Requests For Information Research Articles

KONSEP FILOSOFIS BHANCAK TAUN SEBAGAI RELASAI ANTARA MASYARAKAT DAYAK SUAID DENGAN DWATA

This research focuses on exploring the philosophical concept of Bhancak Taun as a relationship between the Dayak Suiad community and Dwata. Each tribe has its own way of expressing its beliefs. This can be seen in the lives of the Dayak Suiad people who make Bhancak Taun a medium for establishing relationships with Dwata, the Ruler of the universe. Bhancak Taun is one of the rituals or traditional ceremonies of the Dayak Suaid community which is held every year. Bhancak Taun is a form of recognition by the Dayak Suiad community that Dwata's existence is real and influential in their lives. This research aims to explore the concept of Bhancak Taun as a relationship between the Dayak Suaid community and Dwata. The method used in this research is a qualitative method through literature study and interviews. This research found that Bhancak Taun has a deep philosophical concept. The philosophical concept is found in the expression of gratitude of the Suaid Dayak community to Dwata for all the gifts that have been given and a form of request from the Suaid Dayak community to avoid various disasters. Apart from being a traditional ceremony, Bhancak Taun is also a norm of life that regulates the Suaid Dayak community to maintain the balance of the universe. Therefore, the role of Bhancak Taun is very central to the life of the Suaid Dayak community. Bhancak Taun brings awareness, so that you always see the goodness of Dwata and a reminder to preserve the universe.

Sources of Banks' Obligation to Provide Financial Credit Information in Accordance with Jordanian Legislation, as an Exception to the Principle of Bank Secrecy

Objective: The research aims to show the nature of the bank's obligation to provide this information and whether the sources of this obligation are either contractual or legal
 
 Method: The research followed the descriptive and analytical approach in preparing the research to learn about the texts of the law, judicial rulings, and jurisprudence.
 
 Result: The bank’s obligation to provide financial credit information arises either as a direct effect of an agreement concluded between the bank and the information requester or based on the existence of a legal text obligating the bank to provide information to certain parties, and it may be a result of banking customs.
 
 Conclusion: the study concluded that the legislator should enact a specific law on banking secrecy due to its importance, as well as taking into account not to expand on the exceptions in accordance with the principle of banking secrecy.

Method for improving the quality of service of request signals in information systems

The work notes that the request information systems are an important component of information support for air traffic control and airspace control systems. Interrogative information systems include: secondary radar systems, national identification radar systems and short-range navigation radio systems. It is shown that the characteristics of the process of servicing request signals in an aircraft transponder have a significant impact on the statistical properties of the response signal flow, which ultimately, as a consequence, affects the efficiency of the entire radar channel for transmitting response signals with an active response. It is pointed out that one of the important characteristics of the process of servicing request signals in an aircraft transponder is its correlation function, based on the analysis of which one can conclude the choice of the type of response signal flow and the structure of the aircraft transponder. This makes it possible to achieve: increasing the probability of service, increasing the probability of detecting an air object, reducing the root-mean-square error in estimating the azimuth of an air object and increasing the reliability of the transmission of flight information from the observed board of an air object. The article analyzes the possibility of improving the quality of request service by managing the flow of request signals in a network of request information systems. It has been shown that the correct choice of repetition periods of request signals in the area of joint operation of request information systems makes it possible to reduce the likelihood of interaction between individual request signals. Also, as a consequence, it makes it possible to increase the noise immunity of the interrogative information systems under consideration that are part of the specified information system.

UNDERSTANDING THE NEW NIH DATA SHARING REQUIREMENTS: WHY THEY IMPROVE THE QUALITY OF RESEARCH

Abstract In 2021, NIH began a long period of planning, drafting, and requesting public comment to create a new data-sharing policy, beginning with a Request For Information (RFI). The new policy, beginning January 25, 2023, will apply broadly to all scientific data produced with NIH funding. NACDA and (ICPSR), drawing upon our expertise and understanding of best practices for data sharing, have been working actively to develop tools and resources to assist NIH grant recipients in complying with federal data-sharing expectations with minimal disruptions to their research. This presentation will provide a detailed overview of the new data-sharing requirements and how to incorporate them into the required data-sharing plan. We will offer examples of successful data-sharing plans, identifying an appropriate repository, budgeting for the data preparation process, and creating informed consent documents consistent with the spirit of the NIH Data Sharing requirements. In addition to explaining the new data-sharing policy, the presentation will discuss the rationale behind the requirements and how they contribute to data equity using the FAIR principles. By increasing access to federally funded data, we contribute to a multidisciplinary approach that enhances cross-disciplinary communication and a broad understanding of different ways of knowing when working collaboratively with other researchers. Team Science has facilitated substantive discourse between qualitative and quantitative specialists. Multidisciplinary research increasingly represents a critical aspect of overall knowledge creation. Finally, the presentation will illustrate how data-sharing increases the impact of studies and enhances the credentials of researchers who engage in data-sharing.

WHAT MATTERS MOST? REACTIONS TO THE RAISE ADVISORY COUNCIL’S NATIONAL STRATEGY TO SUPPORT FAMILY CAREGIVERS

Abstract This presentation reports on feedback from advocates and researchers, those working in organizations serving family caregivers, and family caregivers themselves regarding the 2022 National Strategy to Support Family Caregivers. The Strategy was issued by the RAISE Family Caregiving Advisory Council, created under the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (2018). A Request for Information (RFI) published in the Federal Register garnered nearly 600 responses from a wide range of individuals and organizations, providing feedback about top priorities for action, topics or populations that were not adequately addressed, and recommendations for actions that could help meet stated objectives; these comments will prove critical in implementing the National Strategy, as well as in updating and revising it. This presentation sets the progress of the National Strategy in context, reports on the RFI analysis, and describes next steps, highlighting key areas of focus for the federal government, states, and other entities. Priorities included expanding the direct care workforce and increasing access to caregiver training and supports, particularly respite. Other top comments pertained to financial and workplace security for family caregivers - encouraging caregiver-friendly workplaces, paying family members to provide care, and strengthening the Family and Medical Leave Act. Respondents broadly endorsed the Strategy and noted the need for campaigns promoting greater awareness of family caregiving. The findings suggest that there is strong consensus among caregiver advocates regarding the most critical areas for action and the most favored strategies to achieve caregivers’ priority goals.

Indications and use of cone beam computed tomography in children and young individuals in a university-based dental hospital

BackgroundThe aim of this study was to evaluate the indications of cone beam computed tomography (CBCT) in children and young individuals in a university-based dental hospital and their association with age, gender and field of view.Methods7131 CBCT scans, taken during 3-year period, were reviewed and a total of 649 pediatric patients (0–18 years) with complete request forms were included. Data related to gender, age, referring department, CBCT indications, field of view (FOV), region of interest (ROI), need for re-exposure and patients received more than one CBCT examination were recorded.ResultsThe mean age was 13.57 ± 3.52 years and “malocclusion and dentofacial anomaly” (28.7%) was the most common clinical indication. Facial trauma, dental trauma and supernumerary tooth in males; “malocclusion and dentofacial anomaly” and implant planning in females were recorded more frequently compared to other gender. Maxilla was the most frequently monitored ROI (35.1%) for patients. Small (≤ 10 cm) FOV was preferred in 58.1% of all patients. Large FOV was selected in the majority of patients who underwent CBCT scan for “malocclusion and dentofacial anomaly” (89.6%). The repeated scans constituted 2.3% of patients and 105 patients (16.2%) underwent multiple CBCT scans on different dates for mainly orthodontic follow-up.ConclusionsThe justification of CBCT scans was not fully compatible with current guidelines and mainly larger FOV was preferred. The number of CBCT examination in children and young individuals tends to increase.Trial registration numberNot applicable.

The under-representation of racially minoritised doctors in academic general practice training: a retrospective analysis.

General practice has one of the most diverse medical training programmes in terms of sex and ethnic background. However, this diversity of race and ethnicity is not reflected in academic GP careers, with just 17% (n = 81/473) of academic GPs being from racially minoritised groups, according to the Medical Schools Council. To determine whether GP academic clinical fellow (ACF) trainees from racially minoritised backgrounds are proportionally represented, compared with the non-academic training programme, using the annual GP ACF conference as a proxy. A retrospective analysis of conference programmes from national academic GP training conferences from 2018-2023 and demographic data obtained from Health Education England (HEE). Using conference programmes and online searches, demographic information on conference speakers was obtained and a freedom of information request was made to HEE for the demographics of GP ACFs for corresponding years. This was compared with demographic data of GP trainees and academics. On average, there were 40 speakers each year at the conference. White females (average 20.2 speakers each year) were the most well represented group, followed by White males (average 12.5), Asian females (average 3.3), Asian males (average 1.8), Black males (average 0.7), and Black females (average 0.3). HEE data from 2022 revealed that 27 (71.1%) of the 38 (excluding five who did not state their ethnicity) ACFs were White British. GP academia should be more representative of the non-academic GP training scheme. Work needs to be done to understand and overcome the structural barriers to recruiting from racially minoritised groups.

Relationship between Age, Histologic Grade, Tumour Size, Immunohistochemical Biomarkers Expressions and Molecular Subtypes of Invasive Breast Carcinoma in Ilorin, Nigeria

Background: Background: Invasive breast carcinoma causes the most cancer-related death in women, and age is an essential non-modifiable risk factor. This study determined the relationship between age and histopathologic grade, tumor size, immunohistochemical biomarkers (ER, PR, and HER-2) expressions, and subtypes of invasive breast carcinoma. Methods: This was a retrospective hospital-based study of patients with prior histopathological diagnoses of invasive breast carcinoma. Relevant data, including age, histologic type, grade, tumor size, and hormonal receptor status, were retrieved from the archival pathology request forms. Results: The mean age of study subjects was 52.14 ± 12.14 years. The peak age group was in the 5th decade, accounting for 37.0 (32.7%) cases. Nottingham grade III invasive breast carcinoma accounted for 47 (41.6 %) cases and predominated in the 6th decade, accounting for 17 (50.0%) cases. Majority of the study subjects presented with tumor size greater than 5.0 cm (75.9%). The mean tumor size was 6.87 ± 3.20 cm and ranged from 3.2 cm to 16.0 cm. The immunohistochemical expressions of ER, PR, and HER-2 biomarkers were 36.3%, 28.3%, and 41.6%, respectively, particularly in the 5th and 6th decades. Also, Luminal A, Luminal B, Triplenegative, and HER-2 enriched subtypes occurred in 16.8%, 20.4%, 42.4%, and 20.4% cases respectively in the 5th and 6th decades. However, the triple-negative subtype was found in the 4th to 6th decades in equal proportions. Conclusion: This study observed triple-negative invasive breast carcinoma immunohistochemical subtypes with age association from the 4th to 6th decade

Unpeeling the onion: Digital triage and monitoring of general practice, private psychiatry, and psychology.

The Australian federal government is considering a 'digital front door' to mental healthcare. The Brain and Mind Centre at the University of Sydney has published a discussion paper advocating that the government should adopt a comprehensive model of digital triage and monitoring (DTM) based on a government-funded initiative Project Synergy ($30 million). We critically examine the final report on Project Synergy, which is now available under a Freedom of Information request. The DTM model is disruptive. Non-government organisations would replace general practitioners as care coordinators. Patients, private psychiatrists, and psychologists would be subjected to additional layers of administration, assessment, and digital compliance, which may decrease efficiency, and lengthen the duration of untreated illness. Only one patient was deemed eligible for DTM, however, during the 8-month regional trial of Project Synergy (recruitment rate = 1/500,000 across the region). Instead of an unproven DTM model, the proposed 'digital front door' to Australian mental healthcare should emphasise technology-enabled shared care (general practitioners and mental health professionals) for the treatment of moderate-to-severe illness.

Physician-directed microbiological testing versus syndromic multiplex PCR in gastroenteritis.

Syndromic multiplex PCR testing is an alternative to conventional stool testing based on physician-directed request forms. The objective of this study was to compare the etiologic yield of conventional microbiological testing based on physician-directed request forms with that of rapid syndromic testing. In addition, the adequacy of the clinician ordering, which is an important piece of the diagnostic stewardship, was evaluated. Physician-directed conventional microbiological testing and extensive molecular syndromic testing with the Fast Track Diagnostics Gastroenteritis Kit were performed in parallel on 1238 samples to evaluate the contribution of a multiplex panel to the diagnostic process of gastroenteritis. A potential causative pathogen was identified in 18.4% of stool samples by standard microbiological testing and in 41.3% of stool samples tested using the syndromic panel. Only 15.1% of the request forms could be considered successful of which 88.2% were labeled inadequate. Conventional physician-directed based testing missed the etiologic diagnosis in 32.3% of the specimens (excluding sapovirus and astrovirus). Bacterial infections were theoretically not missed as bacterial stool culture was requested on all stool samples, but in 28.6% of the cases, no isolate could be recovered. In 36.9% of the samples testing positive for a viral pathogen, no viral testing was requested. In addition, 72.5% of all samples positive for a parasite were clinically suspected by the physician. This study suggests that syndromic multiplex PCR assays are a better strategy for pathogen detection in patients with gastroenteritis than physician-directed laboratory testing based on the clinical presentation.

Tantangan Pemberian Kewenangan Bagi Penyidik Pejabat Pegawai Negeri Sipil (PPNS) Kehutanan Sumatera Barat Pada Tindak Pidana Pencucian Uang

Law Number 8 of 2010 on the Prevention and Eradication of Money Laundering (AML Law) serves as the cornerstone of anti-money laundering enforcement in Indonesia today, but it still falls short in accommodating the needs of money laundering law enforcement. Explanation of Article 74 of the AML Law limits the role of criminal investigators solely to the National Narcotics Agency (BNN), the Corruption Eradication Commission (KPK), the Police, the Prosecutor's Office, Customs, and Tax Authorities. This explanation of Article 74 contradicts the AML Law. This situation leaves the Environmental and Forestry Crime Investigators (PPNS Kehutanan) without the authority to investigate money laundering cases in the forestry sector and hampers efforts to combat money laundering. Ultimately, Constitutional Court Decision No. 15/PUU-XIX/2021 breathed new life into money laundering investigations by broadening the definition of investigators and granting authority to PPNS Kehutanan to handle money laundering cases. Based on this research, the author concludes that following Constitutional Court Decision No. 15/PUU-XIX/2021, PPNS in the forestry sector has the authority to investigate cases of money laundering. The authority held by PPNS Kehutanan in conducting money laundering investigations includes the power to delay transactions, the power to request information about wealth from the reporter, the power to seize assets, and the power to block assets. In West Sumatra, the investigation of money laundering in the forestry sector is assigned to PPNS of the Provincial Forestry Service and PPNS of the Directorate General of Law Enforcement and Forest Protection (Gakkum LHK). These two institutions coordinate to handle all forestry crimes, including money laundering. Furthermore, coordination is also carried out with the National Police (POLRI) and the Financial Transaction Reports and Analysis Center (PPATK) in resolving money laundering cases.

PHILIPPINE EARTH OBSERVATION SATELLITE MISSIONS AND APPLICATIONS: A DECADAL SURVEY

Abstract. The Decadal Survey was conducted to generate recommendations for integrated and sustainable conduct of space-based environmental monitoring and Earth observation (EO) science programs. Inputs from members of the scientific community and various stakeholders were synthesized to gain an in-depth understanding of the current status and gaps in our space- and non-space-based observation systems in addressing challenges that may persist or arise in this decade. The Decadal Survey is conducted in two phases. The first phase is the Request for Information 1 (RFI-1), where 29 experts from the scientific community were asked to describe the most pressing challenges in their field and the corresponding objectives to address these challenges. A total of 54 challenges and 94 objectives were identified across six focus areas. The second phase consisted of the Delphi Survey where stakeholders from the government, academe, private sector, and non-government organization were asked to rank the challenges and objectives identified from Phase 1. A Request for Information 2 (RFI-2) is conducted to gather information on current programs and projects and institutional capabilities in relation to space science & technology applications (SSTA). Six focus areas (FAs) were identified to adequately cover the components of Earth observation. The assessment and validation of the prioritization of the challenges and objectives resulted in the identification of the top challenges per focus area. These priority challenges and objectives were then compared with the current SSTA technology capabilities of the agencies and institutions to identify common initiatives and gaps or areas for improvement. The results provided a glimpse of how the country’s current SSTA capabilities and initiatives are implemented to solve different scientific challenges and objectives. Looking at the list of previous and ongoing projects, much focus has been made on addressing challenges in resource management and disaster risk reduction and management. Fewer programs and projects center on climate and Earth processes studies. Although most of the identified challenges were matched with at least one ongoing project, there is also concern about the continuity and sustainability of these projects. The Decadal Survey provided information regarding the priority objectives, the target observables, and the mission specifications and timelines from the program of record. The collated information was used to conduct a mission gap analysis that eventually determined the satellite payloads needed to address most of the priority challenges and objectives. The performed gap analysis led to the identification of three instrument gaps that will serve as the basis of future EO satellite missions.

Інтелектуальна система ідентифікації рейтингу довіри користувача

The article develops an intelligent system for identifying the user's trust rating, which allows viewing information about contacts that are more aimed at creating trust in the interlocutor or providing information that helps to identify the caller or the person with whom we are trying to contact. The k-nearest neighbours method was chosen to create the recommendation system. The main advantage of using the k-nearest neighbours method is the ability to take into account the unique trust rating of each phone number. It is important not only to find phone numbers with a similar rating, but also to take into account the approximate rating. The k-nearest neighbours method allows you to provide recommendations based on the similarity between phone numbers that have received positive feedback from users with similar preferences. Intelligent recommendation systems can provide phone numbers with similar ratings. When a user requests information about a phone number associated with fraudsters, the system instantly offers low-rated phone numbers that are therefore potential fraudsters.

Clinical audit to assess diagnosis and severity stratification of acute pancreatitis

Abstract Background Acute Pancreatitis (AP) has varying presentations, and guidelines recommend severity stratification of these patients to guide management. Surgical departments commonly use varying methods and/or use these methods incorrectly. The prominent Alanta criteria utilises examination findings, CT scan findings and elevated pancreatic enzymes to diagnose AP. Using the criteria incorrectly can lead to misdiagnosis and unnecessary radiation exposure. Additionally, diagnosing pancreatitis aetiology is crucial to providing targeted treatments, such as a laparoscopic cholecystectomy. Aim The aim of this study was to identify aspects of AP diagnosis and severity scoring requiring improvement in a large general surgery department. Methods We identified adult patients admitted with AP between 01.01.2023 and 31.03.2023, and retrospectively collected data points recommended by a combination of national guidelines and the Atlanta criteria. The results were presented to a panel of expert Upper Gastrointestinal Surgeons and, with the panel’s guidance, an AP protocol was created to improve severity scoring and rapid diagnosis of AP. Results The severity scoring was only completed in 33% of cases and incorrectly used in the majority of cases. Based on request information and cases already fulfilling the diagnostic criteria, almost half of all CT scans performed were deemed unnecessary. Results on interventions for alcohol and gallstone cases highlighted significant shortfallings. Conclusion Significant improvements are required in severity scoring, adherence to diagnostic criteria and targeted treatment. A pancreatic protocol has since been established in this department and further analysis will be completed to create a closed-loop audit.

A novel botnet attack detection for IoT networks based on communication graphs

Intrusion detection systems have been proposed for the detection of botnet attacks. Various types of centralized or distributed cloud-based machine learning and deep learning models have been suggested. However, the emergence of the Internet of Things (IoT) has brought about a huge increase in connected devices, necessitating a different approach. In this paper, we propose to perform detection on IoT-edge devices. The suggested architecture includes an anomaly intrusion detection system in the application layer of IoT-edge devices, arranged in software-defined networks. IoT-edge devices request information from the software-defined networks controller about their own behaviour in the network. This behaviour is represented by communication graphs and is novel for IoT networks. This representation better characterizes the behaviour of the device than the traditional analysis of network traffic, with a lower volume of information. Botnet attack scenarios are simulated with the IoT-23 dataset. Experimental results show that attacks are detected with high accuracy using a deep learning model with low device memory requirements and significant storage reduction for training.Graphical abstract

Abstract C108: Employer-based implementation of Galleri multi-cancer early detection testing to address socioeconomic disparities in receipt of screening

Abstract Background: Multi-cancer early detection (MCED) tests are designed to complement USPSTF-recommended screening to detect many cancers for which no established screening methods exist. Implementing an MCED test as an employee benefit offers an approach to detect cancers for which there is no screening method and to address socioeconomic disparities in receipt of screening. Methods: Galleri, a blood-based MCED test, was implemented in companies with employees in industrial/manufacturing spaces. We approximated educational attainment (≤12 years vs >12 years) as a dichotomous measurement of socioeconomic status (SES). The industrial locations with employees of lower SES were selected based on data from individual companies and focused on diverse employees, low rates of preventive screenings, high healthcare costs, and low health literacy. Enrollment was accomplished through on-site events where consent and blood draws were available, as well as telehealth visits with subsequent blood draws. Results: From October 2021 to May 2023, 812 Galleri MCED tests were administered in a population of industrial employees. Of the participants, 317 (39%) were female and 495 (61%) were male, and the median age was 54 years. A total of 217 (27%) participants were aged 35-49, 531 (65%) were aged 50-64, and 62 (8%) were aged 65-79. Four tests returned a cancer signal detected result with a predicted cancer signal origin of colorectal (n=2), anus (n=1), and breast (n=1). Of the four participants with a cancer signal detected result, three were in the 50-64 age group and one was in the 65-79 age group. The breast cancer diagnosis was confirmed, and follow-up is ongoing in the participants with a cancer sign origin of colorectal and anus. A total of 676 (83%) tests were administered during 9 on-site events and 136 (17%) were obtained by telehealth visits. Factors that were important for taking the Galleri test were onsite events, trusted long-time employees onsite that spoke their language and helped translate the request form, explanation of the test in their native language, and the ability to administer the test without a computer or other digital requirements. Conclusion: MCED testing may be implemented more widely among individuals of lower SES when it is included as an employee benefit with in-person communication by trusted employee messengers and by limiting digital requirements. Supporting the unique needs of individuals before administering an MCED test and those with a cancer signal detected result are important steps for improving access and achieving diagnostic resolution. Citation Format: Ahmedin Jamal, Robert Winn, William Cance, Tim Johnson, Wayne Lilyestrom. Employer-based implementation of Galleri multi-cancer early detection testing to address socioeconomic disparities in receipt of screening [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C108.

How are early career dementia researchers considered and supported by national dementia plans and dementia‐specific charities and associations? An overview of global policy approaches

AbstractBackgroundEarly career dementia researchers (ECDRs) represent a crucial workforce to drive dementia research. Many charities, research leaders, and pressure groups, along with people living with dementia, continue to advocate for greater investment in dementia research. It remains unclear how ECDRs are being supported in this push for research through top‐down policy approaches. This study aimed to understand how ECDRs are considered and supported by national dementia plans or strategies across countries, and dementia‐specific charities and associations.MethodForty‐six countries from the G20 member states were evaluated. Each country’s dementia plan or strategy was reviewed alongside the policies of one governmental and one non‐governmental funding body. Data were gathered through internet searches and information requests to contacts at relevant organisations in each country. Data targeting support for ECDRs were extracted and subject to content analysis using inductive coding. Findings regarding ECDR support were categorised and narratively synthesised.ResultDespite efforts to contact stakeholders directly, little to no information could be obtained from some countries due to language barriers. While most G20 member states have a national dementia plan or strategy, only China, the U.S. (excluding Puerto Rico), England, Scotland, Greece, and Denmark specifically mentioned ECDR support in their national policy, referring to creating specific ECDR funding and career opportunities. Thirteen countries were identified as providing targeted support for ECDRs via dementia‐specific charities or associations. This ECDR support reflected the following four categories: (1) research funding, such as fellowships and research grants; (2) research dissemination and networking, e.g., grants for printing a doctoral thesis or conference travel grants; (3) training and career development opportunities; and (4) research advice, including mentoring programs and grant writing assistance.ConclusionECDR support varied greatly across the G20 member states, with few formally recognising ECDRs in their national dementia plan or strategy, and mixed support provided by dementia‐specific charities and associations or government bodies. Overall, ECDRs were not considered in dementia plans and strategies in the majority of included countries, and discrepancies between support levels exist across countries. To facilitate equal prospects for ECDRs, top‐down policy approaches are urged to enhance their efforts in the future.

Influence of Pre-Transplant Estimated Glomerular Filtration Rate (eGFR) on Outcomes after Allogeneic Hematopoietic Cell Transplantation

Assessment of pre-transplant renal function as measured by estimated Glomerular Filtration Rate (eGFR) is a standard criterion for selection of patients for allogeneic hematopoietic cell transplantation (alloHCT). Despite refinements in alloHCT and reductions in toxicity over time, we hypothesized that baseline renal function is still independently associated with differences in outcomes in the contemporary era. The aim of this study was to identify an optimal eGFR cut point for identifying those at increased risk of HCT-related mortality. Patients who underwent first alloHCT from January 2012 to December 2021 were identified from our institutional database, excluding syngeneic and umbilical cord grafts. eGFR was calculated using the CKD-EPI Creatinine Equation (Inker et a. NEJM 2021). Optimal pre-HCT eGFR cut point for high-risk of non-relapse mortality (NRM) after alloHCT was identified using Cox restricted cubic spline plot. eGRF was grouped into multiple categories based upon the observed association in the spline plot alone with an established cut point of 90 ml/min/1.73 m² for abnormal kidney function. Associations of eGFR, demographics, prognostic factors, and HCT characteristics with NRM and overall survival (OS) were evaluated using survival analysis; non-HCT related death was considered as a competing risk in the NRM analysis. 724 adult patients were studied with a median age of 58 yrs (range, 18-79), 57% males, 92% Caucasian, and 76% KPS >90. HCT-CI: 52% high, 31% intermediate, and 17% low risk. Transplants included 43% myeloablative and 57% reduced-intensity conditioning; 64% peripheral blood and 36% bone marrow grafts. Donor type: 28% related, 55% unrelated and 17% haploidentical. The median (IQR) of pre-transplant eGFR was 96.7 ml/min/1.73 m² (79.6, 107.5). eGFR was categorized as <70 (15.8%), 70-89 (22.4%), 90-119 (52.4%), and >120 ml/min/1.73 m² (9.4%). NRM was significantly higher for the eGFR <70 ml/min/1.73 m² group compared to the others (3-year NRM: 44.9% in eGFR <70 vs 25.0% in 70-89, 23.6% in 90-119, and 13.8% in >120 ml/min/1.73 m²) which was confirmed on multivariate analysis (Figure and Table). Overall survival (OS) was also significantly worse for those with an eGFR <70 ml/min/1.73 m² on multivariate analysis (3-year OS: 34.1% in eGFR <70 vs 51.7% in 70-89, 52.4% in 90-119, and 64.8% in >120 ml/min/1.73 m²) (Table) along with baseline KPS and high ASBMT Request for Information (RFI). The most common causes of death for both the eGFR<70 and >70 ml/min/1.73 m² groups were relapse (44% vs 60%, respectively) and infection (25% vs. 19%, respectively). Both NRM and OS differences among the 3 higher eGFR groups were not statistically significant in multivariate analyses. eGFR was not associated with relapse. We conclude that pre-transplant eGFR <70 ml/min/1.73m 2 is an independent prognostic factor for mortality after alloHCT. Future investigation with larger subgroup analyses regarding specific diagnoses, conditioning regimens and transplant modalities may further identify which patients are more appropriate for transplant and those who may benefit from alternative treatment approaches. Our results also suggest that additional efforts to preserve renal function prior to transplant by limiting nephrotoxic exposures may have implications for optimizing outcomes after transplant, particularly in those with other comorbidities.

Schistosomiasis control in Senegal: results from community data analysis for optimizing preventive chemotherapy intervention with praziquantel

BackgroundOver the past two decades, preventive chemotherapy (PC) with praziquantel (PZQ) is the major strategy for controlling schistosomiasis in Senegal. The objective of this analysis was to update the endemicity of schistosomiasis at community level for better targeting mass treatment with PZQ in Senegal.MethodsDemographic and epidemiological data from 1610 community health areas were analyzed using the schistosomiasis community data analysis tool of Expanded Special Project for Elimination of Neglected Tropical Diseases which developed by World Health Organization/Africa Office (WHO/AFRO). The tool uses a WHO/AFRO decision tree for areas without epidemiological data to determine whether mass treatment should be continued at community level. Descriptive analysis was performed.ResultsOverall, the endemicity of 1610 community health areas were updated based on the data from the district endemicity (33.5%) and the form of Join request for selected PC medicine (40.5%). Up to 282 (17.5%) and 398 (24.7%) of community health areas were classified as moderate and high endemicity. 41.1% of communities were non endemic. High endemicity was more important in Tambacounda, Saint Louis, Matam, Louga and Kedougou. A change in endemicity category was observed when data was disagregted from district level to community level. Implementation units classified non endemic were more important at community level (n = 666) compared to district level (n = 324). Among 540 areas previously classified high endemic at district level, 392 (72.6%) remained high prevalence category, while 92 (17.0%) became moderate, 43 (8.0%) low and 13 (2.4%) non-endemics at community level. Number of implementation units requiring PC was more important at district level (1286) compared to community level (944). Number of school aged children requiring treatment was also more important at district level compared to community level.ConclusionsThe analysis to disaggregate data from district level to community level using the WHO/AFRO schistosomiasis sub-district data optimization tool provide an update of schistosomiasis endemicity at community level. This study has allowed to better target schistosomiasis interventions, optimize use of available PZQ and exposed data gaps.

1343. Drug Education Needs of HCPs and Patients During the COVID-19 Pandemic Based on Over 60,000 Unsolicited Medical Information Requests Globally Over 3 Years (2020-2022)

Abstract Background The COVID-19 pandemic has resulted in 600 million cases and 6 million deaths globally since December 2019. Medical Information (MI) departments are critical during public health emergencies, providing factual, balanced and non-promotional information to healthcare providers (HCPs) and patients on new treatments, in compliance with industry codes of conduct. Methods Unsolicited MI requests for COVID-19 treatment from Jan 2020 to Dec 2022 were analyzed to show the customer journey and evolving needs for drug education. Data gathering and metric analysis were collected from MI databases with interaction dates, countries, contact channels, and responses. Results MI received 60,000+ unsolicited requests globally from Jan 2020 to Dec 2022, including 4,400 from patients. Pharmacists (60%) and physicians (15%) were the primary HCPs who contacted MI. Japan and US had the highest number of HCP questions. Changes in HCP questions over time reflected external events such as regulatory approvals and guideline updates, with initial questions related to medication access and clinical trials in 2020, transitioning to medication dosing and preparation in 2021, and new interests emerging in special populations including renal impairment, pediatrics, and pregnancy in 2022. These results suggest that HCPs used MI to help make clinical decisions about which medications are right for their patients. Patients preferred to contact MI by phone (71%), followed by email (25%) and digital channels (4%). Most patient questions came from US, Mexico, and India. Patients were interested in safety, drug interactions, ingredients, and mechanism of action. Nonclinical topics included drug availability, cost, clinical trial enrollment, and patient assistance programs. Increased patient questions were observed during changes in the medical landscape due to external events (label changes, data updates, and new variants). Conclusion Analyzing MI requests is a valuable tool for understanding and meeting the evolving customer needs for drug education. MI insights provide valuable information that informs targeted communications, data-generation priorities to address unmet needs, and educational opportunities that impact clinical decision making and lead to improved patient outcomes. Disclosures All Authors: No reported disclosures