Testing Programs Research Articles

Characterizing toxicity pathways of fluoxetine to predict adverse outcomes in adult fathead minnows (Pimephales promelas)

Current ecotoxicity testing programs are impeded as they predominantly rely on slow and expensive animal tests measuring adverse outcomes. Therefore, new approach methodologies (NAMs) increasingly involve short-term mechanistic assays that employ molecular endpoints to predict adverse outcomes of regulatory relevance. This study aimed to elucidate the application of NAMs in adult fathead minnows using fluoxetine (FLX) as a model compound. Fish were exposed to three FLX concentrations (measured: 2.42, 10.7, and 56.7 μgL−1) and a control. After 96 h, molecular toxicity signatures were characterized using proteomics and transcriptomics analyses in livers and brains of a sub-set of fish. The remaining fish were sampled at 21 days and assessed for liver histopathology and morphometric measurements. Fecundity was monitored throughout the study. In the livers, 56.7 μgL−1 FLX caused enrichment of PPAR signaling in the proteome and fatty acid-related pathways in the transcriptome, potential upstream responses that led to lipid-type vacuolation of hepatocytes, observed via histopathology. Upregulated genes in the brain suggested alterations in serotonin-related signaling processes and reproductive behaviour, which may explain the observed significant decrease in fecundity. While the relationships between molecular responses and adverse outcomes remain complex, this research provided important insights into the mechanistic toxicity of FLX.

Predicting daily COVID-19 case rates from SARS-CoV-2 RNA concentrations across a diversity of wastewater catchments.

We assessed the relationship between municipality COVID-19 case rates and SARS-CoV-2 concentrations in the primary sludge of corresponding wastewater treatment facilities. Over 1700 daily primary sludge samples were collected from six wastewater treatment facilities with catchments serving 18 cities and towns in the State of Connecticut, USA. Samples were analyzed for SARS-CoV-2 RNA concentrations during a 10 month time period that overlapped with October 2020 and winter/spring 2021 COVID-19 outbreaks in each municipality. We fit lagged regression models to estimate reported case rates in the six municipalities from SARS-CoV-2 RNA concentrations collected daily from corresponding wastewater treatment facilities. Results demonstrate the ability of SARS-CoV-2 RNA concentrations in primary sludge to estimate COVID-19 reported case rates across treatment facilities and wastewater catchments, with coverage probabilities ranging from 0.94 to 0.96. Lags of 0 to 1 days resulted in the greatest predictive power for the model. Leave-one-out cross validation suggests that the model can be broadly applied to wastewater catchments that range in more than one order of magnitude in population served. The close relationship between case rates and SARS-CoV-2 concentrations demonstrates the utility of using primary sludge samples for monitoring COVID-19 outbreak dynamics. Estimating case rates from wastewater data can be useful in locations with limited testing availability, testing disparities, or delays in individual COVID-19 testing programs.

A Longitudinal Study on the Influence of Sibling Support and HIV Testing Among Black Youth.

Healthy familial relationships have been noted as protective against HIV infection among the Black youth. Previous studies have indicated that sibling relationships are important over the life course and may have a significant influence on health behaviors and health promotion. However, the specific interaction between sibling relationships, HIV prevention, and HIV testing is underexplored. This longitudinal study aims to examine the role of sibling relationships, healthcare providers, and other contextual factors on HIV testing. This study was conducted via the secondary analysis of data from the National Longitudinal Study of Adolescent to Adult Health evaluating the health of adolescents. The analysis included Black youth from Wave 1 and 3 (N = 509) with a mean age of 16years. A multinomial analysis evaluated the association of sibling relationships on HIV testing. In Wave 1, youth who reported having love for their sibling were 1.90 (p < .001) times more likely to test for HIV infection than those who reported no love for their sibling. In Wave 1 and 3, the youth who reported no sibling support was 89% (p < .001) less likely to get tested for HIV more than once. This study's findings show that sibling relationships have a significant positive influence on HIV testing among Black youth, and they are a protective factor against HIV transmission. These findings are essential in structuring HIV testing programs and interventions tailored to Black youth.

Assessing the Impacts of HIV/AIDS Programmes on Sexual Health among the Youths of Obiyebe Community in Ogba/Ebgema/Ndoni Local Government Area of Rivers State

This study assessed the impacts of HIV/AIDS programmes on sexual health among youths of Obiyebe community in Ogba/Egbema/Ndoni LGA of Rivers State. The purpose of the study was to identify HIV/AIDS programmes on sexual health, to assess the knowledge of HIV/AIDS programmes on sexual health among the youths and to examine the impacts of HIV/AIDS programmes on sexual health among youths. The study adopted a descriptive survey study design with a sample size of 83 participants which are selected through a simple random sampling technique. A structured questionnaire was used as the instrument for data collection, while a frequency table and simple percentage were used as the instrument for data analysis. The findings of the study revealed that HIV/AIDS programmes on sexual health are; HIV/AIDS testing programmes, HIV/AIDS treatment programmes, HIV/AIDS prevention programmes, and United Nations Programmes on HIV/AIDS (UNAIDS). Another finding of the study showed that sexuality, condoms, sexual anatomy and sex, and adolescence sexual features and puberty are the knowledge of sexual health among the youths that enhance their good sexual health and prevention of HIV/AIDS. Again the study revealed that the impacts of HIV/AIDS programmes on the sexual health of the youths were that their understanding of sexuality is increased, they understand the importance of using condoms if sexually active, there is a reduction in unwanted teenage pregnancies, they are informed of their normal sexual features development, puberty, reproductive anatomy and physiology, they are informed of the option to delay sexual activity until they are ready (matured), and there is a reduction of new HIV/AIDS/ other STI infections. The study made some recommendations and suggestions.

Northeastern Conference on Avian Diseases from 1928-2021: 93 Years of Contributions to Organized Avian Medicine.

Bacillary white diarrhea in chickens was a major disease concern for the poultry industry during the early 1900s. Drs. L. F. Rettger and W. R. Hinshaw organized a meeting in 1928 to discuss methods for controlling this disease. In this meeting, representatives of five northeastern states discussed approaches to test for the presence of the etiological agent of bacillary white diarrhea, namely, Salmonella enterica subsp. enterica serovar Pullorum. Meeting attendees decided to have a yearly meeting of the Northeastern Conference of Laboratory Workers in Bacillary White Diarrhea. The next year, the name was changed to Conference of Laboratory Workers in Pullorum Disease Eradication, which was changed to Northeastern Conference on Avian Diseases (NECAD) in 1957. Not only has NECAD been important for the control of pullorum disease but also, starting with the fifth Annual Conference in 1932, other poultry diseases became an official part of the program. As such, NECAD served for a long time as the premier organization to present new information on avian diseases. The success of NECAD was based on the work of the many committees, which are described in detail in this review. For example, the antigen committee started officially in 1929 and remained active until at least 1987. The main task of this committee was to evaluate Salmonella Pullorum strains to be used by all participants in the pullorum antibody testing programs. NECAD started as a closed organization with participants from universities and government organizations but did not allow representatives from commercial groups until 1968 when all American Association of Avian Pathologists (AAAP) members in the Northeastern United States could participate. The journal Avian Diseases started with discussions by Dr. P. P. Levine with M. S. Cover, H. L. Chute, R. F. Gentry, E. Jungherr, and H. Van Roekel about the idea that NECAD would sponsor a journal dealing specifically with avian diseases. During the first few years of Avian Diseases publication, many articles including abstracts came from the NECAD Annual Conferences. The importance of NECAD as a precursor for other regional meetings and the AAAP and as a forum for graduate students to present their research are described. Several recipients of the award for the best paper presented by a graduate student have continued to work in avian disease research. The decline in the participation of scientists in the late 1990s and early 2000s was discussed extensively in 2006 and led to a merger of the NECAD meeting with the Pennsylvania Poultry Sales and Service Conference. Due to the COVID-19 pandemic, the 92nd Annual Conference was a virtual meeting in 2020. Fortunately, the 93rd Annual Conference in 2021 was an in-person meeting held in State College, PA.

Modelling of Environmental Ageing of Polymers and Polymer Composites-Modular and Multiscale Methods.

Service lifetimes of polymers and polymer composites are impacted by environmental ageing. The validation of new composites and their environmental durability involves costly testing programs, thus calling for more affordable and safe alternatives, and modelling is seen as such an alternative. The state-of-the-art models are systematized in this work. The review offers a comprehensive overview of the modular and multiscale modelling approaches. These approaches provide means to predict the environmental ageing and degradation of polymers and polymer composites. Furthermore, the systematization of methods and models presented herein leads to a deeper and reliable understanding of the physical and chemical principles of environmental ageing. As a result, it provides better confidence in the modelling methods for predicting the environmental durability of polymeric materials and fibre-reinforced composites.

Comparing student motivations for and emotional responses to national standardised tests and internal school tests: The devil in the detail

National testing of students has become an increasingly prevalent policy tool, often implemented to drive improvement through increased accountability and heightened competition between schools. Such testing has been found to generate negative emotional responses among students, including increased stress and anxiety . However, there is little examining whether such responses are associated specifically with national testing regimes or are more general responses to testing situations. This study surveyed 206 students in Australian secondary schools to compare responses to NAPLAN and internal school tests. Students reported higher expectations for their performance in internal school tests than for NAPLAN, higher levels of boredom for NAPLAN and greater levels of confidence for their internal school tests. While most students reported low levels of negative emotional responses to NAPLAN, a small group of students reported strong negative emotional responses to both NAPLAN and internal school tests, suggesting that negative responses to national testing programs may be more dependent on the individual student.

Post-marketing sampling and testing programs for licensed medicinal products: a narrative review

The globalization of the pharmaceutical market has enabled access to a considerable number of new medicinal products. Consequently, the circulation of substandard medicinal products has also increased. To minimize this problem, post-marketing quality sampling and testing programs are performed to monitor and confirm that the medicinal products available in the market meet appropriate quality requirements. In this review, the post-approval sampling and testing procedures of six regulatory authorities were compared with the goal of strengthening these market surveillance systems. Similarities were observed between the procedures adopted by different regulatory authorities. However, the agencies were not always transparent about the results of these monitoring procedures. A probable mismatch between the registration procedures and the quality requirements listed in official compendiums was observed, which resulted in dissonance and contradiction between the specifications approved by the regulatory authorities and those required in the pharmacopeias. Therefore, strengthening harmonization projects related to these activities can help minimize such difficulties.

Assessment of static type checking compliance of EOLANG

The EOLANG programming language is a novel technology relying on formal phi-calculus similar to lambda-calculus for functional programming languages, and on design choices declared as mitigating most weak points of mainstream object-oriented programming languages. EO is under active development up to date and has some obvious development vectors. One of these vectors is development of compilation time type checker. With dynamic type checking provided by now, writing and testing programs in EO takes long and is vulnerable to bugs. In this paper the assessment of static type checking compliance of EOLANG is performed. The results reveal serious weak points in EOLANG implementation and theoretical basis making development of static type checker impossible.

A pilot model of a public-private partnership for implementation of a coronavirus disease 2019 (COVID-19) diagnostic testing program to facilitate a safe school reopening.

We developed an implementation plan to integrate diagnostic testing for coronavirus disease 2019 (COVID-19) into a public school system. Implementation barriers were identified and strategies were mapped to overcome them. A COVID-19 diagnostic testing program leveraging a public-private partnership was developed for a public school system. A suburban school district and a local hospital during the 2020-2021 academic year. Using Consolidated Framework for Implementation Research (CFIR) constructs and evidenced-based implementation strategies, the program was designed as a "closed system" and was adapted based on stakeholder feedback. Implementation barriers and facilitators were identified and mapped to CFIR constructs to provide insights into factors influencing program adoption. Preimplementation stages of engagement, feasibility, and readiness planning were completed. The program did not progress to implementation due to multiple factors, including changes in school leadership (inner setting and process-level constructs), improved access to outside testing, and lack of an existing paradigm for in-school testing (external constructs). Limited support from key stakeholders and opinion leaders was also a barrier (process-level construct). Although this locally initiated program did not progress beyond the preimplementation stage, the processes developed and barriers identified may be useful to inform planning efforts in other testing programs within public school systems. Future programs may consider incorporating multiplex diagnostic testing for influenza in addition to COVID-19. With relaxation of infection control measures, the prevalence of other respiratory viruses will increase. Actionable results will be needed to inform decisions about closures and quarantines.

Impacts of Recent Infection Testing Integration into HIV Surveillance in Ekiti State, South West Nigeria: A Retrospective Cross Sectional Study

Background: Timely detection of recent HIV infections is critical in achieving the HIV epidemic. The aim of this study was to evaluate the effects of integrating the Recent Infection Testing Algorithm in HIV surveillance in Ekiti State, South West Nigeria. Method: Data from the Nigeria Medical Records System (NMRS)/National Data Repository (NDR) and Index Testing (IT) Services data capturing tools were abstracted for a retrospective cross-sectional study of 719 newly diagnosed HIV-positive cases who were screened for HIV incident infection using Asante rapid recency test kits between August 2020 and June 2022 at 5 selected recency testing health facilities. The venous blood (10 ml) of all the rapid Asante tested recent patients were collected into an EDTA tube and processed for viral load testing. The plasma level of HIV-1 RNA was quantified using the CAP/CTM and cobas 4800 platform at Obafemi Awolowo University Teaching Hospital PCR Laboratory Ife. Chi-square was used to characterize the recency status of the patients. A measure of the association was done using Chi-square, while the p-value of 0.05 was considered statistically significant. Results: The median age of the participants was 39 years. The result from the study showed that of the total number of 719 new cases of diagnosed HIV-positive, 626 of them were screened for rapid Test for Recency infection (RTRI) (87%). Overall, we found that 1.8% (11/626) of clients were classified as recent. The investigation also showed that from the index cases of the 11 confirmed recent infections, a total number of 125 additional positive cases were found. Conclusion: This result indicated a rise in the number of cases discovered in the State. Therefore, incorporating recency testing within regular HIV testing programs becomes essential in order to prioritize clients for index testing and provide useful information on transmission clusters.

A Two-Base Pair Deletion in IQ Repeats in ASPM Underlies Microcephaly in a Pakistani Family.

Aims: Autosomal recessive primary microcephaly (MCPH) is a clinically rare and genetically highly heterogeneous developmental disorder. Biallelic variants in the abnormal spindle-like microcephaly-associated (ASPM) gene account for 40% to 68% of all MCPH cases. This study was designed to elucidate the genetic basis of MCPH in an extended family. To highlight recurrent mutations useful in implementing genetic testing programs, we further aimed to carry out a descriptive review of the reported ASPM mutations. Materials and Methods: A large inbred kindred with seven affected members was investigated, and detailed clinical and behavioral assessments were carried out. Single nucleotide polymorphism (SNP)-based homozygosity mapping and exome sequencing were performed. Results: Affected individuals had characteristic features, including small head, receding forehead, mild to moderate intellectual disability, developmental delay, short stature, apraxia, and behavioral anomalies. We mapped the disease gene locus and detected a rare frameshift deletion c.6854_6855del (p.(Leu2285GlnfsTer32)) in exon 18 of ASPM. A total of 215 mutations in ASPM have been reported in at least 453 families, nearly 50% of which are of Pakistani origin. These mutations can be classified as recurrent, founder or private in Pakistani and other populations. Conclusion: SNP-based homozygosity mapping and exome sequencing are essential in delineating the genetically distinct microcephaly types. The highlighted recurrent mutations in ASPM could be useful in implementing genetic testing programs for MCPH.

Interlaboratory comparisons to demonstrate the competence of two similar mobile laboratories

In order to maintain the RENAR (Romanian Accreditation Association) accreditation, each accredited laboratory must periodically participate in interlaboratory testing programs carried out with specialized providers or similar laboratories. In December 2021, an interlaboratory comparison in the field of environmental protection was organized by INCD ISEMEX PETROȘANI. The current paper examines the similarity of results of two auto-laboratories, in similar sampling points to demonstrate the competence of accredited laboratories. During the interlaboratory test session, immission measurements (nitrogen dioxide, nitrogen monoxide, carbon monoxide and sulphur dioxide), ambient noise measurements and determination of suspended dust concentration were performed. The main objective of the interlaboratory tests is to comply with limits established by the bilateral testing protocol, and all these results can be processed and achieved in situ due to systems endowing the auto-laboratories, which integrate all the measurements performed in situ. Results of the study indicate very close values found by the two mobile laboratories, which leads to the performance requirement for all components analysed, namely coefficients of variation below 20%.

Multi-dimensional factors related to participation in a population-wide mass COVID-19 testing program among Hong Kong adults: A population-based randomized survey

RationaleMass testing is considered as an important policy response to the COVID-19 pandemic, and high population coverage is pivotal to its effectiveness. A range of factors derived from health behaviour theories were hypothesized to be associated with public uptake of mass testing, including illness representations of COVID-19, perceived susceptibility to COVID-19, perceived efficacy of the testing program, and general trust toward governmental measures for controlling COVID-19. ObjectiveThis study aimed to investigate the multi-dimensional factors associated with participation in a free and voluntary population-wide mass COVID-19 testing program. MethodsA cross-sectional study was conducted in Hong Kong within two weeks after the Universal Community Testing Program for COVID-19 concluded on September 14, 2020. A random population-based telephone survey interviewed 443 Hong Kong general adults who were aged ≥18 and had not joined other COVID-19 testing programs. The dependent variable was participation in the Universal Community Testing Program. Logistic regression analysis was conducted to test the associations of participation in the program with the proposed factors. ResultsThe standardized participation rate of the testing program was estimated to be about 37.2% among the general adults (33.0% among males; 40.8% among females) in Hong Kong. The participation rates were significantly lower among males and younger adults. Adjusted for socio-demographics, significant factors included four dimensions of illness representations of COVID-19 (treatment control: adjusted odds ratio [AOR] = 1.41; illness identity: AOR = 1.10; concern: AOR = 1.14; emotions: AOR = 1.10), perceived susceptibility to COVID-19 (AOR = 1.40), perceived efficacy of the testing program (AOR = 2.73), and trust toward governmental control measures (AOR = 4.30). ConclusionsThe participation rate of the population-wide mass testing program was not high among general adults in Hong Kong, evidence-based health promotion is necessary. The study informs some critical factors to be addressed to effectively boost public support for the mass testing policy in response to emerging infectious diseases.

Language Matters: Teacher and Parent Perceptions of Achievement Labels from Educational Tests

ABSTRACT Since the standards-based assessment practices required by the No Child Left Behind legislation, almost all students in the United States are “labeled” according to their performance on educational achievement tests. In spite of their widespread use in reporting test results, research on how achievement level labels are perceived by teachers, parents, and students is minimal. In this study, we surveyed teachers (N = 51) and parents (N = 50) regarding their perceptions of 73 achievement labels (e.g., inadequate, level 2, proficient) used in statewide testing programs. These teachers and parents also sorted the labels according to their similarity. Using multidimensional scaling, we found labels used to denote the same level of performance (e.g., basic and below proficient) were perceived to differ in important ways, including in their tone and how much achievement they convey. Additionally, some labels were perceived as more encouraging or clear than others. Teachers’ and parents’ perceptions were similar, with a few exceptions. The results have important implications for reporting results that encourage, rather than discourage, student learning.

Use of standard samples for qualification inspections of testing laboratory for analysis safety of meat and meat products

This article provides insights into qualification testing, interlaboratory comparative testing, and qualification testing programs in testing laboratories that analyze the safety of meat and meat products. Samples with codes OK-MB- 21 were used as a model for interlaboratory comparisons. The uniformity and stability of the CC code was assessed in accordance with GOST R 50779.60-2017 “Statistical methods. Application in proficiency testing through interlaboratory testing ”. Seven laboratories participated in the proficiency testing program. The test preparation procedure was described and the test results determined whether each sample tested was satisfactory or questionable. Participants with unsatisfactory results are encouraged to identify the causes of the alarms, take corrective actions and document them, and identify and eliminate the causes of the unsatisfactory results.

Breast reconstruction in patients with BRCA mutation and breast cancer – our approach

Analysis of our approach to breast reconstruction after mastectomy in women with breast cancer and/or BRCA mutations. Oncoplastic surgery enables procedures that are sufficiently radical and with a very good cosmetic effect. With the development of genetic testing programs, the need for prophylactic procedures is also increasing. One-sided curative performance and at the same time prophylactic surgery on the other breast can be used. We use the possibility of immediate breast reconstruction simultaneously with subcutaneous and skin-saving mastectomy. We solve the reconstruction either with an expander and in the second time by inserting a silicone implant, or directly by inserting the implant alone or in combination with the use of autologous tissue, depending on further oncological treatment (chemotherapy or radiotherapy). One-hundred and three reconstructive surgeries were performed on 58 women with breast cancer and/or BRCA mutations from April 2017 to May 2020. Of these, there were 52 immediate reconstructions for untreated tumors. A tissue expander was inserted in 27 women (46.6% of the group) with locally advanced tumors and the need for subsequent radiotherapy (18 immediate and 9 delayed reconstructions). Breast implants were used in 52 women (89.7% of the group) in a total of 80 implants. Breast reconstruction of own tissues was performed in 8 women, of which 5 operations had immediate reconstruction. Postoperative complications occurred in 11 women and 15 corrective procedures were performed (12.7% of operations). Breast reconstruction is a comprehensive set of techniques by which any patient can obtain a breast so that it does not depend on the epithelium. Patients with locally advanced disease who receive neoadjuvant chemotherapy and radiotherapy are at greater risk of complications. With the growing number of breast cancers, the demand for reconstructive procedures, especially immediate reconstructions, is increasing.

Community-Based Testing Sites for SARS-CoV-2 - United States, March 2020-November 2021.

Immediately following the March 13, 2020 declaration of COVID-19 as a national emergency (1), the U.S. government began implementing national testing programs for epidemiologic surveillance, monitoring of frontline workers and populations at higher risk for acquiring COVID-19, and identifying and allocating limited testing resources. Effective testing supports identification of COVID-19 cases; facilitates isolation, quarantine, and timely treatment measures that limit the spread of SARS-CoV-2 (the virus that causes COVID-19); and guides public health officials about the incidence of COVID-19 in a community. A White House Joint Task Force, co-led by the Department of Health and Human Services (HHS) and the Federal Emergency Management Agency (FEMA), created the Community-Based Testing Sites (CBTS) program working with state and local partners (2). This report describes the timeline, services delivered, and scope of the CBTS program. During March 19, 2020-April 11, 2021, the CBTS program conducted 11,661,923 SARS-CoV-2 tests at 8,319 locations across the United States and its territories, including 402,223 (3.5%) administered through Drive-Through Testing, 10,129,142 (86.9%) through Pharmacies+ Testing, and 1,130,558 (9.7%) through Surge Testing programs. Tests administered through the CBTS program yielded 1,176,959 (10.1%) positive results for SARS-CoV-2. Among tested persons with available race data,* positive test results were highest among American Indian or Alaska Native (14.1%) and Black persons (10.4%) and lowest among White persons (9.9%), Asian persons (7.3%), and Native Hawaiian or Other Pacific Islanders (6.4%). Among persons with reported ethnicity, 25.3% were Hispanic, 15.9% of whom received a positive test result. Overall, 82.0% of test results were returned within 2 days, but the percentage of test results returned within 2 days was as low as 40.7% in July 2020 and 59.3% in December 2020 during peak testing periods. Strong partnerships enabled a rapid coordinated response to establish the federally supported CBTS program to improve access to no-charge diagnostic testing, including for frontline workers, symptomatic persons and close contacts, and persons living in high-prevalence areas. In April 2021, the CBTS Pharmacies+ Testing and Surge Testing programs were expanded into the Increasing Community Access to Testing (ICATT) program. As of November 12, 2021, the CBTS and ICATT programs conducted approximately 26.6 million tests with approximately 10,000 active testing sites. Although the CBTS program represented a relatively small portion of overall U.S. SARS-CoV-2 testing, with its successful partnerships and adaptability, the CBTS program serves as a model to guide current community-based screening, surveillance, and disease control programs, and responses to future public health emergencies.

Novel PHEX gene locus-specific database: Comprehensive characterization of vast number of variants associated with X-linked hypophosphatemia (XLH).

X‐linked hypophosphatemia (XLH), the most common form of hereditary hypophosphatemia, is caused by disrupting variants in the PHEX gene, located on the X chromosome. XLH is inherited in an X‐linked pattern with complete penetrance observed for both males and females. Patients experience lifelong symptoms resulting from chronic hypophosphatemia, including impaired bone mineralization, skeletal deformities, growth retardation, and diminished quality of life. This chronic condition requires life‐long management with disease‐specific therapies, which can improve patient outcomes especially when initiated early in life. To centralize and disseminate PHEX variant information, we have established a new PHEX gene locus‐specific database, PHEX LSDB. As of April 30, 2021, 870 unique PHEX variants, compiled from an older database of PHEX variants, a comprehensive literature search, a sponsored genetic testing program, and XLH clinical trials, are represented in the PHEX LSDB. This resource is publicly available on an interactive, searchable website (https://www.rarediseasegenes.com/), which includes a table of variants and associated data, graphical/tabular outputs of genotype‐phenotype analyses, and an online submission form for reporting new PHEX variants. The database will be updated regularly with new variants submitted on the website, identified in the published literature, or shared from genetic testing programs.

168. Testing, Diagnosis, and Incidence of Sexually Transmitted Infections Among People with Substance Use Disorders in the Veterans Health Administration, 2019

BackgroundPeople with substance use disorders (SUDs) are at increased risk of acquiring sexually transmitted infections (STIs.) In response to the syndemic of STIs and SUDs, the Department of Health and Human Services’ 2020 STI National Strategic Plan called for increased STI testing among people with SUDs and integration of testing and treatment into non-traditional settings. Existing data describing STI testing and incidence rates among people with SUDs are limited to single or regional medical centers. National samples are needed to target interventions. We report on STI testing, test positivity, and incidence rates among people with SUDs who receive medical care in the Veterans Health Administration (VHA). MethodsWe performed a retrospective cohort study of individuals with SUDs who received VHA care in 2018 or 2019. Data were obtained from the Corporate Data Warehouse, a national database that includes data from VHA’s electronic medical record. For individuals with alcohol, opioid, cocaine, and/or other stimulant (e.g. methamphetamine) use disorders, we collected demographic data, testing and results for gonorrhea (GC), chlamydia (CT), syphilis, and HIV during 2019. We calculated rates of testing, test positivity, and incidence rates. ResultsIncidence of all four STIs was highest in the other stimulant use disorder group; incidence of syphilis was particularly elevated at 922.4 cases/100K. Veterans with multiple SUDs were three times more likely to be houseless in 2019 than those with a single SUD and had higher incidence of all STIs than those with single SUDs, except for people with other stimulant use disorders. People with alcohol use disorder (AUD) had a higher incidence of GC, CT, and syphilis than those with opioid use disorder despite similar testing rates. Percent positivity for HIV ranged from 0.27% for AUD to 2.0% for other stimulant use disorders. ConclusionHigh incidence of STIs among people with non-cocaine stimulant use disorder indicates a need for comprehensive testing. The data suggests that veterans with AUD would benefit from increased testing. Houselessness and mental health diagnoses were common, and comprehensive STI testing and treatment programs, including an assessment of HIV risk, should be integrated into programs addressing these comorbidities. Disclosures Holly Villamagna, MD, Nothing to disclose