Value Of Test Statistic Research Articles

An excess radio signal in the Abell 4038 cluster

ABSTRACT In the past decade, various instruments, such as the Large Area Telescope (LAT) on the Fermi Gamma Ray Space Telescope, the Alpha Magnetic Spectrometer (AMS) and the Dark Matter Particle Explorer(DAMPE), have been used to detect the signals of annihilating dark matter in our Galaxy. Although some excesses of gamma rays, antiprotons and electrons/positrons have been reported and are claimed to be dark matter signals, the uncertainties of the contributions of Galactic pulsars are still too large to confirm the claims. In this paper, we report on a possible radio signal of annihilating dark matter manifested in the archival radio continuum spectral data of the Abell 4038 cluster. By assuming a thermal annihilation cross-section and comparing the dark matter annihilation model with the null hypothesis (cosmic ray emission without dark matter annihilation), we obtain very large test statistic (TS) values, TS > 45, for four popular annihilation channels, which correspond to more than 6σ statistical preference. This reveals a possible potential signal of annihilating dark matter. In particular, our results are also consistent with the recent claims of dark matter mass, m ≈ 30–50 GeV, annihilating via the $\rm b\bar{b}$ quark channel with the thermal annihilation cross-section. However, at this time, we cannot exclude the possibility that a better background cosmic ray model could explain the spectral data without recourse to dark matter annihilations.

Fetal magnetic resonance imaging in the evaluation of congenital diaphragmatic anomalies

BackgroundCongenital abnormalities of the diaphragm cause impairment of lung development and are an important cause of post-natal morbidity and mortality. Congenital diaphragmatic eventration (CDE), a less sinister diaphragmatic anomaly compared to the more common congenital diaphragmatic hernia (CDH), often tends to mimic CDH on prenatal imaging. This study evaluates the role of fetal magnetic resonance imaging (MRI) in differentiating these two entities.ResultsThis was a retrospective study which included fetal MRI studies done in patients with ultrasound diagnosis of fetal diaphragmatic anomaly. MRI exam was performed with a 1.5 T superconducting system with eight-element torso array coil. The images were studied by two radiologists experienced in fetal imaging in consensus. Diagnosis of CDE was made if the dome of the diaphragm was visualized as a thin hypointense line separating the lung from abdominal structures on coronal and sagittal MRI sequences. If this thin hypointense line was not visualized, a diagnosis of CDH was made. The findings were then correlated with autopsy/intra-operative findings/post-natal imaging follow-up. A total of 12 patients were included in the study. In these 12 patients, 13 diaphragmatic abnormalities were diagnosed on MRI (1 fetus had bilateral diaphragmatic anomaly). Of the 13 diaphragmatic anomalies detected, 7 (54%) were CDH and 6 (46%) were CDE. The type of diaphragmatic anomaly was correctly identified on MRI in all except one fetus in which CDE was misdiagnosed as CDH. The Fisher exact test statistic value was 0.0047. The result was significant at p < 0.01.ConclusionFetal MRI is a useful tool for assessing congenital diaphragmatic anomalies. Visualization of the diaphragm on coronal and sagittal images helps in diagnosis of complete CDE and differentiating it from the more sinister CDH.

On the X-Ray Properties of the Putative Central Compact Object in 1E 0102.2−7219

Abstract We have analyzed the archival Chandra X-ray Observatory observations of the compact feature in the Small Magellanic Cloud supernova remnant 1E 0102.2−7219, which has recently been suggested to be the central compact object remaining after the supernova explosion. In our analysis, we have used appropriate, time-dependent responses for each of the archival observations, have modeled the background instead of subtracting it, and have fit unbinned spectra to preserve the maximal spectral information. The spectrum of this feature is similar to the spectrum of the surrounding regions that have significantly enhanced abundances of O, Ne, and Mg. We find that the previously suggested blackbody model is inconsistent with the data, as Monte Carlo simulations indicate that more than 99% of the simulated data sets have a test statistic value lower than that of the data. The spectrum is described adequately by a nonequilibrium ionization thermal model with two classes of models that fit the data equally well. One class of models has a temperature of kT ∼ 0.79 keV, an ionization timescale of ∼3 × 1011 cm−3 s, and marginal evidence for enhanced abundances of O and Ne, and the other has a temperature of kT ∼ 0.91 keV, an ionization timescale of ∼7 × 1010 cm−3 s, and abundances consistent with local interstellar medium values. We also performed an image analysis and find that the spatial distribution of the counts is not consistent with that of a point source. The hypothesis of a point-source distribution can be rejected at the 99.9% confidence level. Therefore, this compact feature is most likely a knot of O- and Ne-rich ejecta associated with the reverse shock.

Marble Dust Exposure Relationship to Workers‘ Lung Conditions in Marble Industries

Introduction: Marbel mining in Tulungagung caused air quality pollution of dust. The level of air pollution in the marble industrial mining area in Besole village, Tulungagung, was a high category. Air pollutions from dust cause fibrosis in the lungs if continuously inhaled. This marble dust belongs to the group of differentiative dust—pulmonary disorders due to dust in the form of restriction, obstruction, or mixture of the two. The study aims to analyze the internal factors related to lung conditions in one of the Besole Village industries, Tulungagung. Method: research that has been done using cross-sectional design through a quantitative approach. Determination of the sample size by simple random sampling. Twenty-four workers consisting of 12 exposed and 12 were not exposed to dust. Result and Discussion: The results of measurements of marble dust levels in the study area were 20,000 mg/m3, which exceeds the specified threshold value. Meanwhile, the statistical test value p= 0.000 means a relationship between dust levels and the condition of workers’ lungs in the exposed area. Most workers’ lung conditions in one of the Besole village industries are quite good. Conclusion: The condition of the lungs is closely related to dust levels that exceed the threshold value. The lungs’ condition is also influenced by work time and poor behavior, namely the habit of not wearing PPE and smoking habits, causing decreased lung function.

Short-Term X-ray Variability during Different Activity Phases of Blazars S5 0716+714 and PKS 2155-304

We explored the statistical properties of short-term X-ray variability using long-exposure XMM-Newton data during high X-ray variability phases of blazars S5 0716+714 and PKS 2155-304. In general, the hardness ratio shows correlated variations with the source flux state (count rate), but in a few cases, mainly the bright phases, the trend is complex with both correlation and anti-correlation, indicating spectral evolution. Stationarity tests suggest the time series are non-stationarity or have trend stationarity. Except for one, none of the histogram fits resulted in a reduced-χ2∼1 for a normal and log-normal profile but a normal profile is favored in general. On the contrary, the Anderson–Darling test favors log-normal with a test-statistic value lower for log-normal over normal for all the observations, even if out of significance limits. None of the IDs show linear RMS-flux relation. The contrary inferences from different widely used statistical methods indicate that a careful analysis is needed while the complex behavior of count rate with hardness ratio suggests spectral evolution over a few 10 s of kilo-seconds during bright phases of the sources. In these cases, the spectrum extracted from whole observation may not be meaningful for spectral studies and certainly not a true representation of the spectral state of the source.

Validation of the CASUS score in Tunisian patients: a quality management tool in intensive care units

Abstract Background Early prediction of patients at highest risk of a poor outcome after cardiovascular surgery, including death can aid medical decision making, and adapt health care management in order to improve prognosis. In this context, we conducted this study to validate the CASUS severity score after cardiac surgery in the Tunisian population. Methods This is a retrospective cohort study conducted among patients who underwent cardiac surgery under extracorporeal circulation during the year 2018 at the Cardiovascular Surgery Department of La Rabta University Hospital in Tunisia. Data were collected from the patients hospitalization records. The discrimination of the score was assessed using the ROC curve and the calibration using the Hosmer-Lemeshow goodness of fit test and then by constructing the calibration curve. Overall correct classification was also obtained. Results In our study, the observed mortality rate was 10.52% among the 95 included patients. The discriminating power of the CASUS score was estimated by the area under the ROC curve (AUC), this scoring system had a good discrimination with AUC greater than 0.9 from postoperative Day 0 to Day 5.From postoperative day 0 to day 5, the Hosmer-Lemeshow's test gave a value of chi square test statistic ranging from 1.474 to 8.42 and a value of level of significance ranging from 0.39 to 0.99 indicating a good calibration. The overall correct classification rate from postoperative day 0 to day 5 ranged from 84.4% to 92.4%. Conclusions Despite the differences in the profile of the risk factors between the Tunisian population and the population constituting the database used to develop the CASUS score, we can say that this risk model presents acceptable performances in our population, attested by adequate discrimination and calibration. Prospective and especially multicentre studies on larger samples are needed before definitively conclude on the performance of this model in our country. Key messages The casus score seems to be valid to predict mortality among patients undergoing cardiac surgery. Multicenter study on larger sample is needed to derive and validate models able to predict in-hospitals mortality.

Combining Random Forests and a Signal Detection Method Leads to the Robust Detection of Genotype-Phenotype Associations.

Genome wide association studies (GWAS) are a well established methodology to identify genomic variants and genes that are responsible for traits of interest in all branches of the life sciences. Despite the long time this methodology has had to mature the reliable detection of genotype–phenotype associations is still a challenge for many quantitative traits mainly because of the large number of genomic loci with weak individual effects on the trait under investigation. Thus, it can be hypothesized that many genomic variants that have a small, however real, effect remain unnoticed in many GWAS approaches. Here, we propose a two-step procedure to address this problem. In a first step, cubic splines are fitted to the test statistic values and genomic regions with spline-peaks that are higher than expected by chance are considered as quantitative trait loci (QTL). Then the SNPs in these QTLs are prioritized with respect to the strength of their association with the phenotype using a Random Forests approach. As a case study, we apply our procedure to real data sets and find trustworthy numbers of, partially novel, genomic variants and genes involved in various egg quality traits.

Incorporating a change-point estimator when bootstrapping the empirical distribution of a stationary process

The moving block bootstrap can be used to determine critical values for test statistics used to detect a change-point in the marginal distribution of a stationary time series. We examine the impact of incorporating an estimator of the change-point when centering the bootstrap blocks and establish conditions under which the bootstrapped test statistics remain stochastically bounded regardless of whether or not a change is present.

Exact tests for outliers in Laplace samples

The exact null distributions of test statistics used for testing up to upper outliers in a two-parameter Laplace sample are investigated. Two types of test statistics, namely, the modified Murphy’s test for k upper normal outliers and the general Dixon-type test statistic discussed by Childs, are considered. Utilizing the result of conditional independence of blocked ordered data established by Iliopoulos and Balakrishnan, together with the computational algorithm of Huffer and Lin for distributions of linear combinations of exponential variables, exact critical values of test statistics for testing discordancy of k upper outliers in two-parameter Laplace samples are obtained. For illustration, some examples with pertinent computational details are finally presented.

Improving the Fine Motor Skills with Embroidery among Children with an Intellectual Disability

Introduction: Children with intelletual disability experience delays infine motor skills compared to normal children, if the child's fine motor skills are not trained and developed, it will affect to the child's growth and development. One of occupational therapies to improve their finemotor skills is through embroidery. The purpose of this study was to analyze the effect of embroidery to the fine motor development of children with moderate mental retardation at the special school, Bangkalan Indonesia.Methods: The design was pre experimental research with one pre test-post test design group, population of all children with moderate mental retardationas many as 13 children. The research instrument use dwasobservation sheet.Results: Data analysisby Wilcoxon Signed Ranks Test.The embroidery therapy using cross stitch technique. It was held every Monday and Thursday for eight week, took an hour each sessionConclusion: The results of the study showed that most children after had embroidery had enough finemotor skills (84.6%) and the statistical test value was obtained p&lt;α (0.002&lt;0.05). The students improved their fine motor ability such as how they coloring, scissoring, grasping, and holding up a paper. The conclusion of this study is that there was an effect of embroidery therapy on fine motor skills in children with intellectual disability.

Mediating Role of Communication Patterns in Relationship Between Self-differentiation and Sexual Satisfaction

Objectives: The couples’ marital satisfaction depends on their Communication Patterns. The present study aimed to investigate the mediating role of Communication Patterns in the relationship between self-differentiation and sexual satisfaction of couples. Methods: This study is descriptive correlational research. The statistical population of the study was all couples residing in Bukan City in 2019. A total of 500 couples was selected by the multistage cluster sampling method and the differentiation questionnaires, Communication Patterns, and Larsson sexual satisfaction questionnaire were performed on them. Data were analyzed using the Pearson correlation coefficient and stepwise regression and the Sobel test was performed by using SPSS V. 22 and PLS software. Results: According to the results, the survey of the mediating role of Communication Patterns in the relationship between self-differentiation and sexual satisfaction, the Sobel test statistic value was 18.663 (P≤0/01). Therefore, it can be concluded that the communication variables have a positive and significant mediating effect on their differentiation on sexual satisfaction. On the other hand, the effect of their differentiation on sexual satisfaction is both independent and positive and significant with the mediating variable of Communication Patterns. Conclusion: Considering the results, it can be concluded that couples’ therapists can emphasize improving couples ‘Communication Patterns’ to achieve sexual satisfaction and use this approach to prevent divorcing couples from breaking up in their marriage.

Molecular variation and phylogenetic status of ponyfish (Perciformes: Leiognathidae) in Karaikal, South India

The family Leiognathidae, commonly known as ponyfish and they are mainly classified by mouth morphology. In this study, genetic variation and phylogenetic relationships among nine genera and 13 species of Leiognathidae, inferred from Cytochrome Oxydase I gene. The Neighbour Joining tree showed the paraphyly of the studied species form genus Secutor and monophyly status all the other eight genera. Leiognathus equulus is occupying a basal branch of the family NJ tree. The highest genetic distance (0.349) showed between Eubleekeria and Nuchequula. The lowest genetic distance (0.007) showed between the genus Nuchequula and Leiognathus. Among the nine genera, very less nucleotide diversity (π= 0.1100) was in Secutor and higher value (π = 0.7558) was recorded in Leiognathus. The Tajima’s test statistic (D) value was positive, so, the entire genus is in balancing selection.&#x0D;

THE RELATIONSHIP BETWEEN KNOWLEDGE THROUGH HAZARD PREGNANCY IN PREGNANT MOTHER ON THE THIRD TRIMESTER AT PUSKESMAS SINDANG BARANG

Background :The high rate of maternal and infant mortality is stilla big problem in developing countries. According to the SDKI AKI in Indonesia is 228/100.000 live births. From the MDGs (Millennium Development Goals) 102/100.000 Births (KH) target, in 2007 AKI has decreased from 228/100.000 to 118/100.000 KH. The AKB target for the 23/100 KH MDGs in the same year was recorded to have decreased from 34/1000 to 24/1000 KH.Research Purposes :This study aimed to determine the relationship between knowledge of obstetric danger signs and pregnancy care behavior among third trimester pregnant women.Research Methods : This type of research is analytic with cross sectional research design. The method of sampling in this study with purposive sampling technique with a sample of 83 people. Data collection was obtained through questionnaires in the form of closed questionnaires. Research Result :Based on the level of knowledge of mothers who have good knowledge of pregnancy danger signs as many as 11 people (13,3%) who carry out pregnancy care behavior, the level of knowledge of mothers who have sufficient knowledge about pregnancy danger signs as many as 58 people (69,9%) who carry out pregnancy care behavior, and the level of knowledge of mothers who have less knowledge about pregnancy danger signs as many as 14 people (16,9%) who conduct behavior pregnancy care. Based on the behavior of mothers who have positive behavior in carrying out pregnancy careas many as 31 people (37,3%), and those who have negative behaviors in carrying out pregnancy care as many as 52 people (62,7%). And obtained a statistical test value = 0,678 &gt; 0,05, which means there is no significant relationship between the two variables. Conclusion :There is no relationship between knowledge about the danger signs of pregnancy with gestational care behavior in third trimester pregnant women in the Puskesmas Sindang Barang 2018 year. The results of this study are expected to be used asa scientific reference that is useful for pregnant women in the third trimester to recognize or know the care behavior of pregnancy, to prevent the occurrence of danger signs of pregnancy.

THE RELATIONSHIP OF NUTRITIONAL STATUS WITH CRUDE MOTOR DEVELOPMENT IN CHILDREN AGED 2-3 YEARS IN POSYANDU WORK AREA SITU UDIK PUSKESMAS

According to UNICEF in 2011,dataofthe high number ofgrowth and development disorderinchildren under fivewas obtained,especially motor development disorder where (27.5%) or 3 million children had disorder. This research aims to determine theCorrelation ofNutritional StatusandGross Motor Developmentin 2-3 Year OldChildren atMaternal and Child Health Servicein Situ UdikCommunity Health Center Working Area. This is an analytic researchwith cross-sectional research design. This research was conducted atMaternal and Child Health Service atSitu UdikCommunity Health CenterinOctober 2017-October 2018 with total sample of 114 2-3 year oldchildrenby implementingSlovin formula for the sampling. The instruments used weredemographic questionnaire, DDST IIobservation sheet, and weight scale that had been provided. Furthermore,univariate and bivariate analysis were applied in analyzing the data. Based on nutritional status,children who hadmalnutrition were 22 children (29.7%) with normal motor development, 43 children (58.1%) were suspected abnormal motor development, and 9 children (12.2%) who could not be tested. Children who hadgood nutrition were 21 children (56.8%) with normal gross motor development, 10 children (27.0%) were suspected, and 6 children (16.2%) who could not be tested. Children who hadovernutrition were 2 children (66.7%) with normal gross motor development, 1 (33.3%) child were suspected abnormal motor development. In addition, the statistical test value = 0.026 obtained meaning thatnutritional status has significant correlation withgross motor development in 2-3 year oldchildren atMaternal and Child Health Service in Situ Udik Community Health Center Working Area.

THE AGE RELATIONSHIP AND TYPES OF WORK WITH ASI PRODUCTION REGIONAL PUSKESMAS PUBLIC WORK AREA BOGOR

Indonesian demographic and health survey data (SDKI) in 2016 show that as many as 48'4% of infants in Indonesia receive exclusive breastfeeding at the age of 4-5 months.whereas based on a report from the provincial health office in 2015, the number of exclusive breastfeeding is usually given to infants aged 0-6 months, only reaching 44.1%.relatively few figures, even though breastfeeding and breastfeeding both mother and baby will get many benefits.even this will have an impact on the environment, society, nation and state.3 know the combination of age and type of work with ASI production in the work area of the Pasir Mulya community health center in 2018. This type of research is analytic with cross sectional design. The method of taking samples in this study is total sampling with a sample of 99 people.the instruments used were questionnaires and observation sheets while the data analysis techniques used univariate, bivariate and multivariate Analysis. based on the age of the mother it is known that 53 (53.5%) of the mother's age is not at risk with sufficient milk production and 12 (12.1%) of mothers at risk of adequate milk production, and from maternal work it is known that 50 (50.5%) mothers do not work with sufficient milk production and 15 (15.1%) mothers work with sufficient milk production. From the results of multivariate analysis, it was found that the type of work had more influence on the production of breast milk with P value 0.002 compared to the age of the mother with p value 0.010.so that mothers who do not work will be more sufficient for their ASI production compared to working mothers,because mothers who don't work have more time spent with their children. they can see the child's development, and vice versa. and the statistical test value show p-value (0'000) and α = 0.01 it can be concluded that ha is accepted ho is rejected and it shows there is a relationship between age and type of work with ASI production in Pasir Mulya community health center in 2018.

140-LB: Effect of Vaginal Estrogen as Hormone Replacement Therapy for Menopause on SGLT2 Inhibitor–Associated Urinary Tract Infection: A Prospective Cohort Study

Introduction: Estrogen deficiency after menopause is an important predisposing factor for recurrent UTI (r UTI). Vaginal application of estrogen as “hormone replacement therapy (eHRT)” for prevention of menopause associated r UTI has moderate recommendation and evidence level grade B by AUA/CUA/SUFU guidelines 2019. Glycosuria with use of SGLT 2I among T2DM, increase risk of r UTI by 4-9%. SGLT2 I use among T2DM, post-menopausal females may further increase risk of r UTI. Aim and Objective: This study was designed to observe (1) the Risk and frequency of UTI due to SGLT2 I among post-menopausal females with T2DM and (2) Preventive effect of vaginal e HRT for r UTI among them. Methods: Forty-two, post-menopausal females having T2DM, using vaginal e HRT were selected as cases whereas controls were 38 matched females not using e HRT. Subjects in both groups were prescribed SGLT2 I considering eligibility and simultaneously adjusted the doses of other OHA’s or insulin to maintain the glycemic targets. They were targeted to follow for 12 months and evaluated periodically for symptomatic UTI and maintenance of glycemic targets. Diagnosis of symptomatic UTI was made using standard definition and guidelines. Result: The 42 cases who were using vaginal e HRT (M = 2.5, SD = 1.5) compared to the 38 controls who were not using e HRT (M = 3.5, SD = 1.6) demonstrated significantly lesser frequency of UTI, t (78) = -2.56, p = .012. All the episodes of symptomatic UTI among cases were uncomplicated whereas 1 episode of UTI among 4 comparators forced for withdrawal of SGLT2 I and exclusion from observation period. The Fisher exact test statistic value is 0.0467. The result is significant at p &amp;lt; .05. Conclusion: Estrogen HRT after menopause significantly reduces the frequency of UTI among T2DM females using SGLT2 I. Not using eHRT in these group of subjects may significantly increase risk of complicated UTI. Disclosure A. Gautam: None. P.K. Agrawal: None. N. Pursnani: None. R. Rani: None.

Retraction Notice: A possible radio signal of annihilating dark matter in the Abell 4038 cluster

In the past decade, some telescopes (e.g. Fermi-LAT, AMS and DAMPE) were launched to detect the signals of annihilating dark matter in our Galaxy. Although some excess of gamma rays, anti-protons and electrons/positrons have been reported and claimed as dark matter signals, the uncertainties of Galactic pulsars' contributions are still too large to confirm the claims. In this letter, we report a possible radio signal of annihilating dark matter manifested in the archival radio continuum spectral data of the Abell 4038 cluster. By assuming the thermal annihilation cross section and comparing the dark matter annihilation model with the null hypothesis (cosmic ray emission without dark matter annihilation), we get very large Test Statistic values TS $>45$ for four popular annihilation channels, which correspond to more than $6.5 \sigma$ statistical preference. This provides a very strong evidence for the existence of annihilating dark matter. In particular, our results also support the recent claims of dark matter mass $m \approx 30-50$ GeV annihilating via the $b\bar{b}$ quark channel with the thermal annihilation cross section.

Univariate Time Series Analysis of Short-Term Forecasting Horizons Using Artificial Neural Networks: The Case of Public Ambulance Emergency Preparedness

This study examined the applicability of artificial neural network models in modelling univariate time series ambulance demand for short-term forecasting horizons in Zimbabwe. Bulawayo City Councils’ ambulance services department was used as a case study. Two models, feed-forward neural network (FFNN) and seasonal autoregressive integrated moving average, (SARIMA) were developed using monthly historical data from 2010 to 2017 and compared against observed data for 2018. The mean absolute error (MAE), root mean square error (RMSE), and paired sample t-test were used as performance measures. Calculated performance measures for FFNN were MAE (94.0), RMSE (137.19), and the test statistic value p=0.493(&gt;0.05) whilst corresponding values for SARIMA were 105.71, 125.28, and p=0.005(&lt;0.05), respectively. Findings of this study suggest that the FFNN model is inclined to value estimation whilst the SARIMA model is directional with a linear pattern over time. Based on the performance measures, the parsimonious FFNN model was selected to predict short-term annual ambulance demand. Demand forecasts with FFNN for 2019 reflected the expected general trends in Bulawayo. The forecasts indicate high demand during the months of January, March, September, and December. Key ambulance logistic activities such as vehicle servicing, replenishment of essential equipment and drugs, staff training, leave days scheduling, and mock drills need to be planned for April, June, and July when low demand is anticipated. This deliberate planning strategy would avoid a dire situation whereby ambulances are available but without adequate staff, essential drugs, and equipment to respond to public emergency calls.

THE EFFECTIVENESS OF USING SIWAK TOOTHPASTE ON PLAQUE ACCUMULATION IN FIXED ORTHODONTIC APPLIANCES USERS’

Objective: The objective of the study was to determine the ability of toothpaste containing Salvadora persica (Siwak) to reduce the accumulation of dirt in the oral cavity compared to ordinary toothpaste users in fixed orthodontic users.&#x0D; Methods: It was conducted on 40 subjects, divided into two groups of A and B. Group A uses Siwak, while Group B uses ordinary toothpaste. The research subjects were students that utilized fixed appliances for at least 6 months and without periodontal disease. Data were obtained by measuring the plaque level before and after using the toothpaste.&#x0D; Results: A significant relationship between the use of Siwak and ordinary toothpaste by reducing its accumulation in patients using fixed orthodontic appliances and a Chi-square statistical test value of 0.018.&#x0D; Conclusion: The use of Siwak is more effective in reducing plaque accumulation in fixed orthodontic appliance users compared to ordinary toothpaste.

P919 The correlation between cardiac biomarkers and findings on transthoracic echocardiography in the intensive care unit

Abstract BACKGROUND Trans-thoracic echo (TTE) is a commonly performed non-invasive investigation for the cardiovascular assessment of critically ill patients in the Intensive Care Unit (ICU). Raised cardiac biomarkers are commonly cited as an indication for TTE, however the significance of these biomarker elevations in the critical care setting is unclear. PURPOSE The aim of this study was to describe findings on TTE in an Irish ICU cohort and to determine if there was any correlation between these findings and serum N-terminal pro b-type natiuretic (NT-proBNP) and high sensitivity troponin T (HsTnT) levels. METHODS Patients admitted to the ICU and who received a TTE between January 2018 and February 2019 were identified. Based on TTE findings, patients were divided into two groups: ‘Normal group’ and ‘Abnormal group’. For the purpose of this study, minor abnormalities including concentric left ventricular hypertrophy, diastolic dysfunction and hyper-dynamic left ventricular function were included in the Normal group. The Abnormal group included reductions in LV function, regional wall motion abnormalities and significant valvular heart disease. Continuous variables were expressed as medians and interquartile range. The groups were compared using the z-test for continuous variables and fishers exact test for categorical variables, with a p value of &amp;lt; 0.05 considered significant. RESULTS There were 358 patients admitted to the ICU during the study period. The mean age was 59.8 ± 17 years and over half of the patients (55%) were male. One hundred and fifteen patients (32%) had a reported TTE, of which 55% were normal and 22% had minor abnormalities (Normal group). The remaining 23% showed significant abnormalities (Abnormal group). The prevalence of a NT-proBNP result over 4 times the upper limit of normal (&amp;gt;4xULN) was not significantly different between groups (67% in Normal group vs 71% in Abnormal group, Fisher exact test statistic value is 0.7887, p &amp;lt; .05). However a HsTnT value &amp;gt;4xULN was more common in the Abnormal group than the Normal group (73% vs 46%, Fisher exact test statistic value is 0.0231, p &amp;lt; .05). Similarly, Median NT-proBNP did not differ significantly between the groups; (2254pg/mL; IQR: 11,758 in the Normal group vs 6428pg/mL; IQR: 5,789 in the Abnormal group, p = 0.52218) but Median HsTnT level was significantly higher in the Abnormal group than Normal group; (123ng/L ; IQR: 656 vs 51ng/L; IQR: 163.5 ,p = 0.0278). CONCLUSION TTE is performed commonly in the ICU, with one-third of ICU admissions receiving a TTE. Over 75% were reported as normal or showing only minor abnormalities. NT-Pro BNP was commonly significantly elevated but did not correlate with the subsequent diagnostic yield of significant abnormalities on echocardiography. HsTnT levels were more commonly significantly raised in patients with abnormal TTE results and the role of troponin in this setting requires further evaluation.