Intervention Studies Research Articles

A comprehensive scoping review of global educational strategies and outcomes in aedes-borne disease control

BackgroundAedes mosquito is the primary vector of emerging or re-emerging arboviruses that threaten public health worldwide. Many efforts have been made to develop interventions to control the Aedes mosquito. This scoping review was conducted to identify the nature and scope of educational interventions to prevent and control diseases transmitted through the Aedes mosquito. The findings can be used to evaluate, compare, and develop appropriate control strategies.MethodsThe present scoping review was conducted in 2023 and used Arksey and O’Malley’s approach, which involves five key stages. To search for academic papers, PubMed, Web of Science, Scopus and ScienceDirect databases were used with a combination of keywords about Aedes mosquitoes, educational interventions, and disease prevention and control. The search was not limited by the publication date, yet only included studies published in English. Studies were included that reported the educational interventions about Aedes mosquito control at the community or organizational level. The screening of papers was done based on the PRISMA-ScR guideline. Excel 2019 was used for data analysis.ResultsInitially, 3,172 papers were extracted, and after screenings and reviews, a total number of 45 final papers were selected. The studies focused on educational interventions. Twenty interventional studies were at the organizational level and 25 at the community level. The latter was the most commonly used strategy. Interventions using educational approaches have achieved sustainable results. Out of the forty-five studies, twenty-one were assessed to have a low risk of bias.ConclusionsThe present scoping review evaluates the effectiveness of educational interventions at various community levels for controlling Aedes-borne diseases, emphasizing the need for multidisciplinary collaboration. Controlling Aedes mosquitoes using education and attracting the community’s participation is an effective approach to reduce diseases transmitted through Aedes. The development of education at different levels of the community, such as educational and occupational environments, can play a role in the effectiveness of societal education and can be more cost-effective. Maintaining the effect of this approach is challenging because it requires multi-sector and multidisciplinary team participation and active community engagement over the long term. Further research is required to explore the removal of barriers to the implementation of educational interventions and the consistency of effects.

The Effect of Exercise on Immune Response in Population with Increased Risk Factors for Cardiovascular Disease: A Systematic Review.

This systematic review aimed to provide information on existing interventional studies that evaluate the efficacy of exercise in populations with increased cardiovascular disease (CVD) risk factors through immune functional perspectives. A literature search was conducted in four databases: PubMed, Scopus, Taylor & Francis and ScienceDirect from January 2012 to February 2023. The articles were screened and evaluated for quality before data were extracted. The review protocol was registered at PROSPERO (CRD42022321704). In total, 18 studies were included for quality appraisal and synthesised evidence indicated that exercise contributes to enhancing the functioning of both innate and adaptive immune responses, potentially serving as an anti-immunosenescent response to exercise in individuals with elevated CVD risk factors. Furthermore, the review emphasised that exercise, irrespective of its type, intensity or mode, was well tolerated by individuals at increased risk for CVD and may have significant implications in generating anti-inflammatory effects.

Association Between Oral Hygiene Behaviours and Cognitive Decline in Adults: A Systematic Review and Meta-Analysis.

To evaluate the association between oral hygiene behaviour and cognitive decline in adults. The outcomes include changes in global cognitive function, visual attention, task switching and the risk of dementia. We conducted a systematic review following the preferred reporting items for systematic reviews and meta-analyses guidelines. A systematic search of 11 databases and grey literature sources was conducted from inception to January 2024. We included interventional trials or cohort studies that investigated the effect of oral hygiene behaviours (e.g., toothbrushing, mouth washing, flossing, using toothpicks and cleaning dentures) on cognitive decline in adults. Data extraction and risk of bias assessment were performed by two independent reviewers with expertise in conducting systematic reviews. Meta-analyses were conducted using random-effects models, and heterogeneity was assessed with the I2 statistic and χ2 test. A total of eight studies (six intervention studies and two cohort studies) met inclusion criteria, including 261,772 participants. Follow-up periods ranged from 30 days to 48 months for interventions and 9 to 18 years for cohorts. Toothbrushing was associated with a significantly slower decline in global cognitive overtime. Toothbrushing in older adults with moderate/severe dementia could achieve significant changes in cognitive decline. There was no significant difference between the effectiveness of toothbrushing performed by professionals and caregivers. Other oral hygiene behaviours, including dental flossing, using mouthwash, using toothpicks and cleaning dentures, were not associated with the risk of dementia. Toothbrushing is linked to a decreased risk of dementia and improved global cognitive function. Promoting toothbrushing at least twice daily may significantly reduce the risk of cognitive decline and dementia. These findings highlight the urgent need for programmes that encourage daily toothbrushing, particularly in nursing home settings and among older adults with moderate-to-severe dementia.

Effects of intravitreal Bevacizumab (Avastin) monotherapy in central retinal vein occlusion in young subjects.

To evaluate the efficacy of anti-angiogenic agent Bevacizumab in central retinal venous occlusion treatment. To determine the efficacy of Bevacizumab and ophthalmological parameters such as best corrected visual acuity (BCVA) and central macular thickness (CMT) using optical coherence tomography (OCT) in central retinal venous occlusion in patients aged less than 30. This is a prospective, interventional study, done on 25 eyes of 25 patients aged 30 years and below with central retinal venous occlusion, who received intravitreal Bevacizumab injections for three consecutive months. The mean change in best corrected visual acuity (BCVA), and central macular thickness (CMT) measured by optical coherence tomography were compared and correlated at baseline after 3 months and 6 months follow-up. The mean best corrected visual acuity and the central macular thickness on OCT improved significantly from 1.08±0.29 and 454.80±114.5µm at baseline to 0.77±0.32 logMAR units and 339.7±82.5µm after 6 months follow up. The current study showed that intravitreal Bevacizumab at a dose of 1.25 mg and with strict control of systemic contributory parameters seemed to improve BCVA and CMT and macular edema measured at baseline to 3 months and 6 months follow-up after three consecutive monthly injections.

Assessing the effectiveness of flipped classroom teaching–learning method among undergraduate medical students at gondar university, college of medicine and health sciences: an interventional study

IntroductionThe flipped classroom teaching–learning method has been increasingly adopted in higher education to enhance student-centered learning. Despite its growing popularity, limited evidence exists regarding its effectiveness in medical education in Ethiopia. This study aimed to assess the impact of the flipped classroom method on academic performance, student engagement, and satisfaction among undergraduate medical students at Gondar University, College of Medicine and Health Science.MethodsA quasi-experimental study was conducted involving 100 s-year undergraduate medical students, divided into two groups: the flipped classroom group (n = 50) and the traditional lecture-based group (n = 50). The flipped classroom group received online instructional materials before class, while classroom sessions focused on interactive activities. The traditional lecture-based group attended conventional lectures followed by homework assignments. Data were collected using pre- and post-intervention tests to measure academic performance, the Student Engagement Scale to gauge engagement, and a validated questionnaire to assess student satisfaction. Data were analyzed using Statistical Package for the Social Sciences version 25, with descriptive statistics, paired t-tests, independent t-tests, and Chi-square tests employed to interpret the findings.ResultsThe flipped classroom group demonstrated a significant improvement in academic performance, with mean pre-test and post-test scores of 65.2 ± 8.1 and 78.6 ± 6.9, respectively. In contrast, the traditional lecture-based group had pre-test and post-test mean scores of 62.8 ± 7.5 and 74.2 ± 8.3, respectively. Additionally, the flipped classroom group showed higher levels of student engagement mean scores of 4.5 ± 0.8 and satisfaction mean scores of 4.2 ± 0.7 compared to the traditional lecture-based group, which had engagement mean scores of 3.8 ± 0.6 and satisfaction mean scores of 3.9 ± 0.5. Chi-square tests showed a statistically significant association between the teaching method and both pass/fail rates and participation in activities, but not a significant association with gender distribution.ConclusionThe flipped classroom approach proves to be a superior teaching method, promoting better academic outcomes and greater student engagement and satisfaction. This study adds to the growing body of evidence advocating for the implementation of flipped classrooms in medical education.Trial registrationNot applicable.

Training in the symptothermal method to ameliorate unmet need for family planning: knowledge, attitudes and satisfaction.

Addressing the unmet need for family planning to prevent unintended pregnancies is a high priority for women's health, and training as an element of the symptothermal method (STM) is deemed to be an effective strategy. This study assessed training on knowledge, attitudes and satisfaction with STM to ameliorate the unmet need for family planning. The study adopted a pre-post study design. A total of 136 women participated in this study. Knowledge and attitudes were assessed pre- and post-training as well as the level of satisfaction, using cycle charts and questionnaires. The χ2 test (p<0.05) was used to analyse data on sociodemographics, attitudinal characteristics and satisfaction. Paired samples t-test (p<0.05) was used to establish the mean difference of the two groups (knowledge and attitudes pre- and post-training). The paired samples t-test established that women have significant (t=-058.716, p=0.001) knowledge post-training (1.0000±0.00000) compared with pre-training (0.0682±0.01587) on STM. There was no significant (t=-1.419, p=0.158) difference in attitudes towards STM pre- and post-training. There was a significant level of satisfaction (p=0.001). Our interventional study has enabled women to acquire robust knowledge, positive attitudes and satisfaction with the utilization of STM. This has ameliorated unmet need for family planning among participants.

Improving Performance in Surgical department through Communicating Information to Decision Makers: Intervention Study in a tertiary Hospital

Hospital performance evaluation is crucial for early detection of pitfalls, and problem-solving. Data shouldn’t be passively collected. They must be measured and understood through an underlying conceptual framework. Purpose: The General Surgical Department in collaboration with the Public Health Department had the objective of developing a module for periodic monitoring and evaluation of the eight general surgical units based on calculated key performance indicators (KPIs), Composite Indices (CIs) and communication of growing out information through policy briefs directed to the heads of units for better resources allocation and evidence based decision making. Methodology: An operations research using pre-post intervention design. The exploratory component was completed in six months in the 8 units of the department. Pretest service statistical data analyzed KPIs derived from hospital bed and surgical room utilization. Data were utilized for the calculation of 5 CIs for each unit. Study intervention included the development of policy briefs (PB) that were submitted to the head of the department. Informed decisions were made guided by the info-graph data in the form of traffic color coded ranking matrix to promote various services and to improve performance in the department units particularly lower ranked units. The post-test included reanalyzing of the service statistical data. Findings: Comparing pre-posttest figures revealed improvement in the calculated KPIs and CIs. Originality and practical implications: Bringing up a novel, feasible monitoring and evaluation model using refitted tools would support surgical unit heads in evidence-based decision-making and eventually improve performance efficiency.

Wheat Peptides as Catalysts for Athletic Performance Improvement in Cross-Country Skiers: A Randomized Controlled Trial.

This study investigated the efficacy of wheat peptide supplementation compared to regular proteins in elite cross-country skiers, providing insights into the metabolic and performance effects of these supplements in order to guide athletes in selecting optimal energy sources for training and competition. Nineteen healthy male cross-country skiers were enrolled and assigned to either the peptide group (PEP, n = 9) or the protein group (PRO, n = 10). A four-week intervention study involving supplementation with wheat peptides/regular proteins was conducted, and pre- and post-intervention assessments were performed to evaluate exercise capacity and metabolic profiles. The study found that the PEP group and the PRO group showed distinct within-group effects on exercise performance. The PEP group demonstrated improved aerobic capacity, including better performance in 10 km roller skating, an increased lactate threshold, and reduced resting blood lactate levels. The PRO group enhanced anaerobic capacity, such as improved sprint time, hexagon test performance, and lactate clearance. Metabolomic analysis revealed specific metabolic pathways affected in each group, with the PEP group showing impacts on the α-linolenic acid pathway and the PRO group on ketone body synthesis and degradation as well as vitamin B6 metabolism. Our findings indicate that wheat oligopeptides and regular proteins have comparable effects on exercise performance. However, the wheat peptides may offer greater advantages in enhancing aerobic capacity. No significant variations were observed in blood metabolite profiles between the two groups, but distinct metabolic pathways exhibited different responses.

Applicability of epigenetic age models to next-generation methylation arrays

BackgroundEpigenetic clocks are mathematical models used to estimate epigenetic age based on DNA methylation at specific CpG sites. As new methylation microarrays are developed and older models discontinued, existing epigenetic clocks might become obsolete. Here, we explored the effects of the changes introduced in the new EPICv2 DNA methylation array on existing epigenetic clocks.MethodsWe tested the performance of four epigenetic clocks on the probeset of the EPICv2 array using a dataset of 10,835 samples. We developed a new epigenetic age prediction model compatible across the 450 k, EPICv1, and EPICv2 microarrays and validated it on 2095 samples. We estimated technical noise and intra-subject variation using two datasets with repeated sampling. We used data from (i) cancer survivors who had undergone different therapies, (ii) breast cancer patients and controls, and (iii) an exercise-based interventional study, to test the ability of our model to detect alterations in epigenetic age acceleration in response to theoretically antiaging interventions.ResultsThe results of the four epiclocks tested are significantly distorted by the EPICv2 probeset, causing an average difference of up to 25 years. Our new model produced highly accurate chronological age predictions, comparable to a state-of-the-art epiclock. The model reported the lowest epigenetic age acceleration in normal populations, as well as the lowest variation across technical replicates and repeated samples from the same subjects. Finally, our model reproduced previous results of increased epigenetic age acceleration in cancer patients and in survivors treated with radiation therapy, and no changes from exercise-based interventions.ConclusionExisting epigenetic clocks require updates for full EPICv2 compatibility. Our new model translates the capabilities of state-of-the-art epigenetic clocks to the EPICv2 platform and is cross-compatible with older microarrays. The characterization of epigenetic age prediction variation provides useful metrics to contextualize the relevance of epigenetic age alterations. The analysis of data from subjects influenced by radiation, cancer, and exercise-based interventions shows that despite being good predictors of chronological age, neither a pathological state like breast cancer, a hazardous environmental factor (radiation), nor exercise (a beneficial intervention) caused significant changes in the values of the “epigenetic age” determined by these first-generation models.

Efeitos da atividade física em crianças e adolescentes com síndrome metabólica: uma revisão sistemática

Introduction: evidence demonstrates that regular physical exercise has beneficial effects in the prevention and treatment of high blood pressure, insulin resistance, diabetes, dyslipidemia and obesity in the population. Objective: To evaluate the impact of physical activity on children and adolescents with metabolic syndrome. Methods: Data surveys. Medline (Pubmed), Cochrane Library, LILACS/VHL. Study selection. Cross-sectional studies (2008-2022) that evaluated the ability of physical training to reduce at least one of the following outcomes: HDL-C; triglycerides; HOMA-IR, Fasting Glucose, systolic blood pressure (SBP); diastolic blood pressure (DBP), Body Mass Index (BMI); 2) Intervention (modality, intervention period, weekly session and duration, weekly frequency, intensity, number of sets and repetitions); in children and adolescents classified as having metabolic syndrome. Data extraction and analysis. Two independent reviewers extracted the data and assessed the quality of the included studies. The differences (physical training group minus control group) in the evaluated results were analyzed using (mean values and standard deviation of pre- and post-intervention, and difference between means). Results. Of the 1,961 articles retrieved, 03 studies were included. This review showed that the practice of physical activity, in general, was associated with a reduction in HDL-C levels (before 44.21 mg/dL (± 9.6), after 42.13 mg/dL (± 7. 76), but was associated with reductions in TG levels (before 113.87 mg/dL after 87.53 mg/dL (26.34). AND HOMA (before 2.54 mg/dL after 2.61 mg /dL) Fasting glucose (before 79.86 mg/dL (±9.22) after 82.43 mg/dL (±8.31). Physical activity is associated with reduced HDL-C levels. Conclusion: seems likely that physical training can play an important role in preventing or delaying metabolic syndrome. We emphasize the need for future intervention studies that investigate the effects of physical activity with greater methodological quality. Keywords: Children; adolescent; physical activity; metabolic syndrome.

Standardised and Objective Dietary Intake Assessment Tool (SODIAT): Protocol of a dual-site dietary intervention study to integrate dietary assessment methods

Introduction Current dietary assessment methods face challenges in accurately capturing individuals’ dietary habits, undermining the efficacy of public health strategies. The ‘Standardised and Objective Dietary Intake Assessment Tool’ (SODIAT)-1 study aims to assess the effectiveness of three emerging technologies (urine and capillary blood biomarkers, and wearable camera technology) and two online self-reporting dietary assessment tools to monitor dietary intake. Methods This randomised controlled crossover trial will recruit 30 participants (aged 18-70 years and BMI of 20-30 kg/m2) from Imperial College London and the University of Reading. Exclusion criteria include recent weight change, food allergies/intolerances, following restrictive diets, certain health conditions and medication use. Interested volunteers will be directed to an online screening questionnaire via REDCap and eligible participants will attend a pre-study visit. Volunteers will consume, in a random order, two highly-controlled diets (compliant and non-compliant with UK guidelines) for four days each. Each study arm will be separated by at least one-week. During each test period, dietary intake will be monitored continuously using wearable cameras and self-recorded using eNutri (food frequency questionnaire) and Intake24 (24-hour dietary recall). Urine and capillary blood samples will be collected for biomarker analysis. Data analysis will assess the accuracy of dietary reporting across these methods using Lin’s concordance correlation coefficient. Discussion and ethical considerations This study introduces a novel approach to dietary assessment, addressing the limitations of traditional methods by reducing misreporting and enhancing inclusivity, particularly for underrepresented populations with literacy or language barriers. However, challenges persist, such as variability in biomarker data due to failure to adhere to sample storage requirements and the practicalities of continuously wearing cameras. To protect privacy, participants will be instructed to remove cameras at inappropriate times, and artificial intelligence will be used to blur all images captured apart from food.

Trends and socio-demographic determinants of suicide-related mortality in Türkiye: An epidemiological study from 2009 to 2022.

Suicide is a leading cause of death, particularly among the young age group, in Türkiye, a country with a high population of young people. The aim of this study is determine the suicide related mortality trend and some associated socio-demographic factors in Türkiye between 2009 and 2022. The study includes an epidemiological trend on suicide. The Turkish Statistical Institute's data portal was used. The study population is 46,691 people (Male/female ratios = 74.6%/ 25.4%). Changes in mortality trends were evaluated using the Joinpoint Regression method with Annual Percentage Change (APC) and Average Percentage Change (AAPC) analysis. Over the past 14 years in Türkiye, there has been a statistically significant increase in the standardized mortality rate among males (2009-2022 APC = .76, p = .012) and a statistically non-significant decrease among females (2009-2022 APC = -1.62, p = .083). According to the Nomenclature of Territorial Units for Statistics (NUTS-1) classification, the highest increase is observed in the Central Anatolia region followed by the Western Black Sea region (APC = 3.0 and 2.7, respectively; p < .005). While the percentage of primary school and below has decreasing trends (2009-2022 APC = -7.11, p < .005), there is a significant increase in the percentage of university graduates (2009-2016 APC = 10.87, p < .001). Regarding the marital status, there is a significant decrease in the percentage of those who are married (2009-2013 APC = -3.36, p < .001; 2013-2016 APC = 2.42, p = .037; 2016-2022 APC = -2.31, p = .003) and a significant increase in those who have never been married (2009-2013 APC = 2.63, p < .001; 2013-2016 APC = -1.36, p = .002). Although suicide related mortality is below the global average, there has been an increasing trend in turkey in the last 14 years. Analytical and intervention studies on the socio-demographic determinants supporting the increasing trend are needed.

The pedagogical insights of mathematics teachers integrating artificial intelligence in rural upper primary schools of Namibia

This paper presents a qualitative intervention study that explores the pedagogical experiences of mathematics teachers integrating Artificial Intelligence (AI) technologies into teaching mathematics in rural upper primary schools in Namibia. The Technological Pedagogical Content Knowledge (TPACK) framework, which intersects teachers’ understanding of technology integration with pedagogical techniques and subject matter knowledge, was adopted for the study. The research involved 13 mathematics teachers selected through purposive sampling. Data collection included two sharing circle discussions, lesson observations, and semi-structured interviews. A thematic analysis approach was employed to interpret the collected data. The findings reveal a diverse range of AI tools used by the selected teachers, such as Geogebra, Khan Academy, Virtual Tutors, and various problem-solving mobile applications, including Photomath, Mathway, and Microsoft Math Solver. These AI resources were noted for enhancing the visualisation of mathematical concepts, providing adaptive learning experiences, and promoting independent, paced learning that supports learners' learning styles. Teachers reported a marked improvement in learners’ comprehension and problem-solving abilities attributable to AI integration. Despite the benefits of AI in education, challenges remain, particularly in rural areas. Key issues include inadequate infrastructure, limited access to devices, and the need for ongoing teacher training in technological pedagogical content knowledge. Additionally, the lack of culturally relevant AI technologies hinders effective AI-supported learning in diverse contexts. Greater investment in localised AI educational tools is needed to achieve equitable and effective learning outcomes.

Nursing-Based Sleep Promotion Intervention Effectiveness for Post Cardiac Surgery Patients: Systematic Review.

Sleep is a fundamental prerequisite for physical and mental health. Poor quality of sleep is common among post-cardiac surgery patients and leads to serious health conditions. To conduct a systematic review that investigates the effectiveness of eye masks, earplugs and deep-breathing exercise on sleep quality among post-cardiac surgery patients. A systematic review of interventional studies was established to meet the PRISMA guidelines. PRISMA guidelines were used to assess the findings of 11 selected studies that met the inclusion criteria, published between 2007 and 2023 across four databases: CINAHL, JDNR, MEDLINE and PubMed. The search was conducted on 23 November 2023. The 11 most eligible studies were analysed. All of them were interventional, encompassing a total of 787 participants. Randomised controlled trials were the most common design. Interventions included eye masks, earplugs and deep-breathing exercises. The Richards-Campbell Sleep Questionnaire was the most used assessment scale. Most of the reviewed studies found that the use of non-pharmacological interventions (eye masks, earplugs and deep-breathing exercise) significantly improves the quality of sleep. These interventions were also found to have potentially positive effects on reducing pain and delirium experienced by patients after undergoing cardiac surgery. Non-pharmacological interventions (eye masks, earplugs and deep-breathing exercise) were found to be cost-effective interventions that could be easily applied in the clinical setting and are effective in improving the quality of sleep among patients after cardiac surgery.

7945 Modelling the Factors Associated With Sexual and Mood Symptoms Within the First Year of Anabolic-Androgenic Steroid Cessation in Men

Abstract Disclosure: B. Grant: None. J. Kean: None. N.L. de Silva: None. O. Quinton: None. P. Bassett: None. J. McVeigh: None. A. Lingford-Hughes: None. S. Minhas: None. S. Bhasin: None. W.S. Dhillo: None. C.N. Jayasena: None. Context: Anabolic-androgenic steroids (AAS) are misused by millions of men worldwide to boost muscle size and physical performance. Recent studies have quantified the recovery of cardiovascular markers and testicular function following AAS cessation. Qualitative studies demonstrate that low mood, anxiety, suicidal ideation, and sexual dysfunction are also common following AAS cessation. However, no previous study has focused on quantifying symptoms within the first year of AAS cessation, nor investigated independently associated factors for these symptoms. Methods: Cross-sectional, observational study of 165 men in 3 groups; non-AAS (n=43); current-AAS (n=76); past-AAS ≤1 year (n=46). All participants completed questions on substance misuse, Beck Depression Inventory-II (BDI-II), International Index Erectile Function-15 (IIEF-15), General Anxiety Disorder (GAD-7), Quality-of-life (SF-36), and underwent fasting, morning blood sampling with urine toxicology. Results: As expected, current-AAS had lower gonadotropins and elevated serum total testosterone compared with past-AAS and non-AAS. Sexual function measured using IIEF-15 was impaired in men stopping AAS &amp;lt;1year (past-AAS) compared with current AAS users: (1) total: 69.0 [95% CI 64.0, 71.0], current-AAS; 61.0 [95% CI 56.0, 66.0], past-AAS; p=0.077; (2) erectile function: 30.0 [95% CI 29.0, 30.0], current-AAS; 28 [95% CI 21.0, 29.0], past-AAS; p=0.015; (3) sexual desire: 9.0 [95% CI 8.0, 10.0], current-AAS; 6.0 [95% CI 5.0, 8.0], past-AAS; p&amp;lt;0.0001; (4) overall satisfaction: 10.0 [95% CI 8.0, 10.0], current-AAS; 7.0 [95% CI 7.0, 8.0], past-AAS; p=0.002. Multivariable analysis suggested that psychiatric comorbidity (coefficient -6.5 [95% CI -13.0, -1.3] p=0.03) and AAS cessation (coefficient -10.8 [95% CI -5.6, -17.2]; p&amp;lt;0.001) were associated with lower total IIEF-15 scores.Depression scoring was worse in the past-AAS group compared with non-AAS: BDI-II 4.0 [95% CI 2.0, 7.0], non-AAS; 7.0 [95% CI 4.0, 16.0], past-AAS; p=0.0448. Multivariable analysis suggested that psychiatric comorbidity (OR 2.39 [95% CI 1.60, 3.57]; p&amp;lt;0.001) and lower serum total testosterone (OR 0.85 [95% CI 0.88, 0.94]; p=0.002) were associated with higher BDI-II scores.Energy and fatigue measured using SF-36 was lower in the past-AAS group compared with non-AAS: 70 [95% CI 65, 75], non-AAS; 60 [95% CI 50, 65], past-AAS; p=0.0498. No significant differences in anxiety scoring were detected. Discussion: We report the first, detailed quantification and modelling of symptoms in men currently misusing and stopped AAS within the previous year. These data reveal potentially treatable factors to improve symptoms of AAS cessation if proven within interventional studies. Presentation: 6/2/2024

7945 Modelling the Factors Associated With Sexual and Mood Symptoms Within the First Year of Anabolic-Androgenic Steroid Cessation in Men

Abstract Disclosure: B. Grant: None. J. Kean: None. N.L. de Silva: None. O. Quinton: None. P. Bassett: None. J. McVeigh: None. A. Lingford-Hughes: None. S. Minhas: None. S. Bhasin: None. W.S. Dhillo: None. C.N. Jayasena: None. Context: Anabolic-androgenic steroids (AAS) are misused by millions of men worldwide to boost muscle size and physical performance. Recent studies have quantified the recovery of cardiovascular markers and testicular function following AAS cessation. Qualitative studies demonstrate that low mood, anxiety, suicidal ideation, and sexual dysfunction are also common following AAS cessation. However, no previous study has focused on quantifying symptoms within the first year of AAS cessation, nor investigated independently associated factors for these symptoms. Methods: Cross-sectional, observational study of 165 men in 3 groups; non-AAS (n=43); current-AAS (n=76); past-AAS ≤1 year (n=46). All participants completed questions on substance misuse, Beck Depression Inventory-II (BDI-II), International Index Erectile Function-15 (IIEF-15), General Anxiety Disorder (GAD-7), Quality-of-life (SF-36), and underwent fasting, morning blood sampling with urine toxicology. Results: As expected, current-AAS had lower gonadotropins and elevated serum total testosterone compared with past-AAS and non-AAS. Sexual function measured using IIEF-15 was impaired in men stopping AAS &amp;lt;1year (past-AAS) compared with current AAS users: (1) total: 69.0 [95% CI 64.0, 71.0], current-AAS; 61.0 [95% CI 56.0, 66.0], past-AAS; p=0.077; (2) erectile function: 30.0 [95% CI 29.0, 30.0], current-AAS; 28 [95% CI 21.0, 29.0], past-AAS; p=0.015; (3) sexual desire: 9.0 [95% CI 8.0, 10.0], current-AAS; 6.0 [95% CI 5.0, 8.0], past-AAS; p&amp;lt;0.0001; (4) overall satisfaction: 10.0 [95% CI 8.0, 10.0], current-AAS; 7.0 [95% CI 7.0, 8.0], past-AAS; p=0.002. Multivariable analysis suggested that psychiatric comorbidity (coefficient -6.5 [95% CI -13.0, -1.3] p=0.03) and AAS cessation (coefficient -10.8 [95% CI -5.6, -17.2]; p&amp;lt;0.001) were associated with lower total IIEF-15 scores.Depression scoring was worse in the past-AAS group compared with non-AAS: BDI-II 4.0 [95% CI 2.0, 7.0], non-AAS; 7.0 [95% CI 4.0, 16.0], past-AAS; p=0.0448. Multivariable analysis suggested that psychiatric comorbidity (OR 2.39 [95% CI 1.60, 3.57]; p&amp;lt;0.001) and lower serum total testosterone (OR 0.85 [95% CI 0.88, 0.94]; p=0.002) were associated with higher BDI-II scores. Energy and fatigue measured using SF-36 was lower in the past-AAS group compared with non-AAS: 70 [95% CI 65, 75], non-AAS; 60 [95% CI 50, 65], past-AAS; p=0.0498. No significant differences in anxiety scoring were detected. Discussion: We report the first, detailed quantification and modelling of symptoms in men currently misusing and stopped AAS within the previous year. These data reveal potentially treatable factors to improve symptoms of AAS cessation if proven within interventional studies. Presentation: 6/2/2024

Umbilical Cord Blood Platelet Lysate Eyedrops for the Treatment of Severe Ocular Surface Disorders in Graft vs. Host Disease Patients: Clinical Study

Background: Graft-versus-host disease (GvHD) is an overactive systemic inflammatory response that can arise following allogeneic hematopoietic stem cell transplantation (HSCT). This condition occurs when the transplanted donor immune cells recognize the recipient’s tissues as foreign and trigger an immune response against them. The ocular surface (eyelids, conjunctiva, meibomian glands, lacrimal glands, and cornea) is particularly involved in GvHD, and its response to existing treatments, including potent immunosuppressants and new targeted therapies, is undesirable, with such treatments often being ineffective. Human allogeneic umbilical cord blood platelet lysate stands out as a potent adjunct to conventional therapies for ocular surface disorders related to severe Dry Eye Disease. This study aimed to evaluate the safety and efficacy of umbilical cord blood platelet lysate eyedrops for the treatment of severe ocular surface disorders in graft-versus-host disease patients who have received previous unsuccessful treatments. Methods: This study was a prospective, non-comparative, interventional case series study involving 22 patients (10 females and 12 males) aged 25–46 years with severe ocular surface disorders that were unresponsive to standard treatments. The GvHD patients were categorized based on the severity of their ocular surface disorders into three groups: Group I: five patients with severe Dry Eye Disease and filamentary keratitis; Group II: eight patients suffering from severe blepharo-kerato-epitheliopathy; Group III: nine patients with corneal ulcers. Fresh umbilical cord blood (UCB) was obtained from healthy donors and subjected to centrifugation using a novel PRP preparation kit provided by Sciacca (AG) Cord blood bank, Italy in a one-step process. In all groups, the outcomes before and after treatment were evaluated by means of the OSDI (Ocular Surface Disease Index), SANDE (Symptom Assessment in Dry Eye) questionnaire, VAS (Visual Analogue Scale), slit lamp examination, Esthesiometry, Lissamine Green Staining, the NIBUT (Non-Invasive Break-Up Time) and BUT, fluorescein staining with digital photography and Oxford classification, the Schirmer Test, the Best Corrected Visual Acuity (BCVA), and Meibography. In Group III at each evaluation time, the size of the ulcer and its relative reduction compared to the baseline size were recorded. Clinical variables, such as corneal inflammation, conjunctivalization, corneal neovascularization, or pain, were also considered individually. Results: We observed a significant improvement in the SANDE, VAS, and OSDI scores; Schirmer Test; BUT; BCVA; and Oxford classification after treatment with allogeneic cord blood serum eyedrops. Nevertheless, pain and inflammation reduced markedly over time until complete healing in all cases. The mean reduction in the ulcer surface area (compared to baseline values) was significantly higher at all assessment points (p = 0.001 for day 7 and p &lt; 0.001 for subsequent time points every 30 days for 90 days). At the last check-up (after 90 days of treatment), the number of ulcers (Group III, nine patients) with a reduction in size of greater than 50% was eight (88.8%), of which seven ulcers were completely healed. None of the patients experienced treatment-related local or systemic adverse events. In this study, using a relatively large number of cases, we demonstrated that the use of umbilical cord blood platelet lysate eyedrops is a safe, feasible, and effective curative approach for severe ocular surface disease in patients with GvHD. Conclusions: Our pilot study highlights the remarkable effectiveness of allogeneic cord blood serum eyedrops in patients with severe ocular surface disorders following GvHD who have shown an inadequate response to the usual treatments. It is mandatory to design future studies on the efficacy of this therapeutic approach for acute ocular, mucosal, and cutaneous GvHD.

Prevention of Post Operative Infection in Obese Women Undergoing Emergency LSCS: Role of Surgical Bundle and Vaginal Cleaning, A Prospective Randomised Interventional Study

Prevention of Post Operative Infection in Obese Women Undergoing Emergency LSCS: Role of Surgical Bundle and Vaginal Cleaning, A Prospective Randomised Interventional Study

Association between Inflammatory and Metabolic Biomarkers and Common Mental Disorders among Adults: 2015 Health Survey of São Paulo, SP, Brazil.

Recent studies suggest that plasma inflammatory biomarker concentrations may represent valuable indicators for the diagnosis and prognosis of mental disorders. At the same time, metabolic alterations may contribute to the development and progression of systemic low-grade inflammation. Background/Objectives: This study evaluated the association between plasma inflammatory biomarkers and common mental disorders (CMD), exploring the relationship between metabolic biomarkers, metabolic syndrome (MetS), and inflammatory biomarkers in younger and older adults. Methods: This cross-sectional study used data from the 2015 Health Survey of São Paulo with a Focus on Nutrition Study. The occurrence of CMD was assessed through the Self-Reporting Questionnaire (SRQ-20). Blood samples were used to measure plasma concentrations of inflammatory and cardiometabolic biomarkers. MetS was defined according to the International Diabetes Federation Consensus. The Mann-Whitney test compared inflammatory biomarker concentrations across CMD groups and cardiometabolic conditions, and logistic regression models explored associations between inflammatory biomarker concentration and CMD. Results: The sample included 575 participants, 22.6% (n = 130) of whom had CMD. Concentrations of plasminogen activator inhibitor 1, C-reactive protein (CRP), and the systemic low-grade inflammation score varied significantly among CMD groups. CRP concentrations were positively associated with the presence of CMD, independent of confounding factors. Participants with insulin resistance, dyslipidemia, and MetS exhibited significantly higher CRP concentrations than individuals without these conditions. Conclusions: The findings suggest that increased plasma CRP concentrations may be a potential risk factor for CMD. Higher CRP concentrations were observed in individuals with insulin resistance, dyslipidemia, and MetS. Future interventional studies should explore these hypotheses in diverse populations.

Prophylactic Administration of Perampanel for Post-Stroke Epilepsy (PROPELLER Study): A Trial Protocol.

Post-stroke epilepsy can reduce patients' abilities to carry out various activities of daily living. Despite their importance in preventing the onset of post-stroke epilepsy, the prophylactic administration of antiepileptic drugs is controversial due to a lack of high-level clinical research. In this study, we initiated a prospective interventional study of prophylactic antiepileptic drug administration in patients with a subcortical hemorrhage, who are at the highest risk of developing epilepsy after experiencing a stroke. The study was conducted in a single-center setting and was a single-arm study with no control group; the case entry period started in November 2023 and is due to end in March 2025. Only cases with a subcortical hemorrhage will be included. The treatment regimen used in this study is 2 mg of perampanel per day. Perampanel will be administered for one year, followed by two years of follow-up, for a total study period of three years. The primary endpoint will be the development of epilepsy. Perampanel administration is expected to reduce the incidence of post-stroke epilepsy in comparison to the results of previous reports on the use of alternative treatments. The results of this study will provide new insights into the prevention of post-stroke epilepsy. The relatively small size of this study makes it difficult to provide strong evidence of the efficacy of perampanel, but it may serve as a basis for larger clinical trials.