Pearson Chi-square 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.

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.

Tumor infiltrating T-cells and loss of expression of SWI/SNF genes in varying stages of clear cell renal cell carcinoma.

Patients with clear cell renal cell carcinoma (ccRCC) metastases face poor prognoses, even with adjuvant therapies. Tumor-infiltrating T-cells and macrophages are critical in targeting tumor cells within the renal microenvironment. Beyond VHL mutations, loss-of-function mutations in SWI/SNF complex genes, including PBRM1, BAP1, ARID1A, SETD2, SMARCA4 (BRG1), and SMARCA2 (BRM), have been implicated in ccRCC progression. A tissue microarray of 160 ccRCC cases was analyzed via immunohistochemistry (IHC) for SWI/SNF protein expression and CD4 + /CD8 + T-cell infiltration. Clinical and pathologic features were obtained through electronic medical records. Statistical analyses included one-way ANOVA, two-way ANOVA, Pearson's chi-square and t-tests. Loss of SWI/SNF protein expression was observed in PBRM1 (31 %), ARID1A (51 %), SETD2 (14 %), BRG1 (15 %), BRM (38 %), and BAP1 (40 %). T-cell counts varied significantly with stage: CD4 + counts peaked at Stage 3, while CD8 + counts increased through Stage 4 (p < 0.001). Loss of PBRM1 was more frequent in advanced stages (29.4 %, p < 0.001), while BRM and BRG1 losses were more common in earlier stages (p < 0.001, p = 0.006). ARID1A and BRM losses correlated with reduced CD8 + counts (p = 0.016, p = 0.032) and stage-specific CD4 + variations (p < 0.001, p = 0.042). Loss of PBRM1, SMARCA2/BRM, and SMARCA4/BRG1 expression is significantly associated with ccRCC progression, with PBRM1 loss prevalent in advanced stages and SMARCA2/BRM and SMARCA4/BRG1 in earlier stages. ARID1A and SMARCA2/BRM losses correlate with reduced CD8 + counts and stage-specific CD4 + infiltration, highlighting their potential as biomarkers for disease progression and immunotherapeutic response.

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.

Knowledge of Ghana’s liberal abortion law and use of modern contraceptives among women of reproductive age

BackgroundModern contraceptives have been widely promoted as an effective tool for birth control. They are highly effective for preventing unintended pregnancies thereby reducing the risk of abortions, maternal morbidities, and mortalities. Abortion or planned abstinence from sexual intercourse may be perceived as alternatives to the use of modern contraceptives. The aim of this study was to assess whether knowledge of the legal status of abortion, and knowledge of the monthly fertile period, were associated with the use of modern contraceptives among women of reproductive age in Ghana.MethodsWe used nationally representative secondary data from the 2017 Ghana Maternal Health Survey. A weighted sample of 23,466 non-pregnant women aged 15–49 years were included in the study. Pearson chi-square and multivariable logistic regression analysis were conducted to assess the association between the independent and the outcomes variables. Sampling weight, cluster, and strata were applied at all levels of the analysis.ResultsMore than half (55.4%) lived in urban area, 80.1% were 20 years or older, 52.2% were multiparous women, 61.9% had secondary or higher education, and 34.5% were in the lower two wealth quintiles. We found no statistically significant association between knowledge of the legal status of abortion and use of modern contraceptives, or between knowledge of the monthly fertile period and use of modern contraceptives. Women with history of an induced abortion were 1.57 times as likely to use modern contraceptives compared to those with no history [adjusted odds ratio (aOR) 1.57, 95% CI 1.41–1.75]. Each additional increase in knowledge of a different modern contraceptive method was associated with 1.25 times increase in modern contraceptive use (aOR 1.25, 95% CI 1.22–1.29).ConclusionsIntensifying education on modern contraceptive methods and use, especially at abortion facilities, may help improve the uptake of modern contraceptives among women in Ghana.

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.

RELATIONSHIP BETWEEN DENTAL VISIT TOWARDS QUALITY OF LIFE IN PRIMARY HEALTH CITEREUP CIMAHI

The aim of this study was to determine the relationship between Oral Health Quality of Life (OHRQoL) and the number of visits to the dentist. This is a cross-sectional study. This study using OHIP questionnaire and additional question about healthcare insurance ownership. Data were analysis using SPSS version 25. The findings of a study including 62 respondents. The prevalence respondent on 44-60 years old were 38,7%. Most of them as BPJS ownership and as unemployment. The highest prevalence OHRQOL based on dental utilization were low categorize and more than 6 months dental visit. The result bivariate analytic and statistically of Pearson chi square test, there are differences between OHRQol categorize towards dental visit p=0,000. Correlation between OHRQoL with dental visit statistically significant p=0,000 r=0,606. Maintaining dental and oral health by providing promotive and preventive programs can reduce the prevalence of visits to the dentist and can improve quality of life status. There are several determinant factors affected towards dental utilization. Universal health coverage is one of determinant factors to prevent out of pocket expenditures.

CORRELATION HANDGRIP STRENGTH TO GINGIVAL RECESSION FROM BRUSHING TEETH TRAUMA: PRELIMINARY STUDY

Brushing is affected by the strength of hand movements, including the grasping muscles. Excessive brushing of the teeth can result in trauma to the gingiva. This study aims to review the relationship between the strength of the grasping muscles and the occurrence of gingival recession. The cross sectional research method was carried out at Cirendeu State Elementary School, Cimahi. Measurements of handheld muscle strength were performed with a hand dynamometer and gingival recession on an intra-oral clinical examination. The results of the two data will be correlation tests to see the relationship using the Pearson Chi Square Test. The results of the study of twenty children in grade 6 elementary school were weak grip muscle strength of 30% in 6 male students and 20% moderate in 4 students, weak 20% in 4 female students, medium 15% in 3 female students, and strong 15% in 3 female students. There was a gingival recession of 10% each in 2 female and male students. The relationship between the occurrence of recession and strong grip muscle strength was 33.3% (p value &lt;0.5). In 12-year-old children, there was no significant relationship between the strength of the grasping muscles and the occurrence of gingival recession.

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.

P-890. Risk Factors Associated with Carbapenem-Resistant Enterobacteria Bacteremia and Mortality in Patients with Acute Leukemia

Abstract Background The inclusion of highly cytotoxic drugs for the treatment of acute leukemia (AL) in the last decade has exposed patients to more extended periods of severe neutropenia. The study aims to describe the prevalence and risk factors for blood-stream infection (BSI) due to carbapenem-resistant enterobacteria (CRE) in patients with AL receiving chemotherapy.Table 1.Independent risk factors for blood-stream infection due to carbapenem-resistant enterobacteria FLAG-IDA chemotherapy regimen had an OR 28.8 (CI 2.9-286.68. p=0.004) for CRE-BSI Methods The study was performed at a referral center for adult patients with cancer in Mexico City. From January 2021 to December 2022, all patients with AL treated from first to fourth line chemotherapy were included. CRE and non-CRE BSI were compared for categorical variables with Pearson's chi-square. A bivariate logistic regression analysis was performed to identify risk factors associated with mortality and isolation of CRE.Table 2.Independent risk factors for mortalityPatients with AML had an OR 7 (CI 1.26-39.23 p=0.026), isolation of CRE OR 6.8 (CI 1.17-0.03 p=0.03) and being diagnosed with invasive fungal infection (IFI) OR 5.2 (CI 1.29-26.66 p=0.02) for mortality Results One hundred ten patients were included: 62 (56.3%) with acute lymphoblastic leukemia (ALL) and 48 (43.6%) with acute myeloid leukemia (AML). 119 BSI were confirmed, 41 (34%) blood isolates were antimicrobial resistant, 23 (56.1%) had extended-spectrum beta-lactamases (ESBL), and 16 (39%) had CRE. BSIs were classified as 70 (58.8%) Mucosal Barrier Injury Laboratory-Confirmed Bloodstream Infection (MBI-LCBI), 24 (20.1%) secondary, 23 (19.3%) catheter-related and 2 (1.6%) primary. Of the 23 (56.1%) isolates with ESBL and 16 (39%) CRE, all were classified as MBI-LCBI, as were two (4.9%) methicillin-resistant S. aureus. Overall, 30-day mortality was 9.2%, and at 24 weeks, 16.8%. In the bivariate analysis, receiving a FLAG-IDA had an OR 28.8 (CI 2.9-286.68. p=0.004) for CRE-BSI (Table 1). For mortality, having AML had an OR 7 (CI 1.26-39.23 p=0.026), CRE BSI isolates OR 6.8 (CI 1.17-0.03 p=0.03), and being diagnosed with invasive fungal infection (IFI) OR 5.2 (CI 1.29-26.66 p=0.02) (Table 2). Kaplan-Meier model comparing patients with and without CRE-BSI showed a mean survival of 17.8 months in CRE-BSI vs. 23.4 months without CRE-BSI, although non statistical significance (Figure 1).Figure 1.Kaplan-Meier survival analysisKaplan-Meier model comparing patients with and without CRE-BSI showed a mean survival of 17.8 months in CRE-BSI vs. 23.4 months without CRE-BSI, although without statistical significance Conclusion In this cohort, overall mortality was associated with AML, having CRE isolated in blood, and having been diagnosed with IFI. Having a CRE-BSI was associated with receiving FLAG-IDA. This highly myelosuppressive chemotherapy regime has become a niche for antimicrobial resistance development in our institution. Disclosures All Authors: No reported disclosures

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-396. Can ‘Handshake Stewardship’ Decrease Multi-Drug Resistant Healthcare-Associated Infections and All-Cause Mortality? - Insights from A South Indian Tertiary Hospital

Abstract Background Multi drug resistant Healthcare Associated Infections (MDR HAI) pose significant challenges for both patients and healthcare facilities, often stemming from inappropriate antibiotic usage. 'Handshake Stewardship' involves a proactive approach of auditing and providing feedback on antibiotic prescriptions to ensure their rationality, with discussions held confidentially with treating physicians. Endorsed by the Centers for Disease Control and Prevention and The Joint Commission, this method aims to engage clinicians in addressing clinical barriers to antimicrobial stewardship. Methods This study compares MDR HAI in the inpatients of two timelines, pre period May 2021 to April 2022 and post period May 2022 to April 2023. In the post period, the rationality of the antibiotic therapy is discussed with the clinician (in-person approach) by the Antimicrobial stewardship pharmacists within 24 hours of starting the monitored antibiotic. The clinician may or may not accept the interventions and the outcome was documented electronically. The primary outcome was the MDR HAI. Antimicrobial susceptibility testing was performed by the Clinical and Laboratory Standards Institute and ‘MDR’ was assigned as per the joint initiative document by the European Centre for Disease Prevention and Control (ECDC) and the Centers for Disease Control and Prevention (CDC). HAI referred from the CDC’s National Healthcare Safety Network (NHSN) criteria. The secondary outcome was all-cause mortality. Descriptive cross-tabulations and chi-square tests (for all Categorical variables) were performed. Results 83 HAIs in the pre phase period has 46 cases with MDR status in the culture report, whereas the post era reported 55 MDR status among 108 HAI cases. The post era has less percentage compared to the pre era with no statistical significance (p=0.319) (table -1). The MDR types depicted in table-2. It was found that all-cause mortality in MDR HAI showed no statistically significant difference (Pearson Chi-Square = 0.246) between pre and post phase. Conclusion 'Handshake Stewardship' did not lead to a significant reduction in MDR HAIs or all-cause mortality during the study period, further long-term evaluations are warranted to assess its effectiveness comprehensively. Disclosures All Authors: No reported disclosures

Perioperative Blood Transfusion and Infectious Complications Among Pediatric Patients with Cancer

Perioperative blood transfusion has been identified as a risk factor for postoperative infectious complications in adult patients with cancer. This study aimed to determine whether this association also exists in pediatric patients with cancer. A retrospective analysis was performed using the American College of Surgeons National Surgical Quality Improvement Program Pediatric (NSQIP-P) database. Pediatric patients with an active cancer diagnosis at the time of surgical intervention from 2015 to 2019 were reviewed. Statistical analysis was performed using Pearson chi-square and Fisher’s exact tests as well as multiple logistic regression. In total, 14,973 pediatric patients who underwent a surgical procedure and had an active cancer diagnosis at the time of operation were identified. Of these, 2602 patients (17.4%) received a perioperative blood transfusion (PBT). Patients who received a PBT experienced higher rates of postoperative infectious complications, including surgical-site infection (p &lt; 0.0001), pneumonia (p &lt; 0.0001), urinary tract infection (p &lt; 0.0001), C. difficile infection (p &lt; 0.0001), central-line-associated bloodstream infection (p &lt; 0.0001), and sepsis (p &lt; 0.0001). Patients who received a PBT also had increased 30-day mortality compared with those who did not receive a PBT (p &lt; 0.0001). On multivariate analysis, PBT remained an independent risk factor for postoperative infectious complications (OR 1.9, 95% CI 1.61–2.32) and death (OR 1.8, 95% CI 1.23–2.71). Pediatric patients with cancer who undergo surgery and receive a blood transfusion in the perioperative period have increased 30-day mortality and are at increased risk for postoperative infectious complications. Considering that these patients are often immunosuppressed at baseline, infections can be particularly devastating in this population. As such, it is important to carefully consider the risks and benefits of PBT prior to transfusion.

Fracture Resistance of Glass-Fiber-Reinforced Direct Restorations on Endodontically Treated Molar Teeth with Furcal Perforation

This in vitro study evaluated short-fiber-reinforced composite materials and fiber-reinforced restorations of endodontically treated molars with furcal perforation. The endodontic treatment and mesio-occlusal–distal cavity preparation of 126 two-rooted mandibular third molars were performed. Eighteen non-perforated teeth were restored with resin composite as the control group. Furcal perforations and repair were performed on 108 teeth that were divided into six experimental groups: resin composite (RC), everX Flow (EXF), everX Posterior (EXP), Bioblock (BB), modified transfixed (MT), and horizontal glass-fiber (HGF) groups (n = 18). Fracture resistance tests were performed at an angle of 30◦ using a universal testing machine under static loading, and fracture patterns were classified. Welch’s analysis of variance, Pearson chi-square, and Tamhane post hoc tests (p = 0.05) were used to analyze the data (p = 0.05). The highest fracture resistance values were seen with the HGF (596.305 N), followed by MT (540.365 N), BB (477.906 N), EXP (476.647 N), EXF (414.462 N), control (413.811 N), and RC (335.325 N) groups (p &lt; 0.001). There was no significant difference between the BB and EXP groups or between the EXF and control groups (p &gt; 0.05). In terms of the dominant fracture pattern, the HGF and MT groups were repairable and possibly repairable, whereas the control, RC, and EXP groups were unrepairable. The EXF and BB groups were almost equally divided between possibly repairable and unrepairable. Restorations using horizontal fiber techniques and short-fiber-reinforced materials increased the fracture resistance of endodontically treated teeth with furcal perforation.

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

Evaluation of Objective Structured Clinical Examination-assessed competence and perceived confidence in oral surgery among final-year undergraduate student.

This study aimed to evaluate dental students' competencies and self-confidence in performing common oral surgical procedures. It further aimed to assess potential correlations among levels of competence and confidence with student gender. Final-year undergraduate students from Mosul Dental School in Iraq were enrolled in a summative Objective Structured Clinical Examination (OSCE) to assess their competence in core skills and knowledge in oral surgery (OS). The students were also invited to participate in the ABAOMS self-assessment questionnaire to assess self-perceived confidence in performing OS procedures. Gender correlation with competence and confidence was computed via the Pearson Chi-square test (p ≤ 0.05). A total of 272 students were evaluated for OS competence. Students' highest competence was in dental anatomy (91.1%), while history-taking and tooth extraction scored the highest failure levels (56.1%) and (39.1%), respectively. For self-confidence, students felt adequately prepared to carry out several clinical procedures although they indicated low confidence in performing minimally practiced procedures. No significant correlation was detected in the total confidence versus competence except for the management of post-extraction complications. Results also showed no significant correlation between students' competence-confidence-gender; except for the administration of local anesthesia among females (p-value 0.007 ≤0.01). The findings of this study show that the competence and self-perceived confidence of final-year students were generally satisfactory for a range of clinical and affective skills. However, several areas of weakness were identified which underscore the need for modification of the current curriculum to improve the preparedness of undergraduate dental students as safe beginners in OS.

Assessment of health behaviors of primary school teachers based on their nutritional knowledge and physical activity: A cross-sectional study in the Asir Region.

Primary school teachers play a critical role as educators in imparting healthy eating behaviour and the importance of physical activity to prevent health issues. However, the teachers' health behaviors have not been studied much, particularly in Saudi Arabia. Understanding these factors is essential to developing interventions that enhance teachers' well-being and their ability to influence students positively. This study aims to assess nutritional knowledge and physical activity; to determine correlations between health behaviour factors and Body Mass Index (BMI), and evaluate BMI status concerning demographic factors among primary school teachers in the Asir Region, KSA. A cross-sectional design was employed, involving 370 primary school teachers. Data were collected using a self-administered questionnaire that covered sociodemographic details, anthropometric measurements, physical activity levels, and nutritional knowledge. Statistical analyses included Pearson's correlation and Chi-square tests, with significance at p < 0.05. Among the participants, 38.6% were overweight, and 33.5% were obese, with 76% of married teachers classified as overweight or obese. Only 9.0% exhibited excellent nutritional knowledge, while 25.0% demonstrated poor knowledge. The majority (84.0%) engaged in low or minimal physical activity. A weak but significant correlation was observed between nutritional knowledge and BMI (p < 0.05), whereas no significant associations were found between physical activity levels and either BMI or nutritional knowledge. The study highlights critical gaps in nutritional knowledge and physical activity among teachers, emphasizing the need for targeted school-based health education programs. Improving teacher health behaviors could enhance their well-being and enable them to act as positive role models for their students.

Culture negative sepsis in neonate in a level III NICU of a community hospital in Brooklyn New York

Background: Neonates often diagnosed with possible sepsis without any evidence of bacterial cause, known as “culture negative sepsis (CnS)”. Most data on neonatal sepsis focuses on culture proven sepsis but large number of neonates receives antibiotic for CnS and its epidemiological data is not accurately represented. Studies suggest that its incidence exceeds incidence of proven sepsis by 16 folds in United states and 50-fold in resource limited settings. According to recent estimates CnS contributes to 20% antibiotic usage in Neonatal intensive care units (NICUs). It is linked to adverse neurodevelopmental outcomes. We aim to identify the incidence and frequency of CnS in a community NICU. Methods: It is a retrospective observational study between November 2023 to March 2024 in a level III NICU. Neonates admitted during 1st January 2023 till 30th June 2023 and required antibiotic were included. IRB approval was obtained. Data collected for gestational age, gender, diagnosis, blood culture, indication, type, number of days of antibiotic, length of stay, invasive device and duration, birth weight, blood culture and comorbid condition. Data was analyzed using SPSS 22.0. Frequencies and percentages calculated and Pearson Chi-square used to assess correlations, p&lt;0.05 considered statistically significant. Results: The 95 neonates enrolled. Incidence of CNS was 64%. The 15% patients require invasive devices. Most common indication for antibiotic use was clinical SIRS (75%). The 49% of babies had comorbidities and most common comorbidity was prematurity (47%). Conclusions: CnS has high incidence in community hospital NICU’s then reported in literature.