Significant Difference In Number Research Articles

Human–Robot Co-Facilitation in Collaborative Learning: A Comparative Study of the Effects of Human and Robot Facilitation on Learning Experience and Learning Outcomes

Collaborative learning has been widely studied in higher education and beyond, suggesting that collaboration in small groups can be effective for promoting deeper learning, enhancing engagement and motivation, and improving a range of cognitive and social outcomes. The study presented in this paper compared different forms of human and robot facilitation in the game of planning poker, designed as a collaborative activity in the undergraduate course on agile project management. Planning poker is a consensus-based game for relative estimation in teams. Team members collaboratively estimate effort for a set of project tasks. In our study, student teams played the game of planning poker to estimate the effort required for project tasks by comparing task effort relative to one another. In this within- and between-subjects study, forty-nine students in eight teams participated in two out of four conditions. The four conditions differed in respect to the form of human and/or robot facilitation. Teams 1–4 participated in conditions C1 human online and C3 unsupervised robot, while teams 5–8 participated in conditions C2 human face to face and C4 supervised robot co-facilitation. While planning poker was facilitated by a human teacher in conditions C1 and C2, the NAO robot facilitated the game-play in conditions C3 and C4. In C4, the robot facilitation was supervised by a human teacher. The study compared these four forms of facilitation and explored the effects of the type of facilitation on the facilitator’s competence (FC), learning experience (LX), and learning outcomes (LO). The results based on the data from an online survey indicated a number of significant differences across conditions. While the facilitator’s competence and learning outcomes were rated higher in human (C1, C2) compared to robot (C3, C4) conditions, participants in the supervised robot condition (C4) experienced higher levels of focus, motivation, and relevance and a greater sense of control and sense of success, and rated their cognitive learning outcomes and the willingness to apply what was learned higher than in other conditions. These results indicate that human supervision during robot-led facilitation in collaborative learning (e.g., providing hints and situational information on demand) can be beneficial for learning experience and outcomes as it allows synergies to be created between human expertise and flexibility and the consistency of the robotic assistance.

Discrepancies in Publication Volume Per Matched-Applicant Between Sex, Geographic Regions and Program Affiliation in the 2023 Orthopaedic Surgery Residency Match

Objective: This study aims to examine potential gender-based publication disparities among 2023 orthopaedic surgery matched-applicants, investigate variations in research emphasis based on program affiliation and assess publication differences across different geographic regions. Methods: Orthopaedic surgery residency programs participating in the 2023 NRMP with a publicly available incoming resident class were identified using the NRMP database. Each resident was searched using PubMed and ORCID identifiers for publications. Each program was designated as “university-based”, “community-based”, “community-based/university affiliated” or “other” using the American Medical Association’s FRIEDA database. Results: In total, 763 residents were identified with a mean and median number of publications of 6.1 (SD=10.0) and 3.0 (IQR=1.0-7.0) respectively. There was no significant difference in the median number of publications between males (2.0) and females (3.0, p=0.2315). Those who matched to “community-based/university affiliated” (median=2.0) programs had a lower median number of publications than those who matched to “university-based” (median=3.0, p<0.0001) or “other” (median=6.0, p=0.0006). Geographically, applicants in the West-South Central region (median=1.0) had the lowest publication median compared to those in the New England (median=4.0, p=0.0010) or Pacific (median=4.0, p=0.0015) regions. Conclusion: There lies a perceived increase in significance of research publications for competitiveness in the orthopaedic surgery match. This largely follows the elimination of objective Step-1 scoring to help stratify potential applicants. Research remains an objective manner to stratify applicants; however, new data lacks on recent analysis of the 2023 match pool. There was not a significant difference in the number of publications between male vs female matched-applicants. The program category “other” and the New England and Pacific regions had the highest median number of publications. Keywords: Orthopaedics; Medical Residency; Graduate Medical Education; Medical School; Residency Match; Orthopaedic Education; Orthopaedic Residency

(161) Is there a Difference in Inflatable Penile Prosthesis Mechanical Failure and Infections Rates in Relation to Prostate Cancer Treatment Modality (Radiation Therapy vs Radical Prostatectomy)

Abstract Introduction Inflatable Penile Prosthesis (IPP) implantation as a treatment for ED has high satisfaction rates in the general population; however, there is limited literature on quantification of complication rates as stratified by ED etiology. Objective Our aim was to compare mechanical failure and infection rates in patients undergoing IPP implantation for ED following Radical Prostatectomy (RP) versus radiation therapy (RT) for prostate cancer. Methods A retrospective chart review from our institutional database was conducted to identify 405 patients who underwent IPP placement at our institution from 2015–2019, then selecting for those whose etiology of ED was following RP or RT. To prevent crossover confounding; patients with history of pelvic radiation or salvage radiotherapy were excluded from the RP group and patients with history of RP were excluded from the RT group. Data was obtained from 75 patients who met criteria for inclusion: 44 patients in the RP group and 31 patients in the RT group. Mechanical failure, infection rates, mean EDITS scores and additional survey questions were compared between the radiation and RP groups. Results Patient demographic information and IPP complication and satisfaction rates are listed below in Table 1 and Figure 1. There was a statistically significant difference in number of patients experiencing IPP complications, 19.4% (n=6) of patients in the RT cohort and 4.5% (n=2) in the RP cohort, respectively. There was no statistically significant difference found in stratified complications- infection rates, device erosion rates, mechanical failure rates, or device removal and/or replacement rates between the two groups. The RP cohort had a significantly higher mean Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire score versus the RT cohort, 91.58 to 76.02, respectively. Conclusions These preliminary findings, while requiring large-scale follow up, suggest that there is a higher rate of IPP related complications in patients with device placement following RT for prostate cancer versus RP. Disclosure No.

A national registry-based study of ethnic differences in people with multiple sclerosis in Iran

ObjectiveThe relationship between MS and ethnicity has been understudied in the Middle East compared to the United States and Europe. As Iran as the highest prevalence of MS in the Middle East, we decided to investigate the demographic and clinical differences in people with MS (pwMS) from major ethnicities Iran. MethodsIn a cross-sectional study using data from National Multiple Sclerosis Registry in Iran. PwMS from six provinces were chosen and interviewed for determining their ethnicity. Persians (Fars), Kurds, Lurs, Azeris and Arabs with a clear ethnic background were included. Recorded data from the registry was used to compare the demographic and clinical features. ResultsA total of 4015 pwMS (74.2% female) were included in the study with an average age of 36.76 ± 9.68 years. Persians and Kurds had the highest percentage of pwMS in youngest and oldest age groups, respectively, with 2.9% and 5.7% (p<0.01). The highest average age of onset was seen in Persians (29.47 ± 8.89) and the lowest observed in Mazandaranis (26.82 ± 7.68, p<0.01). Azeris and Kurds had the highest proportions of pwMS diagnosed <18 and >55, at rates of 12% and 1.6%, respectively (p<0.01). There were statistically significant differences in distribution of phenotypes (p<0.01) and time to progression to secondary progressive MS (p<0.01) such that Persians had the highest rate of clinically isolated syndrome (CIS) at 19.3% and Arabs had highest rates of relapsing-remitting MS (86.2%) and secondary progressive MS (16.4%). Lurs, Azeris and Mazandaranis had significantly more patients progressing to secondary-progressive MS <5 years from diagnosis (p<0.01). There was a significant difference in number of relapses between the ethnicities (p<0.01) with Lurs having the highest proportion of participants reporting >4 relapses with 23.0% and Azeris having the highest percentage of pwMS reporting no relapse (53.0%). Kurds had the highest Expanded Disability Status Scale (EDSS) average at 2.93 ± 1.99 and Lurs had the lowest with 1.28 ± 1.25 (p<0.01). The differences in prevalence of positive family history for the whole cohort between ethnicities were significant (P=0.02), ranging from 12.8% in Kurds to 19.6% in Persians. ConclusionWe found Persians to have higher rates of pediatric MS and higher rates of CIS. Kurds and Lurs had higher and lower EDSS scores, respectively. Lurs and Persian had higher annual relapse rates. We also found lower rates of SPMS among Arabs and earlier progression to SPMS in Lurs, Azeris and Mazandaranis. Such differences highlight the importance of the potential role of ethnicities in diagnosis and prognosis of MS, especially considering their observation within the geographical limits of a single country.

Students’ Perceptions on Online Teaching and Learning in Higher Education

Virtual environments allow teachers to approach the teaching process inclusively and creatively, to facilitate the effective transfer of learning and to support student learning with new technologies regardless of various barriers. The hereby study evaluates the students’ views concerning the virtual delivery of courses during their learning process taking into consideration their former face-to-face teaching-learning experience. It was based on the theoretical part which included typical aspects of online teaching and learning are presented and the most recent studies in this area are reviewed. Following previous research, we aim to develop an innovative model of successful online teaching and learning in higher education. A questionnaire-based research methodology was designed for 355 students at a university in the North-Eastern region of Romania. The questionnaire with closed-ended items was used for assessing students’ attitudes on the online teaching activity. The results indicate students’ preference for online courses, as well as a number of significant differences, depending on the study specialisation or form of education. Any future changes to online teaching and learning in universities should also take into account students’ and teachers’ views on this particular issue. Such an approach should allow us to see whether and how effective the use of virtual teaching environments can be for both students and teachers in higher education (HE).

First Contact Physiotherapy: An evaluation of clinical effectiveness and costs.

First Contact Physiotherapy Practitioners (FCPPs) are embedded within general practice, providing expert assessment, diagnosis and management plans for patients with musculoskeletal disorders (MSKDs), without the prior need for GP consultation. To determine the clinical effectiveness and costs of FCPP-led compared to GP-led models of care. Multiple site case study design. UK GP practices. General Practice sites were recruited representing three models: 1. GP-led care; 2. FCPPs who could not prescribe/inject (Standard (St)); 3. FCPPs who could prescribe/inject (Additional Qualifications (AQ)). Patient participants from each site completed clinical outcome data at baseline, 3 and 6 months. The primary outcome was the SF-36v.2 Physical Component Score (PCS). Healthcare usage was collected for 6 months. N=426 adults were recruited from 46 practices across the UK. Non-inferiority analysis showed no significant difference in physical function (SF36-PCS) across all three arms at 6 months (p=0.999). At 3 months a significant difference in numbers improving was seen between arms: 54.7% GP consultees; 72.4% FCPP-St, 66.4% FCPP-AQ; (p=0.037). No safety issues were identified. Following initial consultation, a greater proportion of patients received medication (including opioids) in the GP-led arm (44.7%) compared with FCPP-St (17.5%) and FCPP-AQ (22.8%); (p<0.001). NHS costs (initial consultation and over 6 months follow up) were significantly higher in the GP-led model (median £105.50) vs FCPP-St (£41) and FCPP-AQ (£44); (p<0.001). FCPP led models provide safe, clinically effective and cost-beneficial management for patients with MSKDs in general practice and reduced opioid use in this cohort.

Seroprevalence of Anti-SARS-CoV-2 Antibodies in Cats during Five Waves of COVID-19 Epidemic in Thailand and Correlation with Human Outbreaks.

Human-to-animal SARS-CoV-2 transmission was observed, including a veterinarian contracting COVID-19 through close contact with an infected cat, suggesting an atypical zoonotic transmission. This study investigated the prevalence of SARS-CoV-2 antibodies in cats during human outbreaks and elucidated the correlation between cat infections and human epidemics. A total of 1107 cat serum samples were collected and screened for SARS-CoV-2 antibodies using a modified indirect ELISA human SARS-CoV-2 antibody detection kit. The samples were confirmed using a cPass™ neutralization test. The SARS-CoV-2 seropositivity rate was 22.67% (199/878), mirroring the trend observed in concomitant human case numbers. The waves of the epidemic and the provinces did not significantly impact ELISA-positive cats. Notably, Chon Buri exhibited a strong positive correlation (r = 0.99, p = 0.009) between positive cat sera and reported human case numbers. Additionally, the cPass™ neutralization test revealed a 3.99% (35/878) seropositivity rate. There were significant differences in numbers and proportions of positive cat sera between epidemic waves. In Samut Sakhon, a positive correlation (r = 1, p = 0.042) was noted between the proportion of positive cat sera and human prevalence. The findings emphasize the need for ongoing surveillance to comprehend SARS-CoV-2 dynamics in both human and feline populations.

Comparison of deep learning-assisted blinking analysis system and Lipiview interferometer in dry eye patients: a cross-sectional study

BackgroundAbnormal blinking pattern is associated with ocular surface diseases. However, blink is difficult to analyze due to the rapid movement of eyelids. Deep learning machine (DLM) has been proposed as an optional tool for blinking analysis, but its clinical practicability still needs to be proven. Therefore, the study aims to compare the DLM-assisted Keratograph 5M (K5M) as a novel method with the currently available Lipiview in the clinic and assess whether blinking parameters can be applied in the diagnosis of dry eye disease (DED).MethodsThirty-five DED participants and 35 normal subjects were recruited in this cross-sectional study. DED questionnaire and ocular surface signs were evaluated. Blinking parameters including number of blinks, number of incomplete blinking (IB), and IB rate were collected from the blinking videos recorded by the K5M and Lipiview. Blinking parameters were individually collected from the DLM analyzed K5M videos and Lipiview generated results. The agreement and consistency of blinking parameters were compared between the two devices. The association of blinking parameters to DED symptoms and signs were evaluated via heatmap.ResultsIn total, 140 eyes of 70 participants were included in this study. Lipiview presented a higher number of IB and IB rate than those from DLM-assisted K5M (P ≤ 0.006). DLM-assisted K5M captured significant differences in number of blinks, number of IB and IB rate between DED and normal subjects (P ≤ 0.035). In all three parameters, DLM-assisted K5M also showed a better consistency in repeated measurements than Lipiview with higher intraclass correlation coefficients (number of blinks: 0.841 versus 0.665; number of IB: 0.750 versus 0.564; IB rate: 0.633 versus 0.589). More correlations between blinking parameters and DED symptoms and signs were found by DLM-assisted K5M. Moreover, the receiver operating characteristic analysis showed the number of IB from K5M exhibiting the highest area under curve of 0.773.ConclusionsDLM-assisted K5M is a useful tool to analyze blinking videos and detect abnormal blinking patterns, especially in distinguishing DED patients from normal subjects. Large sample investigations are therefore warranted to assess its clinical utility before implementation.

(119) Impact of Ethnicity on Clinical Outcomes of Intralesional CCH in Peyronie's Disease Patients Across Kaiser Permanente Southern California Database

Abstract Introduction Intralesional CCH injection is an effective treatment for Peyronie’s disease (PD) that utilizes collagenolytic enzymes to break down collagen plaque, thus reducing the penile deformity. The IMPRESS I and II clinical trials demonstrated efficacy of CCH in a predominant Caucasian population of men (95.8%). Little is known about treatment efficacy in the non-Caucasian population. Objective Using Kaiser Permanente’s ethnically diverse database, we sought to study the impact of race on CCH treatment outcomes. Methods This study examined the efficacy of intralesional CCH injection in a large healthcare system over 15 years. We defined treatment efficacy as percent change in penile curvature abnormality from baseline after a maximum of 4 treatment cycles. Impact of comorbidities on CCH efficacy was also examined. Patients with ventral curvature or initial curvature &amp;lt;30 ̊ or &amp;gt;90 ̊ were excluded from analysis. Standard statistical analysis was performed. Results 112 patients underwent CCH therapy and were included in this analysis. 46.4% of men completed all 4 cycles. Among men who received CCH, 66.1% were Caucasian, 22.3% Hispanic, and 9.8% African American. For co-morbidities, 87.5.% of men were not diabetic, while 22.3% of men had erectile dysfunction. The mean baseline pre-injection penile curvature was 51.63 degrees (range was 32-87 degrees). Caucasian men had the largest treatment response to CCH (45.6% decrease in penile curvature) compared to African American men (43.7%) and Hispanic men (40.5%), p = 0.9554. Non-diabetic men had a larger treatment response to CCH (44.9% decrease in curvature versus 39.3% in diabetics, p = 0.4726). Younger Men (age 18-44) also experienced a greater treatment response compared to other age groups (57.9% reduction in curvature, p = 0.171). There was a significant difference in number of cycles completed across different ethnicities (p = 0.0220). Hispanic men were significantly less likely to complete all 4 cycles of CCH compared to Caucasian and African American men (p=0.0004). Only 28.2% of Hispanic men completed all 4 treatment cycles. 48% of Hispanic patients report the need of language interpretation services during health appointments. Conclusions This is the largest post-market analysis of CCH treatment outcomes in a racially diverse PD population. Caucasian men had a greater treatment response after CCH injection possibly due to higher rate of completing all 4 treatment cycles. Nondiabetic men and younger men (aged 18 to 44) also had a greater treatment response after CCH injection. Hispanic men were significantly less likely to complete 4 cycles of injection therapy; possible explanations include language barriers. Future study is needed to determine if patient resources prepared in Spanish can improve treatment outcomes in Hispanic men with PD, and reduce these health care disparities observed in our study. Disclosure No.

Evaluation of Deficit Irrigation on Potato Yield and Water use Efficiency in Gedeo Zone, South Region

Increased water scarcity necessitates the implementation of water-conserving irrigation management practices tosustain crop production, especially in water-limited areas. A two-year field study was conducted during 2020 and 2021 to evaluate the effect of deficit irrigation on potato yield and water use efficiency. The experiment was conducted in randomized complete block design with four irrigation levels (100% ETc (crop evapotranspiration), 85% ETc, 70% ETc, and 55%ETc). The results showed that, deficit irrigation level have a significant difference in number of tuber per plant, marketable, total yield and water use efficiency. Potato yield significantly reduced with deficit irrigation level. Next to full irrigation the maximum yield was obtained under 85% ETc and 70%ETc with better crop and irrigation water use efficiency. Maximum crop and irrigation water use efficiency was obtained under 55% ETc. The partial budget analysis showed that the maximum acceptable MRR was obtained from 70%ETc and the highest net benefit was obtained under full irrigation. Therefore, in area where sufficient amount of water is available full irrigation is recommended to obtain maximum yield, but in water scarce area applying 85%ETcand 70%ETc is recommended with 17.5% and 23.2% yield reduction respectively with acceptable economical benefit.

НЕ НЕОПЛАСТИЧНІ ОДИНОЧНІ ВОГНИЩЕВІ УРАЖЕННЯ ЛЕГЕНЬ: ПОРІВНЯЛЬНИЙ АНАЛІЗ КЛІНІКО-МОРФОЛОГІЧНИХ ПРОЯВІВ

Non-neoplastic solitary focal lesions of the lungs are a fairly common finding during radiological examination. The primary task in the medical management of such patients is to establish the nature of such formations, both in order to rule out a malignant process and for further treatment if necessary. The aim of the work was to conduct a comparative analysis of clinical, radiological data and the results of morphological diagnostics of non-neoplastic solitary focal lesions of the lungs, taking into account one of the important histological features, namely the absence or presence of a necrotic component in the pathological focus. Materials and methods. The study was cohort, retrospective and included all clinical observations for the period 2017-2021 years. 126 patients with solitary lung foci of a non-neoplastic nature with morphological diagnosis of these formations were selected. Patients were divided into two groups depending on the presence or absence of necrotic changes in the composition of the tumor, according to histological examination. The available history, clinical, general laboratory data for each patient, the results of a microbiological examination of the lung tissue for the presence of mycobacteria and non-specific microorganisms, the results of molecular genetic analysis for tuberculosis mycobacteria were evaluated. A number of clinical chemistry and immunology were also considered. Results. Study data are presented in tables. Differences between groups were analyzed. It was established that, in general, females predominate, and formations without necrotic lesions were observed more. common in older women. The main differences were related to the diagnostic procedure - in the group without necrotic changes only minimally invasive interventions were performed (47.6 % of cases); in the group with necrotic formations in most cases (83.4 %) the lung surgery was performed. In both groups, the average size of foci was almost the same (16-17 mm), no significant differences were found by radiological signs. The preliminary clinical diagnosis in most patients of both groups was “lesion of unknown origin”. Based on the results of morphological examination, it was found that cytology was not very informative in 18-50 % of cases. In 23.8 % of cases a specific inflammatory process was established or suspected when necrotic foci. In other cases an inflammation was determined. Histological examination made it possible to establish the etiology of the pulmonary focus in 91.3 % of cases. Moreover, a significantly larger spectrum of various pathological processes was established in cases of necrotized foci. Conclusion. A number of significant differences were objectively determined, mainly at the level of morphological diagnosis, between solitary non-neoplastic focal lesions with and without a necrotic component. Key words: non-neoplastic single lung foci, diagnostics.

Evaluation of computer aided detection during colonoscopy among Veterans: Randomized clinical trial

BACKGROUND There has been significant interest in use of computer aided detection (CADe) devices in colonoscopy to improve polyp detection and reduce miss rate. AIM To investigate the use of CADe amongst veterans. METHODS Between September 2020 and December 2021, we performed a randomized controlled trial to evaluate the impact of CADe. Patients at Veterans Affairs Palo Alto Health Care System presenting for screening or low-risk surveillance were randomized to colonoscopy performed with or without CADe. Primary outcomes of interest included adenoma detection rate (ADR), adenomas per colonoscopy (APC), and adenomas per extraction. In addition, we measured serrated polyps per colonoscopy, non-adenomatous, non-serrated polyps per colonoscopy, serrated polyp detection rate, and procedural time. RESULTS A total of 244 patients were enrolled (124 with CADe), with similar patient characteristics (age, sex, body mass index, indication) between the two groups. Use of CADe was found to have decreased number of adenomas (1.79 vs 2.53, P = 0.030) per colonoscopy compared to without CADe. There was no significant difference in number of serrated polyps or non-adenomatous non-serrated polyps per colonoscopy between the two groups. Overall, use of CADe was found to have lower ADR (68.5 vs 80.0%, P = 0.041) compared to without use of CADe. Serrated polyp detection rate was lower with CADe (3.2 vs 7.5%) compared to without CADe, but this was not statistically significant (P = 0.137). There was no significant difference in withdrawal and procedure times between the two groups or in detection of adenomas per extraction (71.4 vs 73.1%, P = 0.613). No adverse events were identified. CONCLUSION While several randomized controlled trials have demonstrated improved ADR and APC with use of CADe, in this RCT performed at a center with high ADR, use of CADe was found to have decreased APC and ADR. Further studies are needed to understand the true impact of CADe on performance quality among endoscopists as well as determine criteria for endoscopists to consider when choosing to adopt CADe in their practices.

Estimation of genetic parameters and principal component analysis on garlic germplasm using augmented block design

Garlic (Allium sativum L.) is one of the important herbs worldwide. Genetic studies on Indonesian garlic germplasm are still limited. We aimed to estimate genetic parameters and analyze the Principal Component of Indonesian local garlic accessions. Augmented Block Design with three replications (blocks) was used to characterize 20 accessions with 16 accessions as ‘Test’ and four check varieties. The research was carried out at Lembang, West Java (1250 m asl) from October 2022 until March 2023. The result showed that from block-adjusted ANOVA, tested accessions gave significant differences in number of leaves, leaf length, ratio between length and width of stomata, and yield per plot. A high genotypic coefficient of variance (GCV) was observed on pseudo-stem diameter, root length, and yield per plot. It also showed that the number of leaves, the ratio between length and width of stomata, and yield per plot had high value of hBS (broad-sense heritability). Our study also showed that yield per plot had positive and significant (p<0.05) correlations with pseudo-stem diameter, leaf length, chlorophyll content, stomatal length, and root length. Principal Component Analysis showed that 82.75% of the total variance can be explained by the first three PCs viz. 57.19%, 15.27%, and 10.29% respectively.

Temporal Patterns of Diet and Physical Activity and of Diet Alone Have More Numerous Relationships With Health and Disease Status Indicators Compared to Temporal Patterns of Physical Activity Alone.

Daily temporal patterns of energy intake (temporal dietary patterns [TDPs]) and physical activity (temporal physical activity patterns [TPAPs]) have been independently and jointly (temporal dietary and physical activity patterns [TDPAPs]) associated with health and disease status indicators. The aim of this study was to compare the number and strength of association between clusters of daily TDPs, TPAPs, and TDPAPs and multiple health and disease status indicators. This cross-sectional study used 1 reliable weekday dietary recall and 1 random weekday of accelerometer data to partition to create clusters of participants representing the 3 temporal patterns. Four clusters were created via kernel-k means clustering algorithm of the same constrained dynamic time warping distance computed over the time series for each temporal pattern. From the National Health and Nutrition Examination Survey (2003-2006), 1,836 US adults aged 20 through 65 years who were not pregnant and had valid diet, physical activity, sociodemographic, anthropometric, questionnaire, and health and disease status indicator data were included. Health status indicators used as outcome measures were body mass index, waist circumference, fasting plasma glucose, hemoglobin A1c, triglycerides, high-density lipoprotein cholesterol, total cholesterol, and systolic and diastolic blood pressure; disease status indicators included obesity, type 2 diabetes mellitus, and metabolic syndrome. Multivariate regression models determined associations between the clusters representing each pattern and health and disease status indicators, controlling for confounders and adjusting for multiple comparisons. The number of significant differences among clusters and adjusted R2 and Akaike information criterion compared the strength of associations between clusters of patterns and continuous and categorical health and disease status indicators. TDPAPs showed 21 significant associations with health and disease status indicators, including body mass index, waist circumference, obesity, and type 2 diabetes; TDPs showed 19 significant associations; and TPAPs showed 8 significant associations. TDPAPs and TDPs had stronger and more numerous associations with health and disease status indicators compared with TPAPs. Patterns representing the integration of daily dietary habits hold promise for early detection of obesity.

Antidepressant prescribing in transgender and nonbinary individuals diagnosed with gender dysphoria and mood or anxiety disorders.

Transgender and nonbinary (TGNB) individuals are highly stigmatized members of society and are significantly at higher risk of having mood or anxiety-related disorders compared to non-TGNB individuals. In this retrospective cohort study, antidepressant prescribing data were collected from TGNB adults diagnosed with gender dysphoria (GD) and mood or anxiety-related disorder between January 2005 and October 2021. The primary outcome was to compare the number of active outpatient antidepressant prescriptions at the time of GD diagnosis between gender identities. The secondary outcomes were to compare antidepressant class utilization between gender identities as well as the prevalence of concurrent mood or anxiety-related disorder diagnoses between gender identities. Of 131 patients who met inclusion criteria, there was no significant difference in number of active antidepressant prescriptions between gender identities at the time of the GD diagnosis (p = .357). However, transgender females were prescribed bupropion at significantly higher rates than other gender identities (p = .046). Approximately 38% of patients did not have an active antidepressant prescription at the time of GD diagnosis despite concurrent mood or anxiety-related diagnoses. The prevalence of generalized anxiety disorder was significantly greater among transgender males (p = .044). Although the number of active antidepressant prescriptions between gender identities were similar in this study, we found 38% of patients were not prescribed any antidepressants at time of GD and mood or anxiety-related disorders. This serendipitous finding elucidates a potential gap in mental health care among transgender adults.

Abstract B105: Evaluating the racial equity of a digital health patient-reported symptom management system in patients receiving chemotherapy

Abstract INTRODUCTION. The development of behavioral &amp; supportive care interventions to improve quality of life for people receiving chemotherapy treatment for cancer, even with demonstrated overall efficacy, may unintentionally result in unequal benefit including across racial subgroups. The purpose of this study was to determine if Symptom Care at Home (SCH), is efficacious, digital health patient-reported outcome (PROs) symptom managment system, provide equitable benefit across racial subgroups. METHODS. A randomized trial was conducted to determine the active components of SCH. Participants reported daily on 11 common treatment symptoms through an Interactive Voice Response (IVR) telephone-based system that transmitted data through telephone lines. Continuous measures &amp; standard deviations with ordinal &amp; categorical measures, frequencies &amp; percentages of the totals were summarized. Comparisons between participants across Georgia &amp; Utah &amp; between Black &amp; White race were completed using Students t-test &amp; chi-square tests. Statistical analyses were completed using a 5% level of significance. This analysis compared these two groups to determine if participation with the SCH digital health tool &amp; symptom reduction benefits were equitable. RESULTS. Participants were 239 Black plus 13 Other or mixrd-race patients (251; 86%) as compared with the 118 White patients (32%) receiving chemotherapy treatment in Atlanta, Georgia. Blacks had slightly lower call compliance 67.59% (25.92%) versus (vs) Utah Whites 72.75% (22.45%) p=0.005; lower days in study Blacks 48.9% (29.9%) vs 80.8% (50.3%), p&amp;lt;0.001; &amp; lower completion of study all 3 cycles of chemotherapy &amp; still calling (65.4% vs 75.2%), p&amp;lt;0.001. Georgians also had significantly lower average total alerts 5.08% (10.69%) vs Utah 8.12% (15.20%), p&amp;lt;0.001 and lower presence of at least one moderate/severe symptom for most of the 11 symptoms. Georgians were more likely to be Female (72.2% vs 49.2%, p&amp;lt;0.001); Non-marreid (37.7% vs 72.9%, p&amp;lt;0.001); Non-degree holder (59.9% vs 39.8%, p&amp;lt;0.001); &amp; have diagnosis of Breast Cancer (34.9% vs 12.7%). Blacks had slightly lower call complaince 65.17% (27.1%) vs Whites 72.75% (22.45%), p=0.005; but with no statistically significant difference in number of days in study 49.0% (30.2%) vs 48.6% (29.5%), p=0.911; no statistically significant difference in completion of all 3 cycles of chemotherapy (65.4% vs 63.5%, p=0.895); with difference in average number of total alerts 4.89% (10.93%) vs 5.48% (10.20%, p=0.621). CONCLUSIONS. This study found no racial diffrences in how participants engaged the SCH digital health platform or lenght of study, although the Black plus other raccial group reported daily symptoms 7.5% less days than the White grpup. The degree of benefit found from the SCH was equitably distributed across racial categories. Carefully designed digital health tools utilized to measure &amp; manage PROs in patients receiving chemotherapy can achieve equitable symptom benefit across racial groups &amp; may contribute to reducing racial diparities in cancer symptom care. Citation Format: Mary Gullatte, Eli Iacob, Gary Donaldson, Kathi Mooney. Evaluating the racial equity of a digital health patient-reported symptom management system in patients receiving chemotherapy [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 B105.

Effectiveness of subtemporal decompression for the management of slit ventricle syndrome

Objectives To assess the effectiveness of subtemporal decompression in the management of slit ventricle syndrome. Methods We conducted a retrospective review of all patients with slit ventricle syndrome (SVS) who underwent subtemporal decompression (STD) at our centre between 2010 and 2021. Cases were identified using the hospital database. Medical records for each patient were reviewed, including operative and radiological reports. Results Fifteen patients underwent STD for the management of SVS. Median age at time of STD was 9.18 years. Aetiology of hydrocephalus consisted of spinal dysraphism (5), idiopathic (4), post-infectious (1), post-haemorrhagic (3), secondary to tumour (1), and craniofacial anomalies (1). Median age at first shunt insertion was 3.4 months. Median pre-operative period assessed, from initial shunt insertion to STD, was 4.54 (interquartile range [IQR] 3.12–10.47) years. Twelve patients underwent ≥1 shunt revision prior to STD. All patients had a diagnosis of SVS at time of STD. Presenting symptoms, for the admission in which STD was performed, included nausea (9), vomiting (8), lethargy (8), headache (12), irritability (5), and visual disturbances (6). One third underwent shunt revision at the time of STD. Two patients developed post-operative complications requiring further surgery (meningitis requiring shunt revision: 1; wound debridement: 1). Three patients developed uncomplicated post-operative pyrexia, which was managed with antibiotics. Median duration of post-operative follow-up was 5.4 (IQR 1.73–8.54) years. Eleven patients underwent ≥1 shunt related procedure following STD. Wilcoxon signed-rank test demonstrated a significant difference in number of shunt related procedures before (median = 5, IQR 1–8) and after (median = 3, IQR 0–5) STD (Z = −2.083, p = .037). All patients reported subjective symptom improvement post-operatively. Thirteen patients experienced symptom recurrence at a median duration of 10 months post-operatively. Conclusions STD was associated with a reduction in the amount of shunt related procedures required in this group of patients with SVS. Further study is required to confirm this association.

Cold stimulation is feasible and has limited aversiveness in healthy, pain-free dogs.

The study aimed to evaluate the applicability and repeatability of cold stimulation in dogs. 10 healthy Beagle dogs were used in a blinded cross-over experiment. Measurements were performed in triplicate at 4 skin locations. The probe was manually placed, and temperature decreased (32 to 10 °C) at different cooling rates (0.5, 1, and 5 °C second-1) and latency was measured (11 °C for 60 seconds). Stimulations were discontinued when avoidance reactions were detected. Thermal threshold or time-to-reaction were recorded. Experiments were performed 3 times per animal in weeks 1 (Exp1), 2 (Exp2), and 5 (Exp3). Feasibility of cold stimulation was scored (0-5). Data were analyzed with mixed logistic regression. No significant differences in number of avoidance reactions between cooling-rates were detected. Significantly more reactions (P < .001) were observed during Exp1 compared to Exp2 and Exp3. Thermal thresholds were 13 ± 2.6 °C, 17.7 ± 4 °C and 16.3 ± 4.6 °C for 5, 0.5 and 1 °C second-1, respectively. Latency to the reaction was determinable in 37% of measurements. The mean time-to-reaction was 13 ± 11 seconds. In 85% of measurements, a feasibility score of 0 (best feasibility) was assigned. The method is easily applicable and well tolerated, but habituation could not be excluded. Overall, the aversiveness of cold stimulation in healthy dogs is limited and it is not possible to recommend a specific protocol. In future studies, it needs to be determined if the aversiveness of cold stimulation is increased in diseased dogs.

Analysis of tariff agreements of the constituent entities of the Russian Federation: form and completeness of data presentation

Background. Each constituent entity of the Russian Federation (RF) on the basis of the territorial programme of state guarantees of free medical care for citizens forms a tariff agreement (TA) on payment for medical care. Despite the list of requirements to the content and structure of the tariff agreement established by the decree of the Ministry of Health of the RF, there are significant differences among the regional tariff agreements in terms of content and completeness of the information provided.Objective: a comparative analysis of TA of the RF constituent entities and additional agreements to them to identify differences in their structure and content.Material and methods. To carry out the analysis, the data of TA for the full calendar year 2022 were systematised into a single database with the allocation of the main parameters regulated by legal documents. On the basis of the database, the availability and form of information presentation in the TA were analysed.Results. The differences were revealed, which can be divided into two groups. In the first group, they relate to the content and structure of TA; in the second group, to the presentation of TA in public domain. The differences are related to the information content of TA, details of tariffs for medical services, the presence or absence of tariffs for separate medical services, as well as the presentation and formats of TA files on the websites of territorial compulsory health insurance funds.Conclusion. To date, there are still a significant number of differences between TA of the RF constituent entities. The lack of unification in data presentation in the regions increases the risk of errors in comparative analysis, which may ultimately affect the correctness of its results presented to the authorities for decision-making in the health care sector. The new unified form of TA will make it possible to eliminate the above-mentioned differences in content and presentation by bringing the data to a single format.

High Deletion Burden Identified By Whole Genome Sequencing Is Associated with Enhanced Risk in del17p CLL Patients

Presence of deletion17p (del17p) in frontline (1L) and relapsed/refractory (R/R) CLL has been associated with shorter time to treatment initiation, early relapse after therapy and inferior overall survival (OS) (Mato et.al., Haemotologica 2022). However, there exists notable clinical heterogeneity in terms of outcome within this group (Tam et.al., Blood 2009, Stephens et.al; AJH 2015). Previous reports in 1L and R/R CLL have identified percentage of del17p nuclei by fluorescence in situ hybridization (FISH), having TP53 mutations on the second allele, copy number alterations and complex karyotype (CK) as additional risk factors within the del17p population (Yu et al., CCR 2017; Baliakas et al., Blood 2019). Here we profile a cohort of wait and watch (W&amp;W, n=14), 1L treated (n=36) and R/R CLL (n=3) patients by whole genome sequencing (WGS) and RNA sequencing (RNAseq) to gain insights into genomic factors and gene expression pathways contributing to the high-risk nature of del17p across the spectrum of CLL patients. Using the Mayo Clinic CLL Database, we identified 53 patients with del17p (identified by FISH testing in routine clinical practice at diagnosis) who had stored peripheral blood mononuclear cells (PBMCs) available. RNA and DNA from matched peripheral blood (tumor) and DNA from CD19- (germline) samples at diagnosis (n=50) and relapse (n=3) was extracted using Qiagen RNeasy (RNA) and Purene (DNA) kits and subjected to RNAseq and WGS respectively. Additional FISH assays (del11q, trisomy 12, del13q) and CK by chromosomal banding analysis (CBA) were performed. Baseline clinical characteristics, time to first treatment, types of treatment, and survival were abstracted from the CLL Database. The Mayo Clinic IRB approved this study. Copy number analysis identified deletions in 3p, 4p, 8p, 9p, 9q and gains in 2p, 8q, 15q and 17q chromosomal lesions occurring in patients. We explored the association of clinical and genetic factors, and genomic instability signatures with survival to identify high-risk features in del17p patients. Both total number of deletions by WGS and number of chromosomal aberrations by CBA as a continuous variable were significantly associated with unfavorable OS in the entire cohort (n=53) in a univariate analysis (Hazard ratio, HR= 2.29, p= 0.00054 and HR= 2.33, p=0.0054 respectively). However, there was no significant association of number of gained genes by WGS or aneuploidy scores with survival (HR=0.74, p=0.37). In patients with CK data (n=41), deletion burden, but not gains, were highly correlated to chromosomal aberrations by CBA. Using cutpointr package for identifying deletion threshold corresponding to CK≥ 3, we defined patients with deletion burden ≥ 514 as enhanced-high risk (EHR; median OS = 4.83 years) compared to the group with high-risk (HR; median OS=9.94 years) (p=0.025). There was no significant difference in number of deleted genes between WW and treated patients. The EHR group is enriched in patients with high clonal cell fraction of del17p by FISH, unmutated IGHV and CK≥ 3. The EHR group remains significant in a multi-variable analysis with IGHV-mutation status, ZAP70, and age (HR: 5.16, 95% CI: 1.04 - 25.6, p=0.04). Mutational analysis identified 35 known CLL driver mutations with TP53 (86%), ATM (15%), NOTCH1(13%), MGA (13%), CHD2 and MED12(11%) as the top mutated genes. Total number of driver genes mutated was not significantly different between EHR and HR subgroups, but the EHR subset was significantly enriched with mutations in NOTCH1 (21%), and MGA (21%) as compared to no mutations in the HR group in these genes. Deleted genes (≥ 514) was prognostic in bi-allelic TP53 aberration patients as well (p=0.021) Differential expression gene-set enrichment analysis indicated a significant enrichment of DNA repair, cellular response to DNA damage and downregulation of inflammatory responses in the EHR group. CK is a known prognostic marker which includes both chromosomal losses and gains. In this small cohort of del17p we were able to show the prognostic value of deletions only, but not gains, as captured by WGS. Using genome wide sequencing, we identify increasing genomic deletions as a feature of enhanced-high risk del17p. While deletion burden cut-offs identified here are specific to our research method and require further validation in additional independent cohorts, EHR subgroup remained significant after adjusting for other known prognostic variables .