Standard Analog Research Articles

Derivation and Initial Validation of the Utility Function for the Hearing Utility Measure (HUM).

The Hearing Utility Measure (HUM) is a replacement hearing attribute for the Health Utilities Index, Mark 3 (HUI-3) designed to improve the responsiveness of utility estimates to changes in hearing-related quality of life. The final development step is to derive the instrument's utility scoring function. Residents of Ontario, Canada, aged ≥18 years participated in standard gamble and visual analogue scale exercises. Valuations for levels (response options) within each domain, and for each domain relative to the other domains were elicited and used to generate a hearing utility function. The function outputs hearing utility ranging from 0 = 'unable to hear at all' to 1 = 'perfect hearing' for each of the 25,920 hearing states classifiable by the HUM. Performance was assessed relative to the criterion standard: directly elicited standard gamble utility. Distributions of HUM-derived hearing utility were compared with legacy HUI-3 derived estimates. A total of 126 respondents participated (mean age 39.2, range 18-85 years, 53% female [67/126]). The utility function performed well in the estimation of directly elicited utilities (mean difference 0.03, RMSE 0.06). Using the legacy HUI-3, estimated hearing utility was 1.0 for 118/126 respondents (93.6%) compared with just 66/126 (52.4%) using the HUM. The new hearing attribute is capable of measuring variations in hearing utility not captured by the legacy HUI-3, especially near the ceiling of hearing function. These findings justify its application and further work to study its measurement properties in hearing loss populations. 3 Laryngoscope, 134:4754-4762, 2024.

Quantifying Health Utility of Age-related Vocal Atrophy.

Age-related vocal atrophy (ARVA) negatively impacts voice and quality of life (QOL). This study aims to determine utility-based QOL in ARVA patients, correlate findings with traditional patient-reported outcome measures (PROMs), and generate utility-based inferences. Forty ARVA patients were prospectively recruited from a tertiary care center. Health utility was measured using standard gamble, time trade-off, and visual analog scale, assessing participants' current health states relative to defined comparison states (blindness/death). Traditional PROMs (Voice Handicap Index-10 [VHI-10] and Voice-Related Quality of Life Scale [V-RQOL]) were also collected. Descriptive and paired statistics were performed to determine health utility, and Pearson correlation assessed the association between PROMs and health utilities. Mean health utility in ARVA was 0.84 ± 0.22, 0.88 ± 0.17, and 0.62 ± 0.25 using standard gamble, time trade-off, and visual analog scale, respectively. There were positive correlations between V-RQOL and time trade-off (r = 0.66; p < 0.0001) as well as with standard gamble (r = 0.47; p = 0.002). Participants with ARVA reported no difference in health utility impact between their voice impairment and monocular blindness (Mean dif 10.9; 95% CI -1.6, 23.5; p = 0.101). Patients with ARVA were willing to part with an average 4.6 ± 6.1 years of life to restore normal voice. ARVA patients view their voice impairment as a significant health decrement, comparable to monocular blindness. These findings underscore the substantial impact of ARVA on QOL and highlight the need for continued research and new therapies. 4 Laryngoscope, 2024.

Vertebroplasty and kyphoplasty in the management of osteoporotic vertebral compression fractures in elderly individuals: evaluation of the health-related quality of life.

Aim of this study is to investigate the safety, efficacy and impact on Health-Related Quality of Life (HRQoL) of Vertebroplasty (VP) and Kyphoplasty (KP) in the management of Osteoporotic Vertebral Compression Fractures (OVCFs) in elderly individuals. VP and KP represent Minimally Invasive Vertebral Augmentation (MIVA) procedures that are increasingly implemented for surgical treatment of OVCFs in recent years. These interventions have been associated with minimal traumatization and intraoperative hemorrhage, considerable analgesic effect and rapid postoperative recovery. Seventy-seven (77) consecutive individuals with OVCFs were subjected to VP/KP and recruited in this prospectively designed non-randomized study. Clinical evaluation was performed preoperatively and postoperatively at particular chronic intervals at 1, 6 weeks and at 3, 6, 12 months and 2 years. Assessment was conducted via the standardized Visual Analogue Scale (VAS) and Short-Form 36 (SF-36) Medical Health Survey Questionnaire for pain and HRQoL, respectively. No perioperative complications were observed. All studied indices were demonstrated to present a statistically significant amelioration following overall analysis. Pain intensity measured by the VAS score was depicted to be significantly reduced during the first 3 months, but continuous improvement of all indices of SF-36 and VAS was demonstrated to reach a plateau at 6 months, featuring no further clinical improvement.VP and KP represent safe and efficient options for interventional treatment of OVCFs in elderly and oldest-old patients, improving self-reported symptoms of pain as well as overall HRQoL.

Development of a three-dimensional printed model from a digital impression of a real patient for aesthetic dentistry undergraduate teaching.

The acquisition of skills and manual dexterity in aesthetic dentistry in undergraduate teaching requires preclinical practices with simulation that should approximate real clinical situations. We will present a digital procedure for the creation of three-dimensional (3D) resin models adapted to the practices of the Aesthetic Dentistry course. Stereolithography or Standard Tesellation Language (STL) files of a real patient were previously obtained with a 3-shape intraoral scanner. Using the Exocad computer programme for dental prosthesis design, various modifications were made, such as incisor rotation, surface alterations imitating dysplasias or erosions, the creation of diastemas, or even changes in tooth size. The virtual model was printed in resin for use by students. Once the practices were finished, the students and the teachers evaluated the use of the 3D printed models. The result is the typodont model, in which seven laboratory sessions took place: 1-Restoration of conoid tooth morphology, 2-Cervical abrasion/ erosion restoration, 3-Direct Composite Veneer, 4-Aesthetic correction in a tooth with rotation, 5-Diastem closure, 6-Occlusal abrasions/ erosion, and 7-Maryland bridge. 90.48% of the students evaluated the designed 3D model as the best method for laboratory practice compared to other methods, obtaining a general assessment of 8.3 out of 10. The method used has provided a reproducible standard analog model for direct aesthetic dental restoration practice, with a good assessment by students and teachers.

Tonsillar healing membrane characteristic for tonsillectomy using combined cold dissection and bipolar electrocautery

PurposeTo evaluate post-tonsillectomy healing process using combined cold dissection and bipolar cautery for hemostasis.MethodsThis case series included patients for whom tonsillectomy was done by cold dissection and limited the bipolar cautery for hemostasis and dealing with the lower pole only. Saline irrigation was used for the tonsillar bed after tonsillectomy and a wet saline-moistened pack was placed into the tonsil fossa. Intra-oral digital photographs were reviewed postoperative, at 3rd, 5th, 7th, 9th, 11th, 13th, 15th, and 21st day after surgery. Patients were asked to register their postoperative pain using a standardized visual analog scale. The time of separation of the healing membrane (HM) and any blood clot and/or bleeding surface were recorded.ResultsAmong included 114 patients, the HM color was white without odor in all cases. Extension of the HM was limited to the tonsillar bed in 112 patients (98%) and exceeded in 2 patients (2%). The mean time for HM separation was 8.8 ± 1.1 days (range = 7–14) with a significantly longer period of separation in females (p = 0.0008). There was no significant correlation between the time of the HM separation and the age of the patients (P = 0.9).ConclusionCold dissection tonsillectomy with limited hot tools usage for hemostasis by bipolar cautery with frequent saline wash leads to odorless HM and a good healing process with an average separation of the HM and so less pain and post-tonsillectomy bleeding.

P-734 Low cost antagonist protocol in ivf-icsi cycles using oral ovulation induction agents in developing countries

Abstract Study question The study aimed at comparing the cost-effectiveness of a low cost antagonist protocol using oral-ovulation-induction agents with a standard long GnRH-Agonist protocol in IVF-ICSI cycles. Summary answer Low cost antagonist protocol using oral-ovulation-induction agents comparing with a standard long GnRH-Agonist protocol in IVF-ICSI cycles is cost-effectiveness in developing countries. What is known already IVF-ICSI had always been proved to be costly treatment. The additional expenditure is mainly due to use of high dose of gonadotrophins in order to get more number of eggs. To cut down the cost,low dose or mild stimulation protocol have been popularized all over the world in last few years. Use of aromatase inhibitors along with low doses of gonadotrophins have been an effective means of mild stimulation protocols for IVF cycles. Oral ovulogens, reduces the total dose of gonadotrophin required for inducing follicular maturation. We evaluated if incorporation of letrozole could be an effective alternative for low-cost IVF. Study design, size, duration A total of 304 patients under 40 years of age were studied between 2018 to 2022 Subsequently, they were randomly divided into two groups. The agonist group underwent standard long GnRH analogue protocol. The antagonist group received oral ovulation inducing drugs (CC/Letrozole) and 0.25mg antagonist injections upto the day of hCG injection, using a flexible start approach. Participants/materials, setting, methods A total of 304 patients under 40 years of age were studied between 2018 to 2022. All patients received low-dose OCP before starting treatment. Subsequently, they were randomly divided into two groups. The agonist-group underwent standard long GnRH analogue protocol. The antagonist group received oral ovulation inducing drugs (CC/Letrozole) and 0.25mg antagonist injections upto the day of hCG injection, using a flexible start approach. Follicular development was monitored by vaginal ultrasound and serum estradiol levels. Main results and the role of chance There was a significant difference in the gonadotropin usage between the two groups. As a result, the cost of the CC/Letrozole-gonadotropin-antagonist cycle was significantly lower than the long GnRH agonist-gonadotropin protocol. Though the mean number of oocytes retrieved was higher in the long protocol group, yet the clinical pregnancy rate per transfer was the same in both groups. While comparing for the primary outcomes pregnancy rate and miscarriage rate were comparable between two groups. It is of particular importance to note that despite 60%reduction of total dose of rFSH in the Let-rFSH group,which entailed significant reduction of the cost of treatment, the outcomes in all major aspects including pregnancy rate were comparable between the groups. However, numbers of matured follicles, retrieved oocytes and transferable embryos were not statistically different between study and control group in this study. This prospective study, designed to evaluate the efficacy of oral-ovulogens -FSH as a low-cost IVF protocol, involved an average number of patients; however, the results have been encouraging. We have been successful in reaching our objective to modify an expensive conventional down regulated IVF protocol into one in which the cost was reduced to a larger extent, without compromising the rate of success in developing countries. Limitations, reasons for caution Since last Cochrane review, GnRH-antagonist protocol was proved to be a short and simple protocol with good clinical outcome with significant reduction in incidence of severe OHSS and amount of gonadotrophins requirement. Although, we need more RCTs to come to a conclusion on regular use of such combined protocol. Wider implications of the findings Usage of GnRH-antagonist in combination with Oral-Ovulogens offers the advantage of a low-cost economical stimulation in IVF, as compared to an agonist-protocol, with similar pregnancy-rate in developing countries. It not only offers a cost-saving stimulation-protocol but also reduces side effects like OHSS and multiple pregnancies yet maintain a descent success-rate. Trial registration number not applicable

Overall symptom severity as a patient-reported outcome measure for chronic rhinosinusitis: what it reflects and how to measure it.

The objective of this study was to identify how - and to what extent - overall symptom severity (OSS) score reflects individual chronic rhinosinusitis (CRS) symptoms and whether it can be measured using alternatives to the standard visual analog scale (VAS). CRS patients from four sites across three continents rated their OSS scores, severities of nasal obstruction, nasal drainage, decreased sense of smell, facial pain/pressure and sleep disturbance using a standard VAS, VAS with labeled tick marks at every 1 centimeter, and by writing down their OSS on a scale of 0 - 100 (which was divided by 10), all of which lead to severity scores ranging from 0 - 10 in 0.1 intervals. Quality of life was measured using the SNOT-22 and EQ-5D VAS. In 311 CRS patients, OSS score was significantly correlated with SNOT-22 and EQ-5D VAS. OSS score was most greatly associated with the mean of all individual symptom severity scores. From individual CRS symptoms, OSS was most greatly associated with nasal obstruction followed by nasal drainage and facial pain/pressure severities. These results held true for participants with and without nasal polyps. Measurement of OSS and individual symptom severity scores using a standard VAS, tick-marked VAS, and write-in option had near-perfect consistency. We demonstrate for the first time that OSS largely reflects the mean of individual CRS symptom severities, although OSS is=== most weighted by nasal obstruction severity. OSS and individual symptom severity scores can be measured using a standard VAS, tick-marked VAS or write-in prompt with near-perfect consistency.

Use of Magic Tricks as Analogies in the Science Classroom

&lt;p style="text-align:justify"&gt;Science, magic, and education have always been linked, from science-based magic shows to teachers presenting demonstrations as magic tricks to capture their students’ interest and provide a mnemonic reference for the topics under discussion. Magic as an art form is also often used to convey information or act as an analogy for invisible phenomena. This study examined how the use of a magic effect designed as an analogy for active and passive transport in cells affected student scores and perception of the activity when compared to a standard story analogy in a high school integrated science course. To determine this, students participated in either a magic-based analogy activity (MBAA) or a concrete story-based analogy activity (SBAA), and then data was collected and analysed using a pre-test/post-test for the content and a Likert-scale anonymous survey for the student perception of the activity. The MBAA was shown to be similar to the SBAA in helping students learn but had the added benefit of increasing students’ reported engagement with the activity. This study shows how bringing magic into the science classroom can have a positive impact on student engagement and provides teachers with another option to support student learning.&lt;/p&gt;

Efficacy of Celecoxib and Naproxen Sodium After Non-Surgical Extraction of Permanent Teeth: A Randomized Control Study

Objective: To compare the level of pain relief that two NSAID salts offer following a simple closed tooth extraction technique, as well as to assess patient adherence to the prescribed dosage schedule. Methodology: This Randomized Control Design study was conducted at Islamabad medical &amp; dental college, from 2018-2019. 150 patients made up the sample, who were split into two equal groups using a computerized lottery system: the experimental group and the control group. Following tooth extraction under local anesthesia, participants in the experimental group were told to take one 200 mg tablet of celecoxib orally for two days, while the control group was administered two 550 mg tablets of Naproxen Sodium orally twice a day. The standard Visual Analogue Scale (VAS) was used to assess post-extraction pain after 24 and 48 hours. Patients' adherence was verified by having them fill out a Performa form by phone call after 48 hours. After collection of Data, analysis was done with the help of SPSS version 21.0. Results: After tooth extraction, both medications were similarly effective in reducing pain, although participants adhered to the OD dose of celecoxib substantially more than the BD dose of naproxen sodium. Conclusion: There was statistically insignificant difference in pain relief provided by Celecoxib and Naproxen Sodium after 24 and 48 hours of single tooth extraction.

Отдаленные результаты использования системы трехмерной визуализации в сравнении со стандартной аналоговой визуализацией в хирургии хрусталика

Abstract Long-term results of using a three-dimensional imaging system in comparison with standard analog imaging in lens surgery A.V. Zhuravlev, V.S. Stebnev, S.D. Stebnev, I.V. Malov, L.M. Nizamutdinova Samara State Medical University, Department of Eye Diseases, Department of Eye Diseases IPO, Samara, Russian Federation Eye Surgery LLC, Samara, Russian Federation Purpose. Assessment of the safety and effectiveness of lens surgery using three-dimensional visualization based on the analysis of long-term results of operations. Material and methods. The study involved 500 patients (500 eyes). The main group consisted of 250 patients with cataracts operated by phacoemulsification using the NGENUITY three-dimensional digital imaging system. The control group consisted of 250 patients using analog imaging, i.e. using standard eyepieces. Long-term results were evaluated 3, 6 and 12 months after surgery using parameters such as uncorrected and maximally corrected visual acuity, refractometry indicators and corneal endothelial cell density. Results. Although in the long-term period we did not record statistically significant differences between the achieved indicators of visual acuity, refractometry and density of corneal endothelial cells in the main and control groups, their average values were still slightly higher in the group of patients where three-dimensional digital imaging was used in the FEC process. Conclusion. The long-term results of a comparative study of visual acuity, endothelial cell density, spherical and cylindrical components of refraction when using analog and three-dimensional digital imaging in cataract surgery allow us to conclude that the latter method is still more effective than the standard one. All this, combined with great ergonomic capabilities, makes it possible to recommend three-dimensional digital visualization for wider dissemination in clinical practice. Key words:cataract surgery, three-dimensional digital visualization, standard analog visualization, visual acuity, refraction, density of endothelial cells

Mетаболічна та продуктивна дія удосконалених за складом БВМД у раціонах годівлі молодняка овець

The article presents the results of the study of productive and metabolic effect of the use of a protein-vitamin-mineral supplement (PVMS), an improved formulation, as part of the feeding rations of young repair ewes of the Ukrainian mountain-Carpathian breed in the conditions of the natural-climatic zone of the Carpathian foothills, by introducing into their composition local highly nutritious feed components. The research was carried out during a two month period (February – March) in the conditions of the Radvan-Nova farm (Myloshevychi village, Pustomytivskyi district, Lviv region) on young ewes of the above breed in the winter-spring stall period. For this purpose, three groups of 12-month-old young ewes of 10 heads in each group (control and two experimental) were formed by the method of analogues, which were kept separately with the provision of proper care and level of feeding. The feeding ration consisted of meadow grass-herbaceous hay (unlimited), oat-pea straw (unlimited) and compound feed. The calves of the control group received 0.4 kg of standard compound feed according to the recipe of the ITSR named after M. F. Ivanov "Askania-Nova", the young ewes of the first experimental group – the same amount of experimental compound feed, the young ewes of the second experimental group – 0.3 kg of a mixture of whole grains of oats, barley, corn and 0.1 kg of experimental PVMS. The conducted studies established that, in the conditions of the indicated climatic zone, feeding of 12-14-month-old young ewes with the rations of compound feed and PVMS including local feed ingredients in their composition, compared to standard analogues, provides an increase in indicators of weight and linear growth of animals, a decrease in monetary expenditure on increases in live weight, improves biochemical indicators of metabolism in the blood. It is also shown that the use of compound feed and PVMS of an improved recipe compared to standard feed, when growing repair young ewes of the Ukrainian mountain-Carpathian breed aged 12–14 months in the winter-stall period makes it possible to reduce monetary costs for obtaining 1 t of growth gain by 10–13%

Python Red Pitaya Lockbox (PyRPL): An open source software package for digital feedback control in quantum optics experiments.

We present the Python Red Pitaya Lockbox (PyRPL), an open source software package that allows the implementation of automatic digital feedback controllers for quantum optics experiments on commercially available, affordable Field-Programmable Gate Array (FPGA) boards. Our software implements the digital generation of various types of error signals, from an analog input through the application of loop filters of high complexity and real-time gain adjustment for multiple analog output signals, including different algorithms for resonance search, lock acquisition sequences, and in-loop gain optimization. Furthermore, all necessary diagnostic instruments, such as an oscilloscope, a network analyzer, and a spectrum analyzer, are integrated into our software. Apart from providing a quickly scalable, automatic feedback controller, the lock performance that can be achieved by using PyRPL with imperfect equipment, such as piezoelectric transducers and noisy amplifiers, is better than the one achievable with standard analog controllers due to the higher complexity of implementable filters and possibilities of nonlinear operations in the FPGA. This drastically reduces the cost of added complexity when introducing additional feedback loops to an experiment. The open-source character also distinguishes PyRPL from commercial solutions, as it allows users to customize functionalities at various levels, ranging from the easy integration of PyRPL-based feedback controllers into existing setups to the modification of the FPGA functionality. A community of developers provides fast and efficient implementation and testing of software modifications.

Posterolateral Instrumented Fusion in Elderly Patients With a Single Osteoporotic Vertebral Fracture: Evaluation of Health-Related Quality of Life.

Introduction Treatment of osteoporotic vertebral fractures (OVFs) is a factor that affects the quality of life and should be considered during management. In patients with a single OVF and neurologic deficit, surgical procedures aiming at neural decompression with instrumented fusion should be considered in elderly individuals. Posterolateral instrumented fusion (PLF) constitutes a largely performed fusion surgery for patients featuring indications for fusionsurgery. The aim of this study was to determine the safety, effectiveness, and impact on health-related quality of life (HRQoL) of PLF surgery in elderly patients diagnosed with a single OVF. Methods This study was conducted at Interbalkan European Medical Center, Thessaloniki, Greece. Eighty (80) consecutive individuals with OVFs were subjected to PLF and recruited in this prospectively designed non-randomized study. Clinical evaluation was performed preoperatively and postoperatively at particular chronic intervals at one, three, six, and 12 months and two years. The assessment was conducted via the standardized Visual Analogue Scale (VAS) and Short-Form 36 (SF-36) Medical Health Survey Questionnaire for pain and HRQoL, respectively. Results No major perioperative complications were observed. All parameters of SF-36 presented significant improvement over the entire follow-up period with VAS scores reaching a plateau at six months. Depicted improvement of these parameters proves the beneficial role of PLF in elderly patients who suffered from a single OVF with or without referable neurological deficit. Conclusion OVFs have a significant impact on the quality of life of elderly patients, and surgical treatment with PLF with or without decompression can lead to functional recovery, pain relief, and HRQoL amelioration. Our results demonstrated that the outcomes of PLF in the surgical treatment of these patients are remarkably favorable, demonstrating the safety and efficacy of the technique.

Health-Related Quality of Life and Economic Burden Among Hospitalized Children with Hand, Foot, and Mouth Disease: A Multiregional Study in China.

Hand, foot, and mouth disease (HFMD) is an infectious disease with high morbidity and mortality rates among children under 5years old. This study aimed to explore the health-related quality of life (HRQOL), economic burden, and related influencing factors among Chinese HFMD patients. From January to October 2019, a longitudinal cohort study of 296 hospitalized patients (≤5years old) with HFMD and their guardians was conducted using the proxy version of the 5-level EQ-5D-Y (EQ-5D-Y-5L, Y-5L) in face-to-face interviews in Shanghai, Zhengzhou, and Kunming, representing three regions with different economic development levels. Multiple linear regression was used to explore the factors associated with HRQOL and costs. The mean Y-5L health utility score (HUS) (standard deviation, SD), and visual analogue scale (VAS) score (SD) were 0.730 (0.140) and 60.33 (16.52) at admission and increased to 0.920 (0.120) and 89.95 (11.88) at discharge, respectively. The children from Shanghai had the lowest HUSs at admission and had the best health improvement. The mean hospitalization cost and total cost were 4037 CNY and 5157 CNY, respectively. The children from Shanghai had the highest hospitalization cost (4559 CNY) and total cost (5491 CNY). Multiple regression analysis suggested that medical insurance status, type of employment, residence type, and religious status were significantly associated with the baseline HUS and improvement in the HUS after treatment. Region, loss of work time, and length of stay had a significant impact on the hospitalization cost and total cost. Our findings demonstrate that HFMD could lead to poor HRQOL and the economic burden varies in different regions in China. Many pediatric patients still have physical or mental health problems shortly after treatment.

Digital health literacy among the ageing population: A comparative cross-sectional study between rural and urban Telangana, India

BackgroundDigital health literacy (DHL) is the confluence where health literacy meets digital literacy. DHL has been labelled as one of the digital determinants of health by the World Health Organization. The present study estimated and compared the DHL between Telangana's urban and rural ageing adults, and their potential determinants. MethodsA cross-sectional study was undertaken among 318 of the ageing individuals (≥45 years) of Hyderabad, visiting the primary health centres in the rural and urban field practice during March 2023. A Telugu version of the eHealth literacy scale (eHEALS) and health literacy scale tools were administered by the interviewers. Adjusted analysis was conducted by multiple linear regression method. ResultsOverall, 20.4% of the study participants had good DHL, with a similar proportion between rural and urban areas (rural-20.1% and urban-20.8%, p value-0.889). The median eHealth literacy score among the study participants was 8. While 36.5% and 45.9% had smartphones and standard analogue phones, respectively in urban areas, only 19.5% and 38.4% had smartphones and standard analogue phones, respectively in rural areas. Computer usage in the past month, higher educational qualification, and ownership of mobile phones were significant determinants of DHL. A mild but significant correlation between DHL and health literacy screening scores was found. ConclusionConsidering the low DHL among the ageing population, enabling environment with enhanced access to mobile phones/smartphones and familiarity with information and communication technology gadgets must be established to improve their DHL.

A - 189 Subjective Response to a Social Stressor in Individuals with Mild Cognitive Impairment.

Because stress is a risk factor for Alzheimer's disease (ad), characterizing individual differences in the stress response could help identify those who might be targeted in risk-prevention efforts. Studies measuring the stress response in individuals with mild cognitive impairment (MCI), however, are lacking, in part due to concerns that doing so would be too distressing to these individuals. In this study, we aimed to characterize the subjective response to an acute stressor in individuals with mild cognitive impairment (MCI). This study consisted of 20 community-dwelling individuals (9 with MCI and 11 cognitively normal individuals; 11 women) 60years and older (Mean = 70.1, SD = 5.6) who underwent the Trier Social Stress Test (TSST). Subjects rated their subjective distress using a standardized visual analog scale at prespecified intervals 3 points prior to, and 6 points following, the TSST. Data were subjected to repeated measures analysis with sex as a covariate. Subjects with MCI rated the TSST as less stressful than their cognitively normal peers (p = 0.04), due to group differences in both post-TSST ratings of subjective distress (p = 0.013) and an increase from pre-TSST to post-TSST ratings of subjective distress (p = 0.04). No individuals withdrew from the study while participating in the TSST. Our finding that individuals with MCI reported experiencing lower distress than their cognitively normal peers in response to a laboratory-based stressor may help alleviate concerns regarding the risks of studying stress in this population. Future research with larger samples will be valuable in studying other determinants of the stress response in these individuals.

THU023 Sparse Granulation In Growth Hormone Secreting Adenomas: Clinical Implications Of A Rare Histological Finding

Abstract Disclosure: A. Merrill: None. R. Varughese: None. G. Campbell: None. L. Belalcazar: None. Introduction: Acromegaly is an uncommon disease. Endocrinologists may be unfamiliar with the clinical implications of granularity findings on the histology of growth hormone (GH)-secreting adenomas. We present the case of a patient with acromegaly in whom a sparsely granulated (SG) histological subtype was identified post-operatively. We discuss the clinical presentation and therapeutic implications of this finding. Case Presentation: A 36-year-old man was admitted to the hospital with rectal bleeding and incidentally found to have features consistent with acromegaly. Patient reported that over 1 year he had noticed changes in his facial features, enlargement of his hands and had developed hand and knee arthralgias. During the 6 months prior to admission, he experienced worsening fatigue, but denied severe headaches or vision changes. Past medical history was significant for osteosarcoma as a young child treated with an above the knee amputation. Family history was negative for pituitary tumors or colon cancer. Physical exam revealed a blood pressure of 104/53 mmHg and an amputation-adjusted body mass index of 27.4 _kg/ m2 . He had mild frontal bossing, enlarged nose, macroglossia, swollen hands and foot. Rectal examination revealed hemorrhoids but no masses. Gross visual field deficits were identified at bedside. Laboratory findings were significant for an elevated IGF-1 at 975 ng/mL (83-240 ng/mL) and GH 45.2 ng/mL (0.3-9 ng/mL). Patient was also found to have panhypopituitarism: TSH 1.54 mIU/L (0.45-4.70 mIU/L), Free T4 0.62 ng/dl (0.78 - 2.20 ng/dL); ACTH 13.3 pg/ml (7.2 - 63.3 pg/mL), cortisol AM 3.6 ug/dL (4.5-23.0 ug/dL), peak cortisol after ACTH stimulation 16.0 ug/dL; testosterone 31.6 ng/dl (132-813 ng/dL), LH 1.75 mIU/ml (1.2-8.6 mIU/mL). His hemoglobin A1c was 5.7%. MRI of the brain revealed a large enhancing lobulated sellar/suprasellar lesion of 5.0 x 2.4 x 2.8 cm, with extension to the third ventricle and mass effect on the optic chiasm. Patient underwent partial surgical resection of the large tumor. Pathology identified a SG somatotroph tumor with most cells being negative or weakly positive for GH on immunohistochemical staining. TSH, prolactin, and ACTH stains were negative. There was evidence of residual tumor, which was located superiorly, not accessible through the transsphenoidal route.A colonoscopy and formal visual field testing are pending currently. Patient is waiting for a second surgery via craniotomy and, given the SG finding on histology, pasireotide therapy will be offered. Discussion: The sparsely granulated (SG) subtype is an uncommon variant of GH-producing. Our patient illustrates the aggressive nature of SG GH-producing adenomas. These tumors express more invasive growth and resistance to standard somatostatin analogue therapy. There is a growing recognition that adenoma granulation is an important consideration in the management of acromegaly. Presentation: Thursday, June 15, 2023

PEG 400 Ion Suppression in Busulfan Detection by High-Performance Liquid Chromatography-Tandem Mass Spectrometry.

Busulfan (Bu), an alkylating agent commonly used in chemotherapy and transplantation, exhibits high intraindividual pharmacokinetic variability and possible time-dependent variations in clearance, which complicate therapeutic drug monitoring. Numerous analytical methods have been developed to reduce analysis time and facilitate timely decision-making regarding treatment changes; however, the validation procedures rarely involve analysis of potentially interfering excipients. Macrogol 400 (PEG 400) should be considered as a possible interfering agent in the detection of plasma Bu levels, especially as an ionization suppressor. Six intravenous formulations of Bu were compared with identify at least 1 common excipient (PEG 400). During the 176 therapeutic drug monitoring analyses of Bu, one of the PEG 400 specific mass-to-charge ratio transitions was determined using an instrumental method. After coelution with Bu and its internal standard (Bu-d8) was confirmed, all analyses were repeated using a different experimental setup free of ion suppression induced by PEG. The concentration-time profile of PEG 400 was also analyzed. The area under the curve obtained from the 2 data sets was compared and analyzed using Lin concordance correlation coefficient and Bland-Altman plot analysis. The results from the 2 analytical methods were comparable: PEG 400 negatively affected the Bu-d8 coefficient of variation but not the Bu/Bu-d8 ratio. The possible interference of PEG 400 should be thoroughly investigated, especially with respect to analytical methods that cannot be supported by correction of the stable isotopically labeled internal standard analog.

Design and fabrication of an amperometric CO gas sensor and a readout circuit using a low-noise transimpedance amplifier to achieve standard analog outputs

This article presents a sensor design method that utilizes two electrodes made of gold and tin oxide, along with a gas concentration detection circuit. The use of an n-type semiconductor with a rutile structure contributes to improved sensitivity, and a sol-gel coating with SnO2 is applied. The sensor includes 20 finger electrodes printed on a ceramic substrate, along with a heater placed on the bottom layer to enable interaction with the external environment. The gas concentration is detected through the use of an amperometric method and an ultra-low noise amplifier. The proposed system incorporates a microcontroller and a low-noise analog interface, delivering standard analog outputs ranging from 0 ∼ 10 V and 4 ∼ 20 mA, proportional to the gas concentration. The experimental results demonstrate a sensitivity of 6nA/ppm within the range of 0 ∼ 470 ppm, with a detection limit of 1 ppm. Key advantages of the proposed circuit include linear response within the specified range, resistance to thermal changes, and cost-effectiveness. Moreover, the sensor exhibits reliable repeatability, with a response time of 27.5 s and a recovery time of 39 s. The front-end circuit's adjustable bandwidth and gain enable precise fine-tuning of the measured CO concentration range.

A benchmark for evaluating Arabic contextualized word embedding models

Word embeddings, which represent words as numerical vectors in a high-dimensional space, are contextualized by generating a unique vector representation for each sense of a word based on the surrounding words and sentence structure. They are typically generated using such deep learning models as BERT and trained on large amounts of text data and using self-supervised learning techniques. Resulting embeddings are highly effective at capturing the nuances of language, and have been shown to significantly improve the performance of numerous NLP tasks. Word embeddings represent textual records of human thinking, with all the mental relations that we utilize to produce the succession of sentences that make up texts and discourses. Consequently, the distributed representation of words within embeddings ought to capture the reasoning relations that hold texts together. This paper makes its contribution to the field by proposing a benchmark for the assessment of contextualized word embeddings that probes into their capability for true contextualization by inspecting how well they capture resemblance, contrariety, comparability, identity, relations in time and space, causation, analogy, and sense disambiguation. The proposed metrics adopt a triangulation approach, so they use (1) Hume’s reasoning relations, (2) standard analogy, and (3) sense disambiguation. The benchmark has been evaluated against 22 Arabic contextualized embeddings and has proven to be capable of quantifying their differential performance in terms of these reasoning relations. Results of evaluation of the target embeddings revealed that they do take context into account and that they do reasonably well in sense disambiguation but have weakness in their identification of converseness, synonymy, complementarity, and analogy. Results also show that size of an embedding has diminishing returns because the highly frequent language patterns swamp low frequency patterns. Furthermore, the suggest that future research endeavors should not be concerned with the quantity of data as much as its quality, and that it should focus more on the representativeness of data, and on model architecture, design, and training.