Mean Percentage Research Articles

Genetic Studies on Yield and Its Components in Pigeonpea (Cajanus cajan L. Millsp.)

A field trial was carried out at the International Crop Research Institute for the Semi-Arid Tropics, Patancheru, Hyderabad during Kharif, 2023-24, with the aim of studying genetic parameters for yield and its components among pigeonpea genotypes which provides in developing an apt selection index to be included in the breeding programs. This research was conducted on 200 genotypes of Indian pigeon pea on seven traits. Data were analysed to calculate analysis of variance (ANOVA), phenotypic coefficient of variation (PCV), genetic coefficient of variation (GCV), broad sense heritability (h2bs) and estimated genetic progression as percentage mean using R software v 4.3.1. The results of the analysis of variance showed that there was a significant difference for days to 50% flowering, plant height (cm), hundred seed weight and seed yield per plant among the genotypes. The genotypic coefficient of variance was lower than the genotypic coefficient of variance for all the traits under selection. Higher extent of genotypic coefficient of variation is manifested by days to 50% flowering, plant height, seeds per pod, hundred seed weight and seed yield per plant. High heritability coupled with genetic advance as per cent mean was observed in seed yield per plant, number of days to 50% flowering and plant height. The results concluded that seed yield per plant, number of days to flowering up to 50%, and plant height are the traits that should be emphasized as selection indicator in Indian pigeon pea breeding programs.

Accuracy of Echocardiographic Cardiac Output Assessment by Critical Care Fellows.

Advanced critical care echocardiography comprises a specific set of qualitative and quantitative point-of-care echocardiography skills, including a reliable, noninvasive method to measure cardiac output. This technique requires echocardiographic measurement of left ventricular outflow tract (LVOT) diameter and LVOT velocity time integral (VTI). Although there is a demand among critical care fellows to learn these advanced techniques, there are no data describing the acquisition of mastery in these skills. This pilot study aims to describe the accuracy of echocardiographic measurement of LVOT diameter and LVOT VTI obtained by critical care fellows after an educational intervention, as well as to enhance validation evidence for an image scoring assessment that is applicable to these measurements. We implemented a brief mastery learning intervention to teach the measurement of LVOT diameter and VTI. Fellow measurements of these parameters, along with the corresponding echocardiographic images, were compared with a gold standard of measurements obtained by professional echocardiography technicians and interpreted by cardiologists. Seven fellows performed 35 echocardiograms on 32 patients. The average fellow-reported LVOT VTI was 17.0 ± 4.37 cm, whereas the average cardiologist-reported VTI was 17.3 ± 5.19 cm. The correlation (r) between fellow and cardiologist-reported VTI was 0.73 (P < 0.001), with a mean percent difference of 19.5 ± 12.0%. The average fellow-reported LVOT diameter was 2.07 ± 0.23 cm, whereas the average cardiologist-reported LVOT diameter was 2.08 ± 0.22 cm. The correlation (r) between fellow and cardiologist-reported LVOT diameter was 0.51 (P = 0.004), with a mean percent difference of 8.05 ± 7.0%. The sensitivity for fellows to detect an abnormal LVOT VTI was 91%, with a specificity of 43%. Critical care fellow measurement of LVOT VTI and LVOT diameter demonstrated strong and moderate positive correlations with cardiologist-reported values, respectively, with acceptable clinical agreement. However, interrater reliability and percent differences showed room for improvement. Education in these advanced skills is resource intensive, and additional research is needed to determine the most effective approach to training fellows.

Selection Strategy for Yield Improvement of Chickpea Genotypes (Cicer arietinum L.)

An investigation was undertaken to assess the genetic variability parameters, correlation and path analysis in 25 chickpea genotypes for 12 quantitative traits during the Rabi season of 2022-23 in a Randomized Block Design with three replications. Analysis of variance indicated high significant differences among the genotypes for all the traits. Considerable variability existed in the genotypes for all the characters studied. The study found that CG23, CG159, and CG199 were the most superior genotypes for grain yield per plant among 25 chickpea genotypes. High PCV, GCV, heritability and genetic advance as percent of mean were recorded for test weight and biological yield. Grain yield per plant showed positive significant association with number of pods, days to maturity, days to 50% pod initiation and number of primary branches. High and positive direct effect of grain yield per plant at both phenotypic and genotypic levels were depicted by harvest index. These characters may be taken into consideration for selection of quantitative characters for crop improvement.

Teachers’ Utilization of Information and Communication Technology and Learners’ Academic Performance

Several novel concepts and understandings in education can result from researching how teachers use information and communication technology (ICT) and how that use affects students’ academic achievement. It is on this premise that this paper aimed to determine the extent of teachers’ ICT utilization and its relationship with learners’ academic in a public secondary school, in one of the districts of a large size schools division in Central Philippines, during the School Year 2023-2024. Data needed for this descriptive study was collected from 42 respondents using a self-made 30-item questionnaire that has passed the rigorous tests of validity and reliability. This study employed appropriate statistical methods based on the stated objectives namely, frequency and percentage count, Mean, Mann-Whitney U-test and Spearman Rho. Data showed a great extent of teachers’ ICT utilization when analyzed regarding instructional delivery and computer peripherals and equipment. Meanwhile, learners’ academic performance was found to be very satisfactory. The results state that the relationship between extent of teachers’ ICT utilization in teaching and learners’ academic performance is interpreted as not significant, the extent of teacher’s utilization of Information and Communication Technology does not affect the learners’ academic performance. The study results call for the teachers to encourage using technology in delivering the lesson, and the higher authority may support the school in providing the needs of the teachers and students and equip educators with tangible abilities to enhance technology integration in classrooms, fostering creativity, collaboration, and continuous refinement of teaching and learning approaches. Keywords: Information and communication technology, instructional delivery, computer peripherals and equipment, Negros Occidental, Philippines.

Three-Dimensional Planimetry Assessment of Dental Plaque-Covered Area Reduction after Rinsing with 0.2% Sodium Hypochlorite Solution as Part of a Guided Biofilm Therapy® Protocol-Pilot Longitudinal Study.

Background/Objectives: Less often employed as a rinsing solution for controlling oral biofilms, NaOCL was used in oral rinses at various concentrations in steps 1 and 4 of periodontal therapy. The aim of this study was to quantitatively evaluate the biofilm-disruptive properties of a 0.2% NaOCl solution in standardized oral rinses using dedicated plaque-disclosing agents and 3D scanning methods in patients undergoing the regular Guided Biofilm Therapy® protocol. Methods: Eight patients with at least 20 teeth present evenly distributed between the two arches were included. After 24 h of refraining from oral hygiene, dental arches were stained with a disclosing agent, the subjects rinsed for 20 s, clinical photographs and 3D scans were performed, subjects rinsed again for 20 s, photographs and 3D scans were performed again, and then the GBT® protocol was resumed as usual. Data representing areas covered with dental plaque were acquired using the "Medit Scan for Clinics" software and then underwent a post-processing and rendering process. The outcome variable was the percent reduction in the plaque-covered areas. Results: For the upper jaw, the estimated mean percent reduction in the biofilm-covered area was 39.65%, while for the mandible, it was 38.26%. The analysis of individual photographs revealed changes in the plaque-covered areas and reductions in the color intensity of the residual plaque-covered areas under identical lighting conditions. Conclusions: When analyzed using 3D intraoral scanning, the 0.2% NaOCl rinsing solution seems to be a clinically efficient disruptor/dissolvent of the oral biofilm, both when integrated into modern protocols of periodontal therapy like GBT® and for home self-care.

Factors influencing Customers’ Decisions to Use Online Food Delivery Services in Muscat, Oman

Purpose: This study examines the factors that influence customers’ choice of online food delivery services and assesses customer experience with the quality of e-services, personal characteristics of delivery staff, and perceived food quality. Design/methodology/approach: This study employed a quantitative approach and adopted an explorative research design employing a snowball sampling technique and collected the data using a questionnaire. The sample size in this study was 163. The Gretel program was used to extract questionnaire data with greater accuracy and statistical analyses like percentage analysis, mean, standard deviation, ranking, and Correlation measures were used to analyze the data. Findings: Talabat was the most popular online food delivery service in Muscat. The results of the study revealed that the three primary factors that drive customers to place online food orders are affordability, variety, and excellent cuisine. Every respondent places at least one online food order every month, and the majority place three or more orders, primarily using a mobile device. Furthermore, the professional behaviour of the delivery staff, food quality, and website design affect consumer satisfaction. However, there is a weak positive correlation between timely delivery and customer satisfaction. Most of the respondents responded that they would order food again because of their pleasant experiences. Research limitations/implications: To attract more clients, food delivery services can boost social media presence and work with influencers. Most respondents utilize food delivery services between once and three times each month. Thus, firms should implement loyalty programs to retain clients. Improving mobile app functioning should be the primary goal, given that most customers prefer to order food using their phones. Businesses should evaluate food order accuracy and prioritize effective food delivery to clients. Despite the lack of a link between customer satisfaction and delivery timing, timely delivery is critical for customer satisfaction. Social Implications: Online food delivery services serve persons with hectic schedules and mobility challenges. Many individuals who own restaurants and small entrepreneurs working from home may now access a large consumer base and greater visibility can boost their sales. These enterprises allow individuals to try the cuisine of other nations, which was previously impossible, thus broadening the culinary experiences. Originality / Value: Online food delivery companies expanded rapidly during and after the pandemic in response to rising demand. While expanding in popularity, no study of online food delivery services has been conducted in Oman. Therefore, the results of this study will immensely benefit online food delivery companies, and the people engaged in this industry. Keywords: Online Food Services, Customer Experience, Customer Satisfaction, Food Delivery Factors, Delivery Staff, Food Delivery Applications.

Edoxaban pharmacokinetics during in vitro continuous renal replacement therapy

BackgroundTo evaluate the clearance of edoxaban during modeled in vitro continuous renal replacement therapy (CRRT), assess protein binding and circuit adsorption, and provide initial dosing recommendations.MethodsEdoxaban was added to the CRRT circuit and serial pre-filter bovine blood samples were collected along with post-filter blood and effluent samples. All experiments were performed in duplicate using continuous veno-venous hemofiltration (CVVH) and hemodialysis (CVVHD) modes, with varying filter types, flow rates, and point of CVVH replacement fluid dilution. Concentrations of edoxaban and urea were quantified via liquid chromatography-tandem mass spectrometry. Plasma pharmacokinetic parameters for edoxaban were estimated via noncompartmental analysis. Two and three-way analysis of variance (ANOVA) models were built to assess the effects of mode, filter type, flow rate, and point of dilution on CLCRRT. Linear regression was utilized to provide dosing estimations across CRRT effluent flow rates from 0.5 to 5 L/h. Optimal edoxaban doses were suggested using CLCRRT and population non-renal clearance (CLNR) to estimate total clearance and match the systemic AUC associated with efficacy in the treatment of venous thromboembolism.ResultsEdoxaban clearance from the CRRT circuit occurred primarily via hemofilter adsorption to the HF1400 and M150 filters at 74% and 65%, respectively, while mean percent protein binding was 41%. Multivariate analyses confirmed the lack of influence of CRRT mode, filter type, and point of dilution on the CLCRRT of edoxaban allowing dosing recommendations to be made based on effluent flow rate. Edoxaban doses of 30-45 mg once daily were estimated to achieve target the AUC threshold for flow rates from 0.5 to 5 L/h.ConclusionFor CRRT flow rates most employed in clinical practice, an edoxaban dose of 45 mg once daily is predicted to achieve target systemic exposure thresholds for venous thromboembolism treatment. The safety and efficacy of this proposed dosing warrants further investigation in clinical studies.

Prevalence and Correlation between HbA1c Control and Duration of Diabetes with Blindness in the Eastern Part of Libya: Double Centers Study

A prospective cross-sectional study of diabetic patients registered at the Eye department of Tobruk Medical Center in Tobruk-Libya between (01.06.2023 to 29.02.2024). At the same time data was collected in the eye department in Alwahda Derna Teaching Hospital, Data was collected using the same administered questionnaire. Grading of DR was done by slit-lamp examination and Fundoscopy by an ophthalmologist. Descriptive analysis included percentage mean, median, and p - value by using SPSS 25. There were 185 diabetic patients, ages ranging between 30 and 90 years, with a mean of 58, the majority (97.6%) were of Libyan nationality. There were 86 males and 99 females. Patients with a duration of diabetes ranging between 11 and 15 years were at almost a five-fold risk of developing DR compared to those with a duration of &lt; 10 years. Most of advanced complicated diabetic retinopathy cases had diabetes for more than fifteen years, and no advanced disease in the cases with a duration of less than 10 years. The patients with poor controlled blood sugar and HbA1c &gt; 9 throughout the disease were at almost five-folded risk of developing DR compared to those with moderate controlled diabetes cases were HbA1c between (7.5 - 9), patients with poor control of diabetes HbA1c&gt; 9 was 25-folded risk of developing PRP than cases with good control HbA1c &lt; 7.5. The majority of advanced diabetic retinopathy cases were correlated with non-controlled diabetes mellitus HbA1c &gt; 9, where no advanced complication was recorded in well-controlled cases.

Bedside 3D ultrasound fistula maturation assessment by non-expert sonographers provides equivalent accuracy to formal duplex sonography: A prospective clinical trial.

EchoSure is an automated point-of-care 3D ultrasound (3DUS) designed to be used by dialysis technicians without advanced ultrasound training. The EchoMark/EchoSure System is a two-part system comprised of a bioresorbable implant, EchoMark, and a diagnostic ultrasound imaging platform, EchoSure. EchoSure was designed to enable any healthcare personnel in a dialysis clinic setting to obtain non-invasive, direct measurements of flow and vessel parameters that are critical quantifications used in the assessment of AVF maturation and readiness for hemodialysis cannulation. In this pilot feasibility study, we sought to explore whether use of an automated 3DUS could enable fistula assessment by non-experts and obtain measurement accuracy comparable to expert sonographer Duplex. This was a 20 subject prospective multicenter trial conducted at four sites in the United States. All subjects had an EchoMark implanted under their AVF during the fistula creation procedure. Subjects were evaluated at 2-weeks post-op with EchoSure and Duplex, followed by monthly assessments until either the 4-month visit or until radiographic maturation was achieved, whichever was longer. Beyond monthly ultrasound assessments, clinical follow-up continued every 6 months between months 6 and 24. Technical success of EchoMark implantation was demonstrated in 100% of subjects. Technical success of EchoSure was 99% across all scans. The mean percent difference in flow rate measurements between EchoSure and Duplex was -9.2% with a standard deviation of 38.1% compared to a mean percent difference of -15.7% with a standard deviation of 35.5% between Duplex measurements taken at the cannulation zone and brachial artery. Pearson correlation between EchoSure and Duplex was 0.708 versus 0.716 for the two Duplex measurements. Radiographic maturation was achieved in 70% of study subjects by 30 days and continued to rise to 90% through 90 days and 95% through 180 days after baseline. This study demonstrates the feasibility and accuracy of an automated 3D ultrasound system for assessment of maturation at the dialysis bedside by non sonographers.

7838 Improvement of Cognition and Memory Scores in Transgender Individuals Within One Year of Initiating Gender-Affirming Hormone Therapy

Abstract Disclosure: C.M. Godar: None. S.C. De La Torre: None. O. Bonsu: None. M.K. Shakir: None. T.D. Hoang: None. Introduction: The use of gender-affirming hormone therapy (GAHT) in transgender individuals is known to provide many beneficial health effects to reduce gender dysphoria, reduce depressive symptoms, and increase overall quality of life. Cognitive function and memory ability are known to be influenced by sex hormone levels in studies of hormone replacement therapy in post-menopausal women, but studies of GAHT’s effects on cognition and memory in transgender patients have been scarcely reported. We discuss a study of cognitive testing in transgender individuals before and after 12 months of gender-affirming feminizing or masculinizing hormone therapy using a validated cognitive assessment tool. Methods: A prospective study of 32 transgender patients aged 18-45 years was approved by IRB at an academic medical center. The Wechsler Memory Scale 4th edition (WMS®-IV, Pearson) was administered to 19 transgender females and 13 transgender males prior to initiation of GAHT and again after one year of GAHT use. Mean scores were analyzed and reported for five categories of cognitive and memory function: auditory memory (AMI), visual memory (VMI), visual working memory (VWMI), immediate memory (IMI), and delayed memory (DMI). Mean scores for baseline and 12-month data were analyzed for total population and male and female subgroups. Results: Baseline mean WMS-IV values for the total study population were: AMI 105 points, VMI 78 points, VWMI 107 points, IMI 88 points, DMI 91 points. Mean values after 12 months of GAHT were: AMI 120 points, VMI 81 points, VWMI 110 points, IMI 99 points, DMI 102 points. Mean percent change from baseline to 12 months was as follows: AMI 13.4%, VMI 8.9%, VWMI 2.6%, IMI 12.8%, DMI 13%. Similar patterns were noted for both gender subgroups. Discussion: It is well-known that transgender individuals are subject to higher rates of depression, anxiety, and suicidality compared to the general population. Decreased cognitive function and memory are known effects of untreated depression. Our study demonstrated that treatment of gender dysphoria with GAHT provided a tangible cognitive and memory benefit. The long-term impact of GAHT on cognition and memory is not known and deserves additional study. Limitations of this study included the absence of a cis-gender control group and inability to stratify data based on age, which may provide additional significance. Presentation: 6/2/2024

Neonatal birthweight prediction using two- and three-dimensional estimated fetal weight among borderline small fetuses.

This study aimed (1) to determine the degree of correlation between 2D and 3D estimated fetal weight (EFW) and neonatal birth weight (BW) among borderline small fetuses and (2) to compare the accuracy and precision of 2D and 3D EFW in BW prediction. A retrospective cohort study evaluated fetuses who had an ultrasound performed between January 2017 and September 2021 at a tertiary maternal center. All singleton pregnancies with 3D EFW within 4 weeks of delivery were included. Fetuses with known structural or genetic abnormalities were excluded. Pearson's correlation coefficients were determined for both 2D and 3D EFW to BW then compared using Williams' test and Fisher r to z transformation, where applicable. Mean percent difference and standard deviation were used to assess the accuracy and precision, respectively, of 2D and 3D EFWs in BW prediction. Two hundred forty-eight pregnancies were included. Ultrasound studies were performed with a median interval of 2 weeks (IQR 1, 3) between ultrasound and delivery. Both 2D and 3D estimated fetal weights showed a significant correlation with birth weight (r = 0.74 and r = 0.73, respectively), indicating similar accuracy between the two techniques. Two-dimensional and three-dimensional EFWs performed similarly in the prediction of BW in borderline small fetuses.

6848 Improvement Of Free Thyroxine Measurement Quality Through The CDC Clinical Standardization Programs

Abstract Disclosure: A. Ribera: None. N. Vazquez: None. S. Knoblock: None. O. Sugahara: None. T. Buchannan: None. L. Collins: None. D. Spector: None. L. Zhang: None. U. Danilenko: None. H.W. Vesper: None. Thyroid function tests are among the most requested tests in patient care, and reliability of these measurements are crucial for appropriate diagnosis and management of thyroid disorders. In response to concerns from the clinical and research community about the quality of thyroid function tests, the CDC Clinical Standardization Programs (CSP) has created the hormone standardization (HoSt) program for free thyroxine (FT4) in partnership with the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC). As a first step, CDC CSP has completed an interlaboratory comparison study of commercial immunoassays (IA) and lab-developed tests (LDT) to determine the current agreement among assays. Participants received 40 blinded, high quality individual donor serum samples with FT4 reference values assigned by the CDC FT4 reference measurement procedure (RMP). FT4 concentrations ranged between 11-32 pmol/L. Samples were analyzed in duplicate over 2 days and results were compared to the CDC FT4 RMP. To assess the potential impact of standardizing measurements to the CDC HoSt FT4 program, reported results were normalized to the CDC RMP results (recalibrated in silico using linear regression). Mean percent bias to the reference value was evaluated pre- and post-recalibration. In addition, inter-assay agreement of classification (assignment of hypo-, eu- or hyperthyroid status according to FT4 reference intervals) were assessed pre- and post-recalibration using the assay-specific and CDC RMP reference intervals, respectively. A total of 19 methods participated, consisting of 15 IA and 4 LDT. All participants showed a negative mean bias to the RMP, with IA showing a higher magnitude of bias (average: -20.7 ± 0.9%) than LDT (average: -4.7 ± 1.1%). Of the 40 samples measured, only 53% were classified uniformly by all 19 participants. Post-recalibration, mean percent bias improved profoundly (IA average: 0.0 ± 0.8%, LDT average: 0.1 ± 1.1%), and classification agreement improved by 33% to 86% of samples with consistent classification. The CDC CSP interlaboratory comparison among FT4 assays highlights the critical need for measurement standardization to improve accuracy of FT4 measurements and increase consistency in result interpretation. This study demonstrates that it is possible to develop common FT4 reference intervals via measurement standardization, which would allow for universal evidence-based clinical guidelines to be used in patient care. Presentation: 6/3/2024

7838 Improvement of Cognition and Memory Scores in Transgender Individuals Within One Year of Initiating Gender-Affirming Hormone Therapy

Abstract Disclosure: C.M. Godar: None. S.C. De La Torre: None. O. Bonsu: None. M.K. Shakir: None. T.D. Hoang: None. Introduction: The use of gender-affirming hormone therapy (GAHT) in transgender individuals is known to provide many beneficial health effects to reduce gender dysphoria, reduce depressive symptoms, and increase overall quality of life. Cognitive function and memory ability are known to be influenced by sex hormone levels in studies of hormone replacement therapy in post-menopausal women, but studies of GAHT’s effects on cognition and memory in transgender patients have been scarcely reported. We discuss a study of cognitive testing in transgender individuals before and after 12 months of gender-affirming feminizing or masculinizing hormone therapy using a validated cognitive assessment tool. Methods: A prospective study of 32 transgender patients aged 18-45 years was approved by IRB at an academic medical center. The Wechsler Memory Scale 4th edition (WMS®-IV, Pearson) was administered to 19 transgender females and 13 transgender males prior to initiation of GAHT and again after one year of GAHT use. Mean scores were analyzed and reported for five categories of cognitive and memory function: auditory memory (AMI), visual memory (VMI), visual working memory (VWMI), immediate memory (IMI), and delayed memory (DMI). Mean scores for baseline and 12-month data were analyzed for total population and male and female subgroups. Results: Baseline mean WMS-IV values for the total study population were: AMI 105 points, VMI 78 points, VWMI 107 points, IMI 88 points, DMI 91 points. Mean values after 12 months of GAHT were: AMI 120 points, VMI 81 points, VWMI 110 points, IMI 99 points, DMI 102 points. Mean percent change from baseline to 12 months was as follows: AMI 13.4%, VMI 8.9%, VWMI 2.6%, IMI 12.8%, DMI 13%. Similar patterns were noted for both gender subgroups. Discussion: It is well-known that transgender individuals are subject to higher rates of depression, anxiety, and suicidality compared to the general population. Decreased cognitive function and memory are known effects of untreated depression. Our study demonstrated that treatment of gender dysphoria with GAHT provided a tangible cognitive and memory benefit. The long-term impact of GAHT on cognition and memory is not known and deserves additional study. Limitations of this study included the absence of a cis-gender control group and inability to stratify data based on age, which may provide additional significance. Presentation: 6/2/2024

Efficacy of Melia azedarach leaf extract in different solvents against Heterotermes indicola Wasmann (Blattodea: Rhinotermitidae) using non-durable wooden blocks under laboratory and field conditions

Hetertermes indicola Wasman (Blattodea: Rhinotermitidae) is a highly wood-destructive termite species in the urban settings of Pakistan. This study evaluated the biocidal action of Melia azedarach leaf extract in different solvents on H. indicola by conducting choice and no-choice feeding deterrence assays using impregnated palatable wood under field and laboratory conditions. Dose-dependent and time-dependent trends were observed in the leaf extracts of M. azedarach at different concentrations (500, 1000, and 1500 ppm) using solvent water and methanol with 80–100 % termite mortality after 6 days of exposure. A key outcome was the higher termiticidal efficacy of methanolic extract compared to aqueous extract under both field and laboratory conditions. The LC50 values of 358 ppm for methanol and 466 ppm for aqueous extract after 15 days in a laboratory no-choice experiment exhibit a quantitative measure of chinaberry leaf extract toxicity. A significant reduction in mean percent weight loss (8.26 %) of treated wood with 1500 ppm of M. azedarach leaf extract in methanol was observed under field conditions. In conclusion, triterpenoids and phytol present in methanolic leaf extract demonstrated higher efficacy in both lab and field conditions making a solid foundation for the further development of natural wood preservatives. Since they induced rapid lethargic conditions in termites and digestive toxicity which leads to minimum loss of treated wood.

A Descriptive, PostHoc Analysis of Efficacy and Safety of Risankizumab in Diverse Racial and Ethnic Patient Populations With Moderate-to-Severe Psoriasis.

Historically, patients with skin of color are underdiagnosed with psoriasis and underrepresented in clinical trials. In this study, we assess the efficacy and safety of risankizumab in patients with moderate-to-severe plaque psoriasis by race and ethnicity in the open label extension LIMMitless (NCT03047395). Patients received continuous treatment with 150mg risankizumab through their initial trial and the open label extension. Patients self-identified their race and ethnicity. Efficacy was assessed using Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI). Safety is reported by events/100 patient-years. A total of 897 patients (race: 662 White, 196 Asian, 25 Black or African American, 14 Other; ethnicity: 98 Hispanic or Latino, 799 non-Hispanic or Latino) were included in this analysis. Compared to baseline, patients had a mean percent reduction in PASI between 94.6% (Asian) and 99.3% (Black or African American) and reported mean percent improvements in DLQI ranging from 87.1% (Asian and Black or African American) to 93.7% (Hispanic or Latino) at week 100. While the data presented here comprise a small retrospective descriptive analysis and cannot detect statistical differences, efficacy of risankizumab for the treatment of moderate-to-severe plaque psoriasis appears similar across the racial and ethnic groups studied and no new safety signals were detected.

Knowledge and Practice Regarding Vocal Hygiene Among Teachers of Selected Schools, Kathmandu

BackgroundVocal hygiene is the practice of taking care of the voice and minimizing strain on it. This comprises avoiding smoking, alcohol and other harmful substances, remaining hydrated, and practising proper breathing techniques. This study intended to evaluate the level of knowledge and practices concerning vocal hygiene. MethodologyA cross-sectional study design was utilized to conduct the study among teachers in Greenland Higher Secondary School, Basundhara, National Academy and Nirmal Batika Academy using a self-administered structured questionnaire. A sample of 122 teachers was taken using a complete enumerative sampling technique. The data was collected from 1st October to 16th October and was edited, coded, and entered into the Statistical Package for Social Science (SPSS) for further analysis. Data was examined using descriptive (frequency, percentage mean and standard deviation), inferential Statistics (chi-square test) and Karl Pearson’s test. FindingsThe study results presented that nearly half, 49.2% of the respondents, had a moderate level of knowledge, 31.1% had an inadequate level of knowledge, and 19.7% had an adequate level of knowledge regarding Vocal Hygiene (VH). The results discovered that 73% of the respondents had good practice, and 27% had poor practice regarding VH. There was a statistically significant association only between the level of knowledge regarding VH and the number of classes taken per week (p=0.0053). ValueThe study showed that the majority of teachers have moderate knowledge about vocal hygiene, whereas there is good practice among teachers. The results strongly recommend the need for vocal hygiene training sessions for teachers.

Evaluation of Trend Models Performance and Forecasting Onion Production: A Comparative Study

Onions, a significant spice crop in Bangladesh, frequently experience price surges due to an imbalance between demand and supply, compelling the government to import onions. The volatility of the onion market in Bangladesh and the measures needed to stabilize the situation require intensive policy attention. Therefore, this study was carried out to forecast the onion production over time and to evaluate the efficacy of various trend models. The secondary data was collected from the Food and Agriculture Organization's Statistical Database (FAOSTAT) from 1972 to 2022. The autoregressive integrated moving average (ARIMA) model was used to predict the onion production over time. Additionally, metrics such as modified and the coefficient of determination were used to evaluate the effectiveness of eight trend models comprehensively. The findings indicate that the cubic model is superior to others since it has larger and adjusted values. The models' accuracy is also determined utilizing mean absolute percentage error (MAPE) and mean absolute deviation (MAD) metrics. The cubic trend model exhibits lower MAPE and MAD values of 29.43% and 80638.67, respectively. Therefore, it is concluded that the ARIMA (2, 2, 2) model is the best model for forecasting the annual production of onion in Bangladesh. A five-year trend analysis spanning from 2023-2027 indicates an upward trend. Such a result offers a critical insight for stakeholders and policymakers in formulating sustainable onion production strategies. J Bangladesh Agril Univ 22(3): 386-395, 2024

Cardiopulmonary exercise testing following acute pulmonary embolism: Systematic review and pooled analysis of global studies.

Recent reports have revealed a substantial morbidity burden associated with "post-PE syndrome" (PPES). Cardiopulmonary exercise testing (CPET) has shown promise in better characterizing these patients. In this systematic review and pooled analysis, we aim to use CPET data from PE survivors to understand PPES better. A literature search was conducted in PubMed, EMBASE, and Cochrane for studies reporting CPET results in post-PE patients without known pulmonary hypertension published before August 1, 2023. Studies were independently reviewed by two authors. CPET findings were subcategorized into (1) exercise capacity (percent predicted pVO2 and pVO2) and (2) ventilatory efficiency (VE/VCO2 slope and VD/VT). We identified 14 studies (n = 804), 9 prospective observational studies, 4 prospective case-control studies, and 1 randomized trial. Pooled analysis demonstrated a weighted mean percent predicted pVO2 of 76.09 ± 20.21% (n = 184), with no difference between patients tested <6 months (n = 76, 81.69±26.06%) compared to ≥6 months post-acute PE (n = 88, 82.55 ± 21.47%; p = 0.817). No difference was seen in pVO2 in those tested <6 months (n = 76, 1.67 ± 0.51 L/min) compared to ≥6 months post-acute PE occurrence (n = 144, 1.75 ± 0.57 L/min; p = 0.306). The weighted mean VE/VCO2 slope was 32.72 ± 6.02 (n = 244), with a significant difference noted between those tested <6 months (n = 91, 36.52 ± 6.64) compared to ≥6 months post-acute PE (n = 191, 31.99 ± 5.7; p < 0.001). In conclusion, this study, which was limited by small sample sizes and few multicenter studies, found no significant difference in exercise capacity between individuals tested <6 months versus ≥6 months after acute PE. However, ventilatory efficiency was significantly improved in patients undergoing CPET ≥ 6 months compared to those <6 months from the index PE.

Quantification of micropapillary component on transurethral resection is associated with likelihood of occult lymph node metastasis at radical cystectomy

Introduction/BackgroundMicropapillary variant urothelial carcinoma (MPUC) is associated with increased risk of treatment failure with intravesical therapy likely due to the increased risk of occult lymph node (LN) metastasis at radical cystectomy (RC). To date, limited data exists as to whether percent MPUC present within transurethral resection (TUR) samples impacts LN positivity at RC. Our objective is to evaluate the association of percentage MP variant on TUR on incidence of lymph node metastasis and survival outcomes. MethodsA total of 67 patients with MPUC on TUR were identified from a prospectively maintained database of patients undergoing RC at our institution between 2007 and 2022. TUR samples were rereviewed by an expert GU pathologist with over ten years of experience. Presence and percent MP component, LVI, CIS, grade, and clinical stage were evaluated. Pathologic outcomes were collected from subsequent RC specimens, and recurrence free (RFS) and overall survival (OS) were estimated via the Kaplan–Meier method. Associations between percent MP and lymph node metastasis, RFS, and OS were assessed with univariate and multivariable logistic regression and Cox survival analyses as appropriate. ResultsThirty four of 67 (51%) patients underwent RC for cT1 disease, the remainder harbored ≥cT2 disease. 19 of 33 (58%) patients with ≥cT2 disease received neoadjuvant chemotherapy (NAC). Mean percent MPUC was 35% in cT1 patients and 28% in cT2 patients (P = 0.25). On univariate analysis, both MPUC ≥ 30% (Odds Ratio (OR) 3.38, P = 0.02) and clinical ≥T2 (OR 2.88, P = 0.04) were significant predictors of nodal metastasis at RC. On multivariable analysis, MPUC% (OR 1.02, P = 0.036) or MPUC% ≥ 30% (OR 4.01, P = 0.013) and clinical T stage ≥2 (OR 3.73, P = 0.018) were significant predictors of pathologic node positive disease. The lowest rate of LN metastasis was found in patients with cT1 disease and MPUC <30% (3/16, 18.7%), versus the highest in ≥cT2 disease and MP ≥ 30% (12/16, 75%). ConclusionsPercent MPUC component on TUR is associated with increased risk of occult lymph node metastasis at RC. Routine pathologic evaluation of percent MP component has the potential to help select patients with MPUC that might be reasonable candidates for intravesical therapy.

Gastrostomy tube (g-tube) placement timing and clinical outcomes in patients with locally advanced squamous cell carcinoma of the head and neck (HNSCC) receiving definitive chemoradiation.

37 Background: Patients with HNSCC who undergo definitive chemoradiation (dCRT) frequently require nutritional support via G-tubes; despite this, the factors associated with the timing of G-tube placement remain poorly understood. Methods: We performed a retrospective analysis of patients with HNSCC who received dCRT and required G-tube placement between 01/2018 – 01/2024. We segregated G-tube timing into two groups as determined by the intent of the treating clinician: “prophylactic” placement (ordered in anticipation of dCRT start) or “reactive” placement (ordered in response to weight loss or other adverse clinical indicators). We then evaluated associated clinical variables (patient, disease, treatment) and outcomes (weight loss, G-tube duration, healthcare utilization). Differences across G-tube groups were assessed using t-tests or Wilcoxon Rank Sum tests for continuous measures and Fisher’s exact tests or logistic regression for binary variables. Results: We identified 86 patients; 59 (69%) prophylactic and 27 (31%) reactive G-tubes were placed. At baseline, patients had a mean age of 63, BMI of 28 kg/m 2 , and Charlson Comorbidity Index of 4. Patients were 12% non-White, 2% non-English speaking, and 10% unhoused; 27% had a non-metropolitan address, 67% had public insurance, 31% were smokers and 26% had a history of alcohol dependence. The most common site was the oropharynx (66%; 75% HPV+). Across HNSCC types, 38% had stage IV disease and 60% had preexisting dysphagia/odynophagia. Most received weekly (83%) cisplatin (84%) and bilateral (95%) radiation (RT). We collected RT dose data (parotids, esophagus, pharyngeal constrictors) and found no association between RT dose and G-tube group. Patients with prophylactic G-tubes were significantly more likely to have preexisting odynophagia/dysphagia (69% vs 41%, p = 0.017). Compared to the prophylactic group, reactive G-tube placement occurred more often among patients living in non-metropolitan settings (44% vs 19%, p = 0.018) and was associated with a trend towards a higher mean percent weight loss (12% vs 10%; p = 0.128) and cachexia (per int’l criteria; 89% vs 74%, p = 0.159). We observed no difference in the median G-tube duration or in the rate of persistent G-tube use at last follow-up or death. Notably, we found that patients with reactive G-tubes were hospitalized more frequently (74% vs 36%, p = 0.001) and had a longer median length of stay (LOS; 6 vs 0 days, p = 0.001); these findings remained statistically significant when controlling for other factors (OR 3.76 [95% CI: 1.20-12.65]; p = 0.026). Conclusions: We found that reactive G-tubes were associated with increased hospitalization and LOS, suggesting that select patients may benefit from earlier G-tube placement.