Test Date Research Articles

Normative values for tests of central auditory processing disorder in children aged from 6 to 12 years old

IntroductionCentral auditory processing disorders (CAPD) can significantly affect the daily functioning of a child, and the first step in determining whether rehabilitation procedures are required is a proper diagnosis. Different guidelines for making diagnoses have been published in the literature, and in various centers normative values for psychoacoustic tests of CAPD have been used internally. The material presented in this paper is based on more than 1000 children and is the largest collection so far published. The aim of this study is to present normative values for tests assessing CAPD in children aged 6 to 12 years, divided by age at last birthday. MethodWe tested 1037 children aged 6 to 12 years who were attending primary schools and kindergartens. The criteria for inclusion were a normal audiogram, intellectually normal, no developmental problems, and no difficulties in auditory processing. To evaluate auditory processing all children were given three tests on the Senses Examination Platform: the Frequency Pattern Test (FPT), Duration Pattern Test (DPT), and Dichotic Digit Test (DDT). ResultsThe results from 1,037 children allowed us to determine normative values for FPT, DPT, and DDT in seven different age groups (6 through to 12 years). We developed a newapproach, based on quantile-based norms, to determine normative values in each group. Three categories – average, below-average, and above-average – allow for a broader but more realistic interpretation than those used previously. We compare our results with published standards. ConclusionsOur study is the largest normative database published to date for CAPD testing, setting a standard for each child by age in years. We used the Senses Examination Platform, a universal tool, to unify standards for the classification of CAPD. Our study can serve as a basis for the development of a Polish model for the diagnosis of CAPD.

Association of Premorbid GLP-1RA and SGLT-2i Prescription Alone and in Combination with COVID-19 Severity.

People with type 2 diabetes are at heightened risk for severe outcomes related to COVID-19 infection, including hospitalization, intensive care unit admission, and mortality. This study was designed to examine the impact of premorbid use of glucagon-like peptide-1 receptor agonist (GLP-1RA) monotherapy, sodium-glucose cotransporter-2 inhibitor (SGLT-2i) monotherapy, and concomitant GLP1-RA/SGLT-2i therapy on the severity of outcomes in individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Utilizing observational data from the National COVID Cohort Collaborative through September 2022, we compared outcomes in 78,806 individuals with a prescription of GLP-1RA and SGLT-2i versus a prescription of dipeptidyl peptidase 4 inhibitors (DPP-4i) within 24months of a positive SARS-CoV-2 PCR test. We also compared concomitant GLP-1RA/SGLT-2i therapy to GLP-1RA and SGLT-2i monotherapy. The primary outcome was 60-day mortality, measured from the positive test date. Secondary outcomes included emergency room (ER) visits, hospitalization, and mechanical ventilation within 14days. Using a super learner approach and accounting for baseline characteristics, associations were quantified with odds ratios (OR) estimated with targeted maximum likelihood estimation (TMLE). Use of GLP-1RA (OR 0.64, 95% confidence interval [CI] 0.56-0.72) and SGLT-2i (OR 0.62, 95% CI 0.57-0.68) were associated with lower odds of 60-day mortality compared to DPP-4i use. Additionally, the OR of ER visits and hospitalizations were similarly reduced with GLP1-RA and SGLT-2i use. Concomitant GLP-1RA/SGLT-2i use showed similar odds of 60-day mortality when compared to GLP-1RA or SGLT-2i use alone (OR 0.92, 95% CI 0.81-1.05 and OR 0.88, 95% CI 0.76-1.01, respectively). However, lower OR of all secondary outcomes were associated with concomitant GLP-1RA/SGLT-2i use when compared to SGLT-2i use alone. Among adults who tested positive for SARS-CoV-2, premorbid use of either GLP-1RA or SGLT-2i is associated with lower odds of mortality compared to DPP-4i. Furthermore, concomitant use of GLP-1RA and SGLT-2i is linked to lower odds of other severe COVID-19 outcomes, including ER visits, hospitalizations, and mechanical ventilation, compared to SGLT-2i use alone. Graphical abstract available for this article.

Abstract 7321: Second primary cancer risks following breast cancer in BRCA1/2 pathogenic variant carriers

Abstract Background: Second primary cancer (SPC) risk estimates in breast cancer (BC) survivors carrying germline BRCA1/2 pathogenic variants (PVs) remain uncertain. We estimated relative and absolute SPC risks following BC in BRCA1/2 PV carriers using genetic testing laboratory data in England, linked for the first time to population-scale electronic health records data from the National Disease Registration Service and Hospital Episode Statistics. Material and methods: The cohort contained 27,154 women diagnosed with primary BC and tested for germline BRCA1/2 PVs between 1995-2019. Follow-up began at the latest of the genetic test dates and one year following the BC diagnosis and continued until the first SPC diagnosis, death, migration, relevant surgery, and the end of 2020, whichever came first. We estimated overall and site-specific standardized incidence ratios (SIRs) by comparing observed and expected SPC counts, with expected counts calculated using incidences for the general English population accounting for calendar year, SPC site, age, and gender. We stratified the SIRs by age, estrogen-receptor status, and cancer site. We further assessed associations using Cox regression adjusted for age at BC diagnosis and estrogen-receptor status of the first BC, and estimated 10-year absolute SPC risks with Kaplan-Meier analysis. Results: There were 1909 BRCA1 (138 with SPCs) and 1926 BRCA2 (101 with SPCs) PV carriers, with mean follow-up lengths of 4.2 and 4.4y and median follow-up lengths of 3.4 and 3.6y. In BRCA1 PV carriers, there were elevated contralateral BC (SIR:15.3, 95%CI:11.5-19.8), ovarian (SIR:43.3, 95%CI:30.9-58.9), non-breast and non-ovarian combined (SIR:2.23, 95%CI:1.63-2.98), colorectal (SIR:4.72, 95%CI:2.58-7.92) and uterine (SIR:3.42, 95%CI:1.25-7.44) SPC risks. In BRCA2 PV carriers, there were increased contralateral BC (SIR:7.53, 95%CI:5.33-10.3), ovarian (SIR:16.5, 95%CI:10.1-25.5), non-breast and non-ovarian (SIR:1.72, 95%CI:1.27-2.27) and pancreatic (SIR:6.57, 95%CI:2.63-13.5) SPC risks. Consistently, when we compared BC survivors carrying a BRCA1 PV to BC survivors without a PV in either gene, they were at elevated contralateral BC (HR:3.94, 95%CI:2.91-5.33), ovarian (HR:35.7, 95%CI:21.3-60.0), non-breast and non-ovarian (HR:1.53, 95%CI:1.11-2.12) and colorectal (HR:2.95, 95%CI:1.56-5.55) SPC risks, whereas BRCA2 PV carriers were at increased contralateral BC (HR:2.59, 95%CI:1.83-3.65), ovarian (HR:12.3, 95%CI:6.93-21.9) and pancreatic (HR:5.32, 95%CI:2.30-12.3) SPC risks. We estimated 10-year cumulative contralateral BC, ovarian, and non-breast and non-ovarian SPC risks of 15%, 6.3%, and 7.8% in BRCA1 PV carriers and 12%, 2.9%, and 6.2% in BRCA2 PV carriers. Conclusions: Cancer risks were increased, at combined and specific sites, following BC in BRCA1/2 PV carriers. These findings could aid the clinical management of BC survivors carrying BRCA1/2 PVs. Citation Format: Isaac Allen, Hend Hassan, Yvonne Walburga, Catherine Huntley, Lucy Loong, Tameera Rahman, Beth Torr, Andrew Bacon, Craig Knott, Sophie Jose, Sally Vernon, Margreet Lüchtenborg, Joanna Pethick, Francesco Santaniello, Shilpi Goel, Sophie Allen, Katrina Lavelle, Fiona McRonald, Diana M. Eccles, Eva Morris, Steven Hardy, Clare Turnbull, Marc Tischkowitz, Paul Pharoah, Antonis C. Antoniou. Second primary cancer risks following breast cancer in BRCA1/2 pathogenic variant carriers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7321.

Effect of extreme high temperature on cognitive function at different time scales: A national difference-in-differences analysis

BackgroundMounting evidence has demonstrated that high temperature was associated with adverse health outcomes, especially morbidity and mortality. Nonetheless, the impact of extreme high temperature on cognitive performance, which is the fundamental capacity for interpreting one's surroundings, decision-making, and acquiring new abilities, has not been thoroughly investigated. MethodsWe aimed to assess associations between extreme high temperature at different time scales and poor cognitive function. We used longitudinal survey data from the three waves of data from China Family Panel Study, providing an 8-year follow-up of 53,008 participants from China. We assessed temperature and extreme high temperature exposure for each participant based on the residential area and date of cognitive test. We defined the proportion of days/hours above 32 °C as the metric of the exposure to extreme high temperature. Then we used generalized additive model and difference-in-differences approach to explore the associations between extreme high temperature and cognitive function. ResultsOur results demonstrated that either acute exposure or long-term exposure to extreme high temperature was associated with cognitive decline. At hourly level, 0–1 hour acute exposure to extreme high temperature would induce −0.93 % (95 % CI: −1.46 %, −0.39 %) cognitive change. At annual level, 10 percentage point increase in the hours proportion exceeding 32 °C in the past two years induced −9.87 % (95 % CI: −13.99 %, −5.75 %) cognitive change. Furthermore, subgroup analyses indicated adaptation effect: for the same 10 percentage increase in hours proportion exceeding 32 °C, people in warmer areas had cognitive change of −6.41 % (-11.22 %, −1.61 %), compared with −15.30 % (-21.07 %, −9.53 %) for people in cool areas. ConclusionOur results demonstrated that extreme high temperature was associated with reduced cognitive function at hourly, daily and annual levels, warning that people should take better measures to protect the cognitive function in the context of climate change.

Risk factors for SARS-CoV-2 infection at a UK electricity-generating company: a test-negative design case-control study

ObjectivesIdentify workplace risk factors for SARS-CoV-2 infection, using data collected by a UK electricity-generating company.MethodsUsing a test-negative design case-control study, we estimated the OR of infection by job category, site,...

Dried blood spots via remote testing as a possible future application in the doping control process.

The use of DBS as biological matrix in combination with a novel technical remote testing app specifically developed for the doping control process shows that testing is becoming easier and variable through DBS. Supplemented by the remote testing solution, the system could significantly increase in the unpredictability of test dates and sample quantity.

Body conformation traits in early-lactation associated with clinical mastitis and lameness in lactating Chinese holstein cows

BackgroundComprehending the correlation between body conformation traits of cows at the early stages of lactation and prevalent lactation diseases might facilitate the execution of selection and feeding strategies that prioritize cow health. This study aimed to evaluate the impact of body conformation traits on the incidence of clinical mastitis and lameness in Chinese Holstein cows. From a pasture herd of 1472 early lactating Chinese Holstein cows, we evaluated 20 body conformation traits. During lactation, this pasture herd was visited weekly to gather clinical mastitis and lameness data. A nine-point scale was used to determine the conformation traits of cows to clarify their linear characters, including frame capacity, rump (RU), feet and leg (FL), mammary system (MS), and dairy character. A longitudinal binary disease (0 = healthy; 1 = diseased) data structure was created by allocating disease records to adjacent official test dates. The impact of body conformation traits on the risk of developing diseases (clinical mastitis and lameness) was analyzed using the logistic regression models.ResultsCompared to cows with low total scores (75–79 points), those with high total scores (80–85 points) of body conformation traits had a significantly lower risk of mastitis (P < 0.001). The disease status (0 or 1: binary variable) of clinical mastitis in lactating cows was significantly impacted negatively by age (P < 0.05). The fore udder attachment (FUA), angularity, rear attachment height (RAH), and rear teat placement (RTP) were all significantly associated with clinical mastitis during lactation (P < 0.05). The rear leg-rear view (RLRV) was significantly correlated with correlated considerably (P < 0.05) with lameness during lactation. An ideal score of four points on the lameness risk dimension of the RLRV may indicate a low risk of lameness. Since the risk of mastitis decreased as this trait score increased, the RTP may be an ideal marker for mastitis risk.ConclusionsAccording to the study, clinical mastitis and lameness risks in cows can be estimated using their body conformation traits. Cows with more centrally located rear teats have a lower risk of mastitis. These results may help dairy farmers identify cows at high risk of disease early in lactation and aid in breeding for disease resistance in cows.

Association between monoclonal antibody therapy, vaccination, and longer-term symptom resolution after acute COVID-19.

Effective therapies for reducing post-acute sequelae of COVID-19 (PASC) symptoms are lacking. Evaluate the association between monoclonal antibody (mAb) treatment or COVID-19 vaccination with symptom recovery in COVID-19 participants. The longitudinal survey-based cohort study was conducted from April 2021 to January 2022 across a multihospital Colorado health system. Adults ≥18 years with a positive SARS-CoV-2 test were included. Primary exposures were mAb treatment and COVID-19 vaccination. The primary outcome was time to symptom resolution after SARS-CoV-2 positive test date. The secondary outcome was hospitalization within 28 days of a positive SARS-CoV-2 test. Analysis included 1612 participants, 539 mAb treated, and 486 with ≥2 vaccinations. Time to symptom resolution was similar between mAb treated versus untreated patients (adjusted hazard ratio (aHR): 0.90, 95% CI: 0.77-1.04). Time to symptom resolution was shorter for patients who received ≥2 vaccinations compared to those unvaccinated (aHR: 1.56, 95% CI: 1.31-1.88). 28-day hospitalization risk was lower for patients receiving mAb therapy (adjusted odds ratio [aOR]: 0.31, 95% CI: 0.19-0.50) and ≥2 vaccinations (aOR: 0.33, 95% CI: 0.20-0.55), compared with untreated or unvaccinated status. Analysis included 1612 participants, 539 mAb treated, and 486 with ≥2 vaccinations. Time to symptom resolution was similar between mAb treated versus untreated patients (adjusted hazard ratio (aHR): 0.90, 95% CI: 0.77-1.04). Time to symptom resolution was shorter for patients who received ≥2 vaccinations compared to those unvaccinated (aHR: 1.56, 95% CI: 1.31-1.88). 28-day hospitalization risk was lower for patients receiving mAb therapy (adjusted odds ratio [aOR]: 0.31, 95% CI: 0.19-0.50) and ≥2 vaccinations (aOR: 0.33, 95% CI: 0.20-0.55), compared with untreated or unvaccinated status. COVID-19 vaccination, but not mAb therapy, was associated with a shorter time to symptom resolution. Both were associated with lower 28-day hospitalization.

Symptomology following COVID-19 among adults in Alberta, Canada: an observational survey study

ObjectiveFatigue, headache, problems sleeping and numerous other symptoms have been reported to be associated with long COVID. However, many of these symptoms coincide with symptoms reported by the general population,...

Automatic Detection of 30 Fundus Diseases Using Ultra-Widefield Fluorescein Angiography with Deep Experts Aggregation.

Inaccurate, untimely diagnoses of fundus diseases leads to vision-threatening complications and even blindness. We built a deep learning platform (DLP) for automatic detection of 30 fundus diseases using ultra-widefield fluorescein angiography (UWFFA) with deep experts aggregation. This retrospective and cross-sectional database study included a total of 61,609 UWFFA images dating from 2016 to 2021, involving more than 3364 subjects in multiple centers across China. All subjects were divided into 30 different groups. The state-of-the-art convolutional neural network architecture, ConvNeXt, was chosen as the backbone to train and test the receiver operating characteristic curve (ROC) of the proposed system on test data and external test date. We compared the classification performance of the proposed system with that of ophthalmologists, including two retinal specialists. We built a DLP to analyze UWFFA, which can detect up to 30 fundus diseases, with a frequency-weighted average area under the receiver operating characteristic curve (AUC) of 0.940 in the primary test dataset and 0.954 in the external multi-hospital test dataset. The tool shows comparable accuracy with retina specialists in diagnosis and evaluation. This is the first study on a large-scale UWFFA dataset for multi-retina disease classification. We believe that our UWFFA DLP advances the diagnosis by artificial intelligence (AI) in various retinal diseases and would contribute to labor-saving and precision medicine especially in remote areas.

Characteristic Features of the Novel Coronavirus Infection COVID-19 in Oncohematological Patients

Background. The novel coronavirus infection SARS-CoV-2 (COVID-19) is one of high-threat respiratory diseases, characterized by multiple organ disorders with primary respiratory failure and population mortality of 2–5 %. However, the mortality of oncohematological patients treated with chemotherapy is considerably higher.&#x0D; Aim. To analyze the COVID-19 treatment outcomes in hematological malignancy patients who received drug chemotherapy.&#x0D; Materials &amp; Methods. The clinical course of COVID-19 was analyzed in 32 hematological malignancy patients aged 31–81 years (median 62 years). The disease onset was the date of the first positive COVID-19 PCR test. These patients were transferred to an infectious hospital specialized in the therapy of the novel coronavirus infection. Pneumonia was confirmed by standard radiography and CT. Blood oxygen saturation, body temperature, ECG, and respiratory rate were monitored. Moderate and severe COVID-19 was observed in 17 (53.1 %) of 32 patients. The condition of 15 (46.9 %) patients was described as good. For comparison, a control group was collected from 32- to 79-year-old (median 63 years) patients (n = 28) having hematological malignancies but no COVID-19.&#x0D; Results. Nine (28.1 %) of 32 patients under analysis died upon increasing respiratory and multiple organ insufficiency on Day 3–17 (mean 8,6 ± 4,6 days) from the first positive COVID-19 PCR test. Death was predominantly reported in multiple myeloma patients (n = 5) as well as in a patient with Waldenstrom’s macroglobulinemia. In the control group (n = 28) with similar hematological tumors but without COVID-19, three (10.7 %) patients died throughout the 12-month follow-up period. The present paper contains a case report illustrating the clinical features of coronavirus infection in a patient with Waldenstrom’s macroglobulinemia, a monoclonal gammopathy with primary bone marrow lesions.&#x0D; Conclusion. COVID-19 is a life-threatening viral disease with high mortality in patients with hematological malignancies, especially those with plasma cell dyscrasias.

Assessment of birth cohort screening of chronic hepatitis C in colorectal cancer screening patients in British Columbia.

Since 2018, British Columbia (BC) has recommended chronic hepatitis C (HCV) screening for those born between 1945 and 1964, with a provincial prevalence of 2.31%. Combining HCV and colorectal cancer (CRC) screening can facilitate specialist referrals and follow-up. We assessed HCV screening uptake among CRC screening patients following the release of BC's birth cohort guidelines and examined the COVID-19 pandemic's impact on HCV screening practices. A retrospective review was conducted on patients referred to Vancouver Coastal Health Authority's CRC screening program. Two groups, Cohort A (October-December 2019) and Cohort B (December 2021), were studied to identify pandemic-related changes. Data on demographics, liver disease history, hepatitis B or HIV co-infection rates, and initial anti-hepatitis C and ribonucleic acid (RNA) testing dates were collected. Statistical analyses were performed with Stata 15.1. A total of 579 patients were referred for the CRC screening program, of whom 465 were born between 1945 and 1964 and were included in the study. Among the 348 patients in cohort A, 144 (41%, 95% CI 36%-47%) were screened for HCV infection. Of these, four (1.2%) were positive for anti-hepatitis C, and one patient had positive RNA levels. Similar proportions of screenings were observed in cohort B (47.8%, 95% CI 39%-57%). Of those with liver disease, 66% had been screened for HCV. Birth cohort screening for HCV has been underutilized in British Columbia. Combining HCV and CRC screening could provide a practical approach to linking patients to health care.

Do mean platelet volume and platelet count vary on a daily or gender basis?

Aims: Mean platelet volume (MPV) is a measurement based on platelet morphology. We aimed to investigate whether MPV and platelet count exhibit a daily change in relation to the days and gender. Methods: Healthy blood donors aged 18–55 years with no history of the disease and/or drug use participated in the study. MPV values and platelet counts were analyzed with respect to the date of the blood test and the gender of the participant based on a 29–day calendar. Results: A total of 14718 participants (7772 female) were included. The median age of the females and males was similar (38 [range 18–54], and 36 [18–55], p=0.254, respectively). Median platelet count was 278 × 109/L (range 152–448) in females and 244 × 109/L (range 151–439) in males, with a significant difference (p&lt;0.01). The median MPV was 8.9 (range 5.7–12.2) fL in females and 8.4 (range 5.9–12.8) fl in males (p&lt;0.01). MPV and platelet counts were higher in females on all days of the month compared to males. Decreases in MPV values were observed in both females and males on days 9th, 12th, 20th, and 26th, whereas increases in both occurred on days 5th, 15th, 23rd, and 29th. Conclusion: We demonstrated that MPV and platelet count exhibited a daily fluctuating in healthy individuals; MPV values and platelet count were overall higher in females. This study may give a different perspective on future studies of MPV and a lead for evaluating daily changes on other blood parameters.

Seroprevalence of SARS-CoV-2 antibodies among Japanese healthcare workers from 2020 to 2022 as assayed by two commercial kits

Antibody tests are used as surveillance tools for informing health policy making. However, results may vary by type of antibody assay and timing of sample collection following infection. Long-term longitudinal cohort studies on antibody assay seropositivity have remained limited, especially among Asian populations. Using blood samples obtained at health physicals (2020–2022) of healthcare workers (mass vaccinated with mRNA COVID-19 vaccines) at a Japanese medical center, we measured N-specific antibodies using two commercially available systems. Roche Elecsys Anti-SARS-CoV-2 measures total antibodies and Abbott Alinity SARS-CoV-2 IgG measures only IgG. Among 2538 participants, seroprevalence was found to be 16.6% via total antibody assay versus 12.9% by IgG-only (including grayzone) by mid-June 2022. For 219 cases with a previous PCR-confirmed infection, positivity was 97.3% using total antibody assay versus 76.3% using IgG-only assay at the 2022 health physical. Using PCR positive test date as day 0, while the positivity of the total antibody assay was retained for the entire study period (until more than 24-months post-infection), the IgG-only assay’s positivity declined after month 4. The Mantel–Haenszel test found a significant difference in the two assays’ seropositivity, between stratified groups of “within 3 months” and “4 months or more” from infection (P < 0.001). Our study found significant differences in seropositivity over time of total antibody versus IgG-only assays, suggesting an optimal assay for retaining sensitivity over the entire infection period when designing seroprevalence studies.

MAXIMAL EXERCISE CAPACITY IS INVERSELY RELATED TO INCIDENT PERIPHERAL ARTERY DISEASE

https://youtu.be/wLtxZn3XafA BACKGROUND Maximal exercise capacity (EC) is a strong, independent predictor of incident coronary and cerebrovascular disease. However, less is known about the relationship between EC and incident peripheral artery disease (PAD). Using data from the Henry Ford Exercise Testing (FIT) Project, we evaluated the relationship between EC and incident PAD. We hypothesized that EC, measured in metabolic equivalents of task (METs), is inversely related to incident PAD. METHODS We assessed 41,268 patients (age = 55±12 yrs, 49% female, and 64% white) who completed a clinically indicated exercise stress test between January 1991 and June 2009 at a Henry Ford Health facility. Patients with established PAD at the time of testing were excluded. METs were estimated from peak treadmill speed and grade and standardized to the equivalent of a 50-year-old male to account for differences in absolute risk for a given MET level by age and sex. METs were categorized as &amp;lt;6, 6-9, 10-11, and &amp;gt;12. ICD9 codes 440.XX and 443.9 were used to identify first incidence of PAD from the test date through June 2010. Multivariable Cox regression was used to relate METs to incident PAD. Patients were censored at the date of death or last clinic visit. RESULTS During a median follow-up of 7.1 years (IQR 4.2-11.1 yrs) there were 2,596 (6%) incident diagnoses of PAD. In the adjusted analysis, each 1 MET increase in maximal EC was associated with a 7% lower risk of PAD (aHR=0.93 [0.91, 0.94]). There was a graded, inverse risk of incident PAD by MET category (see Table). A significant interaction was noted for race (overall p=.04; white [HR=0.93 (0.92, 0.95)] vs black [HR=0.91 (0.88, 0.93)], p=.02; white vs other [HR=0.97 (0.87, 1.07)], p=0.47), but not for sex (p=.79). CONCLUSION In a diverse cohort that completed a clinically indicated exercise stress test, higher EC measured in METs, is independently and inversely associated with a lower risk of incident PAD.

Improving timeliness and equity in germline genetic testing for pancreatic ductal adenocarcinoma patients: A comparative analysis and future strategies.

611 Background: Germline genetic testing is recommended for patients with pancreatic ductal adenocarcinoma (PDAC). Our previous study identified delays in germline testing for socioeconomically disadvantaged patients. We aimed to compare delays before and after implementing recommendations for same-day germline testing and identify reasons why germline testing was not performed. Methods: Using an IRB-approved protocol, PDAC patients were identified from Jan 2022 to Dec 2022 in our EMR system. Median income was estimated by zip code. Delays were calculated as the difference between diagnosis and germline test date. Social work needs were assessed through EMR review. An in-depth chart review was conducted to identify why tests were not performed. Results: An additional 100 patients were found with tests performed. Compared to our previous 135-patient study with a median delay of 27 days (d) in testing, our recent data showed a median delay of 15d (p=0.0215). In our previous study, 50 out of 135 patients (37%) received testing within two weeks of their PDAC diagnosis, whereas our recent data showed that 49 out of 100 patients (49%) received testing within two weeks (c2=3.372, p=0.0663), a 32% relative increase. The negative correlation between median income and delays in testing (r=-0.2578, p=0.0025) found in our previous study no longer existed in our recent analysis (r=0.0419, p=0.6802). Compared to our previous study in underserved minority (UM) patients (African American and Hispanic), our recent data showed a significant decrease in the delays for testing in UM patients (66d vs 19d, p=0.0041). We did not identify a difference in delays for testing between UM and not UM patients in the recent dataset (UM: 19d vs not UM: 15d, p=0.8075). In addition, compared to our previous study in patients with social work (SW) needs, our recent data showed a significant decrease in the delays for patients with SW needs (104d vs 13d, p=0.0004). We did not detect a significant difference between patients with SW needs and without SW needs in our recent data (SW: 13d vs no SW: 15d, p=0.8041). Finally, in our analysis of 87 patients without documented tests, 51 (59%) received care elsewhere, 25 (29%) were never offered tests, 5 (6%) refused tests, and 6 (7%) pursued a palliative approach. Conclusions: Our recent analysis showed a significant decrease in delays of testing, as more patients received prompt testing after PDAC diagnosis. Socioeconomically disadvantaged patients and those with social work needs no longer experienced significant delays in testing. To further mitigate delays, we plan to initiate germline testing during the first visit by providing introductory videos to increase understanding of consent. Furthermore, the substantial number of patients who were not offered tests will raise physician awareness regarding the necessity of offering germline tests.

Abstract A008: Empowering equity: Accelerated germline genetic testing for pancreatic ductal adenocarcinoma erodes delays, democratizes access, and mitigates disparity

Abstract Background: Germline genetic testing is recommended for patients with pancreatic ductal adenocarcinoma (PDAC) as is pre-diagnostic testing for those with a significant family history. Our previous study identified delays in germline testing for socioeconomically disadvantaged patients. We aimed to compare delays before and after implementing recommendations for same-day germline assessment through a recent data analysis. Methods: Using an IRB-approved protocol, PDAC patients were identified from Jan 2022 to Dec 2022 in our EMR system. Median income was estimated by zip code. Delays were calculated as the difference between diagnosis date and germline test date. Social work needs were assessed through EMR review. Results: An additional 100 patients were found to have germline genetic tests performed. Compared to our previous study of 135 patients with a median delay of 27 days (d) in obtaining germline testing, our recent data showed a median delay of 15d (p=0.0215). In our previous study, 50 out of 135 patients (37.04%) received germline genetic testing within two weeks of their diagnosis of pancreatic cancer, whereas our recent data showed that 49 out of 100 patients (49.00%) received germline genetic testing within two weeks of their diagnosis of pancreatic cancer (Chi square=3.372, p=0.0663), a 32% relative increase. Our previous study identified a negative correlation between median income and delays in germline testing (r=-0.2578, p=0.0025). However, this correlation became non-significant in our recent data capture (r=0.0419, p=0.6802). Compared to our previous study in underserved minority (UM) patients (African American and Hispanic), our recent data showed a significant decrease in the delays for testing in UM patients (66d vs 19d, p=0.0041). We did not identify a difference in delays for testing between UM and not UM patients in the recent dataset (UM: 19d vs not UM: 15d, p=0.8075). In addition, compared to our previous study in patients with social work (SW) needs, our recent data showed a significant decrease in the delays for patients with SW needs (104d vs 13d, p=0.0004). We did not detect a significant difference between patients with SW needs and without SW needs in our recent data (SW: 13d vs no SW: 15d, p=0.8041).Conclusion: Our recent analysis showed a significant decrease in delays of germline testing due to the fact that more patients received prompt testing after their diagnosis of pancreatic cancer. Unlike our previous study, socioeconomically disadvantaged patients and those with social work needs no longer experienced significant delays in testing. Our previous publication has raised awareness in our institution, and we plan to initiate germline testing during patients' first visit by providing introductory videos to increase understanding of consent, encourage participation, and further reduce delays. Citation Format: Xianghui Zou, Baho Sidiqi, Ellen Chen, Noah Kauff, Daniel King. Empowering equity: Accelerated germline genetic testing for pancreatic ductal adenocarcinoma erodes delays, democratizes access, and mitigates disparity [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Pancreatic Cancer; 2023 Sep 27-30; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(2 Suppl):Abstract nr A008.

The effectiveness of COVID-19 vaccines to prevent long COVID symptoms: staggered cohort study of data from the UK, Spain, and Estonia

Although vaccines have proved effective to prevent severe COVID-19, their effect on preventing long-term symptoms is not yet fully understood. We aimed to evaluate the overall effect of vaccination to prevent long COVID symptoms and assess comparative effectiveness of the most used vaccines (ChAdOx1 and BNT162b2). We conducted a staggered cohort study using primary care records from the UK (Clinical Practice Research Datalink [CPRD] GOLD and AURUM), Catalonia, Spain (Information System for Research in Primary Care [SIDIAP]), and national health insurance claims from Estonia (CORIVA database). All adults who were registered for at least 180 days as of Jan 4, 2021 (the UK), Feb 20, 2021 (Spain), and Jan 28, 2021 (Estonia) comprised the source population. Vaccination status was used as a time-varying exposure, staggered by vaccine rollout period. Vaccinated people were further classified by vaccine brand according to their first dose received. The primary outcome definition of long COVID was defined as having at least one of 25 WHO-listed symptoms between 90 and 365 days after the date of a PCR-positive test or clinical diagnosis of COVID-19, with no history of that symptom 180 days before SARS-Cov-2 infection. Propensity score overlap weighting was applied separately for each cohort to minimise confounding. Sub-distribution hazard ratios (sHRs) were calculated to estimate vaccine effectiveness against long COVID, and empirically calibrated using negative control outcomes. Random effects meta-analyses across staggered cohorts were conducted to pool overall effect estimates. A total of 1 618 395 (CPRD GOLD), 5 729 800 (CPRD AURUM), 2 744 821 (SIDIAP), and 77 603 (CORIVA) vaccinated people and 1 640 371 (CPRD GOLD), 5 860 564 (CPRD AURUM), 2 588 518 (SIDIAP), and 302 267 (CORIVA) unvaccinated people were included. Compared with unvaccinated people, overall HRs for long COVID symptoms in people vaccinated with a first dose of any COVID-19 vaccine were 0·54 (95% CI 0·44-0·67) in CPRD GOLD, 0·48 (0·34-0·68) in CPRD AURUM, 0·71 (0·55-0·91) in SIDIAP, and 0·59 (0·40-0·87) in CORIVA. A slightly stronger preventative effect was seen for the first dose of BNT162b2 than for ChAdOx1 (sHR 0·85 [0·60-1·20] in CPRD GOLD and 0·84 [0·74-0·94] in CPRD AURUM). Vaccination against COVID-19 consistently reduced the risk of long COVID symptoms, which highlights the importance of vaccination to prevent persistent COVID-19 symptoms, particularly in adults. National Institute for Health and Care Research.

NAPLEX Preparatory Perceptions from Recent Graduates at One College of Pharmacy

ObjectivesThe current study assessed how students prepared for the North American Pharmacist Licensure Examination (NAPLEX), and examined factors associated with first-time pass rates. In addition, updated information on student perceptions of several currently available NAPLEX preparation resources was collected. MethodsA survey was administered to 2022 graduates from 1 school, which collected data on student demographics, and NAPLEX-related items regarding when the exam was taken and how students prepared, including resources used. The association between first-time success (pass, no pass) and grade point average (GPA), timing of test date after graduation, effort toward exam, and number of hours studied was examined. In addition, student ratings of NAPLEX preparation resources in terms of usefulness, representativeness to actual examination, and monetary value were reported. ResultsA total of 52 individuals completed the survey. Pharmacy GPA over 3.5, taking the NAPLEX within 60 days of graduation, and exerting moderate to extensive effort to pass the NAPLEX were all associated with higher first-time pass rates. All students reported using at least 1 RxPrep resource, which students rated highly and suggested the school provide as a resource for NAPLEX preparation. ConclusionThis study found that taking the NAPLEX examination within 60 days of graduation, contributing moderate to extensive effort to pass the examination, as well as a cumulative GPA of 3.5 (out of 4) or above were related to success on the NAPLEX. Additionally, students reported high satisfaction with RxPrep resources.

Definition and measurement of post-COVID-19 conditions in real-world practice: a global systematic literature review

Post-COVID-19 conditions (PCC) is an umbrella term that encompasses a range of signs, symptoms and conditions present weeks after the acute phase of a SARS-CoV-2 infection. This systematic literature review...