Real Word Research Articles

No survival effect of adjuvant chemotherapy in patients with node-negative pancreatic cancer – a target trial emulation study of real word data

No survival effect of adjuvant chemotherapy in patients with node-negative pancreatic cancer – a target trial emulation study of real word data

Dialect-specificity and learners’ L2 perceptual resilience after study abroad

Abstract The present study examined the perception of two regional variants of Spanish (theta /Ɵ/ and zheísmo/sheísmo [ʒ, ʃ]) by nonnative speakers of Spanish with and without study abroad experience. The study’s goals were to determine whether learners who study abroad accept regional variants more frequently than at-home learners, and whether this effect is limited to cues participants are exposed to while abroad. Participants were L1 English speakers asked to determine whether they considered real and nonce word pairs with matching and mismatching regional variants to be instances of the same word. The findings reveal higher acceptance rates of mismatching variants by L2 learners who had studied abroad than of classroom learners but results for specific location of study abroad that suggest learners likely build perceptual resilience while abroad that goes beyond the specific cues they are exposed to.

Development instrument of interdisciplinary thinking skills in science lesson planning (IITSSL)

<span lang="EN-GB">The IITSSL is an interdisciplinary thinking assessment rubrics for science teacher candidates in a science lesson plan. The IITSSL rubric was developed and qualitative evaluated in three phases: rubric design, first and second pilot tests. The qualitative evaluation during three phases with novice-expert interviews was carried out in four science education classes at three different universities. The rubric development result of the IITSSL rubric with dimensions are objective, disciplinary grounding, integration, and critical awareness in a component science lesson plan are learning objectives, instructional activities, and assessments with valid categories of content validity and fair ICC (0.637) reliability. Evidence of novice and expert validity of the IITSSL rubric from the results of interviews with novices and experts, which in general are meaningful according to the values of validity and reliability. The IITSSL rubric with four dimensions and ten criteria as items is very simple, easy to use, and can in fact detect pupils' capacity for interdisciplinary thinking with accuracy and reliability. in science lesson plans in a range of course settings. The science teacher candidates appear to comprehend the importance of interdisciplinary thinking according to their experience of the science lesson plan coursework and the IITSSL rubric. The IITSSL rubric not only measure understanding of interdisciplinary thinking, but is likely to promote a more integrated method of knowledge how science teacher candidates solve real word problems</span>

Cenobamate as add-on therapy for drug resistant epilepsies: effectiveness, drug to drug interactions and neuropsychological impact. What have we learned from real word evidence?

Background: Cenobamate (CNB) is an anti-seizure medication (ASM) approved in 2021 in Europe for adjunctive treatment of focal-onset seizures in adults who were not adequately controlled with at least two previous ASMs. Methods: seizure outcome, treatment-emergent adverse events, neuropsychological profile, and blood levels of CNB and concomitant ASM were analyzed in a real world setting in two different Italian epilepsy centers in the context of CNB early access program. All patients performed a general cognitive evaluation, while 32 patients underwent the administration of a battery of neuropsychological tests at baseline and 6months after CNB treatment. We performed CNB quantification in plasma in 31 patients at different doses in the range of 100-400mg/day (65 measures). Results: we enrolled 54 patients with a median age of 27.9years. The mean follow-up was 10.7months. Most (91%) completed the efficacy analysis. At last follow-up visit, a 69.5% median seizure reduction was registered. Thirty-two patients (59.2%) had a ≥50% reduction of seizures that was ≥75% in 20 (42.0%) cases, whilst 10 (20.2%) patients were seizure-free. The most common adverse events were somnolence (53.1%), dizziness (28.1%) and diplopia (12.5%). The correlation between CNB dose and plasma concentration, revealed a significant linear correlation (r = 0.86, p < 0.0001), and there was a significant difference in mean plasma concentration/dose administered ratio (C/D ratio) between patients taking or not at least one inducer (0.10 ± 0.04 [(μg/mL)/(mg/day)]; n = 47 vs. 0.13 ± 0.05 [(μg/mL)/(mg/day)]; n = 18, p = 0.04). CNB dose was inversely correlated (r = -0.31, p = 0.02) to the C/D ratio of Carbamazepine blood levels. and positively correlated (r = 0.74, p < 0.0001) with an increased plasma concentration of the active Clobazam metabolite N-desmethylclobazam. General Anxiety Disorder-7 showed a significant improvement of score from baseline evaluation of 6.82 to follow-up 6months evaluation of 4.53 (p = 0.03). Conclusion: In this real-world study, we registered a clinically meaningful reduction in seizure frequency after CNB administration in most patients along with a good tolerability profile. CNB treatment is correlate to a reduction in symptom severity of anxiety score. Plasma levels measurements confirm that CNB acts both as "victim" and as "perpetrator" of drug-drug interactions.

SPSRec: An Efficient Signal Phase Recommendation for Signalized Intersections With GAN and Decision-Tree Model

Signal phase optimization at signalized intersection is of great importance to urban traffic control and management yet is very challenging. The traditional approaches for signal phase optimization heavily rely on the traffic engineering practitioners’ experience. To tackle these challenges, a novel data-driven method is proposed to realize signal phase optimization and recommendation solely using limited amount of real signalized intersection samples. Firstly, all of discrete features related to signal phase design, encoded by one-hot representation, are sampled by the Gumbel-SoftMax distribution, which is a continuous approximation to a multinomial distribution. With this approximation distribution, the generative adversarial network (GAN) is applied to produce the most acceptable signal phase samples among all acceptable choices, dealing with the problem of insufficient samples and uneven sample distribution in real word. Thirdly, a decision-tree based classifier is established to realize signal phase recommendation automatically. We conducted extensive experiments to evaluate our proposed method on three cities in China, including Beijing, Tongxiang and Chaozhou. The experimental results showed that the proposed method could effectively improve the signalized intersection operation efficiency. Moreover, the proposed method has already been deployed in several cities, and it successfully keeps serving hundreds of signalized intersections. This confirms that SPSRec is a practical and robust solution for large-scale real-world signal control services.

Semaglutide for patients with severe obesity: characteristics of a real word cohort and early effect on weight after 6 months

Semaglutide for patients with severe obesity: characteristics of a real word cohort and early effect on weight after 6 months

Safety and Efficacy of Flumatinib in Patients with Chronic Myeloid Leukemia Resistant or Intolerant to Imatinib

INTRODUCTION:Flumatinib mesylate is a derivative of imatinib and has higher selectivity and potency toward BCR::ABL1 kinase compared with imatinib. Flumatinib was approved patients with newly diagnosed CML-CP in China. We analysed the efficiency and safety of flumatinib in CML patients resistant or intolerant to Imatinib in the real word. METHODS:164 adult CML-CP patientsrecieved flumatinib as 2nd line therapy after imatinib were collected from 18 centers in china. The primary outcome was to demonstrate the probabilities of responses including complete hematologic response (CHR), cytogenetic response, and molecular response (MR) after the later line of flumatinib. The secondary outcome was to assess adverse events (AEs). The diagnosis and response evaluation were defined according to the European Leukemian Net 2020 recommendations. The side effect were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0. Results: 164 patients with CML-CP with a median age of 51 (range: 17-87) years were included, 95(57.9%) males. The medium interval from imatinib to flumatinib was 13.2(1-185) months. The median dosage of flumatinib was 600 mg/day. 127 patients had ELTS information with 84 (66.1%), 30 (23.6%), 13 (10.2%) patients in low-, medium-, and high risk groups, respectively. ABL mutations were detected in 144 patients before initiating flumatinib, 5 (3.5%) patients had ABL mutations with 1 patient each showing E279K, E459K, M351T mutation; and 2 patients had F317L mutation. I 56 (34.1%) patients had optimal response but intolerant to imatinib, whereas 43 (26.2%), 65 (39.5%) patients had suboptimal or failure response to imatinib. The median duration of flumatinib treatment was 10.9 (2-25.46) months. Discontinuation of flumatinib treatment was observed in 17 (11%) patients, with a median treatment duration of 8.8 (2-25.46) months. The probabilities of CHR, CCyR/MR 2, MMR, and MR4 or better at baseline and after flumatinib therapy have been represented in Table 1. The patients without evaluable data were considered without response. The rate of CHR, CCyR/MR 2, MMR and MR4 or better were 86% (141/164), 48.2% (79/164), 15.2% (25/164) and 7.9% (13/164) at baseline increased to 97.6% (160/164). 81.1% (133/164), 65.2% (107/164), 34.8% (57/164) respectively during flumatinib treatment. The probabilities of response from CHR to MR after flumatinib therapy were analyzed based on clinical parameters. The gender, age, and ELTS score at diagnosis had no influence on the response to flumatinib, whereas the response to imatinib, the interval from imatinib to flumatinib, transcript levels at baseline were associated with the response to flumatinib. Patients who were intolerant to imatinib had higher rates achieving CCyR/MR 2, MMR, and DMR when compared with those with warning or failure response to imatinib. The median time to CCyR/MR 2, MMR, and DMR was 3.7 months, 4.7 months, and 15 months in intolerant patients; 3.8 months, 7.5 months, and not reached in warning patients; 7.1 months, 8.7 months, and not reached in failure patients, respectively. The patients with transcript ≤10% at baseline showed a higher probability of achieving CCyR/MR 2 and MMR as compared with those with transcript &amp;gt;10% at baseline, while the probabilities to achieve DMR were similar in both groups. The patients switched to flumatinib within 6 months and without CCyR/MR2 at baseline had a higher probability and shorter medium time of achieving CCyR (85.3% vs 51%, 3.3 vs 9.9months). The patient with E279Km and resistant to imatinib achieved MMR with flumatinib treatment. 1 patient with F317Lm achieved MR4. The patient with M351Tm received flumatinib for 4.5 months and with decreasing transcript level, 1 patient with E459Km received flumatinib for 4 months and maintained CHR with stable BCR::ABL transcript levels. 27 patients had hematological toxicities during exposure to Flumatinib. Most nonhematological AEs were grade ≤2, and only 2 patients showed grade ≥3 diarrhea. The major flumatinib-related nonhematological AEs included gastrointestinal AEs ( n = 29), rash ( n = 9), and creatinine elevation ( n =7). conclusion：This retrospective study had suggested promising effects of flumatinib, which showed induced high rates of CCyR and MMR or DMR in patients resistant or intolerant to imatinib. The incidence of AEs during flumatinib treatment was tolerable.

Impact of Response to Systemic Bridging Therapy on Clinical Outcomes and Cytokine Profiles in Patients Receiving CD19- CAR T-Cell Therapy for B-Cell Lymphoma

Background: Prior studies have reported that deeper response to bridging therapy (BT) before CAR T cell therapy is associated with improved outcomes in large B cell lymphoma (LBCL) and mantle cell lymphoma (MCL). We report the impact of response to systemic BT on clinical outcomes and cytokine profiles of patients (pts) with LBCL and MCL treated with CD19 CAR-T in the real word setting. Methods: We included pts with LBCL and MCL treated with systemic BT before receiving commercial CD19-CAR-T at two academic centers, and excluded those who received glucocorticosteroids alone. BT was classified as Polatuzumab (pola) based, intensive chemotherapy, lenalidomide/ Bruton tyrosine kinases inhibitors (len/BTKi), or others. PET/CT scans obtained before and after BT, and after CAR-T therapy were evaluated using Lugano 2014 response criteria. Association between BT and response rates (RR) were examined using Fisher's exact test, and the associations with cytokine levels were examined using Kruskal Wallis tests. The Kaplan Meier method was used to estimate overall (OS) and progression free survival (PFS) from time of CAR T infusion. Cox proportional hazards models were used for univariable and multivariable analyses. Results: We identified 182 pts (166 with LBCL and 16 pts with MCL),whose median age was 66 (range 23-86). Majority of pts (66%) were male. 35 (21%) had central nervous system (CNS) involvement. BTs included: 75 (41%) pola-based, 58 (32%) intensive chemotherapy, 35 (32%) len/BTKi, and 14 (8%) other BT. 9 (5%) pts received ISRT in combination with systemic BT. Among all pts, 86 (47%) received Axicel, 49 (27%) Tisacel, 36 (20%) Lisocel and, 11 (6%) Brexucel. Median time from apheresis to CAR-T was 38 days (IQR 25-44). RR to BT were:14 (8%) complete responses (CR), 51 (31%) partial responses (PR), 100 (61%) either stable disease (SD) or progressive disease (PD), and 17 were unevaluable. RR did not differ among different BT regimens (p=0.92). At day 100 post-CAR-T, RR were: 96 (55%) CR, PR 29 (17%) and 48 (27%) SD/PD. With a median follow up of 15.5 months, median PFS was 6.2 months (95% CI: 3.5-9.5) (Figure 1A) and median (OS) was 16 months (95% CI 12-31). In multivariable analysis, poor response to BT (SD/PD) and elevated LDH prior to CAR-T infusion were associated with worse OS. LDH, ferritin, IL-6, TNF-alfa and CRP (Figure 1B) measured prior to lymphodepletion(LD) and at day 0 of CAR-T infusion were significantly higher in pts with SD/PD compared to pts achieving a CR/PR to BT. Ferritin levels prior to LD were higher in pts receiving intensive chemotherapy compared to other BT Conclusions: Our findings suggest that achieving a response to BT is associated with reduced tumor burden and inflammatory markers pre-LD, reflecting inherent disease biology and treatment-refractoriness. Further studies are required to evaluate which BT strategies may optimize the inflammatory cytokine environment for improved outcomes after CD19 CAR T cell therapy.

Real Word Data on Levels of Emicizumab and Their Correspondence with the Global Hemostatic Capacity and the Spontaneous Joint Bleeding in Patients on Emicizumab Prophylaxis

Introduction: Emicizumab has improved the management of patients with hemophilia A. However, few real-world data are available on drug plasma levels and their correspondence with global hemostatic capacity (GHC) and annualized spontaneous joint bleeding rate (ASJBR). Aims: Evaluation of the correlation between emicizumab plasma levels, GHC and ASJBR in patients on emicizumab prophylaxis. Methods: Multicenter, observational and cross-sectional study was performed in 4 Spanish hospitals. Emicizumab plasma levels and thrombin generation capacity (TGT, Genesia ®, Stago ®) of patients on emicizumab prophylaxis were determined in a central laboratory. Kinetics of clot formation was evaluated by rotational thromboelastometry (ROTEM ®, naTEM ® test, Werfen ®) in one center. Time on emicizumab prophylaxis and the number of spontaneous joint bleeds (SJB) was collected retrospectively using the clinical history. Results are expressed as median (25 th-75 th percentiles) or mean ± standard deviation depending on data distribution. A p-value &amp;lt; 0.05 was considered statistically significant. Results: Twenty-eight patients were included: 18 aged ≥12 years (age= 20.1 [14.7-38.9] years old) (group 1) and 10 patients aged &amp;lt;12 years (age= 6.1 [3.2-8.9] years old) (group 2) (p&amp;lt; 0.001). Globally, emicizumab levels were 46.3 ± 11.9 mcg/mL and similar between both groups: 45.2 ± 13.1 mcg/mL (group 1) and 45.9 ± 7.3 mcg/mL (group 2) (p=0.870) (Figure 1). No correlation was detected between emicizumab levels and TGT or ROTEM ®. Compared with healthy controls, patients presented lower values of thrombin generation: Peak (% compared to controls) = 41.4 (33.3-53.0) % and endogenous thrombin potential (ETP%) = 54.9 (38.9-73.4) %. However, on the contrary, ROTEM ® showed a similar procoagulant profile (example: CT and CT+CFT; p&amp;gt;0.05) or even higher (example: lower CFT values in patients; p= 0.023) compared to healthy subjects (Table 1). Throughout a follow-up period of 57.0 (32.3-102.3) weeks, none of the patients presented SJB (ASJBR =0). Conclusions: Emicizumab treatment provided excellent protection to patients throughout the study period. The wide interpatient variation on emicizumab plasma levels does not appear to have an impact on the development of SJB. TGT and ROTEM ® showed contradictory results: TGT describes lower thrombin generation capacity in patients compared to healthy controls, while ROTEM ® showed a similar or even higher procoagulant function in patients. Additional studies are required to explain these findings and their clinical significance.

Calcified coronary left main disease treated with and without intravascular lithotripsy: a real word first description

Abstract Background Intravascular lithotripsy (IVL) is a promising balloon-based technique to treat calcified coronary lesions. The evidence of its use in LM disease is scarce and there are no studies reporting a comparison between IVL and conventional techniques for calcified lesions, especially in LM PCI that represented an exclusion criteria of the DISRUPT-CAD trials. Methods The aim of this study is to evaluate safety and efficacy of IVL to treat moderate-severe calcified LM disease from January 2018 to December 2022. We stratified our cohort into two groups 1) patients who underwent LM PCI with IVL treatment (bail-out or upfront) and 2) LM PCI with conventional techniques excluding IVL (cutting balloons, NC/OPN balloons, rotational atherectomy). Efficacy endpoint: device success and stent expansion evaluated either by intravascular imaging or angiographic criteria. Safety endpoint: peri-procedural complications (coronary dissection, perforation, no-slow flow, peri-procedural MI, pericardial effusion) and in hospital death or target vessel failure. Results 87 patients were enrolled, 43 (49.4%) underwent LM PCI with IVL (group A), while 44 (50.6%) were treated with conventional techniques (35 NC balloons, 7 RA, 2 cutting balloons). Intravascular imaging was performed in 69% of cases, the 2 groups were similar in terms of age (77.4±9.63, p=0.94), comorbidity, clinical presentation and angiographic characteristics. Both groups presented severe calcifications in terms of calcium length (11.9±10.3, p=0.87), arc (270° 144-350, p = 0.76, and thickness (1.3 ±0.7 p =0.99) assessed by intravascular imaging. IVUS calcium score was similar between 2 groups (1.53±0.7, p = 0.7). Target vessel was distal LM-proximal LAD in 56.6%. IVL most used balloon was 3.5mm (55%), followed by 4.00mm (38.2%). Impella CP was implanted to support 4 PCI and removed at the end of the procedure. Provisional stenting was performed in 55.1% of cases, while two-stents technique was used in 26.4% (mainly represented by DK-crush). Good stent expansion (&amp;gt;80%) was achieved in 85% of cases, with a certain prevalence for patients treated with IVL. Optimal stent expansion (&amp;gt;90%) was higher in patients treated with IVL (9 in group A vs 3 in group B), although it did not reach a statistically significative difference (p=0.06). No differences in terms of complications and peri-procedural myocardial infarction occurred between the two groups. Conclusions This is the first description of a comparison between IVL and conventional techniques in LM calcified PCI. IVL appeared to be safe and effective with good stent expansion and low rate of peri-procedural complications and in-hospital MACE. LM lesions treated with IVL appeared to reach greater stent expansion compared to other techniques, although it was not statistically significative. Certainly, further trials are warranted to establish longer term outcomes and the benefit of IVL over existing calcium-modification therapies.

Cardiological hypertensive emergencies: real word data compared to guidelines indications

Abstract Background The 2018 ESH guidelines have revised the therapeutic goals of cardiological Hypertensive Emergencies (HE) with an indication for a more intensive (target &amp;lt; 140/90 mmHg) and rapid (immediate) Blood Pressure (BP) reduction. Cardiac acute organ damage during HE includes acute myocardial infarction, pulmonary edema, unstable angina pectoris and aortic dissection. However, how much these indications have been applied in clinical practice to date it’s unknown. Aims The first purpose of our study is to analyze the prevalence and clinical characteristics of cardiological HE in our institution. The second purpose is to compare the year before the release of the 2018 guidelines (2017) with the subsequent years (2019) trying to verify adherence to guidelines. Methods This is a single-center retrospective study conducted at a hospital. All patients aged ≥ 18 years with Systolic BP≥ 180 mmHg and/or a Diastolic BP ≥ 120 mmHg with Cardiological Emergency were enrolled. From the Emergency Department (ED) data clinical, anamnestic, blood pressure, symptoms, drug treatment and target achievement were registered. Results Patients with BP &amp;gt; 180/120 mmHg in 2017 were 706 out of a total of 73795 accesses (0.96%) and 601 over 67273 (0.89%) in 2019. 246 (34.84%) in 2017 were HE of which 144 (58.53%) were cardiological: aortic dissection 1 (0.69%), acute coronary syndrome 52 (36.11%), acute pulmonary edema 35 (24.30%), cardiac decompensation 91 (63.19%). During 2019 similar figures were founded with 286 (47.58%) HE of which 286 (47.58%) were cardiological: aortic dissection 2 (1.43%), acute coronary syndrome 43 (30.93%), acute pulmonary edema 20 (14.39%), cardiac decompensation 76 (54.68%). The reduction in BP obtained in ED was significantly greater in 2017 than in 2019 (44.7±31.4 vs 35.4±24.5 mmHg, p = 0.011) with a lower target reaching in 2019 (28.9 vs 51.4%, p&amp;lt;0.001). Pulmonary edema is the cardiological HE on which a greater pressure reduction is obtained and therefore in which the target set by the guidelines is more frequently reached. Conclusions The recommendation for a more intense and rapid BP reduction in cardiological HE seems to be not accepted from ED clinicians that persist to reduce BP accordingly to previous guidelines.

The The Influence of Mind Mapping Model towardsthe Result on Economical Lesson for Tenth Grade Islamic Senior High School in MAN 2 Kutai Kartanegara

The study examines the use of mind mapping model and its result in Economical lesson for tenth grade Islamic Senior High School in MAN 2 Kutai Kartanegara that involves two classes consisting of 35 male and 43 female students. This study uses experimental research by using post-test only control group design as the method. The data collection technique is used by using documentation, interview with the teacher who teaches Economical lesson, test, and questionnaire of the students’ respond. The technique of analyzing the data by using t-test to examine the hypothesis. The results of the study show that the implementation of using mind mapping as a leaning model is running well. The student from experimental class, X-IPS 1 or social studies class 1shows the significant changes and conventional class, X-IPS 2 social studies class 2 shows not really the significant changes. But, from these two classes together show development from how they study, their interests in learning Economical lesson, they become active, creative, and critical student especially their result in score to pass the standard lesson value in Economic is 75 in their school. Based on the research, the average score of the first post-test shows 98,5 in experimental class and 87,64 in conventional class. In the second post-test, the averagescore in experimental class having more significant difference until 10,86. Then, the average score for both two post-test in experimental class is 86,91 and conventional class is 82,07. From ten questions of questionnaire are reached each questions get 70% for the statement of agreement in using mind mapping as learning model to understand and learn Economical lesson. The analyzed of the data by using t-test shows tcount equals 5,931 and ttable equals 5%, and the percent of the freedom (dk) equals 76 or 1,991. Because tcount is bigger than ttable, means the use of mind mapping to increase the result of the students’ learning for economical lesson is accepted and revealed. The use of using mind mapping is also expected to solve the lower student speed in learning a certain lesson, the student to learn other lessons to increase their understanding, and the student and teacher are able to have good interaction and bounding to prepare them in facing the real word especially that links with Economy.

P225 - A real word study of avelumab first-line maintenance in advanced urothelial carcinoma

P225 - A real word study of avelumab first-line maintenance in advanced urothelial carcinoma

Targeted Therapy in Rheumatoid-Arthritis-Related Interstitial Lung Disease.

Rheumatoid arthritis (RA) is a chronic autoimmune multisystem inflammatory disease in which lung involvement is the most common extra-articular manifestation. Parenchymal lung involvement or interstitial lung disease (ILD) is a significant cause of morbidity and mortality and there is a paucity of evidence-based guidance on how to best treat RA-ILD. This review article aims to evaluate the evidence from cohort studies and best real word data from registries. Extensive discussion of the relative merits and drawbacks of glucocorticoids, various biologics, small molecules and anti-fibrotics is presented. The limited available guidelines in RA-ILD are also discussed and a rational treatment algorithm is offered.

The effect of real word stimuli versus non-word stimuli on oral diadochokinetic rates across the life span: An item discrimination analysis.

Diadochokinetic (DDK) rate tasks are extensively used in the evaluation of speech disorders; however, it is unclear how the different types of speech stimuli affect DDK rate performance. To investigate the effect of age, gender and type of stimuli (non-words versus real words) on the DDK rates in individuals across the lifespan and to provide normative data for Greek. Also to examine the discrimination ability of the speech DDK stimuli administered (non-words and real words) based on a dual DDK assessment protocol using a polytomous item response theory (IRT) model. The participants were 1747 monolingual Greek speakers (376 children, aged 4-17 years; and 1371 adults, aged 18-90+ years). All participants had normal hearing acuity which allowed them to understand and follow instructions. Participants with a medical condition or a language disorder which would affect DDK rate performance were excluded from the study. The time-by-count method was used, and all participants had to repeat as accurately and fast as possible: (1) four disyllabic non-words (/'gaba/, /'taka/, /'kata/, /'baga/), (2) four disyllabic real words (/'kapa/, /'tapa/, /ka'la/, /'paka/) and (3) two trisyllabic non-words (/'pataka/, /'badaga/). All responses were recorded and the speech samples that did not include at least 5 s of correct repetitions were excluded from the analysis. Age affected significantly DDK rates with performance increasing gradually until approximately the age of 40 and then gradually decreasing. Gender had no effect. Overall, there was a significant advantage of disyllabic real word stimuli over disyllabic non-word stimuli and of trisyllabic non-word stimuli over disyllabic non-word stimuli on DDK rates performance. IRT analysis suggested that the data fit the polytomous model reasonably well and all DDK stimuli (real words and non-words) showed a strong relationship (loadings > 0.50) with the latent trait. The current study complements prior research which supports that age and type of stimuli significantly affect DDK rates performance. It is the first study, that testifies to the benefit of real-word stimuli over non-word stimuli on DDK rates across the lifespan in a large representative sample. The implementation of IRT analysis provides empirical evidence about the discrimination ability of the DDK stimuli administered and confirms the reliability of this dual DDK assessment protocol. These findings are valuable for clinicians who work with motor speech disorders. What is already known on this subject Age, type of stimuli (real words versus non-words) and language significantly affect DDK rates performance. Current research strongly suggests the administration of language-specific norms since language-dependent features seem to have a noteworthy effect on the DDK rates, but scarce evidence exists about the discriminatory ability of the DDK speech stimuli commonly administered. What this study adds to the existing knowledge Conflicting findings have been reported about the effect of different types of DDK speech stimuli (real words and non-words) but no study to date has evaluated their discriminatory abilities. The current study is the first to implement a polytomous IRT model to examine this issue. This is also the first study to attempt an investigation of the effect of types of stimuli (real words versus non-words) on a large representative sample across the lifespan (4-90+ years) and to provide normative data for Greek. What are the practical and clinical implications of this work? The present study offers concrete evidence about the advantage of real-word stimuli over non-word stimuli in Greek, as well as normative data for the Greek-speaking populations. Moreover, the IRT analysis testifies to the discriminatory ability of real-word and non-word stimuli affirming the reliability of the present dual DDK assessment protocol as a psychometrically sound measure of DDK ability. The above has significant value for clinicians who work with individuals with motor speech disorders as the protocol can help them with the diagnosis and differential diagnosis of motor speech disorders.

FRI060 Real World Experience Of Weight Management In Low Socioeconomic Community Clinic

Abstract Disclosure: B.A. West: None. S. Mon: None. Pilot Study: Real-world experience of weight management in low socioeconomic community clinic Introduction: Management of obesity and unhealthy behaviors is an essential step in patients with Prediabetes and T2DM, particularly those with socioeconomic status (SES) in whom obesity is more prevalent. While several behavior interventions targeting obesity exist, a successful adaptation of interventions in routine care is challenging especially in those with low SES. We examined the real word experience of weight loss management in our community clinic. Method: Retrospective chart review of consecutive patients seen in an endocrinology clinic at a hospital-based community clinic. Result: A total of 23 female patients, average age 48.4 ± 10.8 years, with average BMI 37.4 ± 6.9 kg/m2, were provided comprehensive lifestyle counseling focusing on nutrition, exercise, sleep health at each visits along with semaglutide at the highest tolerable dose of 2.4 mg/dl weekly. Within 6 months from the initiation of semaglutide and the weight loss intervention, 11/23 (48%) patients lost weight by &amp;gt;5% from their baseline visit, and 17/20 (85%) patients at the end of 1 year. 12/20 (60%) and 6/20 (30%) lost weight at least by 10% and 15% respectively at the end of 1 year. Compared to the baseline data, weight ( 101.2±18.4) kg, SBP 127.6 ± 13.4 mmHg, HbA1C 6.0 ± 1.1 mg/dL, Total Cholesterol 182.1 ± 40.4 mg/dL, LDL 102.4 ± 35.8 mg/dL, most parameters were improved at the end of 6 and 12 months respectively: weight 91.0± 18.6 vs 88.4± 16.2 kg, SBP 125.2± 16.8 vs. 126.9± 15.6 mmHg, HbA1C 5.8 ± 1.2 vs 6.3 ± 1.4 mg/dl, Total cholesterol 178.9± 33.1 vs 175.0 ± 50.7mg/dl, LDL 100.4± 27.7 vs 101.8± 47.7 mg/dL. Conclusion: This real-world implementation study reported the benefits of weight loss and other clinical parameters after the intervention consisting of a combined health behavior counseling and use of semaglutide at the low-SES community clinic. Presentation: Friday, June 16, 2023

The effect of unisensory and multisensory information on lexical decision and free recall in young and older adults

Studies using simple low-level stimuli show that multisensory stimuli lead to greater improvements in processing speed for older adults than young adults. However, there is insufficient evidence to explain how these benefits influence performance for more complex processes such as judgement and memory tasks. This study examined how presenting stimuli in multiple sensory modalities (audio–visual) instead of one (audio-only or visual-only) may help older adults to improve their memory and cognitive processing compared to young adults. Young and older adults completed lexical decision (real word vs. pseudoword judgement) and word recall tasks, either independently, or in combination (dual-task), with and without perceptual noise. Older adults were better able to remember words when encoding independently. In contrast, young adults were better able to remember words when encoding in combination with lexical decisions. Both young and older adults had better word recall in the audio–visual condition compared with the audio-only condition. The findings indicate significant age differences when dealing with multiple tasks during encoding. Crucially, there is no greater multisensory benefit for older adults compared to young adults in more complex processes, rather multisensory stimuli can be useful in enhancing cognitive performance for both young and older adults.

The development of speech output processing skills in Greek-speaking children

ABSTRACT There is a growing body of literature on phonological development in Greek-speaking children, either typically developing (TD) or with speech sound disorders (SSD). In this paper, a cross-sectional longitudinal approach was used to investigate the development of speech output processing skills in TD Greek-speaking preschool-aged children. Moreover, a group of Greek-speaking children with SSD were assessed to identify potential loci of impairment in atypical development. The developmental study involved two groups: group 1 (n = 16) aged 3;0–3;5 years and group 2 (n = 22) aged 4;6–5;0 years, assessed at three assessment points six months apart. Children with SSD (n = 15) aged 5;6–6;0 years were assessed to be compared with performance of group 2 TD children (at the third assessment point). Assessment tasks included (a) a picture naming task, (b) a task of real word repetition and (c) a task of nonword repetition. A strong time effect was found in both groups of TD children in the development of speech output processing abilities. Performance accuracy was higher on tasks including real words than nonwords; children performed more accurately on repetition rather than spontaneous naming of real words; repetition accuracy on 2–3 syllables items was significantly better than on 4–5 syllables items. Children with SSD were outperformed by TD children of the same age in all assessment tasks; lexicality and word length effect were found in the clinical group. Findings from the present study may be used as a starting point to diagnose children with speech production difficulties in Greece.

Traffic Flow Pattern Based Approach to Predict Real Driving Emission Test Routes

Due to the poor representation of NEDC emission test, the European Commission put into the force a new procedure, which contains both a laboratory test and a real word driving test. In this new test procedure, even though WLTC replaces NEDC, it is required to test the vehicle under real traffic conditions, which contains urban, rural and highway segments. Due to the new emission regulation, considerable number of academic work focus on the creation of RDE (Real Driving Emission) routes and RDE tests. In this study, it is introduced a new methodology for creating potential RDE routes. The routes, created in MATLAB code by using Istanbul road data containing a half an hour average trip records were used to predict a probable RDE test road. This model creates a number of RDE routes starting from defined coordinates and then analyses all alternative routes with respect to traffic flow rate and RDE boundary conditions identified by the European Commission. The routes obtained using the methodology developed are tested in real life conditions and evaluated according to actual existing traffic conditions. The agreement between the results of the method and the results of the actual driving test is limited in urban road section. However, for rural and highway road sections, there is a significant agreement between the predictions and actual test results.

Design of An Interactive Module for Historical Building Learning Using Board Game Puzzle Based On Multi-Marker Augmented Reality

Augmented Reality (AR) technology is one of the new technologies that can display the virtual world into the real word. Augmented reality technology is widely applied into the educational field to help the learning process by representating an object in more realistic and detailed way. However, most of the implementations that carried out only using AR to show up an object from a single marker, even though there are still many ways on using AR functions to represent an information in more detailed and intersting ways. This study aims to develop a learning media to introduce histrorical building spesifically Indonesian Temple’s using multi-marker augmented reality. This study used ADDIE Model to develop suitable media for learning process. Based on the results of expert testing, the developed media obtained an avarage score 3,76 for media evaluation and 3,84 for material evaluation, which means the developed media was very feasible as a learning medium. Therefore, through this research we expect to provide a recommendation for AR application models using multi-marker AR method, futhermore the modules developed are intended to become information resource and learning material about historical building especially temples in Indonesia.