Pearson's Chi-square Test Research Articles

Going through it Alone: A Cross-sectional Study on the Prevalence of Loneliness among Medical, Nursing, and Paramedical Students in a Health Science Academy in Bangalore, India

Abstract Background: Life of students enrolled in a medical academy is stressful and often demanding in various aspects. Frequently, such students tend to be lonely. The prevalence of this problem has not been assessed and has been given little attention in medical schools. The objectives of this study were to determine the prevalence of loneliness among medical, nursing, and paramedical undergraduate students in a Health Science Academy in Bangalore and to assess the factors associated with loneliness among the study population. Materials and Methods: This was a cross-sectional study conducted among 400 students of a Health Science Academy and the selection of the subjects was performed by stratified random sampling. Each student was given a self-administered questionnaire which comprised of two sections. Section 1 which included the sociodemographic details and Section 2 was the revised UCLA (University of California, Los Angeles) scale (Version 3). Results: Prevalence of loneliness among the students in the academy was found to be 52%. Factors associated with loneliness and possibly contributing to it were assessed using the Mann-Whitney U test and the Pearson Chi-square test. The factors that impacted loneliness significantly were language familiarity, academics, relationships with friends, and family, health problems, and involvement in physical activities. Conclusion: The prevalence of loneliness among the students was found to be 52%. There were various factors, but despite such worrisome scores, the health science academy still ranks high in surveys that assess personality development as part of college rankings in the country. Further research would be needed to know the exact direction of association between loneliness and the associated factors.

Indications, contributing factors, and short-term outcomes of pneumonectomy: an 8-year retrospective study in a resource-limited setting

BackgroundPneumonectomy, the surgical removal of an entire lung, was first performed in 1933 by Evarts A. Graham for lung carcinoma. Today, pneumonectomy is primarily indicated for non-small cell lung cancer (NSCLC) worldwide. However, it carries a higher risk of morbidity and mortality compared to less extensive lung resections.ObjectivesThis study aims to investigate the indications for pneumonectomy and its short-term outcomes among patients who underwent the procedure between 2016 and 2023.Methods and materialsA retrospective study was conducted on 112 patients who underwent pneumonectomy. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 25. Univariate, bivariate, and multivariate analyses were performed to address the study’s objectives. The Pearson chi-square test, crude odds ratio (COR), and adjusted odds ratio (AOR) were calculated for categorical variables where appropriate. To identify factors associated with pneumonectomy, a binary logistic regression model was used, and odds ratios with 95% confidence intervals were calculated. A p-value of < 0.25 was used as a threshold for including variables in the multivariate analysis, while a p-value of < 0.05 was considered statistically significant in the final model.ResultsThe majority of patients were aged between 20 and 30 years, with 54 patients (48.2%) in this age group, and a male-to-female ratio of 1.6:1. The primary indication for pneumonectomy was inflammatory conditions, accounting for 62.5% (70 patients), followed by carcinoid tumors at 32.1% (36 patients). Lung cancer was the diagnosis in 5.4% (6 patients) of cases. Factors significantly associated with pneumonectomy included a history of tuberculosis treatment (AOR 40.3; 95% CI: 3.01, 540.2), intraoperative blood loss > 500 mL (AOR 9.07; 95% CI: 1.04, 79.13), and surgical duration > 180 min (AOR 37.9; 95% CI: 1.82, 792.3). The morbidity rate was 25%, while the mortality rate was 5.4%.Conclusion and recommendationsIn our setting, pneumonectomy is most commonly performed for inflammatory conditions. Significant factors associated with the procedure include a history of tuberculosis treatment, intraoperative blood loss > 500 mL, and surgical duration > 180 min. To reduce the need for pneumonectomy, strategies should focus on tuberculosis prevention, screening, and proper patient evaluation and diagnosis before treatment, to prevent extensive lung damage that often necessitates this procedure.

The Rapid Escalation of Fractures and Hospital Admissions from Electric Bicycle Injuries in the United States: An Analysis of National Injury Data from 2019 to 2023.

To examine the characteristics, trends, and attributes of fractures sustained by electric bicycle riders and assess the recent healthcare burden in terms of hospital admissions. Design: Retrospective review. National sample of 100 emergency departments (EDs) in the United States (US). The National Electronic Injury Surveillance System (NEISS) was queried for ED presentations with fractures related to e-bicycles between January 1st 2019 and December 31st 2023. The clinical narrative associated with each case was reviewed to exclude cases unrelated to fractures sustained by e-bicycle riders. NEISS data is a probability sample of US hospitals; each observed sample has an associated weight enabling a population estimate for each individual sample. Sample weights were determined by NEISS using factors that influence likelihood of selection such as hospital size and geographic locations. US population projections (weighted cases) of fractures and admissions were obtained by summing the weights of raw, unweighted NEISS sampled injuries. Pearson's chi-squared tests were applied to determine differences in injury characteristics among subjects who were admitted to the hospital and those who were not admitted. A total of 22,432 e-bicycle fractures occurred in the US from 2019 to 2023, which was a weighted population estimate from 520 raw, unweighted NEISS samples. The number of fractures and admissions increased by 2,371% and 3,146% in 2023, respectively, compared to 2019. Collision with a motor vehicle occurred in nearly one-fourth of fractures, and motor vehicle involvement was significantly associated with hospital admission (36.4% v. 25.1%; p=0.01). Overall, 27.7% of e-bicycle fractures were admitted to the hospital. Upper leg fractures had the highest association with admission (90.7% admission rate) but only consisted of 2.7% of all fractures. The most common fracture location in riders aged <18 was the wrist, while the 35-55 age group and >55 age group were most likely to possess upper trunk fractures (cervical spine, thoracic spine, ribs, sternum). The 18-34 age group and 35-55 age group most commonly sustained fractures involving motor vehicles (29.7% and 28.7%, respectively), but the 18-34 age group possessed a significantly higher rate of overall admission among all age groups (p=0.04). There has been a substantial increase in fractures and resource utilization as a result of hospital admissions from e-bicycle riding from 2019-2023. The majority of fractures occurred above the waist, although lower extremity injuries more commonly resulted in admission, and riders aged 35-55 sustained the largest proportion of injuries. Prognostic Level III.

The associations of obesity with demographic and lifestyle factors among Hong Kong adults.

Background: Obesity is a risk factor for leading causes of death. Aim: This study investigated the associations of obesity with demographic and lifestyle factors among adults aged 18-64 in Hong Kong. Methods: The study uses data (n = 24,855) from the government online database. It uses T-tests to compare mean values for body mass index (BMI), waist circumference, and weight-to-height ratio obese; analysis of variance for not-obese, BMI-obese-only, central-obese, and BMI + central-obese; Pearson chi-square tests for categorical variables; and multinomial logistic regression to obtain the odd ratios. It uses IBM SPSS version 26 to conduct all analyses, and at a 95% confidence level. Results: The analyses show that the risks of central-obese, and BMI + central-obese increase by 4%, and 4%/year of age, respectively. Females have 60%, 38%, and 60% lower risks of BMI-obese-only, central-obese, and BMI + central-obese, respectively, and people with tertiary education have 28%, 20%, and 20% lower risks, respectively. Employed people have a 40% higher risk of BMI-obese-only when compared with the unemployed; students have a 46% lower risk of BMI + central-obese and home-makers have a 38% higher risk. The risk of central-obese decreases by 14%/10 min/day of moderate physical activity, but could be different among females, and vigorous physical activity yielded mixed results. The risk of BMI + central-obese decreases by 9%/day/week of vegetable intake. Conclusions: Obesity is associated with multiple demographic and lifestyle factors. Keep doing vigorous and moderate physical activity but state alert to obesity risk factors, and frequent vegetable intake are recommended. Lifelong learning and continuing education could be an effective strategy to combat obesity.

Mammography Home Workstations and Remote Diagnostic Breast Imaging: Current Practice Patterns and Planned Future Directions.

Assess current practices and plans regarding home workstations and remote diagnostic breast imaging in the United States. A 43-question survey relating to remote breast imaging was distributed to Society of Breast Imaging members from July 6, 2023, through August 2, 2023. A descriptive summary of responses was performed. Pearson's chi-squared test was used to compare demographic variables of respondents and questions of interest. In total, 424 surveys were completed (response rate 13%, 424/3244). One-third of breast imaging radiologists (31%, 132/424) reported reading examinations from home or a personal remote site for a median of 25% of their clinical time. The most common types of examinations read from home were screening mammography (90%, 119/132), screening US (58%, 77/132), diagnostic mammography and MRI (both 53%, 70/132), and diagnostic US (49%, 65/132). Respondents from private practices were more likely than those from academic practices to read diagnostic imaging from home (67%, 35/52 vs 29%, 15/52; P <.001). Respondents practicing in the West were less likely to read breast imaging examinations from home compared with those in other geographic regions (18%, 12/67 vs 28%-43% for other regions; P = .023). No differences were found among respondents' overall use of home workstations based on age, gender, or having dependents. Most respondents (75%, 318/424) felt that remote breast reading would be a significant practice pattern in the future. Home workstations for mammography and remote diagnostic breast imaging are a considerable U.S. practice pattern. Further research should explore radiologist preferences regarding remote breast imaging and its impact on clinical care and radiologist well-being.

Lack of basic sanitation influence on the enteropathogen presence in a river of the Brazilian Legal Amazon.

Water systems globally are declining in water quality, largely due to anthropogenic activities, with freshwater contamination reaching unprecedented levels. The Brazilian Legal Amazon (BLA), holding 13.56% of the world's fresh water, is affected due to the lack of basic sanitation. This study assesses the quality of the Lontra River, in southeastern BLA, by monitoring physicochemical and microbiological parameters and detecting DEC E. coli and Salmonella spp. over 16months, following current regulations. The data were analyzed using Pearson's chi-square and Fisher's exact test (p ≤ 0.05), Kruskal-Wallis test (p ≤ 0.05), with Tukey post hoc (α = 0.05), and Spearman's correlation (p ≤ 0.05). Results showed pH levels were below the optimal range established by Brazilian water quality indices and legislation, with seasonal variations, and dissolved oxygen also below acceptable limits. Thermotolerant coliforms (TtC) exceeded thresholds, signaling microbiological contamination. DEC E. coli and Salmonella spp. were detected in 32.14% and 67.85% of samples, respectively, even in those with low TtC levels. No correlation was found between TtC and pathogen presence, suggesting that meeting minimum water quality standards does not guarantee the absence of pathogenic microorganisms. These findings reveal significant environmental and public health risks related to surface water quality in the Lontra River. Also highlight discrepancies between regulatory water quality standards and the actual conditions observed, underscoring the need for regionally adapted water monitoring and management practices to protect both environmental and public health in the BLA.

The Statistical Analysis of Social Networks and the Effect on Sleeping Quality of Undergraduate Students

The aim of this article is to study and examine how the different social networks were affecting the sleeping quality of undergraduate students. A case study was performed in Maharani Cluster University. The simple random sampling technique is used to select the samples and data is collected from selected samples through self-administered questionnaire. The suitable statistical tool called Pearson Chi-square test procedure is used to analyze the data and draw the inference based on p-value by using R-software.

Social determinants of health and financial burden among patients with pancreatic cancer at a tertiary cancer center.

678 Background: Financial toxicity (FT) represents a challenge for cancer patients that impacts treatment decisions, patient satisfaction, and quality of life. Social determinants of health (SDoH) screening may predict who is at risk of FT and could potentially benefit from financial interventions. Methods: This is a retrospective study of all cancer patients presenting to Mayo Clinic sites between Sept 2023 – Jun 2024. Patients completed SDoH questionnaires and were given risk scores of Low Risk, Medium Risk, and High Risk for SDoH categories: Financial Strain Risk, Transportation Risk, and Food Insecurity Risk. Patient financial data including active debt amounts, insurance coverage, and financial aid were collected. Patients with pancreatic ductal adenocarcinoma (PDAC) were compared to those with pancreatic neuroendocrine tumors (PNET) and patients with other cancers (Others). Categorical variables were compared with Pearson's Chi-squared test, continuous variables with Kruskal-Wallis rank sum test. P values &lt; 0.05 were considered significant. Results: Data was obtained from 88,039 patients, 2,607 of whom had PDAC and 449 had PNET. Compared to PDAC patients, PNET patients and Others were more likely to have Medium/High risk scores for Financial Strain Risk (6% vs 6.5% and 8.5%, respectively) and Food Insecurity (1.7% vs 3.8% and 3.2%) (Table). There was no statistically significant difference in median medical debt and need of financial assistance between the groups. Among PDAC patients, there were differences in distributions among race, primary language spoken, and patient electronic record access depending on Financial Risk categories. African American patients had the greatest proportion of Medium/High risk (12.9%) compared to Asian (4.4%) and White (5.8%) patients (P&lt;0.001). Among patients with English as their primary language, 64.9% had Low Risk scores compared to 27.7% with other primary languages (P&lt;0.001). Patients with electronic record access were more likely to report High Risk scores (6.9%) compared to those without access (1.6%). Conclusions: Per patient responses collected, PDAC patients presenting to our center have lower risk of financial strain and similar medical debt levels compared to the remainder of cancer patients. Among PDAC patients, higher financial strain was experienced by non-whites (7.9% vs 5.8%). Diagnosis PDAC (N=2607) PNET (N=449) Other (N=84983) p value Current Financial Risk (Grouped) &lt; 0.001 - Low Risk 1662 (63.8%) 304 (67.7%) 59298 (69.8%) - Medium/High Risk 157 (6.0%) 29 (6.5%) 7209 (8.5%) - Unknown/Missing 788 (30.2%) 116 (25.8%) 18476 (21.7%) Food Insecurity Risk &lt; 0.001 - Low Risk 1764 (67.7%) 308 (68.6%) 63235 (74.4%) - Medium Risk 45 (1.7%) 17 (3.8%) 2703 (3.2%) - Unknown/Missing 798 (30.6%) 124 (27.6%) 19045 (22.4%) Median Active Debt in USD 1102.230 1020.010 1141.135 0.593

Impact of software-assisted structured reporting on radiology residents approaching prostate MRI.

To evaluate the potential advantages of software-assisted structured reporting for radiology residents approaching multiparametric prostate MRI (mpMRI). MpMRI scans from 100 patients, performed for prostate cancer (PCa) detection or staging, were anonymized, and reviewed by six second-year radiology residents without previous experience in prostate MRI, following 6h of intensive training. The dataset was split into two subsets of 50 cases each. All residents were asked to report scans from the first subset using a basic text processor (narrative reports -NR-). For the second subset, one group used a dedicated software to produce structured reports (SR) while the other continued with NR. Report completeness was assessed using a PI-RADS-based checklist, and statistical analyses, including Wilcoxon rank sum and Pearson's Chi-squared tests, were performed to compare word count, reporting time, and concordance with an expert radiologist's findings. All readers adopting SR in the second batch demonstrated a significant increase in word count and a decrease in reporting time compared to the first batch. Image quality and final impressions were missing from all NR, while gland size, lesion description, and PI-RADS score were consistently included in nearly all reports (96-100%). One of the three residents using SR showed a statistically significant improvement in concordance with the expert radiologist on index lesion location and clinically significant PCa presence (p=0.001), while the other two exhibited positive trends (p=0.061-0.078). The adoption of SR allowed radiology residents to decrease their reporting time and improve the comprehensiveness of their reports, while increasing concordance with an expert radiologist.

Short- and Intermediate-Term Morbidity Following Total Pelvic Exenteration in Colorectal Cancer.

Total pelvic exenteration (TPE) for clinical T4b colorectal cancer (CRC) is associated with significant morbidity. Short (0-30days)- and intermediate (31-90days)-term temporal analysis of complication onset is not well described, yet needed, to better counsel patients considering TPE. A retrospective cohort study of consecutive patients with primary or recurrent clinical T4b pelvic CRC undergoing open TPE between 2014 and 2023 was conducted. Clinicopathologic variables were collected for each patient. Postoperative morbidity was classified according to the Clavien-Dindo (CD) grade system and stratified by time of onset within 90days of surgery. Pearson's Chi-square test, Fisher's Exact test, and the Mann-Whitney U test were used to compare primary vs recurrent patient groups, and logistic regression assessed predictors of postoperative morbidity. Statistical analysis was performed using R with two-sided significance set at <0.05. Twenty-seven patients were identified of which 24 (88.9%) were male with a median age of 60.4years (interquartile range [IQR]: 56.3-70.5). Seventeen (63.0%) patients had primary disease and 10 (37.0%) had recurrent CRC. Twenty-three (85.2%) patients experienced at least one complication within 90 days of surgery, but no mortality was observed. Ten (37.0%) patients experienced a CD ≥ 3 event, of which 40% took place beyond 30days. The most common complication overall was anemia requiring transfusion, while the most common major complication was pelvic abscess. No clinicopathologic variables analyzed were predictive of major postoperative complication within 90days of TPE. TPE for clinical T4b CRC carries a high risk of postoperative morbidity in both the short- and intermediate-term after surgery, with a significant proportion of complications occurring after 30days. Given the magnitude of operation, an extended recovery with high risk for complications is common. Although a single-center series, this annotated postoperative complication profile may assist patients and clinicians when reviewing informed consent for TPE.

Underappreciated Effects of Delayed Graft Function in Pediatric Kidney Transplantation.

In kidney transplantation (KT), delayed graft function (DGF) is associated with worse outcomes. However, it is unclear what effect DGF plays in long-term survival compared to the impact of the various transplant, donor, and recipient risk factors associated with DGF. This study aims to determine the effect of DGF alone on long-term survival in pediatric deceased donor kidney transplant recipients (DDKTRs). Using a national database, 1728 pediatric patients who received a kidney transplant between 1994 and 2009 (n = 978) and 2010 and 2022 (n = 750) were identified. Cases and controls were matched by DGF status for transplant date, cold ischemia time, distance from the transplant center, HLA mismatch level, PRA, KDPI, recipient and donor age, BMI, sex assigned at birth, and ethnicity. Kaplan-Meier curves were analyzed with a log-rank test. Pearson's chi-squared tests were used to compare survival proportions between groups at time benchmarks. Pediatric DDKTRs with DGF had worse graft (p < 0.001) and patient (p < 0.001) survival compared to non-DGF patients in both eras. Between 1994 and 2009, graft survival rates were lower in the DGF cohort at 1 (p < 0.001), 3 (p < 0.001), 5 (p < 0.001), and 10 years (p = 0.010). Patient survival rates were lower in the DGF cohort at 1 (p = 0.017) and 5 years (p = 0.019) post-DDKT. There was no difference in 3 (p = 0.071) and 10-year patient survival rates (p = 0.141). Between 2010 and 2022, graft and patient survival rates were lower in the DGF cohort at 1, 3, 5, and 10 years (all p < 0.001). There was no difference in rates of retransplantation (p = 0.307 and p = 0.771) between groups for either era. DGF alone is associated with worse outcomes in pediatric DDKTRs. DGF should be taken seriously, especially in cases where pediatric DDKTRs do not possess known, attributable risk factors for DGF.

An Innovative Clinic-Based Intervention to Improve Adolescent Access to Sexual and Mental Health Services: The Total Teen Program.

Adolescents encounter numerous healthcare access barriers, leading to poor health outcomes. Researchers developed the Total Teen (TT) program to improve access to sexual and reproductive health (SRH) and mental health (MH) services in settings providing adolescents and young adults (12-25) health services. This pilot study assessed the TT's impact on care across three settings: school-based health clinics, a federally qualified health center, and an adolescent health clinic for 12 weeks. Sociodemographic data, including age, race/ethnicity, gender, and insurance status, were collected. MH was assessed using patient health questionnaire (PHQ)-9 and generalized anxiety disorder (GAD)-2 scales, and sexual health was evaluated based on CDC guidelines and additional evidence-based questions. One-on-one time, confidential consultations, SRH and MH micro visits, and referrals measured access. Descriptive statistics, Pearson Chi-square tests, and Kruskal-Wallis tests compared site outcomes, while logistic regression models adjusted for age, gender, race, and site. Four hundred and fifty-one participated in the TT program across the three sites. Concerning micro visits and referrals, being male was associated with lower depression rates (P = .0003) and generalized anxiety disorder (P = .0099). Being males also predicted micro visit receipt (P = .0199). Concerning SRH micro visits, higher sexual behavior scores (P < .0001) were significantly associated with a greater likelihood of utilizing SRH micro visits. Results indicate that TT improves access to SRH and MH services and referrals for at-risk adolescents. Findings underscore the importance of integrating SRH and MH services into routine adolescent care and involving health organizations and providers as key stakeholders in enhancing preventive healthcare access.

Evaluation of undergraduate dental students’ awareness, knowledge, and attitudes towards teledentistry: does a course enhance this?

BackgroundTeledentistry is a part of telemedicine and can be used for dental diagnosis, dental care, consultation, and dental education. The objective of this study was to assess the awareness, knowledge, and attitudes of undergraduate dental students toward teledentistry, as well as to investigate the influence of enrolling in a teledentistry course on these variables.MethodsA structured questionnaire-based online survey (Google Form) was used as the survey tool to evaluate the undergraduate dental students’ awareness, knowledge, and attitudes towards teledentistry. All undergraduate dental students during the 2022–2023 academic year, were invited to join this questionnaire. The questionnaire was posted to the students who agreed to answer the survey online. Associations between categorical variables were evaluated using the Pearson Chi-square test or Fisher-Freeman-Halton Exact test. The Mann-Whitney U test was used to compare two independent groups, and the Kruskal-Wallis test was used to compare more than two independent groups. All analyses were conducted using IBM SPSS Statistics for Windows, Version 23.0 (IBM Corp. Released 2015, Armonk, NY: IBM Corp.). The significance level was set at p < 0.05 for all analyses. Explanatory factor analysis and item analysis were used for the evaluation of the validity of the questionnaire.ResultsThere were 293 participants from five classes, with a 36.08% response rate; 190 (64.8%) were female and 103 (35.2%) were male, with a median age of 21 years (minimum 17 years, maximum 44 years). In this study, 37.9% of the participants had heard of teledentistry, 30.7% knew what teledentistry is, approximately one-third of the students were aware that there is a course called teledentistry in our faculty, and only 11.6% took the course. Undergraduate dental students had high levels of knowledge and awareness about the advantages and limitations of teledentistry. Dental students who had taken the course had a more positive attitude towards using teledentistry.ConclusionsEnhancing dental students’ knowledge and awareness of teledentistry could beneficially influence their utilization of teledentistry in their future careers.Clinical trial numberThis study is not a clinical trial involving medicinal products or therapeutic interventions, so the clinical trial number is not applicable.

Typological analysis of the dynamic characteristics of overflows under homogeneous urban form: evidence from Hong Kong’s back alleys

ABSTRACT Urban form refers to the geometric characteristics of a city in two- and three-dimensional space. Homogeneous urban forms often weaken regional characteristics, leading to a decline in urban vitality, among other issues. However, research has generally focused on fixed elements, such as buildings and streets, while paying less attention to semi-fixed elements, such as “overflow” (i.e. movable personal items that people place in public spaces), which plays a crucial role in shaping urban form. This study aims to explore the characteristics of overflow forms in urban spaces. Using a typological approach, it classifies overflows in Hong Kong’s back alleys. The Pearson chi-squared test examines the relationship between position and internal arrangement of overflows, while the Kruskal – Wallis and Nemenyi tests assess the differences in scale among various types of positions and internal arrangements. The findings reveal the dynamic characteristics of overflows, offering insights into how urban residents personalize public spaces in response to challenges and opportunities presented by governmental regulations and the built environment. By introducing new perspectives and research objects into the study of urban form, this study provides valuable ideas for micro-scale urban design and mitigating the homogeneous urban form.

371. Social Determinants of Vaccine Uptake: The Impact of Race and Vulnerability on Influenza, SARS-CoV-2, and RSV Vaccination Rates

Abstract Background U.S. vaccination rates fall short, with social vulnerabilities hindering access to preventive care. The influence of social determinants on vaccine uptake is a critical public health concern. This study explored the connection between the social vulnerability index (SVI), race, and vaccination rates for Influenza, SARS-CoV2, and RSV.Figure 1:Geospatial Distribution of Social Vulnerability Index and Vaccination Rates for Influenza, SARS-CoV-2, and RSV across Ohio Census Tracts with Patients to the University Hospital Healthcare Network. Geospatial representation of A) Public Social Vulnerability Index (SVI) for Ohio census tracts in 2020, B) Percentage of influenza vaccination, C) Percentage of SARS-CoV-2 vaccination, and D) Percentage of RSV vaccination for individuals aged 60 years and above. Figures B, C, and D show census tracts with a minimum of 10 patients presenting with mild to moderate respiratory infections to the University Hospital Healthcare network. The color scale for SVI ranges from 0 to 1, with the darkest red indicating the most vulnerable (SVI = 1) and the brightest cyan representing the least vulnerable (SVI = 0). The color scale for vaccination percentages spans from 0 to 100, with the darkest red denoting 0% vaccinated and the brightest cyan signifying 100% vaccinated. Methods We analyzed data from patients with acute respiratory infections treated at University Hospitals of Cleveland from October 2023 to April 2024. Patient demographics and vaccination statuses were collected from health records and matched with SVI census tract-level public data, which was geocoded and segmented into quartiles. We employed the Kruskal-Wallis and Pearson's Chi-squared tests for statistical analysis, and multivariate logistic regression adjusted for age and sex to assess vaccination odds. Results were depicted using geospatial methods to show the distribution of vaccinations and SVI across Ohio.Figure 2:Vaccinations Rates across race and social vulnerability index quantiles A comparison of vaccination rates for A) influenza, B) SARS-CoV-2, and C) RSV between White and Black populations across 10 quantiles of the Social Vulnerability Index (SVI). The SVI quantiles are represented on the x-axis, range from 0 to 1, with quantile 1 (SVI ≤ 0.2) representing the least vulnerable population and quantile 10 (SVI ≥ 0.8) representing the most vulnerable population. The y-axis shows the vaccination rates for each respective quantile. The color scheme used in the figure shows the White population in blue and the Black population in red. The summary statistics provide insights into the disparities in vaccination rates between White and Black individuals across varying levels of social vulnerability. Results The study analyzed a diverse population of 341,029 individuals, with 60% female and 38% male participants, and primarily consisted of white individuals (81%). Black individuals made up 14% of the population and were disproportionately represented in the highest vulnerability quartile (Q4) at 37%, which was significantly higher than the 3.2% in the lowest quartile (Q1). As the SVI quartile increased, vaccination rates decreased, particularly among Black individuals. Additionally, emergency visits for ARIs increased, while primary care visits decreased with higher SVI quartiles. The likelihood of vaccination decreased as the SVI quartile increased, especially among the Black group. The odds of receiving a flu vaccine were lower for Black individuals compared to White individuals in all SVI quartiles, with the greatest disparity in SVI Q5. Similarly, the odds of receiving the SARS-CoV-2 vaccine and the RSV vaccine were also lower for Black individuals compared to White individuals in all SVI quartiles. Detailed results are presented in the associated tables and figures.Table 1:Study Population Characteristics Across Social Vulnerability Index Quartiles Conclusion Socioeconomic vulnerability and race impact vaccination behaviors, emphasizing the need for tailored interventions to reduce disparities in vaccination rates among diverse populations.Table 2:Multivariate associations between Social Vulnerability Index (SVI) and Vaccination within White and Black Race Population Multivariate logistic regression models were used to evaluate the combined association between the SVI and race with the likelihood of vaccination for A) Influenza, B) SARS-CoV-2, and C) RSV. The models were adjusted for age and gender. The reference group for the combined race-SVI predictor was White individuals in the least vulnerable SVI quintile (Q1). Odds ratios, 95% confidence intervals, and p-values are presented for each race-SVI combination. Disclosures Elie Saade, MD, MPH, FIDSA, Janssen Global Services: Advisor/Consultant|Janssen Research and Development: Advisor/Consultant

P-2268. Candida tropicalis Invasive Infection in Febrile Neutropenia, a High Mortality Infection

Abstract Background Invasive candidiasis due to species other than Candida albicans emerges as a problem in neutropenic patients receiving antifungal prophylaxis, due to decreased susceptibility to triazoles. Candida tropicalis is the most frequently species in this population and is associated with higher mortality when compared to Candida albicans. The aim of this study is to characterize the neutropenic population with invasive candidiasis and establish differences in outcome of patients with Candida tropicalis infection compared to other Candida species. Characteristics of patients with invasive candidiasis Methods Retrospective cohort study of patients with hematological malignancies undergoing chemotherapy who developed invasive candidiasis between 2010 and 2022. Comparison of two qualitative variables was performed using Pearson's Chi-square test or Fisher's exact test. Estimation of group survival was performed using the Kaplan-Meier method and comparison of survival functions with the Log-Rank test. Results of multivariate analysis of risk factors associated with adverse outcomes. Results At the time of fungemia, 85% of patients had active malignancy, with a median of 14 days of neutropenia until the development of infection. 15% of patients had mucositis and up to 60% had concomitant diarrhea. 95% had previously received antibiotics and 87.5% had a central catheter. In 40% of the patients, the infection occurred as a breakthrough infection and in 37.5% it was associated with azole resistance. 32.5% of cases were associated with deep-seated infection and 25% had persistent fungemia. The 30-day mortality of patients with candidemia due to C. tropicalis was higher than that experienced by subjects with candidemia due to other species (69% vs. 35%, p = 0.034). The median overall survival was 15 days (95% CI 12-18) for the first group. Multivariate analysis showed that C. tropicalis infection was associated with an increased risk of all-cause mortality. The risk factors associated with cutaneous lesions were C. tropicalis infection and azul resistance. Overall survival of study patients Conclusion Patients who develop C. tropicalis candidemia during febrile neutropenia after chemotherapy for hematologic malignancies have a higher mortality than those infected with other Candida species. Azole resistance emerges as a threat given routine prophylaxis in this population, so mitigation strategies are necessary. Disclosures All Authors: No reported disclosures

P-1713. Impact of an Evidence-Based Order Panel on Antimicrobial Prescribing in Ambulatory Patients with Complicated and Uncomplicated Cystitis

Abstract Background Optimizing antimicrobial prescribing for urinary tract infections (UTI) represents an area of opportunity for ambulatory antimicrobial stewardship programs. A pre-populated, ambulatory antibiotic order panel for UTI was implemented in the Mayo Clinic Enterprise on 5/16/2022. The order panel provides antimicrobial regimens which align with both institutional and national treatment guidelines based on patient comorbidities, complicating factors, and beta-lactam allergy status. We aimed to assess the impact of panel use on antibiotic prescribing for complicated and uncomplicated cystitis in the ambulatory setting. Methods This retrospective review included ambulatory encounters from the Mayo Clinic Enterprise in 2022 and 2023. Eligible encounters were randomly selected and included those with a primary ICD-10 code of cystitis performed by primary care or urgent care clinicians. Encounters were excluded if patients had symptoms indicative of pyelonephritis, underwent urinary instrumentation within 30 days, or had a urinary pathogen isolated within 90 days. The primary outcome was concordance with institutional guidelines. Secondary outcomes included repeat healthcare contact and therapy duration. Outcomes were analyzed with Pearson's chi-squared and Wilcoxon rank sum tests (α level = 0.05). Results 793 encounters (397 panel vs. 396 non-panel) were included. Prescribing was guideline concordant in 79.3% and 64.9% (p&amp;lt; 0.001) of panel and non-panel encounters, respectively. Inappropriate duration was the most common reason for non-concordance in the panel use cohort. There was no difference between groups for repeat healthcare contact incidence. Antimicrobials prescribed differed between panel and no-panel groups (Table 1), with higher use of sulfamethoxazole/trimethoprim and lower use of cefdinir in the panel cohort. Numerically shorter durations were seen in the panel group, with more 3- and 5-day regimens than the no-panel group. Conclusion Use of a pre-populated antimicrobial order panel for outpatient cystitis encounters resulted in greater adherence to institutional guideline recommendations, particularly in terms of antimicrobial selection, without adversely impacting repeat healthcare contact. Disclosures Paschalis Vergidis, MD, MSc, AbbVie: Advisor/Consultant|Ansun Biopharma: Grant/Research Support|Cidara Therapeutics: Grant/Research Support|F2G: Grant/Research Support|Scynexis: Advisor/Consultant|Scynexis: Grant/Research Support

Preliminary insights into cardiovascular risk and erterial stiffness in patients with ankylosing spondylitis and psoriatic arthritis: a comparative study

Abstract Introduction Chronic inflammation has long been considered as a driving factor for accelerated atherosclerosis and cardiovascular events in patients with rheumatic diseases like Ankylosing Spondylitis and Psoriatic Arthritis. Ultrasound examination of the carotid artery can reveal signs of early asymptomatic stage of atherosclerosis. Aim The study aimed to investigate the cardiovascular risk factors and arterial stiffness in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA) compared to healthy controls. Patients and Methods: 180 participants, of which 109 with AS, 41 with PsA, and 30 healthy controls, were evaluated; 99 men and 81 women, (mean age 49±20). Cardiovascular risk was assessed using the Framingham score, SCORE2, and QRISK3 scales. Biochemical markers (cholesterol, triglycerides, LDL, HDL, ESR, CRP), hypertension, and smoking status were analyzed. Ultrasound examination of the carotid artery, using Aloka Prosound α7, with measurement of the carotid intima-media thickness (CIMT), beta stiffness, augmentation index (AI), pulse wave velocity (PWV), elastic modulus (Ep), and arterial compliance (AC), were analyzed. Statistical analyses included descriptive statistics, Pearson Chi-Square tests for categorical variables, and Mann-Whitney U and Kruskal-Wallis tests for continuous variables. Results All subjects were comparable in terms of age, hypertension, smoking status, lipid indices and risk scores. The ultrasound examination of the carotid artery revealed significant differences in carotid intima-media thickness (CIMT) between controls and patients with AS (p = 0.013) and PsA (p = 0.005), with elevated values in both patient groups, but no significant difference between AS and PsA (p = 0.370). Beta stiffness was markedly higher in both AS (p &amp;lt; 0.001) and PsA (p &amp;lt; 0.001) patients compared to controls, with no significant disparity between AS and PsA (p = 0.322). Pulse wave velocity (PWV) showed significant increases in AS (p &amp;lt; 0.001) and PsA (p = 0.001) patients compared to controls, but no variation between AS and PsA (p = 0.844). No significant differences were noted in the augmentation index (AI) across groups (p = 0.507). Elastic modulus (Ep) was significantly increased in AS (p &amp;lt; 0.001) and PsA (p = 0.001) patients compared to controls, with no significant difference between AS and PsA (p = 0.740). Arterial compliance (AC) did not show significant differences across groups (p = 0.094). (table.1). Conclusion This study reveals significant increase in parameters of arterial stiffness as a marker of premature atherosclerosis in patients with rheumatic diseases as ankylosing spondylitis and psoriatic arthritis in comparison with healthy subjects. Ultrasound examination of the carotid artery – indeces of PWV, AI, EP, AC, beta-stiffness, is an easy and accessible method for diagnosing early vascular impairment in rheumatic patients.

P-1392. Sexual History Documentation Among Veterans with a Sexually Transmitted Infection (STI)

Abstract Background Sexual health discussions in routine healthcare encounters can help identify sexually transmitted infection (STI) risk. We measured the prevalence of sexual history completion in Veterans with an STI and association between STI testing and offer of HIV pre-exposure prophylaxis (PrEP).Table 1.Summaries of levels of sexual history and STI tests ordered by sample sites (N=285)a Pearson Chi-Square Test of Independence Methods We conducted a retrospective review of a Veteran cohort with a STI documented on a clinical encounter between December 2020-December 2021 at five Veterans Affairs (VA) facilities in the southern United States. Primary care, emergency room, and specialty clinic visits were included, and infectious disease clinic visits excluded. STI was defined as a positive result for chlamydia, gonorrhea, and/or syphilis. The CDC’s definition of an appropriate sexual history utilizing the “5 Ps” (partners, practices, protection, pregnancy, and past STIs) was used as the reference standard. Level of sexual history taken was categorized as none (0 Ps), minimal (1-2 Ps), moderate (3 Ps), or full (4-5 Ps for a male, 5 Ps for female). Chi-square tests and logistic regression were used for analyses.Table 2.Associations of demographic characteristics with extent of sexual history taken during the encounter and HIV testing controlling for VA site. (N=285)a Multinomial logistic regression, log likelihood testb p-value of relative risk ratio (RRR), adjusted for study sitec Number of sites included = 283d Other included American-Indian/Alaska Native (1), Asian(1), Hispanic/Latino(6), Native Hawaiian/Pacific Islander(2), Multiple races(6) Results We included 285 records in the review. A sexual history was not conducted (0 Ps) in 43% (122/285) of encounters. There were statistically significant differences in obtaining sexual history and number of STI tests ordered across VA facilities (p&amp;lt; .001 and .006, respectively). No evidence of documentation occurred for sexual practices (93%), history of STIs (78%), and sexual partners (67%). Males were less likely to receive a full sexual health history (p=.01) and HIV testing (53 vs 72%, p=.007) compared to females. Only 4 (1%) Veterans were offered PrEP. After controlling for facility, a statistically significant association between the extent of documented sexual history and STI tests ordered (p=.019). No significant associations were observed between extent of history or HIV testing for Veterans’ age, race, or provider type.Table 3.Associations of extent of sexual health history taken and tests ordered after controlling for VA site. (N=285)a Multinomial logistic regression, log likelihood testb p-value of relative risk ratio (RRR), adjusted for study sitec Other included American-Indian /Alaska Native1), Asian (1), Hispanic/Latino (6), Native Hawaiian/Pacific Islander (2), Multiple races (6) Conclusion Incomplete assessment of sexual history was common in outpatient visits and varied by facility for Veterans with a STI. There was a relationship between increasing level of sexual history and number of STI tests ordered. Future work includes identifying systematic interventions to support standardization of sexual history taking. Disclosures All Authors: No reported disclosures

P-593. Does Dolutegravir increase hypercholesterolemia and/or hypertriglyceridemia?

Abstract Background Antiretroviral therapy improved prognosis of people living with HIV (PLWA). WHO recommends Dolutegravir as the preferred treatment option for HIV in all populations considering its high genetic barrier and rare adverse effects compared to other treatments. In Morocco, the transition to Dolutegravir has begun in 2020 with the regimen: tenofovir desproxil fumarate/lamivudine/dolutegravir TDF/3TC/DTG (TLD). Some studies shown increased cholesterol and triglycerides levels on TLD regimens. The purpose of this study is to compare the effect of TLD on cholesterol and triglyceride levels compared to other antiretroviral therapy (ART) regimens. Methods We conducted an observational comparative study at the Infectious diseases department Mohammed VI university hospital Marrakesh, MOROCCO. We included all PLWA admitted between 1st January 2021 and 31 December 2022 put on any ART and having a lipidic dosage. We excluded all patients with previous hypercholesterolemia and/or hypertriglyceridemia. We compared the occurrence of hypercholesterolemia and/or hypertriglyceridemia in PLHIV on TLD with those on other ART. For the statistical analysis a pearson chi-square test was used with the R software. Results We included 173 PLWA; the median age was 33 years. 66.5% were male. The viral load was available in 152 people and was &amp;lt; 1000 copies/mL in 98%. The CD4 count was available in 161 persons and was &amp;gt;200 cells/mm3 in 69.6%. There were 120 persons on TLD arm (69.36%) and 53 on other ART arm (30.64%). On the TLD arm 15 people (12.5%) and 16 (13%) have developped an hypercholesterolemia and/or hypertriglyceridemia respectively versus 10 (18.86%) and 12 (22.64%) have developped an hypercholesterolemia and/or hypertriglyceridemia respectively on the others ART arm, but the difference was statistically non-significant (X2= 0.74; p=0.38) for hypercholesterolemia and (X2= 1.47; p=0.22) for hypertriglyceridemia. Conclusion This study shows that there is no strong evidence of any association between the TLD regimen and the hypercholesterolemia and/or hypertriglyceridemia. The TLD regimen is more safe on the lipidic metabolism compared with other ART. Further large studies are needed to prove this benefit. Disclosures All Authors: No reported disclosures