Preliminary Report Research Articles

Does mild chronic obstructive pulmonary disease need a standard pulmonary rehabilitation program? A case report

Background: Patients with mild chronic obstructive pulmonary disease (COPD) are usually not recommended for a standard pulmonary rehabilitation (PR)program based on the GOLD guideline in mild COPD GOLD A classification. Especially, the scientific evidence on exercise capacity that can be identified for recruitment in PR programs has been less reported. Thus, a preliminary case study to identify the exercise capacity under cardiopulmonary responses by aerobic exercise testing among patients in mild COPD GOLD A classification was the aim of this study. Objective: To evaluate the cardiopulmonary responses from exercise capacity testing in individual COPD patients with mild COPD GOLD A Classification. Materials and methods: Four participants with mild COPD GOLD A performed an exercise endurance capacity test at home using Spot Marching Exercise Test (SMT), marching on the spot with high hip and arm raising. The load of SMT was indicated by a controlled stepping rate at 70, 80, 90, 100, and 110 steps/min. Every participant performed Incremental SMT (ISMT) with every 3 min incremental load, and the Constant SMT (CSMT) at the peak load. Both exercise tests were terminated at symptom limit. Resting time between ISMT and CSMT was at least 30 minutes. Cardiopulmonary exercise responses, Borg perceived breathlessness (RPB) and exertion (RPE) were monitored every minute during the exercise test. The duration of exercises was recorded. Results: Peak exercise capacity using ISMT was low with the end exercise load at 70, 80, 80, and 90 steps/min which is equivalent to moderate to high intensity at 81%, 62%, 65% and 93% of age-predicted maximum heart rate (HRmax). The exercise test was stopped by breathlessness at RPB 7, 8, 6, and 5. Respiratory rates (RR) were 36, 26, 38, and 38 breaths/min. With CSMT, the results showed very short exercise duration 1.78, 4.60, 2.15, and 2.47 mins with RPB 7, 8, 5, and 5 and RR of 33, 27, 34, and 41 breaths/min respectively. Conclusion: This preliminary report reveals that all four mild COPD GOLD A show low exercise capacity and very poor exercise endurance that should identify the appropriated standard PR program in the future.

Preliminary report on embolization with quick-soluble gelatin sponge particles for angiographically negative acute gastrointestinal bleeding

Prophylactic embolization is usually performed using gelatin sponge particles, which are absorbed within several weeks, for managing angiographically negative gastrointestinal bleeding. This study aimed to evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) with quick-soluble gelatin sponge particles (QS-GSP) that dissolve in less than 4 h for treating angiographically negative gastrointestinal bleeding. We included ten patients (M:F = 7:3; mean age, 64.3 years) who underwent prophylactic TAE with QS-GSP for angiographically negative acute gastrointestinal bleeding between 2021 and 2023. The technical success rate of TAE, clinical outcomes focusing on rebleeding, and procedure-related complications were evaluated. The embolized arteries were the gastroduodenal (n = 3), jejunal (n = 4), and ileal (n = 3) arteries. QS-GSP (150–350 µm or 350–560 µm) were used alone (n = 8) or in combination with a coil (n = 1). A 100% technical success rate was accomplished. In 1 patient (10%), rebleeding occurred 2 days after prophylactic TAE of the gastroduodenal artery, and this was managed by repeat TAE. There were no procedure-related complications. The use of QS-GSP for prophylactic TAE appears to be safe and effective for controlling bleeding among patients with angiographically negative gastrointestinal bleeding. There were no cases of related ischemic complications of the embolized bowels likely attributable to recanalization of the affected arteries following biodegradation of QS-GSP.

A nasal airflow oscillation device targeting nasal congestion: a preliminary report.

Upper respiratory tract complaints are common in the general population. A safe, non-pharmacologic treatment would be an attractive option for many patients either as an alternative to existing therapies, or as a complementary therapy. This study assessed the acceptability, safety and possible efficacy of a nasal airflow oscillation device in a group of people suffering chronic nasal congestion. Subjects with a known history of nasal congestion, but without fixed anatomical obstruction, participated in a prospective clinical study. Efficacy was assessed using peak nasal inspiratory flow (NPIF) and a 10-point visual analogue scale (VAS) administered before and after the oscillation device had been worn for twenty minutes. Twenty-one subjects (mean age 37years; 43% female) were enrolled in the study. After treatment with the small nasal airflow oscillation device for twenty minutes, average NPIF increased significantly from 84.8 L/minute to 99.0 L/minute (p < 0.05). There was a corresponding significant reduction in the VAS score for nasal congestion (p < 0.05). Similar significant improvements were also seen for the immediate sensation of nasal drainage, sinonasal pressure and overall sinonasal symptoms (p < 0.05). There was no change in the sense of smell (p = 0.37). Subjects rated ease of use highly; average = 9.1 (Range 7-10). Treatment of nasal congestion with the nasal airflow oscillation device was found to result in significant improvement in NPIF after twenty minutes of use. Initial patient-reported outcomes improved significantly, and the treatment was safe and highly acceptable. Public clinical trial registration: Universal Trial Number (U1111-1259-0704). Australian New Zealand clinical trials registration: ACTRN12623001307695.

Video-Assisted Telescope Operating Monitor 3D System in Microsurgical Varicocelectomy: A Preliminary Report.

Video-assisted telescope operating monitor (VITOM®) with 3D Visualization technology was developed and has been used with favorable results by several surgical specialties. Our study aims to be a preliminary report for initial experience using the VITOM® 3D system for microsurgical varicocelectomy on varicocele patients. We performed 35 microsurgical varicocelectomy procedures using the VITOM® 3D system on varying types and grades of varicoceles. The surgeon had the option of using either a 2.5 or 3.5 magnifying loupe in addition to the exoscope for each operation evaluated. The exoscope is a standalone camera head with an integrated 3D telescope and remote control with zoom and focus functions. It is connected to the 3D monitor via a mechanical holding arm. During the procedure, surgeons, assistants, and observers were able to view the 3D high-definition stream displayed on a 26-inch 3D monitor at a convenient viewing angle and distance. The varicocele ligation was performed using a Carl Zeiss Meditec AG microscope. There were 35 patients with varicocele aged 31.51years old on average, which were included in this report. Most patients had grade 3 bilateral varicocele (n = 13, 37.1%). All procedures were performed without any intraoperative complications. After the procedures, only a few patients suffered from postoperative complications. Three patients suffered scrotal edema (8.6%), while another had hydrocele (2.9%). The postoperative pain results were also very minimal from .89 1day after the operation to .26 3days after the operation. The VITOM® 3D system showed promise in microsurgical varicocelectomy.

Metatarsal lengthening by distraction osteogenesis for brachymetatarsia in paediatric patients: is it safe and effective?

The primary aim is to assess the efficacy of the surgical callus distraction technique of the metatarsus in paediatric patients. Secondary objectives are to assess complications and treatment duration. We have also described the details of our surgical technique. A case series review of paediatric patients who had metatarsal lengthening at our unit between 2014 and 2022. Patient demographics, duration of time in frame, complications and metatarsal length achieved were recorded. The AOFAS Midfoot and the MOXFQ were taken pre-operatively and at final follow-up. Sixteen metatarsals in 8 patients (14 feet) underwent lengthening between 2014 and 2022 using the MiniRail OrthoFix 100 (Orthofix Medical Inc, Lewisville, TX, USA). The mean age was 13.3 (12-17) years. The average duration between surgery and implant removal was 5.2months. According to Paley's classification, there was one obstacle encountered in a patient who required a revision of their osteotomy and one problem in another patient who had an infected metatarsophalangeal joint stabilising k-wire treated with oral antibiotics. The Mean AOFAS Midfoot score improved from 53.10 to 86.40 (p < 0.0001) and the Mean MOXFQ improved from 32.5000 to 12.1250 (p < 0.05); these were statistically significant. Gradual metatarsal lengthening using the MiniRail external fixator is a safe and effective method to treat brachymetatarsia in paediatric patients. This preliminary report describes and supports metatarsal lengthening in appropriate patients. Holistic care in terms of a pre-operative assessment, psychological support and preparation for the extended rehabilitation period are vital.

Altered receptor binding, antibody evasion and retention of T cell recognition by the SARS-CoV-2 XBB.1.5 spike protein

The XBB.1.5 variant of SARS-CoV-2 has rapidly achieved global dominance and exhibits a high growth advantage over previous variants. Preliminary reports suggest that the success of XBB.1.5 stems from mutations within its spike glycoprotein, causing immune evasion and enhanced receptor binding. We present receptor binding studies that demonstrate retention of binding contacts with the human ACE2 receptor and a striking decrease in binding to mouse ACE2 due to the revertant R493Q mutation. Despite extensive evasion of antibody binding, we highlight a region on the XBB.1.5 spike protein receptor binding domain (RBD) that is recognized by serum antibodies from a donor with hybrid immunity, collected prior to the emergence of the XBB.1.5 variant. T cell assays reveal high frequencies of XBB.1.5 spike-specific CD4+ and CD8+ T cells amongst donors with hybrid immunity, with the CD4+ T cells skewed towards a Th1 cell phenotype and having attenuated effector cytokine secretion as compared to ancestral spike protein-specific cells. Thus, while the XBB.1.5 variant has retained efficient human receptor binding and gained antigenic alterations, it remains susceptible to recognition by T cells induced via vaccination and previous infection.

Living in the Lower Town at Kınık Höyük (Niğde). Preliminary Report on the 2021-2022 Campaigns in Anatolia

Excavations at the site of Kınık Höyük have brought to light over the past twelve years several occupational phases dated to the first Millennium BCE both on the acropolis and in the lower town, especially for the Middle Iron Age and the Hellenistic period. Since 2021 the University of Firenze joined the University of Pavia (Italy), NYU-ISAW (USA) and Dokuz Eylül University in Izmir (Turkey) in the excavations at the site of Kınık Höyük, and since 2022 the same university took over in the management of the project. This article is a preliminary report on recent excavations area D2-3, located in the lower town, where archaeologists could identify six phases of occupation and two large primary contexts dated to the beginning of the Middle Iron Age, that provide new insights on every-day assemblages and inventories produced locally and the architectural and archaeological context they are related to. The most interesting element in terms of urban layout and structure is related to the construction of the massive defensive fortification of the lower town, that seems to be related so far to the earliest occupation of the Iron Age lower town, i.e. possibly at the end of the Early Iron Age. A selection of the materials and a detailed report on deposits and architecture provides the reader with the archaeological data collected mainly in the campaign 2022 and 2021 in the lower town excavations, while a general overview on the urban fortification of the acropolis allows a general picture of the whole settlement defensive system and space organisation.

Preliminary report on therapeutic potential of coal-derived carbon quantum dots against SARS-CoV-2 virus

Due to the pandemic of COVID-19 and subsequent emerging of new mutant strains, there has been a worldwide hunt for therapeutic and protective agents for its inhibition. In this short communication, for the first time, we report the coal-derived carbon quantum dot (CQD) for the possible therapeutic application against SARS-CoV-2. The synthesized C1-CQD is observed to be safe towards the normal cell line at highest dose, while effectively inhibiting growth of SARS-CoV2 (>95%) with IC50 value of 5.469 μg/mL. Moreover, C1-CQD showed activity against SARS-CoV-2 infection which is comparable to known inhibitory antiviral drug i.e., Remdesivir. These novel findings indicate that coal-based CQDs have highly potent anti-viral activity and could be investigated further for developing cheap and safer alternative therapeutic strategies for inhibition of SARS-CoV-2.

Endocannabinoid levels in plasma and neurotransmitters in the brain: a preliminary report on patients with a psychotic disorder and healthy individuals.

Interactions between the endocannabinoid system (ECS) and neurotransmitter systems might mediate the risk of developing a schizophrenia spectrum disorder (SSD). Consequently, we investigated in patients with SSD and healthy controls (HC) the relations between (1) plasma concentrations of two prototypical endocannabinoids (N-arachidonoylethanolamine [anandamide] and 2-arachidonoylglycerol [2-AG]) and (2) striatal dopamine synthesis capacity (DSC), and glutamate and y-aminobutyric acid (GABA) levels in the anterior cingulate cortex (ACC). As anandamide and 2-AG might reduce the activity of these neurotransmitters, we hypothesized negative correlations between their plasma levels and the abovementioned neurotransmitters in both groups. Blood samples were obtained from 18 patients and 16 HC to measure anandamide and 2-AG plasma concentrations. For all subjects, we acquired proton magnetic resonance spectroscopy scans to assess Glx (i.e. glutamate plus glutamine) and GABA + (i.e. GABA plus macromolecules) concentrations in the ACC. Ten patients and 14 HC also underwent [18F]F-DOPA positron emission tomography for assessment of striatal DSC. Multiple linear regression analyses were used to investigate the relations between the outcome measures. A negative association between 2-AG plasma concentration and ACC Glx concentration was found in patients (p = 0.008). We found no evidence of other significant relationships between 2-AG or anandamide plasma concentrations and dopaminergic, glutamatergic, or GABAergic measures in either group. Our preliminary results suggest an association between peripheral 2-AG and ACC Glx levels in patients.

Long-range optical coherence tomography of pediatric airway during drug induced sleep endoscopy: A preliminary report

ObjectiveDrug induced sleep endoscopy (DISE) is often performed for pediatric obstructive sleep apnea (OSA) when initial diagnostic studies do not provide adequate information for therapy. However, DISE scoring is subjective and with limitations. This proof-of-concept study demonstrates the use of a novel long-range optical coherence tomography (LR-OCT) system during DISE of two pediatric patients. MethodsLR-OCT was used to visualize the airway of pediatric patients during DISE. At the conclusion of DISE, the OCT probe was guided in the airway under endoscopic visual guidance, and cross-sectional images were acquired at the four VOTE locations. Data processing involved image resizing and alignment, followed by rendering of three-dimensional (3D) volumetric models of the airways. ResultsTwo patients were included in this study. Patient one had 18.4%, 20.9%, 72.3%, and 97.3% maximal obstruction at velum, oropharynx, tongue base, and epiglottis, while patient two had 40.2%, 41.4%, 8.0%, and 17.5% maximal obstruction at these regions, respectively. Three-dimensional reconstructions of patients’ airways were also constructed from the OCT images. ConclusionThis proof-of-concept study demonstrates the successful evaluation of pediatric airway during DISE using LR-OCT, which accurately identified sites and degrees of obstruction with respective 3D airway reconstruction.

Preliminary report of field reconnaissance on the 6 February 2023 Kahramanmaras Earthquakes in Türkiye

AbstractOn February 6, a successive rupture of major faults in the Eastern Anatolian Fault Zone and Cardak-Surgu fault triggered a strong mainshock (Mw 7.7) and a major aftershock (Mw 7.6) in Kahramanmaras. The successive earthquake sequence hit southern provinces in Türkiye and northern regions in Syria, causing severe fatality and economic loss. After the earthquakes, the International Consortium on Geo-disaster Reduction (ICGdR) organized an investigation team, involving specialists from China, Japan and Türkiye, to conduct a primary field reconnaissance on seismic damage of infrastructure and ground failures. The 10-day reconnaissance, including a mini-symposium at the Istanbul Technical University (ITU), was conducted from 25 March to 3 April and specifically focused on fault ruptures, liquefaction, landslide, rockfall and lateral spreading along the major ruptured faults from Antakya in Hatay to Goksun in Kahramanmaras, passing through provinces of Gaziantep, Adıyaman and Malatya. By this reconnaissance, a large amount of original seismic data was collected and a primary understanding was established for further steps on mitigation and reduction of seismic damages and its secondary geohazards.

The relationship of vitamin D deficiency and childhood diarrhea: a systematic review and meta-analysis

IntroductionVitamin D deficiency may increase the risk of childhood diarrhea. We aim to carry out a review and meta-analysis of the evidence relating vitamin D insufficiency to childhood diarrhea.MethodsWe searched PubMed, Ovid, Scopus, and Cochrane Library (from inception to August 2022), then independently reviewed the eligibility, and read full-text reviews for selected articles. Keywords used were ‘vitamin D’, ’25-hydroxyvitamin D’, ‘vitamin D deficiency’, ‘diarrhea’, ‘gastroenteritis’, ‘children’, and ‘pediatric’. The search was limited to studies only in English and with available full-text. Year limitation was not applied in our search. Unpublished trials, dissertations, preliminary reports, conference abstracts, and repositories were excluded from the study. Newcastle-Ottawa Scale was used as the risk of bias assessment tool. Meta-analysis using the random-effects model was done.ResultsOut of 5,565 articles, 12 articles were included in our systematic review, however only 7 articles were eligible for meta-analysis. Meta-analysis showed a statistically significant association between vitamin D deficiency and diarrhea in children in developing countries (OR = 1.79; 95% CI = 1.15 to 2.80; p = 0.01). On the secondary outcome, the association of vitamin D deficiency and duration or recurrences of diarrhea are conflicting.ConclusionsThere is an association between vitamin D deficiency and the prevalence of diarrhea. Future studies should evaluate the causal association, the impact of vitamin D deficiency on the severity of diarrhea, and whether vitamin D deficiency treatments affects the prevalence of diarrhea.

Routes of Drug Use Among Drug Overdose Deaths - United States, 2020-2022.

Preliminary reports indicate that more than 109,000 drug overdose deaths occurred in the United States in 2022; nearly 70% of these involved synthetic opioids other than methadone, primarily illegally manufactured fentanyl and fentanyl analogs (IMFs). Data from the western United States suggested a transition from injecting heroin to smoking IMFs. CDC analyzed data from the State Unintentional Drug Overdose Reporting System to describe trends in routes of drug use in 27 states and the District of Columbia among overdose deaths that occurred during January 2020-December 2022, overall and by region and drugs detected. From January-June 2020 to July-December 2022, the percentage of overdose deaths with evidence of injection decreased 29.1%, from 22.7% to 16.1%, whereas the percentage with evidence of smoking increased 73.7%, from 13.3% to 23.1%. The number of deaths with evidence of smoking increased 109.1%, from 2,794 to 5,843, and by 2022, smoking was the most commonly documented route of use in overdose deaths. Trends were similar in all U.S. regions. Among deaths with only IMFs detected, the percentage with evidence of injection decreased 41.6%, from 20.9% during January-June 2020 to 12.2% during July-December 2022, whereas the percentage with evidence of smoking increased 78.9%, from 10.9% to 19.5%. Similar trends were observed among deaths with both IMFs and stimulants detected. Strengthening public health and harm reduction services to address overdose risk related to diverse routes of drug use, including smoking and other noninjection routes, might reduce drug overdose deaths.

Preliminary report on ultrashort perioperative partial-breast irradiation with multicatheter interstitial brachytherapy for early-stage breast cancer.

Perioperative partial-breast irradiation (PBI) with multicatheter interstitial brachytherapy (MIB) is less invasive and more convenient than postoperative one. This study aimed to compare ultrashort perioperative MIB-PBI (uPBI) and conventional perioperative MIB-PBI (cPBI) performed during the same period of time. Inclusion criteria of the study were patients aged ≥ 40years and those with T0-2 (≤ 3cm), N0-mi, and negative margins on mammography. The locoregional recurrence (LRR) and toxicity rates were compared between uPBI at a dose of 25.2Gy in four fractions and cPBI at a dose of 32Gy in eight fractions. In total, 198 patients (151 with uPBI and 47 with cPBI) were evaluated. At a median follow-up of 20.1months, one (0.66%) patient in the uPBI group had LRR. The 2-year ipsilateral breast tumor recurrence-free survival rates of the uPBI and cPBI groups were 98.7% and 100%, respectively. The highest toxicity grades were grade 1 in 23 (15.2%) and grade 2 in 2 (1.3%) patients in the uPBI group, and grade 1 in 8 (17.0%) and grade 2 in 1 (2.1%) patient in the cPBI group. None of the patients in the two groups presented with grade 3 and higher toxicities. The toxicity rates between the two groups did not significantly differ. Further, 22 (14.6%) patients in the uPBI group and 8 (17.0%) in the cPBI group, and 3 (2.0%) patients in the uPBI group and 1 (2.1%) in the cPBI had acute and late toxicities, respectively. The timing of toxicity development between the two groups did not significantly differ. Although this preliminary report included a small sample size and had a short follow-up period, the local control and toxicity rates were similar between the uPBI and cPBI groups. Further research is warranted to investigate the ideal dose schedule of MIB-PBI.

Awareness and management practices against rabies among dog owners in livestock farming communities, Plateau State: A preliminary report

Rabies remains a significant public health concern, especially in endemic regions like Africa and Asia, with likely underreported cases.  Primarily transmitted through dog bites, rabies poses a substantial risk in Nigeria, where dogs are the main carriers. This study  investigated rabies awareness and control practices among dog owners in livestock farming communities in Plateau State, Nigeria. This  was done using structured questionnaire interviews with 50 respondents from five Local Government Areas. Data analysis revealed that  78% were aware of rabies, but few recognized its severity. Only 46% knew about rabies vaccination, and merely 16% sought clinical  assistance post-dog bite. Despite relatively high awareness, gaps exist in understanding susceptible hosts, proper management,  prevention, and health-seeking behaviours. Findings underscore the necessity of bolstering awareness and management, including  vaccinations, to encourage effective rabies control measures among vulnerable populations within remote communities and nationwide.  

Preliminary Report on the Influence of Acute Inflammation on Adiponectin Levels in Older Inpatients with Different Nutritional Status.

Inflammation can be triggered by a variety of factors, including pathogens, damaged cells, and toxic compounds. It is a biological response of the immune system, which can be successfully assessed in clinical practice using some molecular substances. Because adiponectin, a hormone released by adipose tissue, influences the development of inflammation, its evaluation as a potential measure of inflammation in clinical practice is justified. In the present contribution, statistical comparison of adiponectin concentration and selected molecular substances recognized in clinical practice as measures of inflammation were utilized to demonstrate whether adipose tissue hormones, as exemplified by adiponectin, have the potential to act as a measure of rapidly changing inflammation when monitoring older hospitalized patients in the course of bacterial infection. The study showed no statistically significant differences in adiponectin levels depending on the rapidly changing inflammatory response in its early stage. Interestingly, the concentration of adiponectin is statistically significantly higher in malnourished patients than in people with normal nutritional levels, assessed based on the MNA. According to the results obtained, adiponectin is not an effective measure of acute inflammation in clinical practice. However, it may serve as a biomarker of malnutrition in senile individuals.

A Preliminary Report on the Late 13th- to Early 14th-Century Bontosikuyu Shipwreck Site, Selayar Island, South Sulawesi, Indonesia: A Case Study for Regional Capacity Building and Research

A Preliminary Report on the Late 13th- to Early 14th-Century Bontosikuyu Shipwreck Site, Selayar Island, South Sulawesi, Indonesia: A Case Study for Regional Capacity Building and Research

Chondrosarcoma of the Alveolar Process of the Mandible Initially Suspected to Be a Periodontal Lesion.

Chondrosarcoma (CS) initially suspected to be a periodontal lesion is atypical and rare. To the best of our knowledge, only six similar cases have been reported so far. A 47-year-old woman presented with a discreet swelling of the alveolar process of the mandible, while adjacent mucosa appeared normal. Upon initial intraoral radiography, a periodontal lesion was suspected by the ordinating dentist. Further radiological evaluations included CBCT, CT, and MRI, which showed a thickening of the supporting bone with ground-glass foci but without visible calcifications. The periodontal space of the affected teeth appeared to be uniformly widened. The destruction of the vestibular and lingual cortex was observed, as well as a discreet periosteal reaction, implying the secondary involvement of these teeth and not the odontogenic nature of the lesion. The lesion was restricted to the alveolar process of the mandible, and the bone marrow was not affected. Upon biopsy, a preliminary histopathology report suggested chondrosarcoma, and the patient underwent surgery. It is important to emphasize the possible malignant nature of atypical lesions in the alveolar bone, especially in cases with the expansion of vestibular and lingual cortical plates. Additionally, postoperative "watch and see" follow-ups may be considered in cases of CS in the jaws.

(121) Utilizing ChatGPT for Urology Trainee Simulation of Peyronie’s Disease Counseling

Abstract Introduction Peyronie’s disease is a medical issue with significant psychological overtones. However, trainee exposure to initial counseling and management can be limited and therefore understanding both the disease state and its psychological effects can be difficult to master. Institutions have incorporated simulation-based education to augment resident skills and knowledge in topics such as transgender health and SICU patient management. The gold standard of assessing trainees in simulated clinical interaction has been objective structured clinical examinations (OSCE). However, novel AI-based technologies like ChatGPT offer a promising alternative for resident education and assessment. ChatGPT, developed by OpenAI, utilizes natural language processing technology to provide human-like responses to open-ended questions posed by users. Preliminary reports have already described its use in training emergency medicine residents in delivering bad news. Objective To simulate a realistic clinical scenario utilizing ChatGPT to improve resident and student confidence in Peyronie’s disease evaluation and treatment, and to assess ChatGPT’s ability to deliver actionable feedback to trainees on both knowledge base and patient interaction compared to evaluation by a sexual medicine specialist. Methods ChatGPT Plus was utilized to roleplay the patient in an initial consultation for Peyronie’s disease. A detailed input was composed to establish the rules of the simulation (Figure 1). ChatGPT was prompted to conduct a final assessment of trainee performance with standardized scales in accuracy, comprehensiveness, and empathy (A, C, E). ChatGPT was prompted to use the 2015 AUA Peyronie’s Disease Diagnosis and Treatment Guidelines when formulating its assessment and feedback. Three trainees with different experience levels performed the simulation. At completion, a fellowship-trained sexual medicine specialist separately graded each trainee’s performance using the same scale. Cohen’s kappa was calculated to assess inter-rater reliability. Results Three urology trainees performed the simulation: a 3rd year medical student, a PGY2 resident, and a PGY4 resident. Trainee performance scores are shown in Table 1. Mean ChatGPT ratings were 8.7, 8.0, and 9.0 (A, C, E), while andrologists ratings were 7.0, 4.7, and 6.3 (A, C, E). Progressive improvement was demonstrated as trainee experience increased. ChatGPT generally rated trainees at higher competency levels than andrologists. Cohen’s kappa was calculated to be -0.125, -0.125, and 0.0 (A, C, E), indicating an overall low level of agreement between ChatGPT and andrologists assessment of trainees. Conclusions Our findings demonstrate that ChatGPT has potential to be a successful tool for urology resident and medical student education on Peyronie’s disease counseling. However, there was disagreement in trainee ratings between ChatGPT and the sexual medicine specialist. ChatGPT provided trainees constructive, actionable feedback referencing current guidelines (Figure 2). When given defined parameters for a clinical scenario, ChatGPT can be effective in designing a realistic standardized patient simulation. However, ChatGPT has not appeared to master the competency and accuracy of that expected from a sexual medicine specialist. Tweaking the initial input can allow for testing competency in various alternative clinical vignettes. Further collection of real-world data is needed to better assess ChatGPT’s rating of the learner’s performance, ideally in conjunction with national/international guidelines. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Fellow, Posterity Health, Coloplast, Hims, Genentech.

A preliminary report on critical antimicrobial resistance in Escherichia coli, Enterococcus faecalis, and Enterococcus faecium strains isolated from healthy dogs in Chile during 2021-2022

Antimicrobial Resistance (AMR) represents one of the main current threats to global public health; where production animals, companion animals, humans, and the environment play a significant role in its dissemination. However, little attention has been given to companion animals as reservoirs and disseminators of relevant antimicrobial resistant bacteria, especially in South American countries such as Chile. For this reason, this research aimed to estimate the prevalence of AMR to different critical antibiotics at a screening level in commensal bacteria such as E. coli and Enterococcus spp., isolated from healthy pet dogs in the Metropolitan Region of Chile, studying their geographical distribution and evaluating associations of phenotypic resistance to different antibiotics. Thus, in E. coli we detected AMR to all critical drugs assessed, including 34.1% to amoxicillin, 20.1% to colistin, 15.7% to enrofloxacin, and 9.2% to cefotaxime. On the other hand, AMR prevalence in E. faecalis was 8.1% for ampicillin and 3.4% for vancomycin; while for E. faecium the AMR prevalence was 19.1% for ampicillin and 10.2% for vancomycin. Additionally, significant differences in prevalence of the different possible AMR were detected according to their geographical distribution, suggesting the existence of various risk factors and stressing the need to establish mitigation measures specific to the differences identified.