive loads is a method that aims to reach the training goals by adjusting factors such as initial load, stage load, and a load of the athletes and can be a monitor of the aerobic and anaerobic exercise on the athlete with potential benefits for the high demand of oxygenation. Objective: Study the changes in heart rate and indexes of cardiorespiratory endurance of sprinters under training with progressive loads. Methods: By random sampling, the study subjects were 15 male sprinters and 15 non-sportsmen as research volunteers. The study subjects performed a protocol with progressive load training on a platform. All subjects underwent the Italian Kosmai cardiopulmonary function test before and after training. Results: The subjects who did not practice the sport showed VO2 max values at an exercise intensity of 13 km/h. The VO2 max maximum for sprinters was 15 km/h. Individuals who were not sprinters generally showed lower VT levels than sprinters (P &lt;0.05). Average non-speeder individuals demonstrated higher MET scores than sprinters. Conclusion: Cardiopulmonary endurance and energy metabolism levels are strongly related to long-term participation in physical activity and exercise intensity. Incremental load training improved cardiorespiratory fitness in sprinters. The results may provide a specific theoretical basis for the daily training of sprinters in the future. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

1075. The MET Project: Distinguishing Multisystem Inflammatory Syndrome in Children from Typhus Using Artificial Intelligence

Abstract Background Multisystem inflammatory syndrome in children (MIS-C) following SARS-CoV-2 infection shares features with other inflammatory states, notably Kawasaki Disease. The rickettsial infection murine typhus is also in the differential for MIS-C in endemic areas. As the therapeutic approaches differ, it is essential to distinguish these disorders soon after presentation, well before confirmatory serologic testing results. Our objective was to develop an algorithm to accurately predict MIS-C versus typhus. Methods Retrospective review extracted demographic, clinical, and laboratory features available within 6 hours of presentation for 133 MIS-C and 87 typhus patients. 33 features were broken into 44 inputs and passed through an attention module to compute importance. Inputs were then entered into machine learning algorithms as MIS-C or typhus. Patients were divided into training and test cohorts respecting proportions in the dataset. An equation was built to calculate the “MET” (MIS-C versus endemic typhus) score. Results MIS-C patients were younger (8.4 v 11.2 years, p&amp;lt; 0.0001) and the majority (71%) presented on day 4-6 of fever; most typhus patients (84%) presented with ≥6 days (mean 4.9 v 7.3 days, p&amp;lt; 0.0001). Typhus patients were more likely to have rash (86% v 51%, p&amp;lt; 0.0001) and MIS-C patients red eyes (71% v 36%, p&amp;lt; 0.0001), other features were similar. MIS-C patients had higher C-reactive protein levels (17.7 v 9.8 mg/dL), procalcitonin (14.0 v 0.48 ng/mL), fibrinogen (558 v 394 mg/dL) and neutrophil-to-lymphocyte ratio (12 v 3.5), all p&amp;lt; 0.0001, other parameters were similar. MIS-C patients were also more likely to have elevated troponin (0.48 v 0.01 ng/mL, p&amp;lt; 0.0001) and require intensive care (66% v 6%, p&amp;lt; 0.0001). A long short term memory network outperformed 6 other models (99% accuracy using all 33 elements). The MET score predicted MIS-C versus typhus with 90% accuracy using only 10 features (sensitivity 90%, specificity 90%). Conclusion The clinical and laboratory similarities between typhus and MIS-C present challenges, but they can be reliably distinguished using artificial intelligence with as little as 10 features. Our ongoing interprofessional collaboration aims to make the MET score readily available to clinicians for use in patient encounters. Disclosures Flor M. Munoz, MD, MSc, Gilead: Grant/Research Support|Moderna: DSMB|Pfizer: DSMB Tiphanie Vogel, MD, PhD, Moderna: Advisor/Consultant|Novartis: Advisor/Consultant|Pfizer: Advisor/Consultant.

Abstract P342: Virtual Cardiac Rehabilitation For Heart Failure - Real World Experience Of Medication Adherence, Blood Pressure Control And Exercise Tolerance

Introduction: India has a high burden of young-onset heart failure owing to an increased incidence of ischemic heart disease(IHD) in young and older adults (&lt;60 years). Hypertension affects 207 million adults in India; less than 20% have controlled blood pressure. Cardiac rehabilitation (CR) effectively improves outcomes in patients with heart failure but is very scarce; there is only one spot for every 360 IHD patients/year, with more than 3 million CR spaces needed each year. Methods: Virtual cardiac rehabilitation is administered via a mobile application, Numen Health. This is a physician-led program delivered by a multi-disciplinary team of experts. The experts provide multi-faceted interventions for IHD patients, targeting increased medication adherence, behavior changes, reinforced lifestyle modification, blood pressure control through diet, exercise, and building mental resilience with continued care post-hospital discharge. Results: Between April 2021 and March 2022, 42 patients with low ejection fraction (LVEF&lt;45%) heart failure registered on the program. They represented nearly 10% of 426 IHD patients who had joined the program. Over a median duration of 90 days, target blood pressure control was achieved in 39/42 (93%). Zero hospital re-admissions were encountered; 17/42(40%) achieved improved cardiac and exercise tolerance compared to baseline exercise tolerance time. It had increased from 15 minutes to 30 minutes, 200% from baseline. The median MET score on day 90 was 13 (9-17). Physical activity duration per week increased; to 90 minutes on average; It had risen from the ability to do for &lt;5 minutes at baseline. Medication adherence and clinical follow-up were 100% of the prescribed. A self-rated satisfaction scale scored the program at 90 - 95 /100 on day 30 by all. Conclusions: Virtual Cardiac Rehabilitation in India is feasible and possibly effective in delivering integrated CR services at home. Numen health shows promise in bridging the gap of negligent CR services across India.