Poor Scores Research Articles

Upregulation of miRNA-196a and miRNA-196b correlates with Bryne’s prognostic score in oral squamous cell carcinoma

BackgroundmicroRNA(miRNA)-196a and miRNA-196b expression has been found to be dysregulated and involved in tumorigenesis and tumor progression in array of cancers through different targets. The role of these miRNAs together in clinical application is not always consistent and, its prognostic value in oral squamous cell carcinoma (OSCC) is still elusive. This study was performed to investigate the correlation of these miRNAs expression with histological grades of OSCC according to Bryne's histological grading system, to predict prognosis and to evaluate their relationship with clinico-pathological data. MethodsReal-time quantitative Reverse Transcription Polymerase Chain Reaction (qRT-PCR) was done to evaluate the expression levels of miRNA-196a and miRNA-196b in 75 pairs of OSCC tissue matched with adjacent normal mucosa, used as a control. ResultsmiRNA-196a and 196b expression in OSCC was significantly higher than that in corresponding adjacent normal tissues (p > 0.001). Also, a significant differential correlation was found in between the expression levels of these two miRNAs (Pearson correlation test r = 0.676, p-value<0.0001). The increased expression of these miRNAs was more frequently observed in OSCC tissues with advanced clinical and pathological TNM stages (IVa and IVb, pIVb respectively, p-value<0.0001). Significant correlation was found between miRNA-196a upregulation and moderate prognostic score (p-value<0.0001) in comparison with good and poor prognostic score of histological grades of OSCC. Sensitivity and specificity for miRNA-196a were 95 % and 85 %, respectively (AUC = 1, 95 % CI = 0.617–0.850; p 0.001), while for miRNA-196b were 94 % and 86 %, respectively (AUC = 0.808, 95 % CI = 0.701–0.916; p0.0001). ConclusionsThese findings suggest that the increased expression of miRNA-196a and 196b may play an important role in tumor progression in OSCC. miRNA-196a might be a useful marker for predicting the clinical outcome of OSCC, especially for advanced stages. In conclusion, our data demonstrate for the first time that these miRNAs may serve as a potent prognostic marker for tumor progression. We further highlight miRNA-196a and miRNA-196b as a promising predictor of prognostic assessment in OSCC.

Impact of Polytherapy on Memory Functioning in Patients With Drug-Resistant Epilepsy: The Role of Attention and Executive Functions.

The aim was to examine the effect of polytherapy (i.e., the number of administered anti-seizure medications (ASMs)) on memory, and whether the interaction between the number of ASMs and attentional/executive functioning affect presurgical memory functioning and postsurgical memory changes in patients with drug-resistant epilepsy. Two studies were carried out. Study 1 consisted of a presurgical assessment of 125 adult patients, in which attention/executive function (EpiTrack screening tool) and memory were assessed (cross-sectional study). Of them, 72 patients underwent a second postsurgical evaluation, in which memory was assessed (Study 2). Patients were distributed into groups based on EpiTrack performance and number of ASMs. The interaction between the number of ASMs and the attentional/executive functioning significantly affected presurgical memory, with patients with impaired EpiTrack performance taking three-four ASMs having poorer scores than patients with intact EpiTrack performance taking three-four ASMs (for all, p < .0001). This interaction also affected postsurgical memory changes, with patients with impaired Epitrack performance taking three-four ASMs having higher postsurgical decline than those with intact Epitrack performance taking three-four ASMs (for all, p< .005). No differences were found in patients taking two ASMs. Furthermore, the number of ASMs was associated with presurgical memory performance and postsurgical memory changes only in patients with impaired EpiTrack performance (for all, p < .05). Our findings underline the utility of EpiTrack, together with the clinical information on the number of prescribed ASMs, to corroborate the impact of polytherapy on memory and to optimize the prediction of postsurgical memory changes.

Written Retelling Strategy in Improving Reading Skill among ESL Students in Malaysia

Skills of reading and comprehending in English are crucial for academic success in schools. Pupils with low reading ability skill may result in obtaining low grades and poor test scores. Traditionally pupils are taught to lift specific information as a reading strategy to answer comprehension questions, comparatively, this study uses retelling strategy to evaluate pupils’ understanding. Past research indicated that retelling strategy enhances accuracy and greater comprehension. Thus, far study that investigates effectiveness of this strategy remains scarce in Malaysian English as Second Language (ESL) primary schools. As reading skill starts to develop in early stage of schooling, it is deemed necessary to conduct this study among primary level pupils. The present study specifically analyzes the effects of written retelling strategy on pupils’ understanding of story structure among year three primary school pupils in Malaysian ESL classroom. A quasiexperimental research design with pretest and posttest was adopted to carry out the study. Pretest and posttest questions consisting of structural comprehension questions and written retelling were used to measure the effects of written retelling strategy on the pupils’ achievement in reading comprehension and their understanding of the story structure. A pretest was conducted before teaching and learning took place. This was followed by a posttest. An independent t-test was used to obtain the mean values and standard deviations. The results obtained in this study conclude the written retelling strategy had notably improved the pupils’ reading skill as they are able to retain information from the story and make better predictions. Subsequently, it increased their abilities in answering the comprehension questions. The results also indicate that written retelling could be a prospective reading strategy along with other strategies for primary ESL learners in Malaysia and similar context.

Relationship of the SITLESS intervention on medication use in community-dwelling older adults: an exploratory study.

Sedentary behavior (SB) and physical activity (PA) interventions in older adults can improve health outcomes. Problems related with aging include prevalent comorbidity, multiple non-communicable diseases, complaints, and resulting polypharmacy. This manuscript examines the relationship between an intervention aiming at reducing SB on medication patterns. This manuscript presents a local sub-analysis of the SITLESS trial data on medication use. SITLESS was an exercise referral scheme (ERS) enhanced by self-management strategies (SMS) to reduce SB in community-dwelling older adults. We analyzed data from the ERS + SMS, ERS and usual care (UC) groups. Patient medication records were available at baseline and at the end of the intervention (4-month period) and were analyzed to explore the effect of SITLESS on medication patterns of use. A sample of 75 participants was analyzed, mostly older overweight women with poor body composition scores and mobility limitations. There was a significant reduction of 1.6 medicines (SD = 2.7) in the ERS group (p < 0.01), but not in the UC or ERS + SMS groups. Differences were more evident in medicines used for short periods of time. The findings suggest that an exercise-based program enhanced by SMS to reduce SB might influence medication use for acute conditions but there is a need to further investigate effects on long-term medicine use in older adults.

Effects of Virtual Laboratory-Based Instruction on the Frequency of Use of Experiment as a Pedagogical Approach in Teaching and Learning of Physics in Secondary Schools in Kenya

Information and communications technology (ICT) incorporation in teaching physics in Kenyan secondary schools cannot be overlooked, given the key roles and benefits that ICT offers in the process of teaching and learning. Consistently poor average scores in the subject currently witnessed at the Kenya Certificate of Secondary Education (KCSE) level in Physics can be attributed to low student motivation and traditional teaching strategies. For instance, in the years 2016, 2017, 2018, and 2019, Kisumu County registered low mean scores of 4.23, 4.98, 4.67, and 4.10, respectively, in physics in KCSE. Therefore, there is a need for the incorporation of more effective teaching strategies to improve performance in physics and for students’ interest and attitude in learning the subject to change. Technology-based or enhanced learning leverages all learners, irrespective of their traits or socio-economic status. This study aimed at establishing the effects of virtual laboratory-based instruction (VLBI) on the use of experiments as a pedagogical approach. The study objectives were to establish the effect of virtual laboratories on the frequency of use of experimental teaching approaches in learning physics in secondary schools and to determine the extent of the relationship between physics teachers knowledge of the selected ICT frameworks and the use of virtual experiments in teaching and learning physics in secondary schools in Kenya. The study was supported by behaviourism learning theory and adopted quasi-experimental research designs. The physics teachers were purposefully sampled from each selected school. The sample size was 44 teachers and 358 students, summing up to 402 respondents. The data was analyzed using both descriptive and inferential statistics. The study concluded that virtual laboratories advance the use of experimental teaching approaches and that there was no statistical significance between the knowledge of the teacher about the selected ICT framework and the use of virtual experiments. The findings of this study would help educational planners successfully design and implement various classroom-based innovations that would enable seamless integration of virtual laboratories into classroom instruction.

Leveraging on Virtual Laboratory-Based Instruction to Achieve Active Classroom Interaction in Teaching and Learning of Physics in Secondary Schools in Kenya

The philosophy that advances the study of physics as one of the learning areas in secondary schools cannot be overlooked due to the realization of the contributions of physics towards the industrial and vocational development of the country. The major concern of this particular study is the consistent poor average scores in the subject currently witnessed at the Kenya Certificate of Secondary Education (KCSE) level in Physics, which can be attributed to low student motivation and traditional teaching strategies. For instance, in the years 2016, 2017, 2018, and 2019, Kisumu County registered low mean scores of 4.23, 4.98, 4.67, and 4.10, respectively, in physics in KCSE. The use of Information and Communications Technology (ICT) in the teaching and learning of physics can be used to promote learners’ centered teaching and learning of physics and eventually improve physics scores. This study therefore underscores the need for virtual laboratory-based instruction (VLBI) to realize active classroom interaction during the teaching and learning of physics. Technology-based enhanced learning leverages all learners, irrespective of their economic and demographic background. The study therefore aimed at establishing the effect of VLBI on students’ level of interaction in the classroom in learning physics in secondary schools in Kenya. The study is supported by behaviorism learning theory and adopted quasi-experimental research designs. The physics teachers were purposefully sampled from each selected school. Physics teachers were purposefully sampled from each of the schools selected. There were 358 students and 72 teachers in the sample. The data was analyzed using both descriptive and inferential statistics. The study concluded that virtual laboratories enhanced the use of experimental teaching approaches and that there was no statistical significance between the knowledge of the teacher about the selected ICT framework and the use of virtual experiments. There is a need to develop a prototype for a technology-enriched ICT framework for active learning of physics that will provide teachers and students with an interactive platform to promote active physics learning.

Utilizing artificial intelligence-based eye tracking technology for screening ADHD symptoms in children.

To explore the potential of using artificial intelligence (AI)-based eye tracking technology on a tablet for screening Attention-deficit/hyperactivity disorder (ADHD) symptoms in children. We recruited 112 children diagnosed with ADHD (ADHD group; mean age: 9.40 ± 1.70 years old) and 325 typically developing children (TD group; mean age: 9.45 ± 1.59 years old). We designed a data-driven end-to-end convolutional neural network appearance-based model to predict eye gaze to permit eye-tracking under low resolution and sampling rates. The participants then completed the eye tracking task on a tablet, which consisted of a simple fixation task as well as 14 prosaccade (looking toward target) and 14 antisaccade (looking away from target) trials, measuring attention and inhibition, respectively. Two-way MANOVA analyses demonstrated that diagnosis and age had significant effects on performance on the fixation task [diagnosis: F(2, 432) = 8.231, ***p < 0.001; Wilks' Λ = 0.963; age: F(2, 432) = 3.999, *p < 0.019; Wilks' Λ = 0.982], prosaccade task [age: F(16, 418) = 3.847, ***p < 0.001; Wilks' Λ = 0.872], and antisaccade task [diagnosis: F(16, 418) = 1.738, *p = 0.038; Wilks' Λ = 0.938; age: F(16, 418) = 4.508, ***p < 0.001; Wilks' Λ = 0.853]. Correlational analyses revealed that participants with higher SNAP-IV score were more likely to have shorter fixation duration and more fixation intervals (r = -0.160, 95% CI [0.250, 0.067], ***p < 0.001), poorer scores on adjusted prosaccade accuracy, and poorer scores on antisaccade accuracy (Accuracy: r = -0.105, 95% CI [-0.197, -0.011], *p = 0.029; Adjusted accuracy: r = -0.108, 95% CI [-0.200, -0.015], *p = 0.024). Our AI-based eye tracking technology implemented on a tablet could reliably discriminate eye movements of the TD group and the ADHD group, providing a potential solution for ADHD screening outside of clinical settings.

Analyzing The Ability of Twelfth Grade Students in Writing Application Letter at Senior High School Number 11 jambi

The Purpose of the research is to analyzed the ability of twelfth grade students to write application letter at senior high school number 11 Jambi. In conducting the research, the researcher used descriptive quantitative. The researcher used quantitative method to analyze the data. It can be seen there are 18 students got excellent score in 80-100, 12 students got good score 66-79, 1 student got fear score in 56-65, 2 students got weak score in 46-55 and no students got poor score in 0-45. This condition showed that some of the twelfth grade of Senior High School number 11 Jambi were able to write the application letter. Because they know how to make a good application letter such as the salutation, the content, and closing.

QOL-16. GLIOBLASTOMAS LOCATED IN THE RIGHT INFERIOR PARIETAL LOBE CAUSE A POOR POSTOPERATIVE PERFORMANCE LEVEL

Abstract OBJECTIVE Managing quality of life has become more important for patients with glioblastoma (GBM). Maintaining independence levels should be given attention while treating GBM. Postoperatively, non-dominant hemispheric GBMs often decrease the Karnofsky Performance Status (KPS) score. This study aimed to investigate the factors that lead to poor KPS scores after tumor resection in non-dominant hemispheric GBM. METHODS Forty-one patients newly diagnosed GBM in the right cerebral hemisphere who underwent resection were included. Brain functions were assessed preoperatively and postoperatively. First, the KPS scores before and after surgery were compared. Second, univariate and multiple regression analyses and voxel-based lesion-symptom mapping (VLSM) were performed to analyze the functions and brain regions related to KPS, respectively. Third, factors associated with prognosis were analyzed using the log-rank test. RESULTS Compared with the preoperative status, KPS significantly decreased after the surgery (81.0% vs. 73.6%, p = 0.020). Brain functions affecting KPS include general cognitive function, processing speed, attention, memory, visuospatial cognition, emotion recognition, and executive function. Among these, multiple regression analysis revealed visuospatial cognition and emotion recognition to be significantly influenced KPS in the chronic postoperative phase (p = 0.030 and 0.048, respectively). VLSM demonstrated that resection of the inferior parietal lobe caused a significant decline in KPS. Visuospatial cognition and emotion recognition were impaired with a higher probability (p = 0.035 and 0.048, respectively) in patients with tumors located in the inferior parietal lobe. In addition, lesions in the inferior parietal lobe were associated with shorter overall survival (p = 0.046). CONCLUSIONS GBMs in the right inferior parietal lobe are more likely to result in poor postoperative KPS due to impairment of visuospatial cognition and emotion recognition, which relate to a poor prognosis.

Abstract 19123: Associations Between Multiple Dimensions of Poor Sleep and Life’s Essential 8 Cardiovascular Health Score During the Menopausal Transition: Findings From the AHA Research Goes Red Weight Study

Introduction: The sleep health metric in AHA Life’s Essential 8 (LE8), a measurement of cardiovascular health (CVH), consists only of sleep duration. Associations of other dimensions of sleep health including sleep quality with the LE8 CVH and its individual components have not yet been evaluated. Methods: Participants were 291 women (n=98 pre-, n=94 peri-, n=99 post-menopausal, mean age=50 ± 3.2yr) between 45-55y from the AHA Research Goes Red Weight Study, which utilized Verily’s online platform. Standardized questionnaires included the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Berlin questionnaire for risk of obstructive sleep apnea (OSA), and a 1-wk NIH ASA 24-Hour Dietary Assessment. The LE8 CVH and component scores were computed. Cross-sectional associations between sleep and overall CVH scores and individual metrics were tested using multivariable logistic regression models adjusted for age, race/ethnicity, education, employment, insurance, and menopausal status. Results: Half of women slept &lt;7 hours/night, 79% reported poor sleep quality (PSQI≥5), one-third had high-risk OSA phenotype, 51% reported insomnia symptoms (ISI≥8), and 12% had evening chronotype. Compared to pre-menopausal women (67%), significantly more post-(83%) and peri-menopausal (86%) women reported poor sleep quality (p&lt;0.01). Women with poor sleep quality had 3-fold higher odds of poor overall CVH score (p=.04). Women with high-risk OSA phenotype and evening chronotype also had ~3-fold higher risk of poor overall CVH scores (OR=3.58, CI=1.79-7.18, and OR=3.33, CI=1.45-7.69, respectively). Poor sleep quality was associated with greater odds of low score on the diet component (OR=2.97, CI=1.55-5.69). Insomnia symptoms were associated with poor score on the BMI component (OR=1.92, CI=1.15-3.21). High-risk OSA phenotype was associated with greater odds of poor scores on the blood pressure, blood glucose, and BMI components (OR=2.3, CI=1.2-4.3; OR=3.2, CI=1.5-7.1, and OR=11.6, CI=6.2-21.6). Conclusions: Multiple aspects of sleep other than duration were associated with overall LE8 CVH score, and individual metrics, among women across menopause. Findings support potential incorporation of sleep quality into CVH constructs.

Comprehensive Outcome Assessment and Quality of Life Following Epilepsy Surgery.

Seizure freedom without deficits is the primary goal for epilepsy surgery. However, patients with medically refractory epilepsy commonly suffer from many co-morbidities related to mood, cognition, and sleep as well as social problems and resultant stigma. While epilepsy surgery literature does describe quality of life (QOL) and neuropsychological outcomes, there is a paucity of information on various common non-seizure outcomes, especially pertaining to mood, sleep, cognition, and social aspects. The objective of this study was to evaluate the role of various non-seizure parameters on post-epilepsy surgery QOL. Consecutive adult patients operated for refractory epilepsy at least 1 year prior to initiation of this study were included and classified as seizure-free (group 1) or non-seizure-free (group 2). QOL was assessed using the QOLIE-31 instrument; patients with a T score less than 40 were categorized as "poor QOL." Non-seizure parameters assessed were cognition, mood disturbances, social improvement, social stigma, and sleep disturbances. Categorization into "good" and "poor" outcome subgroups on each item was carried out by dichotomization of scores. Thirty-seven patients (16 F) [mean age 23.5 ± 5.6 years] were evaluated; 26 were seizure-free (group 1). In this group, impaired memory, lower language scores, depression, not having been employed, not receiving education prior to surgery, and experiencing social stigma were factors significantly associated with poor QOL. In group 2, all patients had poor QOL scores. Non-seizure factors related to common epilepsy co-morbidities and social issues are highly prevalent among seizure-free patients reporting poor QOL after epilepsy surgery.

The Effectiveness of Listen-Read-Discuss (LRD) on Students’ Reading Comprehension

This study aimed to assess the effectiveness of the Listen-Read-Discuss (LRD) strategy in improving students' reading comprehension at SMAN 2 Majene. A quasi-experimental design was used with a population of 277 tenth-grade students. The sample, consisting of 60 students, was selected using convenience sampling. The assessment instrument comprised 20 multiple-choice questions administered to both the experiment and control groups before and after the treatment. The results revealed that the students' average pre-test scores in the experimental group were categorized as poor, with a mean score of 44.33. However, their post-test scores significantly improved to a good level, with a mean of 73.83. Similarly, the control group showed poor pre-test scores with a mean of 44.67, but their post-test scores improved to a good level, averaging 71.83. In conclusion, the students demonstrated enhancement in reading comprehension. The significant value of the pre-test and post-test results for both groups was 0.000, which is less than 0.05. Therefore, the t-test value was smaller than 0.05, confirming that the Alternative Hypothesis (Ha) was accepted, and the Null Hypothesis (H0) was rejected, indicating a significant effect of the LRD strategy on the reading comprehension of tenth-grade students at SMAN 2 Majene.

Real-World Outcomes of Brexucabtagene Autoleucel (brexu-cel) for Relapsed or Refractory (R/R) Adult B-Cell Acute Lymphoblastic Leukemia (B-cell ALL): Evidence from the CIBMTR Registry

Background Brexu-cel is a CD19 CAR T therapy first approved by the FDA in 2021 for adult patients (pts) with R/R B-cell ALL. In the pivotal phase II ZUMA-3 single arm trial, brexu-cel achieved a high rate (71%) of complete remission or complete remission with incomplete hematological recovery (CR/CRi) with a manageable safety profile. Here, we report outcomes of brexu-cel in a broad real-world patient population. Methods A total of 197 pts with B-cell ALL were infused with brexu-cel and prospectively enrolled between July 2021 and May 2023 in the CIBMTR registry across 67 centers in the US. In this analysis, we included 138 pts with at least one scheduled follow-up at Day 100 and evaluable safety and effectiveness outcomes. Descriptive statistics, Kaplan-Meier estimator and cumulative incidence functions were used to summarize outcomes. Results Median age was 43 years (range, 19.4-79.4; 19% were age ≥60 years) and 52% were males. Pts had a diverse ethnic background: 50% non-Hispanic White, 28% Hispanic, 11% non-Hispanic Black and 7% non-Hispanic Asian. More than half (55%) of pts had poor cytogenic risk score at diagnosis. Prior to lymphodepletion (LD), the majority of pts had: ECOG performance status of 0 or 1 (80%); at least one clinically significant comorbidity (79%); and Ph-negative disease (64%). Furthermore, 44% had evidence of ≤5% bone marrow blasts; of these (n=49), 65% were MRD negative. Extramedullary disease and CNS involvement was observed in 22% and 10% of pts prior to LD, respectively. As such, based on adapted criteria available in the registry data, 91% of pts in this cohort would have been ineligible for ZUMA-3. Pts received a median of 4 prior lines of therapy (range 1-13); 46% had prior inotuzumab and 58% had prior blinatumomab. One third (35%) had prior allogeneic (allo) stem cell transplant (SCT). Moreover, 41% of pts received bridging therapy prior to LD. Median time from leukapheresis to brexu-cel infusion was 32 days (inter-quartile range [IQR] 27-42)) and median follow-up time was 5.9 months (95% CI: 5.1-6.1) (Table 1). Overall CR/CRi rate by Day 100 post infusion was 76%; 70% were still in remission at 6 months post initial response (95% CI: 55-80). For those who were not in response before LD, 63% of them converted into a CR/CRi. Relapse free survival at 6 months was 53% (95% CI: 42-62). The overall survival rate at 6 months was 78% (95% CI: 69-84); primary causes of death were primary disease (n=13/32, 41%) and infection (n=7/32, 22%). About one third (31%) of responders received a subsequent allo SCT. High response rates were observed in all pts regardless of age, prior exposure to blinatumomab, allo SCT, or presence of extramedullary disease prior to LD. Grade ≥3 cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS, ASTCT consensus) occurred in 9% and 24% of pts, respectively (Table 2). Treatment for CRS and/or ICANS consisted mainly of tocilizumab (67%) and corticosteroids (51%). Most of these adverse events were resolved within 3 weeks of infusion (CRS, 94%; ICANS, 80%). Prolonged cytopenia and neutropenia 30 days post infusion was experienced by 42% and 33% of pts, respectively. Conclusion In this largest-to-date real-world evidence study of brexu-cel in adult pts with B-cell ALL, response and safety outcomes were consistent with findings from ZUMA-3, even with 91% of patients not meeting ZUMA-3 eligibility criteria. Updated data with longer follow-up will be reported at the time of presentation. *First and second authors are equal contributors

35 Correlations Between Sleep and Cognitive Functioning in Healthy, Older Adults

Objective:Alzheimer’s disease (AD), a leading cause of dementia worldwide, affected an estimated 47 million people in 2015, placing a burden of over $1 trillion on health systems. Subclinical markers of AD pathology are seen many years before the clinical onset of dementia, suggesting that steps could be taken to prevent progression to disease in healthy individuals. Sleep optimizes cognition by creating a window of opportunity to consolidate memories, prune synaptic networks, and clear waste products. Studies that characterize the relationship between sleep and cognitive function prior to the onset of clinical AD could guide research into effective methods of delaying AD onset or preventing it altogether. The objective of our study is to describe how sleep quality and quantity correlate with performance on cognitive assessments within a healthy, aging population.Participants and Methods:Seventeen participants, between 62-82 years of age enrolled in an ongoing clinical trial assessing the effects of melatonin (5mg daily) versus placebo, were included in our study. Participants were observed over a 2-month period, during which no experimental interventions were administered. At study entry, participants underwent a comprehensive neuropsychological evaluation evaluating cognitive domains of attention, memory, speed of information processing, language, executive functioning, and mood. Afterwards, all participants wore a watch that measured actigraphy and light data (Philips Actiwatch Spectrum Pro actigraphy monitor) for 8 weeks to evaluate their sleep habits. Pearson and Spearman partial correlations were used to evaluate relationships between objective sleep parameters and baseline cognitive function test scores.Results:Aberrations of sleep length, sleep fragmentation, and daytime activity measures significantly correlated with cognitive performance on memory, language, visuospatial skills, and speed of processing tests (p = &lt;0.05). Greater variability of awakenings at nighttime associated with better scores on memory tests but worse scores on language tests. Longer sleep times associated with worse language scores, while greater variability in daily activity correlated with poorer scores on visuospatial skills tests and speed of processing tests.Conclusions:This study establishes a framework for obtaining longitudinal sleep data in conjunction with serial cognitive function testing, encouraging further exploration into how sleep metrics affect specific domains of cognitive function. Findings suggest that having a less consistent sleep routine correlates with poorer cognitive function across multiple domains. The authors recommend broader analysis of actigraphy and cognitive function testing as objective measures of sleep and cognition in research and clinical practice.

Long-term outcomes of deep pediatric arteriovenous malformations.

Multimodality treatment has been shown to be the optimal management strategy for pediatric arteriovenous malformations (AVMs). Deep AVMs represent a subset of AVMs for which optimal management may be achieved with a combination of radiosurgery and highly selective embolization, in the absence of compelling features requiring operative intervention. The objective of this study was to identify predictors of good functional outcomes in pediatric patients with deep AVMs. A retrospective cohort study of the outcomes of 79 patients with deep AVMs from January 1988 through December 2021 was performed. Deep AVMs were defined as those with the majority of the nidus centered in the basal ganglia, thalamus, or brainstem. Collected data included patient demographics and presenting symptoms, presenting modified Rankin Scale (mRS) score, radiographic findings and outcomes, management strategy, complications, and clinical outcomes as indicated by follow-up mRS score. A good outcome was defined as a follow-up mRS score ≤ 2, while a poor outcome was defined as a follow-up mRS score ≥ 3. Statistical analysis was performed to identify factors associated with functional outcomes. With a mean follow-up duration of 85.6 months, there was a 72.2% angiographic obliteration rate, with 75.9% of patients having a good clinical outcome (mRS score ≤ 2). Presenting symptoms and radiographic characteristics were not significantly associated with long-term functional outcomes. There was a significantly higher rate of posttreatment hemorrhage in patients with a poor versus good outcome (11.8% vs 0%, p = 0.010). On multivariate logistic regression analysis, poor long-term functional outcome was only associated with poor presenting mRS score (p = 0.002). Satisfactory angiographic obliteration rates and good long-term functional outcomes can be achieved for deep AVMs, with stereotactic radiosurgery as the cornerstone of multimodality treatment.

Machine learning based phase prediction and powder metallurgy assisted experimental validation of medium entropy compositionally complex alloys

Medium entropy alloys (MEAs) are a subset of compositionally complex alloys whose mixing entropy lies between R and 1.5 R where R is the universal gas constant. The properties of MEAs largely depend on the phases present in the alloy such as solid solution (SS), solid solution + intermetallic (SS + IM) and amorphous (AM). Hence, the correct prediction of phases can enable the efficient selection of material compositions with anticipated properties. In this paper, three machine learning (ML) algorithms viz. k nearest neighbors (KNNs), artificial neural network (ANN), and random forest (RF) were employed for the ternary phase classification problem. An MEA dataset was constructed by utilizing all reported MEAs till February 2023 to the best of authors’ knowledge. The study implied that the use of only three features (mixing enthalpy, atomic size mismatch, and a strain energy related parameter) were sufficient for the phase prediction in MEAs. Among the three ML algorithms, ANN had the highest macro averaged F1 score (86.7%) and accuracy (87.3%) in predicting the phases in MEAs, while RF has the lowest macro F1 score (84.67%) and accuracy (84.8%). However, for phase prediction between single phase SS and multi-phase SS (binary classification), distance-based algorithm (KNN) was found to be suitable. The prediction performance of ML model over a completely unseen data was assessed in the case study section. The experimentally determined phase details of three new MEA compositions fabricated by powder metallurgy route was also included in the unseen dataset. The SS and AM phases were correctly labeled nine times out of eleven instances by using ANN model. However, the model prediction for SS + IM phase was found to be less reliable (three out of five correct) owing to its relatively poor F1 score.

Abstract 256: Proposal of multimodal CT‐based scoring system in prediction of hemorrhagic transformation in acute ischemic stroke

Introduction The routinely used computed tomography (CT)‐based workup in the setting of acute ischemic stroke (AIS) includes non‐contrast brain CT, CT angiography (CTA), and CT perfusion. Several CT, CTA, CTP‐based radiological biomarkers of hemorrhagic transformation (HT) were reported. To assess the predictive value of the combined multimodal CT parameters for HT after AIS and proposal of predictive scoring scale. Methods The source images of the NCCT, CTA and CTP of 282 AIS patients involving the anterior circulation (HT = 91, non‐HT = 191) were retrospectively reviewed and the following biomarkers were recorded and analyzed: Early subtle ischemic signs, hyperdense middle cerebral artery sign (HMCAS) and Alberta Stroke Program Early CT Score (ASPECTS) &lt; 7 in NCCT, large‐vessel occlusion (LVO), clot burden score (CBS) &lt; 6, large‐vessel occlusion, poor collateral score (CS) and Tmax &gt; 6 s ≥ 56.5 ml. A scoring system to predict HT based on these biomarkers was developed. Each biomarker counts for a single point with the total score ranging from 0 to 7. Results All the aforementioned multimodal CT biomarkers and the selected cut offs were significantly associated with higher HT risk. The calculated scores were statistically significant different between the HT and the non‐HT groups with AUC 0.761 (95% CI 0.703–0.819, P &lt; 0.0000001). Rates of HT were approximately five times higher in patients with score ≥ 3. Conclusion Multimodal CT‐based scoring system may provide highly reliable predictive model of hemorrhagic transformation in acute ischemic stroke.

Factors associated with the knowledge of obstetric danger signs among pregnant women attending primary health care antenatal care clinics in Abha city.

Knowledge of obstetric danger signs would equip women to make the right decisions and appropriate actions timely to have better health care assistance which will impose a significant impact on maternal mortality and morbidity. Hence, this study aimed to know the factors associated with the knowledge of obstetric danger signs among pregnant women who attend the primary health care clinics, which is considered as the first gate to seek health care for pregnant women during antenatal checkups. This is a cross-sectional study conducted among 400 pregnant women selected by simple random sampling technique who were attending antenatal clinics at primary health care centers at Abha City by using an interview-based questionnaire.cores of <50%, 50-75%, and >75% were considered to be poor, intermediate, and good scores. Frequencies and percentages were used for descriptive variables, whereas for association, tests of significance (Chi square, t-test, and F-test) were applied. Almost 70.8% of participants received health information on obstetric danger signs. The main sources of information were the Internet (23%), family, relatives or friends (17%), and health care providers. The highest participants' correct responses regarding obstetric danger signs were related to severe vaginal bleeding (93.5%), convulsions (76.8%), and decreased fetal movements (76.5%). Proportions of participants with poor knowledge showed an inverse and significant increase with their educational levels (P < 0.001). The highest percentage of poor knowledge grade was observed among participants with no children (54.6%). Participants who received previous information on danger signs had significantly better knowledge grades than those who have not received previous information (P < 0.001). Women's knowledge was suboptimal regarding obstetric danger signs. 30% of women did not receive information about danger signs. Health education provided on obstetric danger signs to pregnant women should be enforced to those who are illiterate, are unemployed, have a low family income, and are with no or less previous pregnancies.

Knowledge, attitude and practices towards SARS-CoV-2 genetic mutations and emerging variants among the population in Bangladesh: a cross-sectional study

ObjectivesThe coronavirus is continuously mutating and creating new SARS-CoV-2 variants. Public awareness about SARS-CoV-2 mutation is essential for effective preventive measures. The present study aimed to assess the knowledge, attitude...

Perinatal Outcome in Overweight Women: An Audit.

Obesity in pregnancy is associated with a myriad of well-documented complications. However, the outcomes of pregnancy in overweight females, who are not classified as obese, have not been studied. The aim of the study was to assess foeto-maternal outcomes in primigravida who are overweight and compare them to normal-weight patients. This was a prospective observational cohort study and included primigravida with full-term gestation (between 38 and 42 weeks), with a single live foetus in vertex presentation, who were admitted for labour induction. Based on pre-pregnancy weight, patients were divided into normal weight (body mass index, BMI<23kg/m2) and overweight (BMI≥23kg/m2 and<25kg/m2) categories labelled as groups A and B, respectively. Data was collected for gestational age, demographics (age, education, occupation), and obstetric and labour-related parameters per pre-designed proforma. Parameters included were the reason for induction, number of doses of prostaglandin E2 (PGE2) gelused, duration of labour, induction to delivery interval, and mode of birth- operative/ non-operative. Data was also collected for peri-partum maternal complications, neonatal Apgar score, and need for Neonatal Intensive Care Unit (NICU) admissions. One hundred and fifty patients were recruited in the study and divided based on weight into two groups- 115 in Group A (normal weight) and 35 in Group B (overweight). Compared to Group A, a higher proportion ofpatients in Group B needed a third dose of PGE2 gel (n=24, 20.8%vs n=18, 51.4%). Also, more patients in Group B had an induction to delivery time of longer than 30 hours (n=7, 20% vs n=5, 4.3%)and had a higher incidence of failed induction needing caesarean section (n=9, 25.7% vs n=13, 11.3%).Neonates born to overweight mothers had a poor Apgar score at 1 min. However, on reassessment, Apgar improved at 5 minutes, and no statistically significant difference was seen for admission to NICU- 5.7% (n=2) in Group B vs 1.7% (n=2) in Group A Conclusion: Pregnancy in overweight females is associated with prolonged labour, higher instances of failed induction, and poor neonatal outcomes at initial assessment. Thus, perinatal counselling and management should focus on weight control while also planning appropriate strategies for monitoring and treating pregnancy-related complications if weight control measures fail. Although obesity is the main focus of research, we suggest including overweight but non-obese females in such studies as they have similar adverse outcomes and complications.