Pre Period Research Articles

Influence of sowing windows on seed yield ofsoybean [Glycine max (L.) Merill] cv. JS-335

The soybean seed production has been limited due to lack of supply of quality seed; this is because soybean seed is affected by field weathering and environmental condition during pre and post-harvest period and thus loses its viability in storage and cannot be stored from one season to next. Therefore, the present study was conducted during 2020-21 and 2021-22 to determine the soybean cv.JS-335 breeder seed production feasibility in three seasons. The result revealed that, maximum number of pods (60/plant), pod length (4.25 cm), number of seeds per pod (3.12), test weight (75 g) and seed yield per acre (10.50 q) were recorded when soybean was sown during kharif season followed by summer as compared to Rabi season.

Risks and representations: Creating consensus narratives about risk with pregnant women involved with child protection systems in Aotearoa New Zealand and Scotland

Social work aspires to empowerment ideals, including taking a ‘non-expert’ position of professional curiosity, and validating the perspectives of people in contact with services. Yet in child protection, social workers are involved in practice that refutes the views and opinions of people and are positioned by their role as an identifier of abuse and risk manager. Social workers and people who are subject to child protection services can be locked into meaning battles regarding the effect of parental behaviour and the representation of risks to children. These negotiations over meanings are especially difficult in the pre and perinatal period, where who controls the representation of the baby's voice or best interests is fundamental to decision outcomes. Using Fricker's concept of ‘testimonial injustice’ as an analytical lens, this article draws on studies in two different contexts: Aotearoa New Zealand and Scotland, to examine the implications of the intense mediation of meanings that affect child protection practice. We find that concepts relating to the importance of mothering, love for children, and extended family relationships were sources of mother's disagreements with professional views of risk, but that through qualified agreement or advocacy from community workers, a shared risk narrative could be constructed.

PP151 HTA Of Fast Track Hip And Knee Joint Replacement

IntroductionThis retrospective study was conducted, in accordance with the STROBE guidelines, (Vandenbroucke et al., 2007), considering patients receiving surgical interventions for hip and knee replacement at the IRCCS Orthopedic Institute Galeazzi, located in Milan (Italy), between 1 January 2016 and 31 December 2019 (two years of traditional procedure, and two years of new one).MethodsWe evaluated 10,922 patients treated for hip or knee joint replacement; there were 5,085 treated following the traditional procedure and 5,837 treated by fast track procedure. Excluding cases which could not satisfy the study criteria we evaluated finally 697 with traditional procedure and 1120 with the new one.ResultsWith the new fast track procedure, knee replacement mean costs were decreased by an average of EUR1,112.4 (-19.9%). Excluding the cost of prostheses from the analysis, the mean costs in the pre fast-track period for knee replacement are equal to EUR3,918.1, while the mean cost of the intervention in the fast-track period was equal to EUR3,245.8, being EUR572.3 lower (-17.2%). Considering the number of days of hospitalization, the adoption of fast-track leads to a decrease of -2.8 days (-37.6%) in knee replacement, from a mean number of days of 7.6 (± 2.8), to a mean number of days of 4.8 (± 1.8), and of – 2.9 days (-39.2%) in hip replacement, from a mean number of days of 7.3 (± 2.7) to a mean number of days of 4.4 (± 2.0).ConclusionsWe performed a study over four years, with a wide number of cases treated by various teams in the hospital having the highest workload on hip and knee joint replacements in Italy.The new fast-track procedure is efficient; the length of stay was decreased by the procedure; the direct and indirect costs were decreased; the hospital organization was improved; the increase of care intensity did not modify efficiency and costs; the effectiveness was similar to the traditional procedure as defined by outcomes collected in a registry, including patient reported outcome measures (PROMs); legal and social effects were not modified.

The Impact of Montelukast’s Black Box Warning on Pediatric Mental Health Adverse Event Reports

OBJECTIVE In March 2020, the US Food and Drug Administration (FDA) required a black box warning for montelukast due to serious mental health side effects. We hypothesized the warning would lead to an overall decrease in reports of mental health symptoms and disorders related to montelukast in both ­pre-adolescent and adolescent groups. METHODS Adverse events of pre-adolescent and adolescent children taking montelukast sodium were reviewed from March 1, 2018 to March 3, 2020 and March 4, 2020 to February 28, 2022 using the FDA’s Adverse Events Reporting System. The objective was to determine if mental health adverse event reports were influenced by placement of a Boxed Warning. Adverse reactions were grouped into 8 categories deemed to be related to mental health guided by the research team’s interpretation of the FDA Sentinel Report. Chi-square tests were used to compare time periods and reports of the mental health categories. RESULTS Of the 1570 reports assessed, 1295 (82.5%) included ≥1 mental health concern. Nine hundred ninety-six (84.2%) of the 1183 reports involving pre-adolescents and 299 (77.3%) of the 387 reports involving adolescents included ≥1 mental health reaction. Statistically significant changes for pre-adolescents were found in reports related to depression (χ2 (1) = 4.30, p = 0.044), and sleep (χ2 (1) = 5.74, p = 0.019), which both decreased between the pre and post periods. The only statistically significant change across categories for adolescents was a reduction in aggression reports between time periods (χ2 (1) = 8.5, p = 0.004). CONCLUSIONS After placement of an FDA black box warning on montelukast, total number of reports ­including mental health adverse events decreased in pre-adolescents; however, several categories ­assessed increased for adolescents.

Growth and dimensions of monkeypox research: a scientometrics study

Purpose This study aims to analyse the trend of Mpox research in the pre and post-outbreak period. The study compared the growth pattern, major research areas, sources of publications, funding agencies, countries and institutions invested in Mpox research, and institutional and countrywide collaboration patterns in Mpox research in both periods. Design/methodology/approach This study is based on the data retrieved from the Web of Science database for two time frames: the pre-outbreak period (January 1989–April 2022) and the post-outbreak period (May 2022–December 2022). The study is limited to research articles and reviews articles from Web Science. The study used Microsoft Excel and VOSviewer visualization software to derive results. Findings The study found few publications on Mpox before the epidemic outbreak, and a steep increase is visible after it. Before and after the Mpox pandemic, the USA ranked first in the production of literature. The focus of research before the outbreak of the epidemic was on virology, which was replaced by infectious diseases during the post-epidemic period. More publications were found available in open-access journals during the post-outbreak time. Author collaboration with US authors from other countries is higher in the post-outbreak period. During the pre-outbreak time, the principal supporters of Mpox research were American funding agencies and institutes. The study reveals that the research in post-outbreak is more concentrated on diagnosis, prevention and treatment of Mpox. Practical implications This study offers a systematic literature review on Mpox’s overall research productivity. It contrasted the patterns of this field’s pre- and post-epidemic research. The conclusions of this study will act as a guide for scientists operating all across the world. Originality/value A thorough scientometric analysis of the trend of Mpox research in the pre- and post-outbreak period has not been attempted. It will help identify the nature of research on Mpox over the years, which will support future research on Mpox attempted across the globe.

Comparative Analysis of Super Nations’ Pre and Trade War Periods on Nigeria

There is no contention that the contemporary world has been reduced to a global village but of great concern is how policies that were made in other distant economies affect other places’ economy, politics, culture, education, etc. This study primarily investigated whether US-China trade war had any impact on their trade with Nigeria. This is because the US and China are Nigeria’s important trading partner and it is expected that whatever happened in these two leading world economies would have impacts on other countries. The period Q12014-Q42019 was adopted for the study because it allowed the researcher to compare the performance of the Nigeria’s trade with the two countries before trade war with the performance during the trade war period. The pre-trade war period adopted for this study was Q12014 to Q42016 while the trade war period was Q12017 to Q42019. The study used secondary data from Nigeria’s export and import trade with US and China. All the data were quarterly data and obtained from the website of National Bureau of Statistics (NBS) quarterly bulletin. The study was delimited to export and import trade between Nigeria and US-China because trade tariff policies have significant impact on imports and exports and the effect is strongest on trade. The paired-samples t-test techniques were used to analyse the data. The findings revealed that there was a significant difference in Nigeria’s trade flow with the US and China during the trade war periods when compared to the periods before the trade war.

COMPARATIVE ANALYSIS OF COMPLEX INFORMATION SYSTEM TESTING METHODS


 
 
 
 The research has been based on surgical experience of multiple decades and on retrospect study of more that 4000 clinical cases, among them 3500 surgical invasion due to different types of traumas. Since it relies on the latter, it shows the evolution of our approaches towards severe cerebral cranial traumon includes different matters regarding diagnostics and surgical treatment with neuropathogenetic approach. We have shown the advantages of certain surgical procedures in cases of cerebral cranial trauma and also the way approaches were changing after introduction of high medical technology and taking into consideration bio mechanisms and pathological data. Computer diagnostics changed several surgical procedures and opportunities. In cases of traumas impacted in immobilized condition method of choice used to be plastic craniotomy, when in cases of cerebral congestion would cause decompression, placing bone fragment under the skin. 902 surgeries were performed among 1990. In 894 cases surgeries were performed using plastic trepanation, 217 among them was performed with improved modified method. In cases of negligible brain congestion, bone fragment was left in its place without suture fixation and after the congestion resolution fragment would return to its anatomical location. In several times it would be ligated in 2-3 points. This method was the most efficient in bi-frontal low craniotomy. The need of removing bone fragment was observed in zero cases.
 In cases of acceleration traumas, which is characterized by diffuse damage, multifocal hemorrhages and bruises, in 157 cases double decompression method was used, in some case with falcostomy, effective in 49 cases. Trafination and resection trepanation were removed from practice.
 Trafination method was sometimes use in cases of chronic hematomas and acute hydromas. In Recurrent and chronic hydromas method was less effective, in such conditions plastic trepanation method was used in order to create extra space for fluid. In singular cases of collapsed brain and for resolving tunica arachnoidea broken surface, we used to infuse 25-35 cubic oxygen or 20-25 distillate in spinal cord. This method was proved effective in 70 cases. Therefore, taking into consideration patho-mechanisms and pathology data, using differential pathogenetic methods of surgical invasion and computer monitoring of post-operative period we managed to decrease mortality in severecerebro-cranial traumas to 29-30% comparing to pre computer periods 36-38 % and comparing to data of other clinics 35-45%.
 
 
 

Incremental Burden Associated with Dose Escalation in Patients with Paroxysmal Nocturnal Hemoglobinuria Treated with Complement Inhibitors

Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare blood disorder characterized by complement-mediated hemolytic anemia. Terminal complement component C5 inhibitors eculizumab (ECU) and ravulizumab (RAVU) inhibit the formation of membrane attack complex, and thereby ameliorates intravascular hemolysis in PNH. Some patients exhibit breakthrough intravascular hemolysis near the end of 14-day treatment cycle for ECU or 8-week treatment cycle for RAVU. To manage breakthrough hemolysis, different treatment strategies may be attempted in the clinical practice, including shortening the dosing interval and/or increasing the dose of ECU and RAVU. This study aimed to estimate the incremental costs associated with dose escalation in patients with PNH treated with ECU or RAVU in the US. Methods: Adult (age ≥18 years) patients with PNH (ICD-10-CM code D59.5) treated with ECU or RAVU from health plan claims data (01/01/2011 to 09/30/2022) with ≥3 months of continuous health plan coverage following the first claim for ECU or RAVU were included in this retrospective cohort study. Dosing patterns were investigated during the maintenance phase. Consistent with label-recommended dosing schedule, the maintenance phase started from day 29 and day 15 post-first claim for ECU and RAVU, respectively, until the earliest of treatment discontinuation/loss to follow-up/end of data. Dose escalation for ECU was defined as 1) an increased dose (i.e., 1,200 or 1,500 mg) and/or 2) an increased infusion frequency (i.e., ≥2 infusions within 12 days). Patient-weight information was not available; dose escalation for RAVU was defined as an increased infusion frequency (i.e., ≥2 infusions within 49 days). All-cause and PNH-related direct healthcare costs measured during maintenance phase for the overall cohort and subgroup of patients with dose escalation were assessed for ECU and RAVU separately. Incremental costs associated with dose escalation in the pre vs. post dose escalation period were assessed for ECU and RAVU separately; p-values from Wilcoxon signed-rank tests were reported. Results: A total of 278 patients treated with ECU (mean± SD age, 42±13 years; 60% female) were included in the overall cohort and a subgroup of 151 patients were observed with a dose escalation (mean±SD age, 41±13 years; 58% female). For the overall ECU cohort (N=278), during a mean follow-up of 23 months, total all-cause and PNH-related costs (mean±SD) were $67,650±$32,518 and $65,751±$31,379 per patient per month (PPPM), respectively. In the subgroup of patients with dose escalation (N=151), over a mean follow-up of 30 months, total all-cause and PNH-related costs (mean±SD) were $71,466±$33,452 and $69,471±$31,595 PPPM, respectively. In the overall cohort and subgroup of patients with dose escalation, PNH-related treatment costs represented 90% and 92% of total all-cause costs respectively. A total of 171 patients treated with RAVU (mean± SD age, 39±12 years; 43% female) were included in the overall cohort and a subgroup of 26 patients were observed with a dose escalation (i.e., increased infusion frequency only) (mean± SD age, 37±11 years; 54% female). For the overall RAVU cohort (N=171), during a mean follow-up of 17 months, total all-cause and PNH-related costs (mean±SD) were $50,779±$26,258 and $49,213±$25,751 PPPM, respectively. In the subgroup of patients with dose escalation (N=26), over a mean follow-up of 20 months, total all-cause and PNH-related costs (mean±SD) were $52,819±$20,965 and $50,740±$20,837 PPPM, respectively. In the overall cohort and subgroup of patients with dose escalation, PNH-related treatment costs represented 93% and 91% of total all-cause costs, respectively. Incremental costs (mean cost differences) associated with dose escalation for ECU were of $16,861 (p<0.01) and $15,956 (p<0.01) PPPM for all-cause and PNH-related total costs, respectively; and for RAVU were of $4,950 (p<0.05) and $3,738 (p=0.06) PPPM for all-cause and PNH-related total costs, respectively (Figures 1A and 1B). Conclusions: In this study of PNH patients treated with C5 inhibitors, dose escalation was associated with significant incremental costs for both ECU and RAVU. Further research is warranted to clarify the reasons for dose escalation, which may potentially indicate an unmet clinical need for more efficacious treatment options to help prevent breakthrough symptoms and reduce the burden of PNH.

1272. Teaching the ABCs of ASB in a 60-minute educational intervention. A quality improvement project.

Abstract Background Asymptomatic bacteriuria (ASB) refers to the presence of bacteria in the urine of individuals that do not present with symptoms of urinary tract infection (UTI). Treatment for ASB is not recommended in most cases. [1] Previous studies have shown that provider education on proper antibiotic use has been effective in mitigating the ongoing wave of antimicrobial-resistant organisms across hospitals in the United States.[2] We aimed to decrease the proportion of cases classified as having asymptomatic bacteria by 20% in four months after the intervention using a small group discussion and a presentation. Methods We evaluated the rates of inappropriate antimicrobial prescribing for asymptomatic bacteriuria (ASB) for 4 months before educational intervention and 4 months after. Data was extracted from the electronic medical record (Cerner®), imported into REDCap®, and with standardized manual chart review. Data analysis was completed using STATA® 17 & 18. Results The mean duration of antibiotic therapy was 7.9 days in the pre-intervention group and 6.1 days in the post-intervention group. See Table 1 for more details on demographics. Following the intervention, the rate of inappropriate use of antimicrobial therapy in ASB was reduced by 29.8% (p-value 0.035). The mean duration of antibiotic therapy decreased by almost 2 days in the post-intervention group. Conclusion This quality improvement project suggests that focused interventions of short interactive educational sessions in small groups may reduce the inappropriate use of antibiotics in ASB by almost 30%. The mean duration in days of antibiotic treatment decreased from 7.9 days to 6.1 days in the pre and post-intervention groups (p-value 0.060). Of note the total number of cases with providers selecting UTI as an indication was also lower in the post-intervention group and although we can’t determine causality, it provided evidence of a lower number of cases, providers initially classified as UTI between the pre and post-intervention period from 33 to 19. Further research may include incorporating small groups and interprofessional educational interventions to help implement good antimicrobial stewardship in inpatient care facilities. [4,5,6] Disclosures All Authors: No reported disclosures

Spatio-temporal variability of streamflow in major and medium rivers of Nepal

Study regionWe selected six (three on each) major and medium river basins of Nepal as a study domain for the analysis. The study areas were so selected that they represent the river basins across the country from East (Kankai basin) to West (Karnali basin). Study focusThis study focuses on the long-term hydrologic alteration in the river flow of Nepal's medium and major rivers of different river basins. The overarching objective of the study is to evaluate the spatio-temporal change in flow magnitude, duration, frequency, timing, and rate of change in the major and medium rivers in Nepal. With continuity in the development activities, it is imperative to analyze the potential impact of human activities in the hydrologic regimes. For this, we used a set of 33 indicators from the indicator of hydrologic alteration (IHA) developed by The Nature Conservancy for the pre and post-impact period. The pre and post-impact period is defined here as the time before and after which the substantial alteration occurred, possibly due to multiple reasons. The pre and post impact periods were determined using the Pettitt statistical test carried out at the most downstream of the hydrological gauge station of each river basin. Further, the trends in the annual flow were estimated using the Mann-Kendall test, and the slope of the trend was estimated using Sen’s slope. New hydrological insights for the regionThe results showed that in the post-impact period, the mean annual discharge in major and medium rivers of Nepal was found to decrease by 5.86% and 7.94%, respectively. Except for the West Rapti River (−14.3%), the hydrologic change of 1-day maximum flow is observed to have increased in the medium rivers and decreased in the major rivers. Moreover, except for the Kankai River (+14.29%), the hydrologic change of 1-day minimum flow is observed to be reduced in both the major and medium rivers. In major rivers, the overall degree of alteration ranges from 28.7% to 38.0%, which resembles the low to mid variability range. Similarly, the result of the hydrologic alteration showed that for the medium rivers, the overall degree of alteration varied from 35.8% to 46.7%, representing the medium range of variability. This suggests that the river systems undergoing moderate hydrologic alteration have experienced moderate alteration. These rivers might be capable of sustaining a healthy ecosystem, however, could be more susceptible to other stressors like drought.

Changes of Public Sector Human Resource Management (HRM)

Public sector human resource management is a way to manage human in a hierarchical activity which acts as the main rotor of efficiency and effectiveness of public-scale growth and development. As our environment changed in 2020 caused by covid-19 pandemic, so does the human resource management. Substantial changes in society impacted the way we shape management activity. This study aims to map the research trend changes of public sector human resource management in pre and post covid-19 period. We conduct bibliometric study to explore the factors and criteria of a toxic leader from open access scopus indexed journals using biblioshiny application limited to pre (2016 to 2019) and post (2020 to 2023) covid-19 periods. The criteria for filtering journal articles are based on PRISMA and JBI standards. Data suggested that covid-19 event ignite the research production. The research domains for pre covid-19 were focused on human resource growth and development, while post covid-19 domains were focused on survival and resilient. Country rank of most published paper related to the locus field also related to worldwide survey of economic growth in pre to post covid-19 pandemic. However, rapid increase of publication in post covid-19 period did not followed by study continuity and relatedness.

HPB P56 Service Evaluation of Hot Gall bladder Pathway

Abstract Background Management of acute cholecystitis has traditionally been conservative. Initially patients are treated with antibiotics posted for LC after 4-6 weeks.Surgery during acute settings was previously avoided due to fear of injuring surrounding structures. NICE guidelines published in October 2014 now advises that patients presenting with acute cholecystitis should have LC within a week which has been proven to be safe and effective. With respect to acute pancreatitis the standard of care should be lap chole during index admission for all non-severe cases. The purpose of this study is to evaluate the management of patients admitted with acute gall stone diseases. Methods It was a retrospective study of all the patients admitted with acute gall stone diseases and compare the outcomes after introduction of Hot Gall Bladder Pathway. We screened a total of 245 patients who had been included in this study between October 2018 to March 2020 with two groups: Data were collected form EZ Notes,IT Systems,Databases,Observations and Paper Records. Results Acute cholecystitis with no associated organ dysfunction who underwent Laparoscopic Cholecystectomy within week of diagnosis in the pre Hot GB List period was 43%(31/74) wheras in the Post Hot GB List period was 81% (93/116). Mild Acute Biliary Pancreatitis who underwent LC within index admission was 30% (5/17) in the preHot GB List Period wheras 78%(14/19) of patients with gall stone pancreatitis under went LC during the same admission after the beginning of Hot GB lists. Conclusions We had achieved almost 81% of the expected outcome in surgically dealing with patients presenting with acute cholecystitis and 78% with patients presenting with gall stone pancreatitis after introduction of Hot Gall bladder pathway. Safe and cost-effective hot gall bladder service can be provided by the EGS with input from upper GI surgeons with acceptable morbidity and a satisfactory outcome. Hot gall bladder pathway has proven to be effective in treatment of GS related diseases without significant increase in complication rate. It also helps avoiding readmissions, Gall stone related complications, reduces bed occupancy and improves patients’ quality of life.

Flow alterations due a constructed reservoir in the Menik Ganga basin, Sri Lanka

Natural water flows and their ecosystems are altered due to manmade hydraulic structures like dams. However, limited research on hydrologic alteration has been carried out in developing countries. This research explores the hydrologic alterations which occurred in the Menik Ganga basin, Sri Lanka due to the Weheragala reservoir constructed in 2009 for inter basin transfer. The hydrologic variations of the flow regime due to the construction of the reservoir was analyzed using Indicators of Hydrologic Alterations (IHA). For this purpose, we compared the calculated IHAs for streamflow at the Kataragama station (located downstream of Weheragala) during pre-construction (1990–2009) and post construction (2010–2019) periods. Also, the IHAs of simulated flows from the Water Evaluation And Planning (WEAP) model during 2010–2019 was compared with observed gauge discharge during the same period. The monthly observed flows in the “Maha” rainfall season (September to March) demonstrated a decreasing trend in post dam period with respect to pre dam period (highest decrease of 77 m3/s during October), whilst it showed an increasing trend (highest increase of 5 m3/s during August) in the Yala season (May to August) in the post-reservoir construction scenario. This was further visualized by comparing the indicators of the simulated flows with observed for post reservoir period, in which highest percentage differences occurred in June (− 4000% in 2016) and November (− 300% in 2010) for Yala and Maha periods respectively. Large alterations of the river flow due to the impoundment depicted by higher percentage differences. These alterations are extensively examined by other indicators as well. The fluctuations of flows have been decreased due to the construction of the reservoir which resulted in reductions of low and high pulses. The results are highly appealing to the authorities who are in water resources management to reach sustainable goals.

A Legal History of Land Acquisition in India

Development-induced displacement (DID) significantly dominates the problem of internal displacement in India. It occurs when people are forced to leave their habitat to implement large-scale infrastructural projects. Some 10 million people worldwide are displaced or resettled every year due to development projects, with the largest share of displacement due to the construction of dams, urbanization and mining. It has been regarded as ‘the youngest type of involuntary migration.’
 In India, the problem of development-induced displacement is quite historical. However, it was only during the British period that the development-induced displacement started gaining attention. This paper seeks to discover the roots of development-induced displacement in India in its pre and post-independent periods. It also discusses the development of various acts of land appropriation since the Company Raj till the present day to understand the patterns and nature of land acquisition and displacement.

Variation in parental experiences with their child’s hospitalization over the COVID-19 pandemic

BackgroundHospitals and healthcare workers have been greatly impacted by the COVID-19 pandemic. The potential impacts upon the patient experience have been less documented, particularly in the pediatric setting. Our aim was to examine how parental experiences with their child’s hospitalization varied during the COVID-19 pandemic at two children’s hospitals in Alberta, Canada.MethodsA random sample of parents were surveyed within six weeks of their child’s discharge from Alberta’s two children’s hospitals. Surveys were administered using the Alberta Pediatric Inpatient Experiences Survey (APIES) - a validated instrument used to assess parental experiences during their child’s hospitalization. Surveys were linked with administrative inpatient records. Three cohorts were created based on hospital discharge date: Pre-COVID (Pre: April 2019 to March 2020), COVID year one (C1: April 2020 to March 2021), and COVID year two (C2: April 2021 to March 2022). We examined 48 survey questions, including four overall rating scales. Survey responses were Likert scales. These were transformed to normalized scores from 0 (worst) to 100 (best). Differences between cohorts were assessed using ANOVA and the post-hoc Tukey test.ResultsA total of 3,611 surveys (1,314 Pre; 997 C1; 1,300 C2) were completed over the three-year period. Five questions showed differences between the Pre and C1 periods, six showed differences between Pre and C2, and 13 showed differences between C1 and C2. Among these questions, scores pre-COVID were lower than COVID year one, while results in COVID year two were lower than pre-COVID and COVID year one. Thirty-one survey questions showed no statistical differences between the three time periods. For the overall ratings, only hospital rating showed a difference in any of the periods (91.4 C1 vs. 90.2 C2). Overall ratings of doctors, nurses, and recommendation of the hospital to others showed no differences.ConclusionThis study showed that the experiences of parents during the first year of the COVID-19 pandemic were mildly better or comparable to historical results. This changed over the following year, where lower scores were reported on 13 questions.

Evaluation of the impact of COVID-19 pandemic on hospital-acquired infections in a tertiary hospital in Malaysia

BackgroundInfection prevention measures are the gold standard for preventing the spread of hospital-acquired infections (HAIs). COVID-19 pandemic caused major disruptions in infection prevention measures, and this has implications on the rate of HAIs. This study assessed the impact of COVID-19 pandemic on the rate and the types of HAIs at Sultan Ahmed Shah Hospital.MethodThis is a retrospective cohort study that compared the rate of HAIs from April to October 2019 (pre COVID period) and April to October 2020 (during COVID period). Data was collected through the review of patients’ electronic medical records.ResultsThere were a total of 578 patients included in the selected wards during the pre- and during the pandemic. Thirty-nine episodes (12.1%) of HAIs were report in the pre COVID period and 29 (11.3%) during COVID-19. In both periods, hospital-acquired pneumonia (HAP) was the most frequent HAI among the patients. There was a rise in catheter-associated bloodstream infections (CLABSI) (0.8%) and ventilator associated pneumonia (VAP) (1.1%) during the COVID-19 period. The most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA) (28.2%) and Enterococcus faecalis (17.9%) in the Pre COVID-19 period, and Pseudomonas aeruginosa (27.6%) and Stenotrophomonas maltophilia (6.9%) during COVID-19.ConclusionOur research concluded that the rates of HAIs during the COVID-19 pandemic were not significantly impacted by the improved in-hospital infection prevention efforts to control the pandemic. There is need for further efforts to promote adherence to preventive practices.

Change in demand for health-related undergraduate studies in Spain during 2015–2021: a temporal series study

Introduction The expansion of higher education is a worldwide phenomenon. To our knowledge, there are no studies analyzing the trends in demands of enrollment in health-related studies in Spain. Therefore, the objective was to analyze the change in demand (the number of requests for enrollment divided by the number of offered places) for undergraduate health-related studies in Spain during the period 2015–2021 as well as compare the change by region in the pre (2015–2019) and pandemic (2020–2021) period. Methods This is an observational (ecological type) study with temporal series analyses using data from public (non-for-profit) higher education institutions from the Integrated University Information System. For the analysis by region, we calculated the demand of all twelve undergraduate health-related degrees and the percentages of change between both periods using the Wilcoxon test. The Joinpoint Regression program was used to analyze the trends in demand for each degree during the 7-year period. Results Significant (p < 0.001) increases in demand during the pandemic period were observed in all regions. During the pandemic, medicine, biomedicine, nursing, odontology and pharmacy presented a higher demand in comparison with data collected before the pandemic started. In contrast, this pattern was not confirmed in the following cases: physiotherapy, occupational therapy, podiatry, psychology, social work, human nutrition and dietetics. By regions, Navarra, Asturias, and La Rioja presented the most drastic changes. In regions with the biggest number of universities, such as Catalonia, Andalusia and Madrid, the change observed was smaller.

Abstract 13066: Ten-Year Atherosclerotic Cardiovascular Risk Trajectory Among Women Veterans Diagnosed With Breast, Colorectal, Lung and Thyroid Cancer

Introduction: Despite recognized sex-difference in cardio-oncology, women are understudied due to lack of large and diverse data. The study examined atherosclerotic cardiovascular disease (ASCVD) risk in women veterans with breast, colorectal, lung, and thyroid cancer using Veterans Affairs (VA) national Electronic Health Records (EHR) data. Hypothesis: Elevated ASCVD risk in women with breast, colorectal, lung and thyroid cancer after cancer diagnosis due to accumulated cardiotoxicity induced from cancer therapy. Methods: We retrospectively followed 78,556 women veterans aged 30-79 from 2007 to 2017. We used AHA/ACC ASCVD risk score and VA women CVD risk score to measure ASCVD risk over the study period. Both scores included age, systolic blood pressure (treated/untreated), total cholesterol and HDL-C, smoking status, diabetes, and major depression. The study selected the top four most common cancers among women veterans. Discontinuity regression models were used to estimate trajectories of ASCVD risk at both pre and post cancer periods. Results: Both pre- and post-cancer ASCVD risk in women with breast, colorectal, and lung cancer was significantly elevated compared to the no cancer group, while women with thyroid cancer had lower ASCVD risk during the pre-cancer diagnosis. All women veterans with cancer except colorectal cancer showed premature aging in ASCVD risk after cancer diagnosis (Figure 1). Conclusions: Women cancer survivors are at increased risk of ASCVD not only post-cancer, but also long before their cancer diagnosis. ASCVD risk monitoring and management in women may serve as shared risk reduction and cancer prevention along with heightened cancer screening.

Abstract 13784: Impact of the Variation of Aortomitral Positional Anatomy for the Atrioventricular Conduction Disorder in the Mitral Valve Surgery

Introduction: Advances in cardiac imaging have provided detailed anatomical information, including the variation of the aortic root rotation. This variation affected the distance between membranous septum and right fibrous trigone, that might be synonymous with variation of the conduction system location. However, clinical significance has been unknown. We aimed to analyze the variation of the aorto-mitral position and its relationship of conduction disorder in the mitral valve surgery. Methods: This study included 180 patients underwent simple mitral valve surgery (valve repair: n=159, replacement: n=21). The anatomical variations were classified by preoperative three-dimensional transesophageal echocardiography (3D-TEE), and postoperative occurrence of new conduction disorder was analyzed. Results: As in the image, the variations in the aorto-mitral position were classified into Lateral (14%) or Center appearance (86%) groups, which was further classified to Center (83%), Lateral (14%), or Medial rotation (3%) groups. Atrioventricular conduction disorder was observed as first-degree block (n=24 (13%)) including complete right bundle branch block (n=1 (0.6%)). This disorder newly occurred more in the Lateral appearance compared to the Center (36% vs 10%, p=0.0003). The prolongation of the PR interval (msec) between the pre and postoperative period (ΔPR) was greater in the Lateral appearance than the Center (+17 vs +14, p=0.02). Regarding the aortic root rotation, the conduction disorder occurred in 6%, 27% and 20% patients, and each ΔPR was +2, +16 and +22 of the Center , Lateral , and Medial rotation respectively. Conduction disorder occurred more in the Lateral rotation than the Center (p=0.0017), persisting one year after the surgery (19% vs 2%, p=0.0059). Conclusion: The variation of the aorto-mitral position could be classified by 3D-TEE. The Lateral rotation would be a risk of atrioventricular conduction disorder in the mitral valve surgery.

PSV-21 Evaluation of the Effect of Daily Probiotic Administration on the Prevalence of Shiga Toxigenic E.Coli and Select Serum and Immune Parameters During Pre and Peri-Weaning Period in Goat Kids

Abstract Probiotics are microorganisms generally regarded as safe (GRAS) that have a beneficial effect when ingested by a host. While research on the benefits of probiotics in farm animals has mainly concentrated on major livestock species, little is documented on potential benefits in small ruminants. Probiotics in goats and sheep could offer a dual benefit of reducing pathogenic bacteria loads and resulting in improved immunity and overall health. In this study, we evaluated the effect of one-month daily commercial probiotic administration followed by weekly administration until weaning and daily administration for one week after weaning on select serum parameters, and also the prevalence of pathogenic E.coli in healthy pre-weaned goat kids beginning at two days of age. Overall, the general health of the animals in both groups remained the same throughout the study period. No significant difference in total lactic acid bacteria was detected between probiotic supplemented and control group. Probiotic administration generally improved the total serum protein and immune markers. The difference was significant after twenty-eight days of administration and two days after weaning for total serum protein and immune markers, respectively. Shiga toxin E.coli (STEC) was detected in both control and probiotic-treated goats in early life, but no significant differences were detected between treatment groups on prevalence. These results suggest that daily probiotic administration may have some health benefits in pre-weaned goats.