Multiple Studies Research Articles

A meta-analysis of the effect of visiting zoos and aquariums on visitors' conservation knowledge, beliefs, and behavior.

Zoos and aquariums are well placed to connect visitors with the issues facing biodiversity globally and many deliver interventions that seek to influence visitors' beliefs and behaviors with respect to conservation. However, despite primary studies evaluating the effect of such interventions, the overall effect of engaging with zoos and the factors that influence this effect remain unclear. We conducted a systematic review to investigate the effect of zoo-led interventions on knowledge, beliefs (attitudes, intentions, self-efficacy, and social norms), and behavior among zoo visitors. These outcomes were identified using the Theory of Planned Behavior as a theoretical lens. We identified and described the nature of zoo-led interventions in 56 studies and used the behavior change technique (BCT) taxonomy to identify 6 specific BCTs used in interventions to date. Multilevel meta-analyses revealed a small to medium positive effect of engaging with zoo-led interventions on outcomes (d+ =0.40, 95% confidence interval=0.28-0.51). Specifically, visitors were more knowledgeable about conservation issues, held more favorable attitudes toward conservation, and reported being more likely to act for the benefit of biodiversity. No evidence of publication bias was present. Effect sizes were, however, heterogeneous and subgroup analyses revealed that the nature of the intervention or type of outcome did not explain this variance. Larger effects were, however, found in studies conducted at a single institution relative to research at multiple institutions and studies that used within-participant designs relative to between-participant designs. Taken together, these findings demonstrate how behavior change frameworks can be used to describe zoo-led interventions and supports the assertion that zoos and aquariums can promote changes in beliefs and behaviors that may help protect biodiversity.

FIDES Athlete Development Programme: project background and study protocol of an embedded multiple case study

Most sports science research revolves around male subjects. As a result, most of the knowledge and practices within sports are male-centric. Failing to take the biological, psychological and social (biopsychosocial)...

The psychiatric-mental health nurse practitioner as coordinating practitioner in the Netherlands: A multiple case study.

Psychiatric-mental health nurse practitioners (PMHNPs) in the Netherlands have been allowed to perform the role of coordinating practitioner (CP) since 2018. This role is reserved for mental health care specialists who are trained and qualified at the master's degree level. Earlier studies have not addressed how PMHNPs perform that role and what mechanisms and contextual factors determine their performance. This understanding could help optimize their performance in this role and promote effective deployment of PMHNPs in mental health care. To understand how PMHNPs perform this role and what mechanisms and contextual factors underlie that performance. A multiple case study involving PMHNPs who work in various settings as CPs. Data were collected and analyzed using the realistic evaluation approach. We identified four mechanisms related to the performance of PMHNPs in the role of CP: (1) autonomous performance; (2) unique expertise; (3) accessibility, availability, and professional involvement; and (4) additional roles. The extent to which these mechanisms are present is largely determined by organizational factors, team factors, and individual factors. Psychiatric-mental health nurse practitioners are seeking to identify and interpret the role of CP. This study helps to elucidate the mechanism of role performance by PMHNPs and what they should focus on to deliver effective and patient-centered mental health care. Policymakers, health care professionals, and educators should consider the mechanisms and contextual factors to facilitate and support PMHNPs' employment and training in the role of CP.

The peaks and valleys of narcissism: The factor structure of narcissistic states and their relations to trait measures.

Although interindividual differences in narcissism are well studied, little is known about assessing narcissism at the within-person level. To fill this research gap, we investigated whether the narcissism construct is represented in the same way at the between- and within-person levels. We analyzed four established narcissism measures across multiple studies. In each of the studies, participants completed narcissism measures in ecological momentary assessment or daily diary studies. Equivalent construct representation across between- and within-person narcissism (i.e., cross-level measurement invariance) was found. State narcissism measures showed convergent validities for the trait narcissism scales. Moreover, we also found that antagonistic narcissism was most strongly related to within-person variability in narcissism. Our investigation sheds new light on the structure and assessment of narcissism on the within-person level by providing a comprehensive examination of its measurement. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Abstract WP24: Safety of Tenecteplase vs Alteplase in Telestroke: A Large Multistate Experience (STAT)

Background: Prompt treatment with IV thrombolytics (IVT) in acute ischemic stroke (AIS) patients is critical for improved recovery and survival. Recently, hospital systems are switching to the IVT tenecteplase (TNK) instead of the FDA approved alteplase (tPA) for treatment. Multiple studies and meta-analyses evaluating the efficacy and safety of TNK demonstrate similar or superior outcomes when compared to tPA. TNK is not FDA approved for treatment leading to hesitation and attention on the complications profile including intracranial hemorrhage (ICH) rates. Methods: AIS consults seen in the ED by TeleSpecialists, LLC at 220 facilities (26 states) from January 1, 2022 to May 31, 2023 were extracted from the TeleCare by TeleSpecialists TM database. The encounters were reviewed for IVT candidate, door to needle (DTN) time, IVT used, advanced imaging, LVO, complication occurrence, complication type, symptomatic ICH, and ECASS II ICH score. Comparison of complications was performed between the two groups by IVT: TNK or tPA. Comparison of continuous variables was performed by student’s t-test for normally distributed data, and the Mann-Whitney test for nonnormally distributed data. Pearson's Chi-square test was employed for comparisons of categorical variables. Results: A total of 2305 TNK patients and 3337 tPA patients were extracted. DTN times were faster (37 min vs 42 min, p < 0.0001) and more total complications were seen in the TNK group (87 vs 80, p =0.0035). In nonLVO IVT patients, TNK group had more complications (57 vs 47, p 0.0078), specifically ICH (48 vs 35, p= 0.0036). In LVO IVT patients, TNK group did not have a statistically significant difference in ICH (21 vs 18, p =0.07). In IVT patients not accepted for NIR, TNK group had more complications (77 vs 69, p=0.005), specifically ICH (63 vs 51, p=0.0026). In IVT patients accepted for NIR, no significant differences were observed. There were no statistically significant differences in symptomatic ICH between groups. Conclusions: TNK group was found to have significantly more complications including ICH compared to tPA group driven by non-LVO patients. Closer analysis of potential for increased risk to non-LOV patients is warranted based on this data from the largest simultaneously collected data.

Xanthine Oxidoreductase in the Pathogenesis of Endothelial Dysfunction: An Update.

Xanthine oxidoreductase (XOR) is a rate-limiting enzyme in the formation of uric acid (UA) and is involved in the generation of reactive oxygen species (ROS). Overproduction of ROS has been linked to the pathogenesis of hypertension, atherosclerosis, and cardiovascular disease, with multiple studies over the last 30 years demonstrating that XOR inhibition is beneficial. The involvement of XOR and its constituents in the advancement of chronic inflammation and ROS, which are responsible for endothelial dysfunction, is the focus of this evidence-based review. An overabundance of XOR products and ROS appears to drive the inflammatory response, resulting in significant endothelium damage. It has also been demonstrated that XOR activity and ED are connected. Diabetes, hypertension, and cardiovascular disease are all associated with endothelial dysfunction. ROS mainly modifies the activity of vascular cells and can be important in normal vascular physiology as well as the development of vascular disease. Suppressing XOR activity appears to decrease endothelial dysfunction, probably because it lessens the generation of reactive oxygen species and the oxidative stress brought on by XOR. Although there has long been a link between higher vascular XOR activity and worse clinical outcomes, new research suggests a different picture in which positive results are mediated by XOR enzymatic activity. Here in this study, we aimed to review the association between XOR and vascular endothelial dysfunction. The prevention and treatment approaches against vascular endothelial dysfunction in atherosclerotic disease.

Four best-practice recommendations for improving the conceptualization and operationalization of motivational intensity: Reply to Kaczmarek and Harmon-Jones.

Replies to the comments made by Kaczmarek and Harmon-Jones (see record 2024-44184-002) on the current authors original article (see record 2021-21096-001). Kaczmarek and Harmon-Jones (2023) provide a commentary on our original empirical piece, does motivational intensity exist distinct from valence and arousal? (Campbell et al., 2021). In this response, we articulate the motivation behind our work, including the major issues with the conceptualization and operationalization of motivational intensity in prior literature. For example, while motivational intensity was proposed to replace valence as the determinant of cognitive scope more than a decade and a half ago, in both this original work and ongoing work since then, motivational intensity has been operationalized in a variety of questionable ways, including via participants' ratings of valence, rather than motivational intensity. That is, in multiple studies, differences in cognitive processes measured in two conditions have been attributed to motivational intensity which was not explicitly measured, while the conditions do demonstrably differ in the valence participants experienced. We explain exactly what we found in Campbell et al. (2021) and our subsequent follow-up work (Campbell et al., 2023), and what aspects of our interpretation converge versus diverge with the views offered in Kaczmarek and Harmon-Jones' commentary. We also identify four important recommendations for best-practice research going forward. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Abstract WMP64: Late Lesion Growth Following Endovascular Therapy: Is 24 Hours Too Early to Assess Acute Infarct Size Including the Effects of Secondary Injury?

Background: Measurement of “final” lesion volume at 24hr following endovascular therapy (post-EVT) has been used in multiple studies as a surrogate for clinical outcome. However, despite successful recanalization, a significant proportion of patients do not experience favorable clinical outcome. Methods: This is a prospective study of acute ischemic stroke patients at two stroke centers who met the following criteria: i) anterior large vessel occlusion (LVO) acute ischemic stroke, ii) attempted EVT, iii) written informed consent obtained, and iv) had MRI post-EVT at 24hr and 5-day. We defined “Early” and “Late” lesion growth as ≥10mL lesion growth between baseline and 24hr DWI, and between 24hr DWI and 5-day FLAIR, respectively. Results: One hundred fourteen patients met study criteria with median age 67 years, 56% female, median admit NIHSS 19, 54% received IV or IA thrombolysis, 67% with M1 occlusion, and median baseline DWI volume 28.2mL. Successful recanalization was achieved in 86% and 67% had complete reperfusion, with an overall favorable clinical outcome rate of 54%. Nearly two thirds (65%) of the patients did not have Late lesion growth with a median volume change of -0.2mL between 24hr and 5-days and an associated high rate of favorable clinical outcome (65%). However, ~1/3 of patients (35%) did have significant Late lesion growth despite successful recanalization (85% TICI 2b/3). Late lesion growth patients had a 26.2mL change in Late lesion volume and 19.9mL change in Early lesion volume. These patients had an increased hemorrhagic transformation rate of 68% with only 1 in 3 patients having favorable clinical outcome. Late lesion growth was independently associated with incomplete reperfusion, hemorrhagic transformation, and unfavorable outcome even after adjusting for admit NIHSS and Early lesion growth. Conclusions: Approximately 1 out of 3 patients had Late lesion growth following EVT, with a favorable clinical outcome occurring in only 1 out of 3 of these patients. Identification of patients with Late lesion growth could be critical to guide clinical management and inform prognosis post-EVT. Additionally it can serve as an imaging biomarker for the development of adjunctive therapies to mitigate reperfusion injury.

Enrichment of Smectite in the REY‐Rich Mud of the Clarion‐Clipperton Fracture Zone in the Eastern Pacific and Its Geological Significance

AbstractREY‐rich mud, consisting of deep‐sea sediments with high concentrations of rare‐earth elements and yttrium (REY), holds significant economic potential. Many studies have been conducted on biogenic apatite, ferromanganese micronodule, and phillipsite within these deposits to ascertain the REY enrichment mechanisms. However, the knowledge of clay minerals in REY‐rich mud, which is the predominant component of pelagic sediments, is still limited. In this study, two adjacent gravity cores (core GC02: REY‐rich mud; core GC03: typical sediments of equatorial Pacific) were collected from the Clarion‐Clipperton Fracture Zone (CCFZ) of the Eastern Pacific to study the role of different clay minerals in REY enrichment. The clay minerals in core GC03 and core GC02 are primarily illite (averaging 60%) and smectite (averaging 63%), respectively, and the smectite in core GC02 was mainly Fe‐rich, which was probably formed via the reaction between opal and FeOOH. Moreover, multiple studies have reported similar smectite enrichment in REY‐rich mud, suggesting that it is a common characteristic. The presumed hydrothermal or volcanic origination of smectite in REY‐rich layers of core GC02 indicates the essential role of hydrothermal and volcanic activities in REY‐rich mud formation during the Oligocene in the western CCFZ.

Abstract IA18: Genetic susceptibility to breast cancer: Recent advances and application to personalised prevention

Abstract The past two decades have seen dramatic progress in our understanding of the inherited basis of breast cancer, driven by large international collaborative epidemiological studies. Genetic factors identified include rare coding variants in susceptibility genes, and more than 200 common polymorphisms, identified through genome-wide association studies (GWAS) and largely in non-coding regions, that confer more moderate risks. The majority of the common variants are more strongly associated with ER-positive disease, but a subset is specifically associated with ER-negative disease. Variants are strongly enriched for regulatory regions and transcription factor binding sites, and the putative target genes are strongly enriched for known breast cancer drivers: however, the underlying target genes and mechanisms remain largely obscure. The associations for common variants appear to be largely independent of each other and can be summarised by a polygenic risk score (PRS) that is strongly predictive of risk. The most extensively validated PRS, comprising 313 SNPs, is associated with a relative risk of approximately 1.6 per standard deviation; women in the top 1% of the risk distribution have an approximately 4-fold risk of ER-positive disease and 3-fold risk of ER-negative disease. The PRS was developed in women of European ancestry but is also predictive of risk in Asian ancestry women, though less so in African ancestry women. In contrast, despite their widespread use, the evidence for association with cancer for coding variants in genes on genetic testing panels is often weak. Recent very large-scale targeted sequencing studies, however, have clarified the position, providing strong evidence for an association between protein truncating or missense variants and breast cancer risk for nine genes: BRCA1, BRCA2, ATM, CHEK2, PALB2, BARD1, RAD51C, RAD51D and TP53. Recent large-scale exome-wide sequencing analysis has shown that rare variants in several additional genes are also risk associated, with the majority being tumour suppressor genes: these include MAP3K1, ATRIP and SAMHD1. These analyses also demonstrate, however, that the contribution of coding variation, beyond the known genes, is likely to be small. The currently identified variants explain about half of the familial risk of breast cancer. Part of the “missing” heritability is due to weaker common variants, many of which should be identified in ongoing larger GWAS. The causes of the remainder are obscure and may include rare non-coding variants, repeat polymorphisms, and epistatic interactions. Risk discrimination is most powerful when all risk factors are considered. The BOADICEA model, implemented in the CanRisk tool, provides a well validated model that incorporates the effects of gene variants, polygenic risk scores, lifestyle factors and breast density to predict breast and ovarian cancer risk. Multiple translational studies are ongoing to evaluate the feasibility and utility of such personalised risk prediction for stratifying screening and prevention. Citation Format: Douglas F Easton. Genetic susceptibility to breast cancer: Recent advances and application to personalised prevention [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Breast Cancer Research; 2023 Oct 19-22; San Diego, California. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_1):Abstract nr IA18.

Causal Relationship Between Sleep Traits and Hypothalamic-Pituitary-Target Gland Axis Function: A Mendelian Randomization Study.

In recent years, multiple observational studies have confirmed the association between sleep traits and various human physiopathological states. However, the causal relationship between sleep traits and hypothalamic-pituitary-target gland axis (HPTGA) function remains unknown. We obtained summary statistics on sleep traits (insomnia, chronotype, and sleep duration (long and short)) from the UK Biobank database. Data related to the HPTGA functions were obtained from the publicly available database. Subsequently, a two-sample Mendelian randomization (MR) analysis was performed to investigate the causal relationship between different sleep traits and the HPTGA function. Reverse MR analysis was conducted to examine the direction of causality. The MR analysis results suggested that chronotype is associated with decreased levels of six hormones in HPTGA. Sleep duration was causally associated with decreased levels of free thyroxine and progesterone. Both long and short sleep durations are detrimental to the secretion of prolactin-releasing peptide, somatostatin, and plasma cortisol, while short sleep duration can promote progesterone secretion. After gender stratification, we found that female reproductive function is more susceptible to the influence of unfavorable sleep traits. Our MR analysis indicated a significant causal association between chronotype and suppressed gonadal function in healthy adult humans, with no apparent gender-specific effect. Extreme sleep durations were also found to be detrimental to the maintenance of normal HPTGA secretion function. Compared to males, gonadal function in the female cohort is more susceptible to extreme sleep habits. Subsequent observational studies are urgently needed to confirm the underlying mechanisms.

The Occurrence, Antibiotic Susceptibility Pattern and Multiple Drug Resistance Index Studies of E. coli from Fresh Meats in Marathwada Region of Maharashtra

Background: Foodborne diseases are a huge social burden in both developed and underdeveloped countries. Escherichia coli is a natural inhabitant of the human and warm-blooded animal digestive tracts. It is considered as an indicator organism for direct or indirect faecal contamination of raw meats. The presence of antibiotic-resistant microorganisms in meat accounts for a public health risk. Methods: In current study, all 39 characterized E. coli isolates recovered on screening 405 fresh meat samples collected from different butcher shops in the Udgir city, Marathwada region of Maharashtra were also tested for Congo red dye binding assay and haemolysis assay. Antimicrobial resistance profiling of recovered isolates was carried out using the disc diffusion method. Result: Overall occurrence of E. coli in fresh meats was noted to the tune of 9.63% and the corresponding group wise occurrence in chicken and chevon samples were 12% and 7.32%, respectively. All E. coli tested positive in the Congo red dye binding assay and haemolysis assay, suggesting virulent nature of isolated organisms. On screening for antimicrobial resistance, these isolates were found resistant to mainly â-lactams (94.87%), lincosamides (84.62%), 4th Generation cephalosporins (82.05% each), DHFR Inhibitors (64.10%), glycopeptides (51.28%). The multidrug resistant isolates showed resistance to a minimum of 4 and maximum of 12 antibiotics with MAR index ranging from 0.27 to 0.8 and 9 resistance patterns.

Impact of human papillomavirus age-related prevalence and vaccination levels on interpretation of cervical screening modalities: a modelling study

ObjectiveCervical screening is a life-saving intervention, which reduces the incidence of and mortality from cervical cancer in the population. Human papillomavirus (HPV) based screening modalities hold unique promise in improving...

Towards advanced piezoelectric metamaterial design via combined topology and shape optimization

Metamaterials open up a spectrum of artificially engineered properties otherwise unreachable in conventional bulk materials. For electromechanical energy conversion systems, lightweight materials with high hydrostatic piezoelectric coupling coefficients and negative Poisson’s ratio can be obtained. Thus, in this contribution, we explore the possibilities of piezoelectric metamaterials design by employing structural optimization. More specifically, we apply a sequential framework of topology and shape optimization to design piezoelectric metamaterials with negative Poisson’s ratio for electromechanical energy conversion under uniform pressure. Topology optimization is employed to generate the initial layout, whereas shape optimization fine tunes the design and improves durability and manufacturability of the structures with the help of a curvature constraint. An embedding domain discretization (EDD) method with adaptive domain and shape refinement is utilized for an efficient and accurate computation of the state problem in the shape optimization stage. Multiple case studies are conducted to determine the importance of desired stiffness characteristics, symmetry conditions and objective formulations on the design of piezoelectric metamaterials. Results show that the obtained designs are highly dependent on the desired stiffness characteristics. Moreover, the addition of the EDD-based shape optimization step introduces significant changes to the designs, confirming the usability of the sequential framework.

A Warmer and Wetter World Would Aggravate GHG Emissions Intensity in China's Cropland

AbstractMany agricultural regions in China are likely to become appreciably wetter or drier as the global climate warming increases. However, the impact of these climate change patterns on the intensity of soil greenhouse gas (GHG) emissions (GHGI, GHG emissions per unit of crop yield) has not yet been rigorously assessed. By integrating an improved agricultural ecosystem model and a meta‐analysis of multiple field studies, we found that climate change is expected to cause a 20.0% crop yield loss, while stimulating soil GHG emissions by 12.2% between 2061 and 2090 in China's agricultural regions. A wetter‐warmer (WW) climate would adversely impact crop yield on an equal basis and lead to a 1.8‐fold‐ increase in GHG emissions relative to those in a drier‐warmer (DW) climate. Without water limitation/excess, extreme heat (an increase of more than 1.5°C in average temperature) during the growing season would amplify 15.7% more yield while simultaneously elevating GHG emissions by 42.5% compared to an increase of below 1.5°C. However, when coupled with extreme drought, it would aggravate crop yield loss by 61.8% without reducing the corresponding GHG emissions. Furthermore, the emission intensity in an extreme WW climate would increase by 22.6% compared to an extreme DW climate. Under this intense WW climate, the use of nitrogen fertilizer would lead to a 37.9% increase in soil GHG emissions without necessarily gaining a corresponding yield advantage compared to a DW climate. These findings suggest that the threat of a wetter‐warmer world to efforts to reduce GHG emissions intensity may be as great as or even greater than that of a drier‐warmer world.

Balancing Non‐CO2 GHG Emissions and Soil Carbon Change in U.S. Rice Paddies: A Retrospective Meta‐Analysis and Agricultural Modeling Study

AbstractU.S. rice paddies, critical for food security, are increasingly contributing to non‐CO2 greenhouse gas (GHG) emissions like methane (CH4) and nitrous oxide (N2O). Yet, the full assessment of GHG balance, considering trade‐offs between soil organic carbon (SOC) change and non‐CO2 GHG emissions, is lacking. Integrating an improved agroecosystem model with a meta‐analysis of multiple field studies, we found that U.S. rice paddies were the rapidly growing net GHG emission sources, increased 138% from 3.7 ± 1.2 Tg CO2eq yr−1 in the 1960s to 8.9 ± 2.7 Tg CO2eq yr−1 in the 2010s. CH4, as the primary contributor, accounted for 10.1 ± 2.3 Tg CO2eq yr−1 in the 2010s, alongside a notable rise in N2O emissions by 0.21 ± 0.03 Tg CO2eq yr−1. SOC change could offset 14.0% (1.45 ± 0.46 Tg CO2eq yr−1) of the climate‐warming effects of soil non‐CO2 GHG emissions in the 2010s. This escalation in net GHG emissions is linked to intensified land use, increased atmospheric CO2, higher synthetic nitrogen fertilizer and manure application, and climate change. However, no/reduced tillage and non‐continuous irrigation could reduce net soil GHG emissions by approximately 10% and non‐CO2 GHG emissions by about 39%, respectively. Despite the rise in net GHG emissions, the cost of achieving higher rice yields has decreased over time, with an average of 0.84 ± 0.18 kg CO2eq ha−1 emitted per kilogram of rice produced in the 2010s. The study suggests the potential for significant GHG emission reductions to achieve climate‐friendly rice production in the U.S. through optimizing the ratio of synthetic N to manure fertilizer, reducing tillage, and implementing intermittent irrigation.

Abstract PR014: Multiregion biopsies and corresponding neurosphere cultures reveal spatial divergence in glioblastoma evolution

Abstract Spatial organization of normal tissues is key for their function, yet the role of distribution of distinct clones of cancer cells in tumor in not usually studied as a potential vulnerability in cancer. This is of particular interest in glioblastoma (GBM), most aggressive brain tumor, in which extensive intratumor heterogeneity hampers effectiveness of treatment. Multiregion sampling has been used in multiple studies to uncover evolutionary trajectories of the tumor. To better understand tumor evolution and the complexity of cancer ecosystem in GBM, we performed profiling of biopsies collected from MRI-defined regions of the tumors, spanning the surface, tumor core and deep tumor margins, which drive local recurrence after surgery. To test how spatially distinct biopsies differ in their cancer cell composition and how heterogeneous the tumor microenvironment is in these samples, we took advantage of 5-ALA metabolite fluorescence, which accumulates in GBM cells. 5-ALA administration prior to the surgery allows the surgeon to visualize cancer under blue light. We used it to separate cancer cells (predominantly 5-ALAhigh) from tumor microenvironment (5-ALAlow) and subjected the fractions to bulk and single cell transcriptomics, respectively. We found a gradient of cellular states associated with location in the tumor, with the deep margin samples having more 5-ALAlow cancer cells and generally less defined phenotype. We have also developed neurosphere cultures from our collection of spatially distant biopsies. Despite the selection pressure of the in vitro culture conditions, cells from different regions of the tumor adopted different morphologies, suggesting retention of some of their differential features. The differences between cultures were reflected in metabolism, proliferation, and differential sensitivity to a drug panel. Whole exome sequencing and transcriptomic analysis were also performed to identify the selection bottleneck of culture conditions, establish evolutionary trajectory of the distinct regions and neurosphere cultures, and test how strongly our cultures represent both the 5-ALAhigh and 5-ALAlow subpopulations of GBM cells. Our study identified properties associated with different spatial locations within GBM tumors, which will help uncover the cellular and microenvironmental dependencies that could lead to novel therapeutic targets for this highly heterogeneous tumor. Citation Format: Roberto Salatino, Ugoma Onubogu, Benjamin Oakes, Oszkar Szentirmai, Michalina Janiszewska. Multiregion biopsies and corresponding neurosphere cultures reveal spatial divergence in glioblastoma evolution [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Translating Cancer Evolution and Data Science: The Next Frontier; 2023 Dec 3-6; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_2):Abstract nr PR014.

Abstract WP23: Hemorrhagic Transformation Following Anticoagulation in Victims of Acute Ischemic Stroke Secondary to Intra-Cardiac Thrombi

Introduction: Hemorrhagic transformation (HT) following acute ischemic stroke (AIS) is a common consideration especially when therapeutic anticoagulation is indicated in cases such as left ventricular or left atrial appendage thrombi. Although there have been multiple studies investigating the safe timing of anticoagulation initiation following AIS in patients with atrial fibrillation, the results varied. Evaluating the infarct volume and correlating it to time of anticoagulation initiation and HT can be detrimental to patient safety. Methods: We performed a retrospective review of all patients who were diagnosed with AIS secondary to cardio-embolic mechanisms and were admitted to our hospital between January 1, 2018, and December 31, 2022. The inclusion criteria consisted of patients aged 18 to 100 years who were found to have intra-cardiac thrombi and were initiated on anticoagulation within 80 hours of symptom onset. Infarct volume was measured using the ABC/2 formula. Statistical analysis was conducted using the R statistical program. For variables with a normal distribution, we used the mean and standard deviation (SD), and for variables with skewed distribution, we reported the median with interquartile range (IQR). Results: A total of 597 patient charts were reviewed for this study. After applying the inclusion criteria, 36 patients were deemed eligible for inclusion in the analysis. Among the included patients, a majority were male, constituting 80.6% (n=29) of the sample. The infarct volume among the included patients ranged from 0 ml to 100 ml. A breakdown of infarct volumes is as follows: Twenty-three patients (63.9%) had infarct volumes of 10 ml or less. Seven patients (19.4%) had infarct volumes ranging between 11 - 20 ml. Six patients (16.7%) had infarct volumes that exceeded 21 ml, with the largest infarct measuring 100 ml. There was no clinically significant HT. There were no surgical interventions required for any of our study subjects. Conclusion: The initiation of anticoagulation within 80 hours following AIS secondary to intra-cardiac thrombi may be safe, especially in patients with infarct volumes of 20 ml or less when using the ABC/2 formula.

Relationship between individual and country-level socio-economic background, USMLE step scores, and demographics of international medical graduates and residency match results

PurposeTwenty five percent of practicing physicians in the US are International Medical Graduates (IMGs) – physicians who completed their medical school training outside of the United States and Canada. There are multiple studies demonstrating higher socio-economic background is associated with medical school matriculation in the US. However, despite a substantial prevalence of IMGs in the American healthcare system, studies of the association between demographics, socio-economic background, and securing a residency position in the match are lacking.MethodsWe created a survey with questions on residency match-related data and information on personal socio-economic background. An invitation to participate in the study was sent to all IMGs that applied to the included residency programs after the conclusion of the 2022 residency match. We used multivariable logistic regression to compare survey responses to the odds of securing a residency match.ResultsThe total number of survey respondents was 744 (response rate 15.1%). We found that younger age, higher United States Medical License Examination (USMLE) scores, higher-income country of origin (including the United States), fewer match attempts, applying to fewer specialties, having parents with college degree or higher, and coming from higher-than-average or lower-than-average family income were independently associated with increased odds of matching. Gender, personal income, and visa status did not demonstrate significant associations with residency match.ConclusionsResidency match is a significant expense for IMGs, especially for those from lower-income countries. International applicants from higher socio-economic backgrounds might have advantages in securing medical residency positions in the United States when controlling for other variables.

Indonesian EFL students’ anxiety factors and solutions for listening comprehension: Multiple case study

Students’ anxiousness affects the EFL listening process. Listening anxiety is also an aspect that may impact a foreign language student’s success or failure in listening comprehension. Therefore, this study aimed to ascertain the factors that lead to students’ listening anxiety and the strategies lecturers use to alleviate it. Multiple qualitative case study was the method used in the study. Twenty-one undergraduate students enrolled in a listening class and three lecturers, from three universities in Palembang, Indonesia, participated in this study. Data collection methods included interviews and observation. The results of thematic analysis of qualitative data revealed four factors contributed to students’ anxiety when listening: 1) lack of listening skills; 2) lack of attention; 3) mood; and 4) classroom environment. Meanwhile, the lecturers were committed to implementing strategies that alleviate students’ listening anxiety. These strategies included: 1) preparing students for listening activities, 2) exposing them to a variety of authentic listening materials, and 3) improving the learning environment. The research findings imply that the lecturers who taught listening class have observed that each student experienced anxiety while listening due to specific factors. As a result, they have begun to devise suitable teaching strategies to foster a more enjoyable learning experience in listening classes, thereby enhancing student comfort and engagement.