Significant Statistical Association Research Articles

Hepatitis B vaccination coverage and associated factors among nurses working at health centers in Addis Ababa, Ethiopia: a cross-sectional study.

Hepatitis B virus (HBV) poses one of the most serious workplace health risks facing healthcare workers, especially nurses, due to occupational exposure. The HBV vaccination coverage among healthcare workers in Ethiopia ranged from 5.4 to 21.9%. However, little is known about HBV vaccination coverage and associated factors among nurses in Ethiopia. Therefore, the aim of this study was to assess HBV vaccination coverage and associated factors among nurses working in health centers in Addis Ababa, Ethiopia, in 2023. An institutional-based cross-sectional study was conducted from March 2 to March 31, 2023, among 428 nurses working in 32 health centers in Addis Ababa, Ethiopia. Data were entered into Epi-Info version 7.2.5.0 and then exported to SPSS version 27 for analysis. Descriptive statistics (frequencies and proportions) were used to summarize the data on the study variables. Bivariate and multivariate logistic regression analyses were conducted to determine the strength of the association, and the statistical significance of associations between the variables was determined using adjusted odds ratio with a 95% CI and p values < 0.05. HBV-full vaccination coverage among 428 nurses in health centers in Addis Ababa, Ethiopia, was 36.9%. Male nurses [AOR = 1.78, 95% CI: 1.08, 2.95], taking training on infection prevention [AOR = 1.73, 95% CI: 1.08, 2.78], having good knowledge about HBV vaccine [AOR = 1.98, 95% CI: 1.28, 3.04], and testing for HBV [AOR = 1.98, 95% CI: 1.08, 3.64] were more likely to have HBV full vaccination coverage, whereas monthly salary ≤ 7,071 Ethiopian Birr was 54% less likely to have HBV full vaccination coverage [AOR = 0.46, 95% CI: 0.25, 0.85] at p-value < 0.05. This study revealed that the full HBV vaccination coverage of nurses working in health centers in Addis Ababa, Ethiopia, was low (36.9%), and consequently, the majority of nurses are at a high risk of being infected with HBV. Therefore, the Ministry of Health and health centers should promote awareness, implement prevention programs, provide diagnostic, treatment, and care services, enhance information generation and utilization, and strengthen the health system to increase vaccination coverage among nurses.

A cross-sectional study of musculoskeletal injuries related to exercise among gym members in Saudi Arabia in 2022: prevalence, common types, and predictor factors

BackgroundDespite the importance of enhancing exercise, exercising can cause injuries that lead to disability and increase the load on the medical sector. This study aimed to estimate the prevalence of exercise-related injuries among gym members in the Kingdom of Saudi Arabia (KSA) and evaluate the more common types of such injuries. It also investigated the association between injury prevalence and the factors selected.MethodsA cross-sectional study with a self-reported survey was conducted targeting members of Fitness Time gyms across the KSA. The survey consisted of three parts: part one concerns participant demographic data and part two contains four questions regarding the participants’ training experience. Part three contains ten questions targeting those with a history of injury. Descriptive statistical analysis was performed using frequencies and percentages for categorical variables. Crosstabs and chi-squared tests were used to assess the prevalence of exercise-related injuries when appropriate. Binary logistic regression was employed to investigate the association between injury prevalence and the potential associated factors. Odds ratios and their 95% confidence intervals were calculated and the threshold for statistical significance was set at p ≤ 0.05.ResultsA total of 713 subjects participated in the study. The mean age was 36.5 ± 11.2 years and (n = 422, 59.2%) of the participants were female. The study found a prevalence of injury among gym members of about (n = 404, ~57%). The most commonly reported types of injuries were muscle strain (n = 126, 37%) and bruising (n = 45, 13%). The most prevalent anatomical location of injury was the knee (n = 287, 84.3%), followed by the shoulder (n = 283, 83.3%), and the least common was the head/neck (n = 7, 2.1%). The present study suggests some factors associated with exercise-related injury. A significant statistical association (p < 0.5) was found between injury prevalence and age, gender, educational level, period of training, and presence of a trainer. However, no association was detected between injury prevalence and Body Mass Index (BMI), place of residence, or source of advice.ConclusionOver half of the participants of this study reported at least one exercise-related injury. This study identifies factors associated with injury prevalence related to exercise among gym participants. Promoting safety and minimizing the incidence of injuries are crucial.

Cruciferous vegetables intake reduces pancreatic cancer risk: an updated systematic review with meta-analysis.

The escalating disease burden associated with pancreatic cancer has led to its inclusion as a target of public health efforts. The relationship between the consumption of cruciferous vegetables and the incidence of pancreatic cancer has generated conflicting findings in various epidemiological studies. Eligible studies were cohort or case-control studies reporting on the association between consumption of cruciferous vegetables and pancreatic cancer. PubMed, Cochrane, and Embase were systematically searched for potential studies before 27 July2022. These databases were finally searched again on 1 February 2023. The meta-analysis was conducted using random-effects models, and Stata 17 was employed for the statistical analyses. Sixteen studies, encompassing 1,135,281 participants from 1989 to 2021, met the inclusion criteria. An inverse association of statistical significance was observed (RR 0.83, 95% CI 0.72-0.96). The sensitivity analysis indicates that this result is robust. We conducted subgroup analyses based on region, gender, study design, quality, exclusivity to endocrine tumors, adjustment for smoking, alcohol consumption, diabetes, and BMI. This review provided support for the inclusion of cruciferous vegetables in the diet as a cost-effective and readily available prevention.

Survey of Schistosoma haematobium and Environmental Factors in Donga Local Government Area, Taraba State, Nigeria

Schistosoma haematobium infection is known to be endemic especially among residents along Rivers, This study was conducted to establish the preval_ence of urinary schistosomiasis in relation to some epidemiological factors among elementary pupils in Donga Local Government Area. Urine filtration technique using polycarbonate membrane filters was employed to check the presence of Schistosoma haematobium eggs in urine and questionnaires were administered. Overall preval_ence of 8.94% (21) was recorded out of the 235 urine examined. Chi square analysis showed insignificant association of the infection with the various schools (χ²= 6.192, P = 0.185). Similarly, ANOVA revealed no significant difference in the mean egg intensity (27.29 eggs/10ml of urine) among the schools (p = 0.293). Males were more infected 13.33%(16) than females 4.50%(5) with a significant difference (P=0.020). However, there was no statistical significant difference in their mean egg intensities (30.3 eggs/10ml of urine in male and 17.6 eggs/10ml of urine in female) (p = 0.27). The age-related preval_ence was higher 11.82% (13) in 10-15 years children while children aged 16-20 had the least preval_ence 0.01% (1). Chi square showed statistical significant association between infection and age (χ²=12.964, P=0.002). But there was a statistical insignificant difference between their mean egg intensities; 10-15, 4-9 and 16-20 (31.08, 23.4, 5 eggs/10ml of urine respectively) with p=0.462. Children who fish had the highest preval_ence 16.67% and children that do not partake in any of these activities had no case of infection 0%(64). Chi square revealed a statistical significant association between participant's water contact activities and infection (χ² =11.21; p = 0.024). However, ANOVA showed statistical insignificant difference in the mean egg intensity among these activities (p = 0.486). This findings indicates that urinary schistosomiasis has low endemicity in this area which could be due to the fact that It was concluded that the overall low preval_ence could be attributed to improved environmental hygiene among others.

Solid Waste in Urban Areas: A Multidimensional Statistical Approach on Irregular Disposal and Burning in the Municipality of Governador Valadares, Minas Gerais

The improper disposal of urban waste is a global concern, especially in large cities considering aspects of environmental and visual pollution. This study provides a detailed analysis of the municipality of Governador Valadares, Minas Gerais, identifying local nuances and a better understanding of this issue to support decisions for corrective actions. It assesses the persistence and incidence of waste burning at irregular disposal sites in the municipality, emphasizing its environmental and health impacts. This work utilized a combined approach of georeferenced mapping with Google Earth Pro images, complemented by in-situ checks with GPS devices. The statistical analysis of the collected data was performed using the PSPP software. Statistical analyses were supported by contingency tables, the application of the chi-square test, Phi, Cramer's V, and Odds Ratio, evaluating the characteristics of the associations. A strong association was identified between the persistent disposal of solid waste in undeveloped areas and the presence of tree pruning and gardening waste. The research also demonstrated a significant association of areas with signs of burning that were located in public spaces. Additionally, a significant statistical association was confirmed at sites where paper and plastic disposals and burning were identified. This research expands the understanding of disposal practices in urban contexts and provides a replicable model of combined georeferenced analysis with physical checks, in addition to the risks to public health and the environment. The results obtained demonstrate direct implications for waste management policies, raising awareness of the consequences of improper disposal and burning.

Association of Ultrasound Abdomen Findings with Liver Function Test and Alcohol Use Disorders Identification Test Scores in Cases of Alcohol Use Disorder

Introduction: There are three independent variables used in clinical practice to evaluate patients suffering from alcohol use disorder (AUD); these are Alcohol Use Disorders Identification Test (AUDIT), liver function tests (LFTs), and imaging findings on ultrasound of the abdomen. There is limited literature about the association of imaging findings with LFT and AUDIT scores in cases of AUD. Objective: The study was conducted to determine the association of ultrasound abdomen findings with LFTs and AUDIT scores in patients with AUD. Methods: This study was conducted using data from 439 patients of AUD (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) treated in the psychiatry department of a tertiary care hospital. The data hence obtained were subjected to statistical analysis. The ordinal data sets were compared using the Chi-square test, and P &lt; 0.05 was taken as statistically significant. Results: The ultrasonography (USG) findings of hepatic/portal system changes in patients of AUD show a significant association with the corresponding changes in AUDIT scores, serum bilirubin, and aspartate transaminase (AST) levels. The ultrasound findings were also significantly associated with total years of drinking and average drinking (in g) per day in the last 3 years. The USG findings did not show a significant statistical association between ALT (alanine transaminase) and serum gamma-glutamyl transferase levels. Conclusion: In patients with alcohol use disorder, USG abdomen findings correlate with the severity of dependence as indicated by years of drinking, average alcohol consumption per day for the last 3 years, AUDIT score (last 1 year), and markers of liver injury (serum bilirubin and AST). Combined use of clinical severity indicators (e.g., AUDIT), lab parameters, and USG abdomen can help in the early diagnosis of ALD.

Epidemiology of Household Transmission of COVID-19 among Patients Attending Outpatient Clinics of Teaching Hospital in Cairo, Egypt

Abstract Background Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). People in closed settings with COVID-19 patients, such as household contacts, were more likely to become infected. Household studies can provide informative data for COVID-19 prevention and control. Aim to identify the epidemiological features of household transmission in a sample of patients attending the family medicine clinic of a tertiary hospital in Egypt, and to calculate the household COVID19 secondary clinical attack rate for the recruited patients. Materials and Methods An observational follow-up study was conducted among a sample of 180 primary probable COVID-19 cases attending a tertiary hospital in Cairo, Egypt and their 395 household contacts. The modified WHO case reporting form was used for follow-up of primary probable COVID-19 cases, and the modified WHO contact reporting form was used for their household contacts follow-up. Follow-up phone calls were conducted after 7, 10, and 14 days after attending to the hospital. Results The mean household Secondary clinical attack rate is 65.3 ± 29.9 (95 CI: 60.5% - 70.1%). There was a significant statistical association between reporting symptoms consistent with COVID-19 and sharing a room with the primary case, being not vaccinated, not using Personal protective equipment (PPE) as well as taking care of a primary case (p &amp;lt; 0.001). Conclusion and Recommendations Secondary clinical attack rate among the household contacts was high; more than the average reported rates globally. Vaccination and using PPE had important roles in lowering the risk of reporting symptoms consistent with COVID-19 among household contacts, yet the overall rate of using PPE was low and vaccination coverage was low compared to the rates reported globally. which necessitates more efforts to increase awareness of household transmission and how to safely care for a home-isolated COVID-19 case. The presence of co-morbidities increased the risk of hospitalization among symptomatic contacts This gives an alert to increase the awareness of cases with comorbidities about warning signs that necessitate early hospitalization for a better prognosis. about using PPE among household contacts with a COVID-19 case and also about the importance of vaccination against COVID- 19.

Clinical Outcomes of Early vs. Late Tracheostomy in Ventilated COVID-19 Patients.

Background The coronavirus disease 2019 (COVID-19) global pandemic prompted a significant use of intensive care resources for managing hypoxic respiratory failure. A substantial portion of these patients required mechanical ventilation. While intubation is common, its impact on mortality improvement has been questionable. Tracheostomies have become crucial for patients needing prolonged ventilation. However, tracheostomies also risk infections, ranging from early-stage mild cellulitis to later-stage nosocomial pneumonia. Our study evaluates the incidence of bacterial infections in COVID-19 patients who underwent tracheostomy early (within 14 days) versus late (more than 14 days after initiation of mechanical ventilation) during their stay in the intensive care unit (ICU). Methods We conducted a retrospective single-center study at Royal Medical Services Military Hospital. The study included COVID-19 patients who underwent tracheostomy and were admitted to the ICU from March 2020 to March 2022. We analyzed the incidence of ventilator-associated pneumonia, the timing of weaning from mechanical ventilation, and outcomes between early and late tracheostomized patients. Analyzed variables included demographics, comorbidities, use of steroids, tocilizumab, inflammation parameters, tracheostomy timing, incidence of bacterial infections, complications, and outcomes. Results The study comprised 36 patients. We found no statistically significant difference in the incidence of bacterial infections between the early and late tracheostomy groups (P>0.05). Complications and overall outcomes did not show significant statistical associations. Inotropes use was more frequent in the late tracheostomy group (P=0.122). In contrast, continuous renal replacement therapy was higher in the early tracheostomy group, showing no significant association (P>0.05). Mortality was higher in the early tracheostomy group, with nine deaths compared to seven in the late tracheostomy group. Interestingly, infection with Acinetobacter baumannii was associated with a statistically significant lower mortality rate, with 75% survival following tracheostomy. Conclusions Findings suggest that tracheostomy timing does not significantly impact the incidence of bacterial pneumonia or other complications, such as the use of inotropes, continuous renal replacement therapy, or mortality rates. These results support the use of personalized decision-making while conducting tracheostomies. Further research is necessary to determine the impacts of tracheostomy timing on patient outcomes more definitively.

Relationship Between Body Mass Index, Occlusion, and Dental Caries among School Children in Riyadh

ABSTRACT Background: Malocclusion and lifestyle diseases like obesity can lead to poor oral hygiene and food stagnation, resulting in increased caries incidence. Objectives: To evaluate the interrelationship of age, body mass index (BMI), occlusion, and dental decay in children aged between 5 and 14. Methodology: Our study included 423 school students aged 5-14 visiting dental clinics. Correlation between BMI and DMFT index using Spearman’s correlation coefficient and the association of BMI with gender, age group, and occlusion using the Chi-square test were assessed. Results: The study comprised a larger sample of students aged above 10 years (n = 217) and between 6 and 10 years (n = 183), with Angle’s Class I and II malocclusion being predominant. A weak positive correlation was found between BMI and the missing component of the DMFT index, while significant statistical associations were observed between underweight students below 5 years (8.5%) and obesity in those between 6 and 8 years (53.3%) (P &lt; 0.05). Conclusion: Dental practitioners must pay attention to the BMI of children and consider diet as a major intervention for dental caries prophylaxis.

Cerebellitis following COVID-19 infection: A case-based systematic review and pooled analysis

BackgroundThe COVID-19 pandemic has been linked to neurological complications, including Cerebellitis. This study aims to investigate the clinical features, and consequences of Cerebellitis following COVID-19 infection, informing medical management strategies. MethodsA systematic search was conducted through PubMed, Web of Science, Embase, ProQuest, and Cochrane databases from January 2018 to September 12, 2023, on cases post-COVID-19. Demographics, clinical characteristics, and diagnostic techniques were analyzed using descriptive statistics. Chi-Square tests assessed associations between diagnoses and treatments, with visualizations including heatmaps and scatter plots. ResultsAfter the final Screening, the analysis of 18 cases revealed Cerebellitis post-COVID-19 spanned 9 countries, predominantly from the USA (27.8 %), with a mean patient age of 40.1 years (±24.6). Males comprised 94.4 % of cases. Common underlying conditions included hypertension (22.2 %) and diabetes (11.1 %). Neurological symptoms presented on average 15.15 ± 12.7 days post-COVID-19 infection. A moderate negative correlation (r = −0.358) was observed between age and symptom onset. Blood and CSF biomarkers showed weak correlations with symptom onset intervals. Treatment efficacy varied, with most cases achieving symptom-free outcomes. The Chi-Square test for diagnosis-treatment associations yielded a p-value of 0.089, and for follow-up outcomes, a p-value of 0.283, indicating no significant statistical associations. ConclusionThis systematic review highlights increased reports of Cerebellitis in males in their fourth decade of life, with the highest comorbidities being vascular diseases. Marker assessments show a decrease in CSF protein in half of patients, along with complete recovery following combination treatment with antivirals and steroids in acute Cerebellitis.

Dietary Fiber Intake and Clinical Outcomes in Chronic Kidney Disease: A Report From the Chronic Renal Insufficiency Cohort Study

ObjectiveDietary interventions are the mainstay of chronic diseases prevention in general population, but the evidence to support such therapeutic approaches in patients with chronic kidney disease (CKD) is less robust. The objective of this study is to examine the association between dietary fiber intake and adverse cardiovascular and kidney outcomes and all-cause mortality in participants with CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study. Design and MethodsA total of 3791 CRIC participants with self-reported dietary fiber intake were included in the analyses stratified by tertiles of dietary fiber at study baseline. Hazard Ratios for occurrence of all-cause mortality, composite cardiovascular events and composite kidney events were calculated using Cox Proportional Hazards models adjusted for demographic, clinical, and laboratory characteristics, including levels of inflammatory markers, C-reactive protein (CRP) and Interleukin-6 (IL-6). ResultsMean daily dietary fiber intake was 15.2 g/d. During a median (SD) follow up of 14.6 (4.4) years, 1074 deaths from any cause occurred. In multivariable adjusted models, participants in the middle and low dietary fiber tertiles had a 19% (HR [95%CI]), 1.19 [1.02, 1.39]) and 11% (1.11 [0.95, 1.31]) greater risk of death respectively, compared to those in the highest fiber intake tertile. No statistical significant associations were observed between dietary fiber intake and adverse cardiovascular and kidney outcomes. Higher dietary fiber intake was not significantly associated with lower levels of CRP and IL-6. ConclusionA lower intake of dietary fiber was not associated with all-cause mortality in participants with CKD after adjustments for kidney function and inflammatory biomarkers. There was no significant association between dietary fiber intake and adverse kidney and cardiovascular outcomes. Future randomized intervention trials are needed to identify whether a high dietary fiber intake translates into improved clinical outcomes in CKD.

Prevalence and associated factors of maternal birth trauma following vaginal delivery at University of Gondar Comprehensive Specialized Hospital, North-West Ethiopia, 2022

BackgroundMaternal injury with any form of perineal trauma following vaginal delivery is very common which ranges globally from 16.2 to 90.4%. The frequency of Obstetric anal sphincter Injuries and the incidence of cervical laceration increases rapidly. However, in Ethiopia, there is limited evidence on the prevalence of maternal birth trauma and its determinant factors after vaginal delivery.ObjectiveTo assess the magnitude and associated factors of Maternal Birth Trauma after vaginal delivery at University of Gondar Comprehensive Specialized Hospital, Gondar, North-West Ethiopia, 2022.MethodsAn Institution based cross-sectional study was conducted among mothers with singleton vaginal delivery at University of Gondar Comprehensive Specialized Hospital from 9th May to 9th August 2022 among 424 study participants. Pre-tested semi-structured questioner was utilized. Epi-Data version 4.6 was used for data entry and exported to SPSS version 25 for data management and analysis. To identify the determinant factors, binary logistic regression model was fitted and variables with p-value < 0.2 were considered for the multivariable binary logistic regression analysis. In the multivariable binary logistic regression analysis, Variables with P-value < 0.05 were considered to have statistical significant association with the outcome variable. The Adjusted Odds Ratio (AOR) with 95% CI was reported to declare the statistical significance and strength of association between Maternal Birth Trauma and independent variables.ResultsA total of 424 mothers who delivered vaginally were included. The mean age of participants was 26.83 years (± 5.220 years). The proportion of birth trauma among mothers after vaginal delivery was47.4% (95%CI: 43.1, 51.7). Of different forms of perineal trauma, First degree tear in 42.8%, OASIs in 1.5% and Cervical laceration in 2.5% study participants. In the multivariable binary logistic regression analysis being primiparous (AOR = 3.00; 95%CI: 1.68, 5.38), Gestational age ≥ 39 weeks at delivery (AOR = 2.96; 95%CI: 1.57, 5.57), heavier birth weight (AOR = 12.3; 95%CI: 7.21, 40.1), bigger head circumference (AOR = 5.45; 95%CI: 2.62, 11.31), operative vaginal delivery (AOR = 6.59; 95%CI: 1.44, 30.03) and delivery without perineum and/or fetal head support (AOR = 6.30; 95%CI: 2.21, 17.94) were significantly associated with the presence of maternal birth trauma.Conclusion and recommendationMaternal birth trauma following vaginal delivery was relatively high in this study. Prim parity, gestational age beyond 39 weeks at delivery, heavier birth weight, bigger head circumference, operative vaginal delivery and delivery without perineum and/or fetal head supported were factors affecting perineal outcome. The Ministry of Health of Ethiopia should provide regular interventional training as to reduce maternal birth trauma.

Feasibility and Impact of Embedding an Extended DNA and RNA Tissue-Based Sequencing Panel for the Routine Care of Patients with Advanced Melanoma in Spain.

Targeted NGS allows a fast and efficient multi-gene analysis and the detection of key gene aberrations in melanoma. In this study, we aim to describe the genetic alterations in a series of 87 melanoma cases using the oncomine focus assay (OFA), relate these results with the clinicopathological features of the patients, and compare them with our previous study results in which we used a smaller panel, the oncomine solid tumor (OST) DNA kit. Patients diagnosed with advanced melanoma at our center from 2020 to 2022 were included and DNA and RNA were extracted for sequencing. Common mutated genes were BRAF (29%), NRAS (28%), ALK, KIT, and MAP2K1 (5% each). Co-occurring mutations were detected in 29% of the samples, including BRAF with KIT, CTNNB1, EGFR, ALK, HRAS, or MAP2K1. Amplifications and rearrangements were detected in 5% of cases. Only BRAF mutation showed a significant statistical association with sun exposure. For patients with a given genetic profile, the melanoma survival and recurrence-free survival rates were equivalent, but not for stage and LDH values. This expanded knowledge of molecular alterations has helped to more comprehensively characterize our patients and has provided relevant information for deciding the best treatment strategy.

The prospective multicenter observational study of acute mesenteric ischemia (AMeSI): the results of the Arkhangelsk center

The objective was to assess the disease rate, prevalence of risk factors, diagnostic and management methods as well as outcomes in patients with acute mesenteric ischemia (AMI).Materials and methods. During 10 months in 2022-2023, the study included all patients with probable or confirmed diagnosis of AMI, in whom we recorded the presence of known risk factors, clinical and laboratory manifestations of AMI, methods of its diagnosis, management and outcomes within one year.Results. Totally, 705 patients from 32 centers were included in the work, among whom 418 patients were diagnosed with AMI. In Arkhangelsk, 39 patients (mean age – 73 years) were included into the study. According to results of the center in Arkhangelsk, the diagnosis of AMI was confirmed in 69% of patients, while the incidence among all hospitalized was 0.13%. None of the known risk factors (smoking, atrial fibrillation, atherosclerosis, arterial hypertension, previous myocardial infarction and thromboembolic complications) demonstrated a significant statistical association with the development of AMI. Among clinical manifestations, patients with confirmed AMI more likely developed signs of shock compared to patients with unconfirmed AMI (p = 0.028). Laboratory parameters did not differ significantly in both groups; however, in AMI non-survivors, we observed higher blood lactate concentrations. In most cases with confirmed AMI, the diagnosis was established during surgery. In 72% of cases, the situation was assessed as incurable; in 24% of patients, intestinal resection was performed. Mortality in patients with confirmed AMI was 78%.Conclusion. The lack of clear predictors of the disease, specific clinical signs of AMI and available laboratory tests often leads to delay in diagnosis and appropriate management, which causes significant mortality. Further analysis of the data is necessary to improve diagnosis and the results of treatment of the patients with AMI.

Racial Disparities in Glioblastoma Genomic Alterations: A Comprehensive Analysis of a Multi-Institution Cohort of 2390 Patients

Although molecular biomarkers have significantly advanced precision oncology in glioblastoma, the prevalence of these biomarkers by race remains underexplored. This study aims to characterize the genomic alterations in glioblastoma across Asian, Black, and White patients, offering insights into racial disparities that may influence treatment outcomes and disease progression. Analyzing data from the American Association for Cancer Research Project Genomics Evidence Neoplasia Information Exchange database V13.0, this study examined 2390 primary glioblastoma samples from unique patients. Genomic alterations in 566 cancer-related genes were assessed using targeted next-generation sequencing panels from 3 large cancer institutes. The patient cohort included 112 Asians, 67 Blacks, and 2211 Whites. Statistical significance of associations between genomic alterations and race was evaluated using the chi-squared test, with the Benjamini-Hochberg method applied to control for multiple testing adjustments. Significant racial differences were observed in the frequency of genomic alterations. Asians exhibited a higher frequency of TP53 alterations (52.68%, P < 0.001), Blacks showed more frequent alterations in NRAS (7.46%, P < 0.001), MTOR (10.45%, P= 0.039), and TET2 (8.96%, P=0.039), and Whites had a higher occurrence of PTEN alterations (48.67%, P= 0.045). Additionally, Black patientshad an elevated rate of RET deletions (14.29%, P<0.001). This study identifies significant racial disparities in the alteration frequencies of 6 key glioblastoma genes: NRAS, TP53, MTOR, TET2, PTEN, and RET. These findings underscore the need for racial considerations in glioblastoma treatment strategies and highlight potential avenues for targeted therapeutic interventions. Further research is needed to explore the clinical implications of these genomic disparities.

Baseline value and longitudinal kinetics of circulating nucleosomes during neo-adjuvant chemotherapy in newly diagnosed ovarian cancer: Results from the randomized phase II trial CHIVA (GINECO).

e15029 Background: Nucleosomes (DNA wound around histone proteins) were reported as potential cancer biomarkers (1). The links between circulating nucleosomes and clinical endpoints in advanced ovarian cancer (OC) patients treated with neo-adjuvant chemotherapy (NACT) +/- interval debulking surgery (IDS) were retrospectively assessed in the randomized phase II CHIVA trial (2). Methods: The diagnostic concentration and the longitudinal kinetics of 2 nucleosomes (H3K27 and H3K36, log-scale) were investigated at baseline, during NACT, after IDS, and at progression. The baseline titer measured with Nu.Q prototype immunoassays (H3K27Me3, H3K36Me3 (Belgian Volition SRL, Belgium)) was compared to those of a cohort of 201 cancer-free subjects. Their prognostic values regarding the probability of obtaining a complete IDS and progression-free survival (PFS) were assessed with respect to the modeled CA-125 KELIM (3), classical clinical covariates and treatment arms. The maximum selected rank statistics was used to determine the optimal cut-off at different disease management times. Results: H3K27 and H3K36 nucleosome concentrations were available for 148/188 patients. H3K36 and H3K27 baseline concentrations were correlated and significantly higher in OC patients compared to cancer-free subjects (H3K36, 2.8 vs 2.4 ng/mL, P&lt;0.0001; H3K27, 3.2 vs 2.1, P&lt;0.0001), without difference according to BRCA status. The baseline titer of H3K36 was an independent predictor of the completeness of IDS (OR=0.33; 95% CI=0.13-0.71, p=0.009). The baseline concentration of H3K27 was independently associated with PFS (&lt; or ≥3.8 ng/mL, HR=1.84, 95%CI=1.11-3.02, p=0.016), complementary to the CA-125 KELIM. Both nucleosome longitudinal kinetics showed a decrease during NACT, but there was no significant statistical association between their kinetics and radiological response rate, completeness of IDS or PFS. Conclusions: Baseline values of H3K36 and H3K27 could represent a non-invasive method for detecting OC, with potential relevant prognostic value of initial titers in newly diagnosed OC patients. 1. McAnena, Cancers 2017. 2. Ferron, Gynecol Oncol 2023. 3. You, CCR 2020.

#1122 Anaemia in CKD and cardiovascular risk; all cut from the same cloth?

Abstract Background and Aims Anaemia in chronic kidney disease (CKD) has been repeatedly associated with increased cardiovascular morbidity and mortality, but most studies have not investigated its longitudinal association by sex and age. Our aim was to study the association between haemoglobin (Hb) current value and the hazard of major adverse cardiovascular event (MACE) in specific subgroups of CKD patients defined by age and sex. Because erythropoiesis-stimulating agents (ESA) are incriminated to modify the effect of Hb level on the hazard of event for high level of Hb, we have here only focused in non-ESA users CKD patients. Method We used data from the CKD-REIN cohort, which included 3033 patients with moderate to severe CKD from 40 nationally representative nephrology clinics in France between 2013 and 2016. We included patients with at least one Hb, estimated glomerular filtration rate (eGFR), transferrin saturation (TSAT) or ferritin measurement. We studied all Hb measurements available until a first MACE defined as the first event among cardio-vascular death, myocardial infarction, stroke or hospitalization for acute heart failure; initiation of kidney replacement therapy; death from other causes; or initiation of ESA therapy, whichever came first. First, we estimated the individual trajectories of Hb, eGFR, TSAT, ferritin using multivariate share random effect joint model. Then, we estimated the association between Hb current value and MACE using a cause specific multivariate Cox model in 4 specific subgroups separately: women ≤ and &amp;gt;70 years, men ≤ and &amp;gt;70 years. All models were adjusted on current value of eGFR, TSAT, Ferritin, and baseline value of albumin-to-creatinine ratio, age, CKD aetiology, heart failure past history, alcohol consumption, iron treatment, antithrombotic and anticoagulant. When appropriate, spline functions were used for continuous variables to account for potential non-linear effects. Reference value of Hb for computing hazard ratio was 12 g/dL in women, and 13 in men according to current definition of anaemia. Results A total of 2742 patients were included in the analysis (median eGFR 33 ml/min/1.73 m2, median age at inclusion 69 years) together with 28423 Hb measurements (median of 13 per patient) collected during a median follow-up of 5.0 years. There were 551 women ≤70 (median Hb 12.4 g/dL, 34 (6.2%) MACE), 349 women &amp;gt; 70 (12.2 g/dL, 61 (17.5%) MACE), 1009 men ≤ 70 (13.4 g/dL, 104 (10.3%) MACE) and 833 men &amp;gt; 70 (13.0 g/dL, 163 (19.6%) MACE). No statistical significant association was found in males whatever their age (Hazard ratio of MACE for each 1 g/dL increase in Hb 1.0 (95% CI 0.9-1.1) in men &amp;lt; 70 and 0.9 (95% CI 0.8-1.1) in men &amp;gt; 70). For women, the hazard of MACE raised as the Hb values decreased, with a more pronounced increase in women &amp;gt; 70 (Fig. 1). For example, the hazard ratio for a Hb value of 10 g/dL compared to the reference was 2.0 (95% CI 0.9-4.7) in women &amp;lt; 70 and 3.3 (95% CI 1.5-7.2) in women &amp;gt; 70. Conclusion In non-ESA users CKD patients, anaemia is associated with the occurrence of MACE in females, especially those older than 70 years. These results raise question about a one-size-fits-all approach in the interpretation of low values of haemoglobin and anaemia management. It also suggests to evaluate the effect of anaemia therapies in men and women separately.

#3052 mTOR inhibitors in kidney transplant recipients with high immunological risk: practical insights from clinical experience

Abstract Background and Aims The use of mTOR inhibitors (mTORi) is not usually considered in high immunological risk kidney transplant recipients (KTR) for a perceived increased risk of rejection. However, in most of the studies that examined the combination of mTORi with calcineurin inhibitors (CNI), hypersensitized patients have been excluded from enrollment. The aim of the present study is to analyze our clinical experience with the use of mTORi in association with calcineurin inhibitors (CNI) in this subset of patients. Method Analysis of 212 consecutive kidney transplant recipients with a baseline calculated panel reactive antibody (cPRA) ≥50% who received a graft from June 2013 to December 2019. Immunosuppression was based on tacrolimus, steroids and, alternatively, mycophenolic acid (MPA; n = 96) or mTORi (either sirolimus or everolimus, target trough levels 3-8 ng/ml, n = 116) depending on the active Institution's protocol at the time of transplantation. The outcomes chosen included rejection-free, graft and patient survival and were analyzed by means of Cox-regression analysis. Results Demographic and immunological characteristics were similar between groups, apart from the higher number of living donors in the MPA group (42.7% vs 14.7%%, P &amp;lt; 0.001). Baseline cPRA was 92.5 [76-98]% for the MPA and 94 [77.25-98]% for the mTORi group, respectively (P = 0.882). Induction therapy with lymphocyte-depleting agents was employed in the majority of patients (91.7% in the MPA group and 88.8% in the mTORi group, P = 0.898). Median follow-up time was 2.6 [1.45-4.05] years. Biopsy-proven rejection (either cellular or humoral) occurred in 33.3% of the MPA and in 19.8% of the mTORi group, respectively. Cox-regression analysis of rejection-free survival revealed better rejection-free survival with mTORi versus MPA (HR [95% CI], 0.54 [0.32-0.98], P = 0.028). The only other baseline factor associated with rejection was previous transplantation (HR [95% CI] 1.96 [1.07-3.60], P = 0.030). When entered into a bivariable Cox-regression analysis, both mTORi and previous transplantation maintained a statistical significant association with rejection (mTORi versus MPA HR [95% CI] 0.53 [0.31-0.91], P = 0.023, and previous transplantation HR [95% CI] 2.01 [1.09-3.69], P = 0.024). No differences between mTORi and MPA were noted for graft (HR [95% CI] 0.90 [0.40-2.02], P = 0.807) and patient survival (HR [95% CI] 1.23 [0.60-2.50, P = 0.606). Median creatinine 1 year after transplantation was 1.45 [1.11-1.98]mg/dl for the MPA group and 1.51 [1.09-2.06]mg/dl for the mTORi group (P = 0.917). Conclusion This retrospective study suggests that hypersensitized KTRs can receive safely a maintenance immunosuppression based on a combination of CNI with mTORi, without an increased risk of rejection.

The Correlational Study of the Quality of Students Enrolled in the University and Employability of Graduates from Selected Universities in South-Western Uganda

The employability of university graduates is a concern for higher education stakeholders globally and Uganda is also concerned due to high unemployment rates post-graduation. Not much has been written about the relationship between quality of students enrolled in the university and their employability of graduates from selected Universities in South Western Uganda. This study aims to establish this relationship in selected universities in south western Uganda. A correlational study collected data from 512 participants, including graduates, employers, university lecturers, administrators, and officers from quality assurance directorate of national council for Higher Education. Data on students discipline, grades, performance and employability were collected. SPSS and Structural equation modelling (SEM) version 21 was used to analyse associations between predictor and outcome variables. The findings derived from conducting this research clearly demonstrate the presence of a significant statistical association between the quality of students enrolled in the university and employability of graduates at R= 0.589, R squared change 0.347, P =0.000 This suggests that by ensuring the quality of students enrolled in the University through discipline, students’ grades and performance increases the likelihood of producing graduates who are employable. It is very important that stakeholders in higher education make it a priority to keep a high standard of students and their moral fibre and this may facilitate their integration into the workforce.

Association of E-Cadherin Expression with Histological Type and Grade of Gastric Adenocarcinoma

Objectives: To determine the immune expression of E-Cadherin in gastric adenocarcinomas and its association with tumor histological type and grade to evaluate its prognostic significance. Methodology: This descriptive cross-sectional study was conducted at the Pakistan Institute of Medical Sciences Islamabad, from December 2017 to January 2021. Eighty-one patients from both genders, aged 21 to 83 years, undergoing gastric biopsies and Gastrectomy specimens to diagnose gastric adenocarcinoma were included in our study. Immunohistochemical processing was performed and the results were interpreted by the consultant pathologist for the expression of E-cadherin on gastric adenocarcinoma. The data were analyzed with SPSS version 17. Results: There was a significant statistical association between loss of E-Cadherin with histological type of adenocarcinoma (p = 0.000). In total 81 cases, there were 53 (65%) cases of intestinal type adenocarcinoma and 28 (35%) cases of diffuse type adenocarcinoma. Of the 28 cases with diffuse type gastric Adenocarcinoma, 10 cases showed complete loss of E-Cadherin. This complete loss of Cadherin was also seen in four out of 53 cases of intestinal adenocarcinoma, all of which were poorly differentiated intestinal type of adenocarcinomas. Total cases of well differentiated type of adenocarcinoma were nine; all of these showed high expression of E-Cadherin. Conclusion: There is a strong association of E-Cadherin expression with the histological type and grade of gastric adenocarcinoma according to Lauren’s classification. As the grade of the adenocarcinoma gets higher there is more loss of E-Cadherin expression which proves its prognostic significance. It was also established that gastric adenocarcinoma is a disease of elderly with male predominance.