Two-tailed T-test Research Articles

Feline Responses to Increasing Inclusion of Natural Olive Extract in Liquid or Dry Palatant Formulations Applied to Kibble Diets

Olive extract (OE) has been used in human foods for its nutraceutical effects, making it a product of interest for pet food. However, OE’s effect on palatability has not been examined. The study objective was to evaluate the palatability of dry cat foods with OE applied at differing inclusions within liquid or dry palatants. Twenty-seven volatile compounds were identified by gas chromatography–mass spectrometry for a potentially earthy or fruit-like flavor profile. Liquid palatants were formulated to supply 0 (control), 15, 30, 50, 75, and 150 ppm OE, and dry palatants were formulated to provide 0, 100, 200, 400, and 600 ppm OE when coated onto kibble. Palatability was evaluated using two-day, two-bowl testing of OE-containing versus control rations in adult cats (n = 20) with two-tailed t-tests to determine if OE affected intake ratio (IR). The observed IR of rations with OE were 0.45 to 0.56. The only preference was the 200 ppm treatment (IR = 0.56; p = 0.01) while the other OE rations were not different from the control (p ≥ 0.05). These findings indicate that palatant formulations can supply kibble diets with up to 150 ppm OE for liquid and 600 ppm for dry applications without negatively impacting cat food palatability.

Patients' Health-Related Quality of Life and Use of Medicinal Cannabis: A Cross-Sectional Survey Study.

Studies on medicinal cannabis (MC) have primarily investigated effects on diseases and symptoms, while there is only sparse knowledge on patients' health-related quality of life. Our aim was, firstly, to compare the health-related quality of life of patients (MC users and non-users) within four specified diagnostic indications (multiple sclerosis, paraplegia, neuropathy, and nausea and vomiting after chemotherapy) with that of patients with other diagnostic indications (MC users only) and the adult population (non-users only). Secondly, we estimate the associations between use of MC and health-related quality of life for patients in the four specified diagnostic indications. We collected data on quality-adjusted life years (QALYs), using EQ-5D-3L, and patients' self-reported use of MC in a Danish nationwide online survey distributed to 23,846 patients in October 2020. We compared QALY scores of all groups using a two-tailed t-test, listed QALY scores of MC users versus non-users, and investigated associations between QALY score and MC use using unadjusted and adjusted linear regression analyses. Significance level was set to p-value <0.05. A total of 9265 patients took part in the survey. All diagnostic indications had a statistically significant lower QALY score than the adult population (0.87). Paraplegia patients had the lowest QALY score, being 0.36 lower, followed by other diagnostic indication (- 0.34), multiple sclerosis (-0.20), neuropathy (-0.13), and nausea and vomiting after chemotherapy (-0.06). MC users had a statistically significant lower QALY score than non-users (0.44 vs 0.74). Users redeeming 1-6 and ≥7 MC prescriptions (except for paraplegia patients) had a statistically significant lower QALY score than non-users, ranging between 0.11-0.24 and 0.26-0.32 lower than non-users, accordingly. Although, it should be noted that the number of users was small when stratifying by number of prescriptions. Patients with either multiple sclerosis, paraplegia, neuropathy, or nausea and vomiting after chemotherapy had a significantly lower health-related quality of life than individuals from the adult population. Users of medicinal cannabis also had a significantly lower health-related quality of life compared with non-users, in all diagnostic indications.

Dosimetric Impact of AAA and AXB Dose Calculation Algorithm in VMAT Treatment Planning for Rectal Tumors

Abstract Aim: The study aims to compare the accuracy of Anisotropic Analytical Algorithm (AAA) and acuros XB (AXB) dose calculation algorithms for radiotherapy (RT) planning of rectal tumors. Materials and Methods: Treatment plans from 20 patients with previously treated rectal cancer were retrospectively analyzed. All patients underwent VMAT treatment planning using the AAA algorithm in Eclipse (v15.6) system. These plans were recalculated with AXB in Eclipse (v15.6) while maintaining the original multileaf collimator fluence. Dosimetric parameters and gamma analysis (3%/3 mm and 2%/2 mm criteria) were compared between the two algorithms. A paired two-tailed t-test was used to statistically compare dosimetric and gamma analysis results between the AAA and AXB algorithms. Results: The results indicate that AAA could be potentially overestimating the dose to planning target volume (PTV). While the mean bowel dose was marginally lower in AAA plans (P = 0.013), doses to other organs at risk (OARs) were slightly higher, suggesting a general overestimation trend. This implies that AAA could be potentially overestimating the dose to OARs and PTV as compared to AXB. The statistical analysis of the Gamma parameters also shows a significant change. Conclusion: The results indicate that the dose calculation accuracy of AXB is superior to AAA for rectal cancer RT.

Depression levels of the general public increases during the COVID-19 pandemic in China: A web-based cross-sectional survey.

The coronavirus disease 2019 (COVID-19) outbreak lasted several months, having started in December 2019. This study aimed to report the impacts of various factors on the depression levels of the general public and ascertain how emotional measures could be affected by psychosocial factors during the COVID-19 pandemic. To investigate the depression levels of the general public in China during the COVID-19 pandemic. A total of 2001 self-reported questionnaires about Beck Depression Inventory (BDI) were collected on August 22, 2022 via the website. Each questionnaire included four levels of depression and other demographic information. The BDI scores and incidences of different depression levels were compared between various groups of respondents. χ 2 analysis and the two-tailed t-test were used to assess categorical and continuous data, respectively. Multiple linear regressions and logistic regressions were employed for correlation analysis. The averaged BDI score in this study was higher than that for the non-epidemic periods, as reported in previous studies. Even higher BDI scores and incidences of moderate and severe depression were recorded for people who were quarantined for suspected COVID-19 infection, compared to the respondents who were not quarantined. The participants who did not take protective measures were associated with higher BDI scores than those who made efforts to keep themselves relatively safer. Similarly, the people who did not return to work had higher BDI scores compared to those managed to. A significant association existed between the depression levels of the subgroups and each of the factors, except gender and location of residence. However, quarantine was the most relative predictor for depression levels, followed by failure to take preventive measures and losing a partner, either through divorce or death. Based on these data, psychological interventions for the various subpopulations in the general public can be implemented during and after the COVID-19 pandemic. Other countries can also use the data as a reference.

Novel pre-spatial data fusion deep learning approach for multimodal volumetric outcome prediction models in radiotherapy.

Given the recent increased emphasis on multimodal neural networks to solve complex modeling tasks, the problem of outcome prediction for a course of treatment can be framed as fundamentally multimodal in nature. A patient's response to treatment will vary based on their specific anatomy and the proposed treatment plan-these factors are spatial and closely related. However, additional factors may also have importance, such as non-spatial descriptive clinical characteristics, which can be structured as tabular data. It is critical to provide models with as comprehensive of a patient representation as possible, but inputs with differing data structures are incompatible in raw form; traditional models that consider these inputs require feature engineering prior to modeling. In neural networks, feature engineering can be organically integrated into the model itself, under one governing optimization, rather than performed prescriptively beforehand. However, the native incompatibility of different data structures must be addressed. Methods to reconcile structural incompatibilities in multimodal model inputs are called data fusion. We present a novel joint early pre-spatial (JEPS) fusion technique and demonstrate that differences in fusion approach can produce significant model performance differences even when the data is identical. To present a novel pre-spatial fusion technique for volumetric neural networks and demonstrate its impact on model performance for pretreatment prediction of overall survival (OS). From a retrospective cohort of 531 head and neck patients treated at our clinic, we prepared an OS dataset of 222 data-complete cases at a 2-year post-treatment time threshold. Each patient's data included CT imaging, dose array, approved structure set, and a tabular summary of the patient's demographics and survey data. To establish single-modality baselines, we fit both a Cox Proportional Hazards model (CPH) and a dense neural network on only the tabular data, then we trained a 3D convolutional neural network (CNN) on only the volume data. Then, we trained five competing architectures for fusion of both modalities: two early fusion models, a late fusion model, a traditional joint fusion model, and the novel JEPS, where clinical data is merged into training upstream of most convolution operations. We used standardized 10-fold cross validation to directly compare the performance of all models on identical train/test splits of patients, using area under the receiver-operator curve (AUC) as the primary performance metric. We used a two-tailed Student t-test to assess the statistical significance (p-value threshold 0.05) of any observed performance differences. The JEPS design scored the highest, achieving a mean AUC of 0.779±0.080. The late fusion model and clinical-only CPH model scored second and third highest with 0.746±0.066 and 0.720±0.091 mean AUC, respectively. The performance differences between these three models were not statistically significant. All other comparison models scored significantly worse than the top performing JEPS model. For our OS evaluation, our JEPS fusion architecture achieves better integration of inputs and significantly improves predictive performance over most common multimodal approaches. The JEPS fusion technique is easily applied to any volumetric CNN.

Diagnostic value and efficacy of multimodal magnetic resonance imaging in differentiating radiation necrosis from tumor recurrence in glioblastomas.

Distinguishing radiation necrosis (RN) from recurrent tumor (RT) in patients with gliomas treated with radiation therapy presents an important clinical dilemma. To evaluate the diagnostic performance of multiparametric magnetic resonance imaging (MRI) techniques in distinguishing RN from RT in patients with histologically confirmed glioma treated previously with radiotherapy and chemotherapy or without chemotherapy using a combination of dynamic susceptibility-weighted contrast-enhanced (DSC) perfusion MRI, diffusion tensor imaging (DTI), and MR spectroscopy (MRS). Patients with glioma who developed a new enhancing mass after standard treatment were retrospectively evaluated. Conventional MRI, DTI, DSC, and MRS were performed. The region of interest (ROI) was manually drawn in the enhancing lesions, peri-lesional white matter edema, and the contralateral normal-appearing white matter. Apparent diffusion coefficient (ADC), fractional anisotropy (FA), relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), N-acetylaspartate (NAA), choline (Cho), creatine (Cr), NAA/Cr, Cho/NAA, and Cho/Cr were calculated. Two-tailed t-test and receiver operating characteristic (ROC) curve analysis were performed. In total, 34 patients with RT and 25 with RN met our inclusion criteria. FA, rCBF, rCBV, Cho/NAA, Cho/Cr were statistically significant between the two groups (P < 0.05). The sensitivity and specificity of FA, rCBF, rCBV, Cho/NAA, and Cho/Cr in the diagnosis of RT were 70.6%, 97.1%, 91.2%, 91.2%, and 82.4% and 64%, 100%, 100%, 96%, and 72% respectively. DTI, DSC, and MRS are of great value in the differential diagnosis of RN and RT of glioma. The diagnostic performance of DSC is better than DTI and MRS.

Patient-reported outcomes in physical, cognitive, and sexual health in early-onset gastrointestinal cancers (EOGIC).

72 Background: Incidence of early-onset (ages 18-49) gastrointestinal cancers is alarmingly increasing. To assess unmet needs in health-related quality of life (HRQoL), we conducted this pilot study using PRO measures in patients with EOGIC. Methods: Patients ages 18-49 with any GI cancer seen at our center during a clinic visit were invited to participate in this cross-sectional study. Validated PRO tools PROMIS 29+2, GP5 from FACT-G, AYA Sexual Health PRO Battery and Adult Neuro-QOL Cognitive Function short form were administered. Participants’ PROMIS 29+2 responses were scored to generate a T score, and two-tailed t-tests were used to compare T scores with the average score from a large general US population. The electronic medical record was reviewed to collect demographic, diagnosis and treatment information. Results: 39 (85% response rate) patients were enrolled from 03-08/24. Table 1 describes demographics, diagnoses, and treatment. In the PROMIS 29+2, EOGIC patients reported significantly lower physical function and higher anxiety, depression, fatigue and pain interference compared to the general US population: t-score (T-test p-value) 40.4 (p 0.0003), 57.7 (p 0.005), 55.7 (p 0.017), 55.1 (p 0.033) and 58.5 (p 0.0001), respectively. 56% reported being at least somewhat “bothered by side effects of treatment,” and this measure has a known correlation with clinician reported adverse events. Regarding sexual health (SH) in prior 30 days, 79% of participants felt less whole or “damaged” due to their disease, 64% were sexually active, 56% had some distress due to change in SH, and 50% were worried about their romantic relationship(s). Patients identified discussing safe sex with low counts, body image, contraception and addressing sexual problems as areas of unmet need during their care. They reported not receiving counseling from their care teams: only 15% discussed safe sex with low counts, 28% contraception, 13% STI prevention, and 18% discussed effect of cancer on body image. No significant change in cognitive functioning over the preceding 7 days was reported in this study. Conclusions: PROs are an important tool in clinical and survivorship care of young patients with GI cancers. We discovered that decreased physical function, increased anxiety, depression, fatigue and pain significantly effect HRQoL patients with EOGIC. We also found high unmet need to address sexual health in patients with EOGIC. Our ongoing work aims to better understand and address these needs for our patients. Demographic, diagnostic, and therapeutic characteristics of participants. Age At study participation 24-49 median 43 Gender Female 26 66.7% Primary cancer Colorectal 19 48.7% Pancreatic 5 12.8% Biliary tract cancers 5 12.8% Esophageal/Gastric 3 7.7% Other (including anal, NET, GIST, appendiceal) 7 17.9% Stage Metastatic 22 56.4% Treatment On any active treatment 24 61.5% On chemotherapy 20 51.2%

Infection rate following mandibular distraction with internal and external devices in infants.

Infection rate following mandibular distraction with internal and external devices in infants.

The Burden of Revision Arthroplasty: An Ergonomic Analysis of Surgeon Posture in the Operating Room.

Revision total joint arthroplasties are physically demanding cases. Recent studies have shown increased cardiovascular stress in surgeons performing revision total knee arthroplasty (rTKA) and revision total hip arthroplasty (rTHA) compared with primary cases. To our knowledge, no study has compared surgeon ergonomics during these cases. The purpose of this study was to analyze surgeon posture during primary and revision THA and TKA. We prospectively evaluated 286 consecutive cases (103 primary TKAs, 95 primary THAs, 57 rTKAs, and 31 rTHAs) performed by three high-volume, fellowship-trained arthroplasty surgeons. Throughout each case, surgeons wore a posture-tracking device to evaluate time spent slouching. The threshold for slouching was set to 30 degrees of flexion from the neutral spinal axis. Demographic and surgical factors were collected. Two-tailed t-tests and multivariate analysis were used to assess differences between groups. After controlling for individual differences in posture, we found an increase in percentage and duration of time spent slouching between rTHA and primary THA cases (58.9% vs. 43.2%, P < 0.001; 65.1 vs. 32.6 minutes, P < 0.001). In the multivariate analysis, patient body mass index and rTHA were found to be an individual contributor to slouching percentage in THAs (P = 0.001). We found increased duration of time spent slouching between rTKA and primary TKA (80.2 vs. 45.7 minutes, P < 0.001); however, percentage time slouching showed no difference (67.1% vs. 58.5%, P = 0.175). Active fellow involvement was an individual contributor to decreased time slouching in both TKA and THA groups (P < 0.001). Surgeons performing revision total joint arthroplasty spend markedly more case time in a slouched posture compared with primary arthroplasty, particularly in patients with a higher body mass index. Awareness of the surgical and patient factors that can affect posture in TKAs and THAs can help arthroplasty surgeons gain more awareness about injury prevention and potentially help prolong their career.

Abstract TMP114: Characterizing Anemia’s Impact on Cerebral Immune Response after Intracerebral Hemorrhage

Background: Anemia is a risk factor for worse intracerebral hemorrhage (ICH) outcomes, yet the underlying drivers remain unclear. Though anemia and inflammation are interrelated, it is unknown whether anemia influences inflammatory responses to ICH. We investigated the impact of anemia on inflammatory cell phenotypes seen in murine brains with and without ICH. Methods: Two different models of anemia were generated from 8-week-old, female C57/BL6 mice. The separate cohorts included: 1) chronic anemia model via iron-deficient chow compared to iron replete control diet, and 2) acute anemia model via red blood cell hemolysis using anti-TER119 injection compared to IgG control injection. After confirmation of anemia vs control via modified Drabkin assays, ICH was induced via collagenase injection into the right striatum, and brains and peripheral blood harvested 24 hours after ICH. Separate single cell suspensions were prepared from ICH and non-ICH hemispheres as well as peripheral blood and cells were stained for immunophenotyping using flow cytometry. Similar procedures were performed in mice without ICH. Two-tailed Student's t-tests were performed to compare immune cell populations between anemic vs non-anemic mice. Results: We identified a robust cerebral immune response to ICH in all groups. In the chronic anemia model, infiltrating macrophages and lymphocytes, particularly T cells, were elevated, while helper and gamma-delta T cells were lower in the ICH hemisphere in iron deficient anemic mice compared to iron replete controls (p&lt;0.05). However, in the acute anemia model, only non-parenchymal intracranial macrophages were significantly elevated in the ICH hemisphere in anemic anti-TER119 injected mice compared to IgG injected controls (p&lt;0.05). Notably, we observed a significant increase in infiltrating lymphocytes in the contralateral hemispheres in both acute and chronic models of anemia, compared to non-anemic controls. These findings in the brain were distinct from peripheral blood, where no major differences in immune cell populations were noted. Finally, in anemic mice without ICH, we did not identify a differential cerebral immune response compared to non-anemic controls. Conclusions: Anemia can differentially impact the inflammatory response to ICH in the central nervous system, based on its etiology and chronicity. Further work is required to assess whether anemia modification can abrogate pathologic immune pathways and improve ICH outcomes.

Reducing Dietary Branched-Chain Amino Acids Intake Alleviates High-Fat Diet-Induced Pain Sensitization and Postoperative Pain in Male Mice.

Reducing Dietary Branched-Chain Amino Acids Intake Alleviates High-Fat Diet-Induced Pain Sensitization and Postoperative Pain in Male Mice.

Unbiased transcriptomic analysis of primary early-onset vs late-onset colorectal cancer.

228 Background: Colorectal cancer is the 3rd most diagnosed and 2nd leading cause of cancer death. Despite the decline in incidence late-onset colorectal cancer (LOCRC), there is an increase in early onset of colorectal cancer (EORC). Clinicopathologic examinations from single centers revealed left-sided and rectal enrichment, poorly differentiated, and higher stage at presentation. Genomic studies examining the potential germline mutations/variants for EOCRC demonstrated mixed results. Transcriptomic analysis of the EOCRC compared to LOCRC remains limited. We hypothesized that EOCRC present with enrichment in aggressive molecular signatures consisting of CMS4 and iCMS3 signatures. To understand the mechanism behind EOCRC, we performed an unbiased RNA-Seq analysis in age groups of 32-82 in 95 patients. Methods: We utilized RNA-Seq data from the Orien Network, a collaborative between 19 NCI/NCCN cancer centers. We identified 95 patients diagnosed with colorectal cancer ranging in age from 32-82 and undergone RNA-sequencing of their primary tumors. Clinicopathologic assessment were analogously performed. We collected unnormalized raw-count RNA-Seq data from these patients. To account for differences in sequencing depth across samples, raw counts were scaled using the Reads Per Million (RPM) formula. The scaled reads in RPM were then utilized to assess the Consensus Molecular Subtypes (CMS) classification through two distinct approaches: the R package CMScaller and a deconvolution analysis using the R package SpatialDecon with the iCMS gene signature. Differences in age at the sample collection across patients with different CMS classifications were assessed by performing two-tailed unpaired T-tests. Additionally, differential expression analysis between EOCRC and LOCRC patients, defined by the upper and lower quartiles of the patients’ ages at the sample collection, was conducted using the LIMMA R package. Results: Clinicopathologic assessment of the primary tumors revealed left-sided tumors with poorly differentiated phenotype. Differential gene expression analysis between EOCRC and LOCRC demonstrated no significant differences. Stratification of transcriptomic data by decades also did not reveal any significant differences. Furthermore, there were no differences in CMS or iCMS classifications between different age groups. Conclusions: The RNA-Seq analysis comparing EOCRC and LOCRC did not identify any differential gene expression patterns. There was no significant differences were observed in CMS or iCMS classifications. These findings suggest that EOCRC and LOCRC share similar tumor biology based on molecular phenotypes. This implies that the initiating events for the disease may occur earlier in life while triggering a same disease process. As such, the findings underscores the importance of considering preventive measures, including earlier colonoscopy screenings.

Clinical Evaluation of Nd:YAG Capsulotomy on the Light-Adjustable Intraocular Lens.

To investigate the safety and refractive outcomes of neodymium-doped yttrium-aluminum-garnet (Nd:YAG) capsulotomy in pseudophakic eyes with the Light Adjustable Lens (LAL) both before and after completing the light delivery device (LDD) lock-in treatments. Private practice in Orange, California, USA. Retrospective, comparative study. Patients were divided into two groups according to the timing of their YAG capsulotomy (Group I underwent YAG capsulotomy before lock-in treatments and Group II underwent YAG capsulotomy upon completion of lock-in treatments). Sphere, cylinder, axis, spherical equivalent, uncorrected visual acuity, and best-corrected visual acuity were compared pre- and postoperatively using two-tailed paired t-tests. Postoperative data were measured one month after Nd:YAG capsulotomy. The alpha level (type I error) was set at 0.05. The LAL was successfully implanted in 485 eyes from January 2020 to March 2023. Ten eyes (0.02%) needed YAG capsulotomy prior to the completion of lock-in treatments (Group I) and 28 eyes (5.77%) needed YAG capsulotomy after the lock-in was completed (Group II). Postoperative BCVA significantly improved compared to preoperative values in both groups. Changes in sphere, cylinder, axis, SE, and UCVA pre- and postoperative measurements were not statistically significant (p > 0.05) in both groups. YAG capsulotomy can be safe and effective for patients with the LAL who develop PCO during the adjustment period. There were no significant changes in sphere, cylinder, axis, or spherical equivalence after YAG capsulotomy in both groups.

Left Ventricular Twist and Circumferential Strain from MRI Tagging Predict Early Cardiovascular Disease in Duchenne Muscular Dystrophy.

Background/Objectives: Duchenne Muscular Dystrophy (DMD) is a prevalent fatal genetic disorder, and heart failure is the leading cause of mortality. Peak left ventricular (LV) circumferential strain (Ecc), twist, and circumferential-longitudinal shear angle (θCL) are promising biomarkers for the improved and early diagnosis of incipient heart failure. Our goals were as follows: 1) to characterize a spectrum of functional and rotational LV biomarkers in boys with DMD compared with healthy age-matched controls; and 2) to identify LV biomarkers of early cardiomyopathy in the absence of abnormal LVEF or LGE. Methods: Boys with DMD (N = 43) and age-matched healthy volunteers (N = 16) were prospectively enrolled and underwent a 3T CMR exam after obtaining informed consent. Breath-held MRI tagging was used to estimate left ventricular Ecc at the mid-ventricular level as well as the twist, torsion, and θCL between basal and apical LV short-axis slices. A two-tailed t-test with unequal variance was used to test group-wise differences. Multiple comparisons were performed with Holm-Sidak post hoc correction. Multiple-regression analysis was used to test for correlations among biomarkers. A binomial logistic regression model assessed each biomarker's ability to distinguish the following: (1) healthy volunteers vs. DMD patients, (2) healthy volunteers vs. LGE(-) DMD patients, and (3) LGE(-) DMD patients vs. LGE(+) DMD patients. Results: There was a significant impairment in the peak mid-wall Ecc [-17.0 ± 4.2% vs. -19.5 ± 1.9%, p < 7.8 × 10-3], peak LV twist (10.4 ± 4.3° vs. 15.6 ± 3.1°, p < 8.1 × 10-4), and peak LV torsion (2.03 ± 0.82°/mm vs. 2.8 ± 0.5°/mm, p < 2.6 × 10-3) of LGE(-) DMD patients when compared to healthy volunteers. There was a further significant reduction in the Ecc, twist, torsion, and θCL for LGE(+) DMD patients when compared to LGE(-) DMD patients. In the LGE(+) DMD patients, age significantly correlated with LVEF (r2 = 0.42, p = 9 × 10-3), peak mid-wall Ecc (r2 = 0.27, p = 0.046), peak LV Twist (r2 = 0.24, p = 0.06), peak LV torsion (r2 = 0.28, p = 0.04), and peak LV θCL (r2 = 0.23, p = 0.07). In the LGE(-) DMD patients, only the peak mid-wall Ecc was significantly correlated with age (r2 = 0.25, p = 0.006). The peak LV twist outperformed the peak mid-wall LV Ecc and EF in distinguishing DMD patients from healthy volunteer groups (AUC = 0.88, 0.80, and 0.72), as well as in distinguishing LGE(-) DMD patients from healthy volunteers (AUC = 0.83, 0.74, and 0.62). The peak LV twist and peak mid-wall LV Ecc performed similarly in distinguishing the LGE(-) and LGE(+) DMD cohorts (AUC = 0.74, 0.77, and 0.79). Conclusions: The peak mid-wall LV Ecc, peak LV twist, peak LV torsion, and peak LV θCL were significantly impaired in advance of the decreased LVEF and the development of focal myocardial fibrosis in boys with DMD and therefore were apparent prior to significant irreversible injury.

Students’ Clarity of Conceptual Understanding and Medium of Instruction in the Biology Subject at Secondary School Level in the Hyderabad District

The language in which students are taught holds the key to their educational experiences and academic outcomes. This is perhaps the central issue in our educational system at every level. In the last 10 years, the language of instruction in our schools has seen a shift from Urdu to English at an unprecedented rate. The National Education Policy 2007 of Pakistan preferred Urdu over English. But in 2010, the Supreme Court made it compulsory for the federal government to adopt English as the medium of instruction and first language in addition to Urdu, which is the national language. The push for English-medium schools claims that mother tongue-based schools are not effective in producing universally competent students. Statistical analyses, including ANOVA and an independent two-tailed t-test, were conducted. The ANOVA results were significant at an alpha level of 0.05, F(2, 187) = 42.55, p &lt; .001, indicating that the medium of instruction has a significant effect on student performance. The t-test further reinforced this, showing a significant mean score difference between students taught in their mother tongue versus a non-mother tongue, t(188) = 9.042, p &lt; .001.The study concludes that students who learned Biology in their mother tongue exhibited superior conceptual understanding and problem-solving skills, outperforming their peers taught in a non-mother tongue by approximately 45.74%. These findings offer vital insights for educational policymakers and practitioners, advocating for the use of the mother tongue as the medium of instruction to enhance cognitive capacity and academic achievement.

P-1939. Health status and symptom perception among patients recently diagnosed with Long COVID in the United States

Abstract Background Long COVID (LC) remains an urgent public health concern. The objective of this study was to explore recent patient perspectives of the COVID-19– or LC–related journey. Perceptions regarding symptoms and health status among patients diagnosed with LC are reported. Methods An online survey study was conducted in the United States by the Harris Poll (March 12-April 1, 2024) in 3090 adults aged ≥18 y who had COVID-19 or LC diagnosed in the previous 12 months. Non-demographic data were weighted by age, gender, race/ethnicity, region, education, marital status, household size, household income, and propensity to be online. Sampling precision was measured using a Bayesian credible interval. Statistical significance was determined by two-tailed t-test at the 95% (P&amp;lt; 0.05) confidence level. Results Of respondents, 2695 were diagnosed with COVID-19 and 445 were diagnosed with LC in the previous 12 months. Demographics were generally similar between groups (Table 1). A significantly greater proportion of LC patients (42%) self-described their current overall health as poor/fair vs those with COVID-19 alone (23%, P&amp;lt; 0.05; Table 2); LC patients also reported poorer physical and mental health. LC patients were significantly more likely to describe their initial LC symptoms as very/somewhat severe compared to the initial COVID-19 symptoms described by patients who did not develop LC (69% vs 44%, respectively; P&amp;lt; 0.05). Figure 1 shows self-reported COVID-19 or LC symptoms experienced within the first 3 days of feeling sick. LC patients waited over twice as long as those who did not develop LC to seek medical care following initial symptoms (8.0 vs 3.2 days, respectively; P&amp;lt; 0.05); Hispanic patients reported the longest wait times. Overall, 57% of respondents diagnosed with LC had experienced symptoms for ≥1 year. Fatigue and headache were reported as the most severe persistent symptoms (Figure 2). Conclusion COVID-19 and LC remain important areas of concern for the US population. Patients with recent LC reported greater initial LC symptom severity, a longer time to seeking medical care, and poorer overall, physical, and mental health compared with those who did not develop LC. Further analyses will explore perspectives related to healthcare access and differences by race/ethnicity. Disclosures Thomas F. Oppelt, PharmD, BCPS, Gilead Sciences, Inc: I am an employee of Gilead Sciences, Inc|Gilead Sciences, Inc: Stocks/Bonds (Public Company) Michael Caron, PharmD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company) Jamie Zagorski, MSN, FNP, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company) Rodney H. Taylor, PharmD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company) Chinonso Akano, PharmD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company) LaKeisha Williams, PharmD, MSPH, Gilead Sciences, Inc.: Grant/Research Support Gary A. Puckrein, PhD, Dexcom: Grant/Research Support|Gilead Sciences, Inc.: Grant support for National Minority Quality Forum|National Minority Quality Forum: Employee

P-1938. Impact of Race and Ethnicity on Patient-reported Health and Symptoms Following COVID-19 or Long COVID Diagnosis

Abstract Background SARS-CoV-2 infection and COVID-19 hospitalization and mortality rates are higher in Black and Hispanic patients compared to White patients. Patient perspectives give key insights into healthcare inequities and treatment disparities. This study aimed to describe differences in the perceptions of health status and COVID-19 symptoms by race and ethnicity. Methods An online survey was conducted by the Harris Poll in the US (March 12-April 1, 2024) among adults aged ≥18 y diagnosed with, but not hospitalized for, COVID-19 or Long COVID (LC) in the past 12 months. Non-demographic data were weighted by age, gender, race/ethnicity, region, education, marital status, household size, household income, and propensity to be online to align them with their real-world proportions. Outcomes were compared among non-Hispanic White (White), non-Hispanic Black (Black), and Hispanic participants. Statistical significance was determined by two-tailed t-test (95% CI). Results 3090 participants diagnosed with COVID-19 or LC in the past 12 months completed the survey, with equal representation of White, Black, and Hispanic participants. White participants were more likely than Black and Hispanic participants to be older, live in suburban areas, have a 4-y college education, and earn &amp;gt;$100,000 (Table 1). Black and Hispanic participants were more likely to live in the South and be employed full-time. More Black and Hispanic participants reported their current health as “Poor/Fair” than White participants (P &amp;lt; 0.05; Table 2). Compared to White participants, greater proportions of Black and Hispanic participants described their initial COVID-19 or LC symptoms as “Very/Somewhat Severe” (White: 40%; Black: 55%; Hispanic: 59%; P &amp;lt; 0.05) and reported difficulty breathing, nausea/vomiting, diarrhea, and persistent pain/pressure in the chest (P &amp;lt; 0.05; Table 3). More Black (19%) and Hispanic (23%) participants reported that gaining access to healthcare when needed was “Very/Somewhat Difficult” versus White participants (8%; P &amp;lt; 0.05). Conclusion Black and Hispanic participants recently diagnosed with COVID-19 or LC reported poorer health and more severe initial symptoms compared to White participants, which aligns with other studies highlighting healthcare disparities and treatment inequities. Disclosures Thomas F. Oppelt, PharmD, BCPS, Gilead Sciences, Inc: I am an employee of Gilead Sciences, Inc|Gilead Sciences, Inc: Stocks/Bonds (Public Company) Michael Caron, PharmD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company) Jamie Zagorski, MSN, FNP, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company) Rodney H. Taylor, PharmD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company) Chinonso Akano, PharmD, Gilead Sciences, Inc.: Employee|Gilead Sciences, Inc.: Stocks/Bonds (Public Company) LaKeisha Williams, PharmD, MSPH, Gilead Sciences, Inc.: Grant/Research Support Gary A. Puckrein, PhD, Dexcom: Grant/Research Support|Gilead Sciences, Inc.: Grant support for National Minority Quality Forum|National Minority Quality Forum: Employee

Surgical Scheduling Errors During Manual Data Transfer.

Retrospective studies examining errors within a surgical scheduling setting do not fully represent the effects of human error involved in transcribing critical patient health information (PHI). These errors can negatively impact patient care and reduce workplace efficiency due to insurance claim denials and potential sentinel events. Previous reports underscore the burden physicians face with prior authorizations which may lead to serious adverse events or the abandonment of treatment due to these delays. This study simulates the process of PHI transfer during surgical scheduling to examine the error rate of experienced schedulers when manually transferring PHI from surgical forms into electronic health records (EHR). Participants (n=50) manually input PHI from four surgical scheduling forms into a simulated EHR form. Eight critical data points were identified and defined as data that delay claim approvals and payments. Subjects were randomly assigned to either a control (18minutes) or experimental (10minutes) group. Transcription errors were flagged to measure the percentage of incorrectly inputted data fields. Two-tailed t-tests were used to determine statistical significance (P <.05). 100% of subjects in both cohorts had at least one or more errors in every form. The 10-minute cohort had a higher average "critical errors" rate than the 18-minute cohort (P =.03). Of the 200 forms completed, 171 forms contained 1 or more "critical errors," resulting in a potential 85.5% delay or denial in authorization or payments. The highest incidence of critical errors across all fields occurred with ICD-10 codes, CPT codes, authorization number, procedure, and insurance ID number. As critical errors fields of authorization number and insurance ID often lead to automatic denials, not only are they more susceptible to transcription error due to alphanumeric values but more indicative of delays in treatment. These findings reveal a clear "pain point" in the routine scheduling process that leads to authorization and payment denials. With various touch points of manual data transfer in surgical scheduling, data degradation due to human error may compound at each step. Health care institutions should consider adopting digital solutions and investing in training programs to optimize clinical practice efficiency and reduce the possibility of inaccurate manual PHI transfer. Future case studies on denied payments will help further elucidate the economic impact on practices, as well as inform strategic decisions by those who directly handle health care management.

P0507 pTRACK generated normalised average T2 signal is an accurate and sensitive measure of Perianal Crohn’s disease activity

Abstract Background Magnetic resonance imaging (MRI) is the gold standard for diagnosing, classifying, and monitoring perianal Crohn’s disease (pCD). Fistula T2 signal intensity and volume/complexity are predictive of treatment response. We developed pTRACK, an interactive tool that enables radiologists to measure fistula volume, normalised average T2 signal intensity, and anatomical relationships to generate 3D digital models of pCD within minutes. This study aimed to evaluate pTRACK-generated MRI metrics against MAGNIFI-CD and assess their predictive value for clinical outcomes. Methods We retrospectively included consecutive adult patients (&amp;gt;18 years) with pCD who underwent pelvic MRI and clinical assessment. Two independent, blinded abdominal radiologists scored MAGNIFI-CD and pTRACK metrics (figure 1) on axial T2 STIR TSE sequences. Clinical outcomes (remission, response, non-response) were scored using the fistula drainage assessment (FDA). Correlations, unpaired two-tailed t-tests, and leave-one-patient-out cross-validation (LOPOCV) performance metrics were used to compare MRI metrics (fistula volume, normalised average T2 signal intensity, MAGNIFI-CD score) and predict FDA categories. T2 signal intensity was normalised using an ROI in adjacent pelvic muscles. Results 36 patients having 77 MRI scans were included. Mean C-reactive protein at the time of assessment was 12.9 ± 22 mg/L. 38.2% of patients had class 1 disease, 42.7% had class 2a disease with a minority having more complex disease. 58.4% of patients experienced non-response, with 14.3% experiencing response and 27.3% experiencing remission. Significant differences were observed across metrics when dichotomized into remission and active groups (responding and non-responding): normalised T2 signal (1.65 ± 1.10 vs. 2.98 ± 1.52, p&amp;lt;0.001), fistula volume (1.58 ± 3.08 mL vs. 4.55 ± 8.66 mL, p=0.03), and MAGNIFI-CD scores (5.86 ± 4.70 vs. 12.41 ± 5.80, p&amp;lt;0.001). Fistula volume and average T2 signal intensity showed moderate correlation to MAGNIFI-CD (r=0.72, p&amp;lt;0.001; r=0.49, p&amp;lt;0.001 respectively). LOPOCV AUC for normalised average T2 and fistula volume were 0.77 and 0.74, respectively, with sensitivities of 87% and 95%, and specificities of 62% and 52%. For MAGNIGI-CD, LOPOCV AUC was 0.84, with a sensitivity of 77% and specificity of 81%. Conclusion pTRACK’s normalised T2 signal and fistula volume demonstrated comparable accuracy to MAGNIFI-CD, with higher sensitivity for predicting pCD activity and distinguishing active from non-active disease. These findings underscore pTRACK’s potential utility, warranting prospective validation in cohorts with more severe disease.

Direct-to-consumer semen analysis products: Content, accountability, and adherence to clinical guidelines.

Direct-to-consumer (DTC) semen analysis (SA) products obviate barriers that deter men from clinic testing and have made strides in providing higher quality data. However, it is unclear how well these products adhere to the 2021 WHO guidelines on examination and processing of human spermatozoa as they pertain to the evaluation of male fertility. We investigate the content and adherence to clinical guidelines associated with consumer-facing information on DTC analysis products. Google search terms "at-home sperm test" and "mail-in sperm test" were used to identify commercially available products. Products that were offered to providers or were designed for use after vasectomy were excluded. We determined which semen parameters each product offered; if it was validated in subfertile men and against an established semen analysis method; and if it provided guidance in accordance with the WHO 2021 guidelines and related AUA/ASRM guidelines. The accountability and esthetic appearance of content for each product were assessed using the Silberg accountability and modified Abbott's criteria, respectively. Readability was assessed using the Flesch-Kincaid score. Descriptive statistics and two-tailed t-tests were used to compare characteristics, with p<0.05 as statistically significant. We identified 20 at-home (n=17) and mail-in (n=3) products. 85% of tests reported sperm concentration, with 60% and 15% of tests reporting motility and morphology, respectively. Fewer than half recommended men perform more than one test (40%), and none highlighted the need for partner evaluation. Only 25% were validated among subfertile men. Most tests lacked information on their credentials and sponsors, though were esthetically pleasing. Consumer-facing information on average required a high school level education for comprehension. DTC products inconsistently provide clinical recommendations in accordance with guidelines. Additionally, while product content is on average aesthetically appealing, it may lack accountability. Formal recommendations on the content and use of such products may improve their clinical integration.