Ethnic and sex differences in the distributions of body mass index and waist circumference among adults: a binationally representative study in South Korea and the United States

OBJECTIVE

The ethnic and sex differences in the distributions of body mass index (BMI) and waist circumference (WC) among adults are largely unknown. Therefore, we aimed to investigate the percentiles of BMI and WC in groups divided according to age, sex, and ethnicity.

PATIENTS AND METHODS

We conducted a population-based binational study of adults aged ≥20 years based on data from two sources: US National Health and Nutrition Examination Survey (2015 to 2020) and Korea National Health and Nutrition Examination Survey (2016 to 2019).

RESULTS

Weight, height, and WC were measured in 13,144 American adults and 30,191 Korean adults. Overall, BMI increased at younger ages and decreased at older ages, which indicates a reversed U-shaped relationship, and differed in terms of age, sex, and ethnicity. Women in the other Hispanic, non-Hispanic white, non-Hispanic black, and "other ethnic groups" showed a common BMI peak at ages 50-54 years. The patterns of WC distribution were similar to those of BMI distribution.

CONCLUSIONS

In this binational representative study, we found varied distributions of ethnic and sex differences in BMI and WC. Considering the differences in these distributions may help improve individual and personalized treatment strategies.

Laparoscopic fluorescence imaging technique for visualizing biliary structures using sodium fluorescein: the result of a preclinical study in a porcine model

Purpose

Near-infrared fluorescence imaging has been recently applied in the field of hepatobiliary surgery. Our objective was to apply blue-light fluorescence cholangiography during laparoscopic surgery. Therefore, we designed a preclinical study to evaluate the feasibility of using blue-light fluorescence for cholangiography in a porcine model.

Methods

Five millimeters of sodium fluorescein (SF) solution was administered into the gallbladder of 20 male 3-way crossbred (Landrace × Yorkshire × Duroc) pigs in laparoscopic approach. The biliary tree was observed under blue light (a peak wavelength of 450 nm) emitted from a commercialized light-emitting diode (LED) light source (XLS1 extreme, Chammed).

Results

In 18 of 20 porcine models, immediately after SF solution was administered into the gallbladder, it was possible to visualize the biliary tree under blue light emitted from the LED light source.

Conclusion

This study provided a preclinical basis for using blue-light fluorescence cholangiography using SF in laparoscopic surgery. The clinical feasibility of blue-light fluorescence imaging techniques for laparoscopic cholecystectomy remained to be demonstrated.

Handwritten Multi-Scale Chinese Character Detector with Blended Region Attention Features and Light-Weighted Learning

Character-level detection in historical manuscripts is one of the challenging and valuable tasks in the computer vision field, related directly and effectively to the recognition task. Most of the existing techniques, though promising, seem not powerful and insufficiently accurate to locate characters precisely. In this paper, we present a novel algorithm called free-candidate multiscale Chinese character detection FC-MSCCD, which is based on lateral and fusion connections between multiple feature layers, to successfully predict Chinese characters of different sizes more accurately in old documents. Moreover, cheap training is exploited using cheaper parameters by incorporating a free-candidate detection technique. A bottom-up architecture with connections and concatenations between various dimension feature maps is employed to attain high-quality information that satisfies the positioning criteria of characters, and the implementation of a proposal-free algorithm presents a computation-friendly model. Owing to a lack of handwritten Chinese character datasets from old documents, experiments on newly collected benchmark train and validate FC-MSCCD to show that the proposed detection approach outperforms roughly all other SOTA detection algorithms.

Indicative factors for surgical or angiographic intervention in hemodynamically stable patients with blunt abdominal trauma: A retrospective cohort study

INTRODUCTION

The standard of care for intraperitoneal injury in hemodynamically stable patients after blunt abdominal trauma has been replaced by non-operative management (NOM). However, selective NOM, depending on the situation, seems necessary in determining the treatment plan. In this study, we attempted to identify risk factors for surgical or angiographic intervention (SAI) in hemodynamically stable blunt abdominal trauma patients.

METHODS

This retrospective study which included adult patients who were brought to a regional trauma center was conducted from March 2015 to October 2019. We evaluated the characteristics of blunt abdominal trauma patients and analyzed factors that were related to the requirement of SAI in these patients. Patients were divided into SAI and conservative management (CM) groups.

RESULTS

We reviewed 1,176 patients, and after exclusions, of whom 248 blunt abdominal trauma and free fluid observed on CT were identified. The mean pulse rate was higher in the SAI than in the CM (P=0.025). Laboratory findings showed that lactate and delta neutrophil index (DNI) levels were higher in the SAI than in the CM (P=0.002 and 0.026 respectively). Additionally, the mean free fluid size in the SAI (85.69mm) was significantly larger than that in the CM (68.12mm; P=0.001), and blush was more frequently observed in the SAI (P<0.001). In multivariate analysis, only blush was an independent prognostic factor for SAI (OR 11.7, 95% CI, 5.1-30.8, P<0.001).

CONCLUSION

In hemodynamically stable patients with blunt abdominal trauma, blush but also high lactate and DNI are associated with the requirement of interventional radiology and/or surgery.

17-year trends of body mass index, overweight, and obesity among adolescents from 2005 to 2021, including the COVID-19 pandemic: a Korean national representative study

OBJECTIVE

There is a lack of pediatric studies that have analyzed trends in mean body mass index (BMI) and the prevalence of obesity and overweight over a period that includes the mid-stage of the COVID-19 pandemic. Thus, we aimed to investigate trends in BMI, overweight, and obesity among Korean adolescents from 2005 to 2021, including the COVID-19 pandemic.

SUBJECTS AND METHODS

We used data from the Korea Youth Risk Behavior Web-based Survey (KYRBS), which is nationally representative of South Korea. The study included middle- and high-school students between the ages of 12 and 18. We examined trends in mean BMI and prevalence of obesity and/or overweight during the COVID-19 pandemic and compared these to those of pre-pandemic trends in each subgroup by gender, grade, and residential region.

RESULTS

Data from 1,111,300 adolescents (mean age: 15.04 years) were analyzed. The estimated weighted mean BMI was 20.48 kg/m2 (95% CI, 20.46-20.51) between 2005 and 2007, and this was 21.61 kg/m2 (95% CI, 21.54-21.68) in 2021. The prevalence of overweight and obesity was 13.1% (95% CI, 12.9-13.3%) between 2005 and 2007 and 23.4% (95% CI, 22.8-24.0%) in 2021. The mean BMI and prevalence of obesity and overweight have gradually increased over the past 17 years; however, the extent of change in mean BMI and in the prevalence of obesity and overweight during the pandemic was distinctly less than before. The 17-year trends in the mean BMI, obesity, and overweight exhibited a considerable rise from 2005 to 2021; however, the slope during the COVID-19 pandemic (2020-2021) was significantly less prominent than in the pre-pandemic (2005-2019).

CONCLUSIONS

These findings enable us to comprehend long-term trends in the mean BMI of Korean adolescents and further emphasize the need for practical prevention measures against youth obesity and overweight.

Retained cartilaginous core in the distal radius of a small breed dog

A 5-month-old castrated male Smooth Fox Terrier presented for a 1-month history of right thoracic limb lameness. Physical examination revealed right elbow pain on extension and mild soft tissue swelling of the distal antebrachium. Radiographs and computed tomography showed elongated focal radiolucent regions in the distal radial metaphysis. There was incongruity of the right elbow with a short radius. Bone biopsy and histopathology of the regions confirmed a retained cartilaginous core characterised by bony trabeculae with frequently retained central cartilaginous cores. A dynamic proximal ulnar ostectomy was performed to improve elbow congruity. The owner was instructed to restrict activity to short leash walks for 8 weeks followed by a gradual activity increase. On follow-up examination 16 weeks after operatively, the lameness and elbow pain were resolved. Radiographs at that time showed a healed ulnar ostectomy, proper elbow congruity, and resolved retained cartilaginous core.

Factors associated with adverse mental health outcomes during the COVID-19 pandemic

Objectives

Even with significant advances to advance the health status of the general American population, the increased prevalence of mental health conditions and re-emergence of highly infectious diseases across all levels of society present a significant threat. This study aimed to quantify the effects of pandemic-, healthcare-related, and sociodemographic variables on adverse mental health outcomes, and determine their relative magnitudes.

Study design

This study employed publicly available data from the Household Pulse Survey, conducted by the United States Census Bureau to examine the social and economic impacts of the COVID-19 pandemic on American households.

Methods

A multiple regression model formed the basis of analysis, with adverse mental health as the outcome and various pandemic-, healthcare-related, and sociodemographic variables as predictors. Missing data was handled using multiple imputation.

Results

The factors with significant contributions to adverse mental health outcomes were those associated with mental health services and prescriptions. General healthcare-related variables followed those specific to mental health, along with sociodemographic variables contributing smaller changes. There were differential outcomes in mental health that were in part attributable to sociodemographic factors, but also a lack of access to both mental and physical healthcare due to factors both related and unrelated to the ongoing pandemic.

Conclusions

There is a need for policymakers and other stakeholders to work towards a mental health system that is more robust to restrictions brought on by events like the COVID-19 pandemic, and to address inequities in health care that have been exacerbated.

Sales of Electronic Nicotine Delivery Systems (ENDS) and Cigarette Sales in the USA: A Trend Break Analysis

Electronic nicotine delivery systems (ENDS) are a potentially lower-risk tobacco product which could help smokers switch completely away from cigarettes. However, the lack of strong evidence to date of a measurable, population-level effect on reducing smoking has generated skepticism about ENDS' potential benefits. This study examines whether increased US ENDS sales have been associated with reduced cigarette sales. Retail data on weekly per-capita cigarette and ENDS purchases in the USA during 2014-2019 were obtained from a national sample of brick-and-mortar retail outlets. Trends in cigarette sales were modeled before (2014-2016) ENDS had a substantial market share, and, after adjusting for macroeconomic factors, projected into the post-period (2017-2019). Actual cigarette sales were lower than projected sales (by up to 16% across the post-period), indicating a substantial "cigarette shortfall" in the post-period. To explore whether general (i.e., inclusive of potentially many mechanisms) substitution by ENDS can explain the cigarette shortfall, its association with per-capita ENDS volume sales was examined. Higher ENDS sales were significantly associated with a greater cigarette shortfall: for every additional per-capita ENDS unit, cigarette sales were 1.4 packs-per-capita lower than expected (B = 1.4, p < .0001). Error correction models which account for spurious correlation yielded similar results. These findings support ENDS serving as a substitute for cigarettes (through potentially many mechanisms including cigarette price), causing cigarette consumption to decline. Since ENDS potentially pose lower risk than cigarettes, this general substitution effect suggests that risk-proportionate tobacco regulation could mitigate the tobacco-related health burden.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10603-022-09533-4.

Highly effective biosorption capacity of Cladosporium sp. strain F1 to lead phosphate mineral and perovskite solar cell PbI2

Fungus Cladosporium sp. strain F1 showed highly effective biosorption capacity to lead phosphate mineral and perovskite solar cells lead iodide compared to other fungi Aspergillus niger VKMF-1119 and Mucor ramannianus R-56. Scanning electron microscopy and transmission electron microscopy analyses shows that Cladosporium sp. strain F1, which previously showed high biosorption capacity to uranium phosphate nanorods and nanoplates, can accumulate lead phosphate mineral and lead iodide on the fungal hyphae surface in large amounts under a wide range of pH conditions, while A. niger VKMF-1119 and M. ramannianus R-56 adsorbed small amounts of minerals. After biosorption of lead iodide minerals on Cladosporium sp. strain F1, aqueous dimethyl sulfoxide (50%) at pH 2 (70 °C) released the mineral more than 99%. Based on the fungal surface analyses, hydrophobic properties on the surfaces of Cladosporium sp. strain F1 could affect the higher biosorption capacity of strain F1 to lead phosphate mineral and lead iodide as compared to other tested fungi. Cladosporium sp. strain F1 may be the novel biosorbents to remediate the phosphate rich environment and to recover lead from perovskite solar cells lead iodide.

Multiscale Polymeric Materials for Advanced Lithium Battery Applications

Riding on the rapid growth in electric vehicles and the stationary energy storage market, high-energy-density lithium-ion batteries and next-generation rechargeable batteries (i.e., advanced batteries) have been long-accepted as essential building blocks for future technology reaching the specific energy density of 400 Wh kg^-1 at the cell-level. Such progress, mainly driven by the emerging electrode materials or electrolytes, necessitates the development of polymeric materials with advanced functionalities in the battery to address new challenges. Therefore, it is urgently required to understand the basic chemistry and essential research directions in polymeric materials and establish a library for the polymeric materials that enables the development of advanced batteries. Herein, based on indispensable polymeric materials in advanced high-energy-density lithium-ion, lithium-sulfur, lithium-metal, and dual-ion battery chemistry, the key research directions of polymeric materials for achieving high-energy-density and safety are summarized and design strategies for further improving performance are examined. Furthermore, the challenges of polymeric materials for advanced battery technologies are discussed.

Integrated silicon microfluidic chip for picoliter-scale analyte segmentation and microscale printing for mass spectrometry imaging

A silicon single-chip microfluidics system that integrates microscale fluidic channels, an analyte segmentation device, and a nozzle for electrohydrodynamic-assisted printing is designed for hyphenation with MALDI mass spectrometry (MS) imaging. A miniaturized T-junction segments analytes into monodisperse picoliter oil-isolated compartments. The printing nozzle deposits generated droplets one-by-one into an array on a conductive substrate without splitting or coalescing. Virtually single-shot MS analysis is enabled due to the ultrasmall droplet volumes and highly localized printing. The signal-to-noise ratio indicates that detection limits at the attomole level are achieved for γ-aminobutyric acid.

GPS Spoofing Detection Method for Small UAVs Using 1D Convolution Neural Network

The navigation of small unmanned aerial vehicles (UAVs), such as quadcopters, significantly relies on the global positioning system (GPS); however, UAVs are vulnerable to GPS spoofing attacks. GPS spoofing is an attempt to manipulate a GPS receiver by broadcasting manipulated signals. A commercial GPS simulator can cause a GPS-guided drone to deviate from its intended course by transmitting counterfeit GPS signals. Therefore, an anti-spoofing technique is essential to ensure the operational safety of UAVs. Various methods have been introduced to detect GPS spoofing; however, most methods require additional hardware. This may not be appropriate for small UAVs with limited capacity. This study proposes a deep learning-based anti-spoofing method equipped with 1D convolutional neural network. The proposed method is lightweight and power-efficient, enabling real-time detection on mobile platforms. Furthermore, the performance of our approach can be enhanced by increasing training data and adjusting the network architecture. We evaluated our algorithm on the embedded board of a drone in terms of power consumption and inference time. Compared to the support vector machine, the proposed method showed better performance in terms of precision, recall, and F-1 score. Flight test demonstrated our algorithm could successfully detect GPS spoofing attacks.

Real-world first-line treatment of patients with BRAFV600E-mutant metastatic colorectal cancer: the CAPSTAN CRC study

BACKGROUND

BRAFV600E mutations occur in 8%-12% of metastatic colorectal cancer (mCRC) cases and are associated with poor survival. European guidelines recommend combination (doublet or triplet) chemotherapy plus bevacizumab in first line. However, an unmet need remains for more effective treatments for these patients.

PATIENTS AND METHODS

CAPSTAN CRC is a European, retrospective, multicenter, observational study evaluating real-world treatment practices for patients with BRAFV600E-mutant mCRC treated between 1 January 2016 and 31 January 2020. The primary objective was to describe first-line treatment patterns. Secondary objectives included describing baseline demographics, mutational testing procedures, treatment effectiveness, and safety.

RESULTS

In total, 255 patients (median age 66.0 years; 58.4% female) with BRAFV600E-mutant unresectable mCRC from seven countries were included. Most had right-sided tumors (52.5%) and presented with synchronous disease at diagnosis (66.4%). Chemotherapy plus targeted therapy (68.7%) was preferred at first line over chemotherapy alone (31.3%). The main first-line treatments were FOLFOX plus bevacizumab (27.1%) and FOLFOXIRI (folinic acid, 5-fluorouracil, oxaliplatin, irinotecan) with/without bevacizumab (27.1%/19.2%). Median duration of first-line treatment was 4.9 months. Overall, 52.5% received second-line treatment. Across all first-line regimens, progression-free survival (PFS) and overall survival were 6.0 [95% confidence interval (CI) 5.3-6.7] months and 12.9 (95% CI 11.6-14.1) months, respectively. Triplet plus targeted therapy was associated with more adverse events (75.0%) compared with triplet chemotherapy alone (50.0%) and doublet chemotherapy alone (36.1%). Multivariate analysis identified low body mass index and presence of three or more metastatic sites as significant prognostic factors for PFS.

CONCLUSIONS

This study is, to date, the largest real-world analysis of patients with BRAFV600E-mutant mCRC, providing valuable insights into routine first-line treatment practices for these patients. The data highlight the intrinsic aggressiveness of this disease subgroup, confirming results from previous real-world studies and clinical trials, and stressing the urgent need for more effective treatment options in this setting.

Formation of robust bound states of interacting microwave photons

Systems of correlated particles appear in many fields of modern science and represent some of the most intractable computational problems in nature. The computational challenge in these systems arises when interactions become comparable to other energy scales, which makes the state of each particle depend on all other particles1. The lack of general solutions for the three-body problem and acceptable theory for strongly correlated electrons shows that our understanding of correlated systems fades when the particle number or the interaction strength increases. One of the hallmarks of interacting systems is the formation of multiparticle bound states2-9. Here we develop a high-fidelity parameterizable fSim gate and implement the periodic quantum circuit of the spin-½ XXZ model in a ring of 24 superconducting qubits. We study the propagation of these excitations and observe their bound nature for up to five photons. We devise a phase-sensitive method for constructing the few-body spectrum of the bound states and extract their pseudo-charge by introducing a synthetic flux. By introducing interactions between the ring and additional qubits, we observe an unexpected resilience of the bound states to integrability breaking. This finding goes against the idea that bound states in non-integrable systems are unstable when their energies overlap with the continuum spectrum. Our work provides experimental evidence for bound states of interacting photons and discovers their stability beyond the integrability limit.

Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry

BACKGROUND

Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months.

METHODS

We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed.

RESULTS

We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05).

CONCLUSION

While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.

Noise-resilient edge modes on a chain of superconducting qubits

Inherent symmetry of a quantum system may protect its otherwise fragile states. Leveraging such protection requires testing its robustness against uncontrolled environmental interactions. Using 47 superconducting qubits, we implement the one-dimensional kicked Ising model, which exhibits nonlocal Majorana edge modes (MEMs) with ℤ 2 parity symmetry. We find that any multiqubit Pauli operator overlapping with the MEMs exhibits a uniform late-time decay rate comparable to single-qubit relaxation rates, irrespective of its size or composition. This characteristic allows us to accurately reconstruct the exponentially localized spatial profiles of the MEMs. Furthermore, the MEMs are found to be resilient against certain symmetry-breaking noise owing to a prethermalization mechanism. Our work elucidates the complex interplay between noise and symmetry-protected edge modes in a solid-state environment.

Multimodal interaction: Input-output modality combinations for identification tasks in augmented reality

Multimodal interaction (MMI) is being widely implemented, especially in new technologies such as augmented reality (AR) systems since it is presumed to support a more natural, efficient, and flexible form of interaction. However, limited research has been done to investigate the proper application of MMI in AR. More specifically, the effects of combining different input and output modalities during MMI in AR are still not fully understood. Therefore, this study aims to examine the independent and combined effects of different input and output modalities during a typical AR task. 20 young adults participated in a controlled experiment in which they were asked to perform a simple identification task using an AR device in different input (speech, gesture, multimodal) and output (VV-VA, VV-NA, NV-VA, NV-NA) conditions. Results showed that there were differences in the influence of input and output modalities on task performance, workload, perceived appropriateness, and user preference. Interaction effects between the input and output conditions on the performance metrics were also evident in this study, suggesting that although multimodal input is generally preferred by the users, it should be implemented with caution since its effectiveness is highly influenced by the processing code of the system output. This study, which is the first of its kind, has revealed several new implications regarding the application of MMI in AR systems.

Trends and Disparities in Telehealth Utilization for Cancer Care during COVID-19

Purpose/Objective(s)

COVID-19 has dramatically increased telehealth utilization for cancer care delivery. However, telehealth access and utilization may differ amongst minority populations. We evaluated differences in telehealth utilization and patient satisfaction based on patient demographics.

Materials/Methods

Anonymized patient surveys from all virtual visit (VV) and in-person visits (IP) collected between April 2020 - January 2022 at a single comprehensive cancer center were included. Available patient demographic data included age, gender, race/ethnicity, language, and marital status. Patient demographics for virtual visits were compared to in-person visits using Wilcoxon rank-sum, chi-square, or Fisher's exact test as appropriate. Patient satisfaction surveys consisted of 10 closed-end questions assessing the following aspects of the patient experience: connection quality (2/12), patient-physician communication (6/12), and overall provider quality (2/12. Qualitative responses were given on a 1-3 Likert-type scale ranging from no, yes (somewhat), and yes (definitely). Responses were binned into satisfied (yes, [definitely] responses) and not satisfied (no and yes [somewhat] responses). Univariate and multivariate analyses of patient satisfaction questions were carried out with a logic regression model with a significance level of 0.05.

Results

In total, 3424 VV and 17303 IP surveys were assessed. Compared to IP, VV had significantly less utilization amongst Asian (6% vs. 9%, p<0.01) and Hispanic patients (6% vs. 9%, p<0.01), but similar utilization for White (71% vs. 66%, NS), Black (10% vs 9%, NS), and other (5% vs 5%, NS) patients. VV had significantly fewer non-English speaking patients compared to IP (3% vs. 6%, p<0.01). There were no significant differences in patient satisfaction scores based on race/ethnicity for White, Asian, or Black patients. Hispanics were more likely to be satisfied compared to White, Black, and Asian patients regarding connection ease (OR 3.4, p<0.01), connection quality (OR 2.18, p<0.01), quality of explanation (OR 2.85, p<0.01), appointment timing (OR 2.63, p<0.01), and follow-up instructions (OR 1.75, p=0.03). English-speaking patients were significantly more than non-English speaking patients regarding connection quality (OR 1.68, p=0.03), patient-provider trust (OR 1.87, p=0.04), and overall rating (OR 1.77, p=0.05). There was a significant decrease in VV utilization compared to IP over time as the pandemic progressed (p<0.01). Compared to White patients, Asian (p<0.01) and Black (p=0.04) patients saw a larger decrease in VV utilization over time.

Conclusion

Virtual compared to in-person visits were less likely to be utilized by Asian, Hispanic, and non-English speaking patients. Hispanic patients were more likely to be satisfied with their virtual visit, while non-English speaking patients were less likely to be satisfied. Further research is needed to understand the reason for disparities in telehealth utilization.

COVID-19 vaccination intent and associated factors in healthcare workers: cross-sectional study

Background

Considering the vaccine hesitancy recorded among healthcare workers (HCW) during the 2009/10 influenza pandemic, we aimed to examine the COVID-19 vaccination intent of HCW at one of the largest hospitals in Germany and to identify associated factors.

Methods

We conducted a cross-sectional anonymous survey at LMU University Hospital in Munich, Germany, between February 25 and March 20, 2021. Data was collected on COVID-19 vaccination intent as main outcome and on potential associated factors.

Results

In total, 2555 HCW completed the survey; 48,3% (n = 1325) of them had already received at least one COVID-19 vaccine dose. Of those not yet vaccinated 51,7% (n = 1320), 83,6% (n = 1104) reported intention to get vaccinated, while 10,2% (n = 134) were undecided and further 6,2% (n = 82) reported refusal. Disagreeing that everyone should receive the generally recommended vaccines was associated with refusal (RR = 529,500, p = 0,000) while being vaccinated against influenza in the 2020/21 season was linked with lower likelihood of refusal or indecisiveness (RR = 0,124, p = 0,000; RR = 0,182, p = 0,000). Low or partial conviction of the effectiveness and safety of COVID-19 vaccines were linked to refusal (effectiveness; RR = 485,471, p = 0,000; RR = 9,247, p = 0,000; safety: RR = 116,829, p = 0,000; RR = 5,423, p = 0,025). Feeling ill informed about COVID-19 vaccines was associated with refusal and indecisiveness (RR = 25,900, p = 0,000; RR = 21,104, p = 0,000).

Conclusions

At the beginning of the vaccination campaign in Germany, a small proportion of HCW at LMU University hospital was hesitant on receiving a COVID-19 vaccine. Factors associated with refusal or indecisiveness were a sceptical attitude towards vaccines in general as well as feeling ill informed about COVID-19 vaccines, especially regarding their effectiveness and safety. Having received an influenza vaccine was associated with COVID-19 vaccination intent.

Key messages

• The presented results provide insight into the reasons for hesitancy of HCW against COVID-19 vaccines, indicating a pattern-like behaviour in the acceptance of novel vaccines by HCW.

• The evidence from our analysis can help inform the communication aims and emphases of vaccination campaigns among HCW within similar organizational contexts or in future outbreak scenarios.

Diverse perspectives on social determinants of multicultural adolescents: A focus group study

Background

As Korea transforms into a multicultural society, social vulnerability of the multicultural adolescents (MAs) puts them at risk for poor health and health disparities. However, there is shortage of evidence on social determinants of health (SDH), which refers to the circumstances of people from birth to death, which affects their health outcomes, for MAs. Thus, this study aims to explore the SDH of MAs from diverse stakeholders’ perspectives.

Methods

This qualitative study comprised 17 focus group interviews with 99 participants (MAs, peers, parents, teachers, neighbors, and community leaders), conducted from June to September 2020. The directed content analysis was conducted using the Minority Health and Health Disparities Research Framework with a high rigor level based on the four criteria of Lincoln and Guba’s trustworthiness.

Results

The participants addressed SDH of MAs in five domains: biological (vulnerability and mechanism); behavioral (health behavior, family/school/peer functioning, and policies and laws); physical/built environment (school/community environment); sociocultural environment (MAs'/parental sociodemographic, language proficiency, MAs'/parental acculturation, social network, and response to/interpersonal/local/societal structural discrimination); and health care system (insurance coverage, MAs'/parental health literacy, availability of services, and health care policies). However, limited SDH in biological and physical/built environment domains were identified.

Conclusions

SDH in sociocultural environment domain and interpersonal influence level were the most commonly addressed. Interpersonal discrimination of both MAs and parents were found to be the most important SDH. These findings suggest that future programs to enhance MAs’ health may be targeted toward reducing discrimination and involving their parents.

Key messages

• Sociocultural environment was found to be the most salient SDH domain to affect MAs’ health.

• SDH of MAs are linked to discrimination and their parents’ sociocultural aspects such as acculturation.

Visualization of macrophage inflammatory activity on visceral obesity in high-fat diet-induced obese mice by 18F-FDG PET/CT

Background

Obesity induced inflamed visceral adipose tissue (VAT) secretes pro-inflammatory cytokines thereby promoting systemic inflammation and insulin resistance which further exacerbate obesity-related cardiovascular disease (CVD). Macrophages are the key players in the development of obesity-associated VAT inflammation. Extensive clinical studies have reported that 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) can be used to evaluate the macrophage inflammatory activity on VAT in human beings. However, due to difficulty in human VAT biopsy, pathologic correlations were lacking and there was a few study on preclinical animal models.

Purpose

Here, we investigated whether 18F-FDG PET/CT could reflect the macrophage inflammatory activity on VAT in high-fat diet-induced obese mice.

Methods

Obese animal models were induced by a high-fat diet (60% fat) for 20 weeks using the male C57BL/6 mice. Insulin tolerance test was performed to evaluate the status of insulin resistance and C-reactive protein (CRP) was measured to assess the status of systemic inflammation. All animals underwent 18F-FDG PET/CT before sacrifice. Macrophage inflammatory activity was evaluated using the maximum standardized uptake value (SUVmax). Flow cytometry-, histological-, and molecular analyses were performed on harvested VAT.

Results

All obese animals showed insulin resistance which resembled the human metabolic syndrome, a key pathophysiological process that contributes to increase CVD risk. VAT SUVmax was increased in obese mice and significantly correlated with the levels of CRP. Furthermore, VAT from obese mice showed increased macrophage infiltration, compared to normal mice.

Conclusions

18F-FDG PET/CT could visualize and evaluate the macrophage inflammatory activity on obesity-driven inflamed VAT in obese mice model. Our preclinical study strongly supports the clinical application of 18F-FDG PET/CT in the assessment of VAT inflammation to patients who are vulnerable to CVD.

Funding Acknowledgement

Type of funding sources: None.

Caregiver willingness to give TPT to children living with drug-resistant TB patients

BACKGROUND Pediatric household contacts (HHCs) of patients with multidrug-resistant TB (MDR-TB) are at high risk of infection and active disease. Evidence of caregiver willingness to give MDR-TB preventive therapy (TPT) to children is limited.METHODS This was a cross-sectional study of HHCs of patients with MDR-TB to assess caregiver willingness to give TPT to children aged <13 years.RESULTS Of 743 adult and adolescent HHCs, 299 reported caring for children aged <13 years of age. The median caregiver age was 35 years (IQR 27-48); 75% were women. Among caregivers, 89% were willing to give children MDR TPT. In unadjusted analyses, increased willingness was associated with TB-related knowledge (OR 5.1, 95% CI 2.3-11.3), belief that one can die of MDR-TB (OR 5.2, 95% CI 1.2-23.4), concern for MDR-TB transmission to child (OR 4.5, 95% CI 1.6-12.4), confidence in properly taking TPT (OR 4.5, 95% CI 1.6-12.6), comfort telling family about TPT (OR 5.5, 95% CI 2.1-14.3), and willingness to take TPT oneself (OR 35.1, 95% CI 11.0-112.8).CONCLUSIONS A high percentage of caregivers living with MDR- or rifampicin-resistant TB patients were willing to give children a hypothetical MDR TPT. These results provide important evidence for the potential uptake of effective MDR TPT when implemented.

Attomole-Level Multiplexed Detection of Neurochemicals in Picoliter Droplets by On-Chip Nanoelectrospray Ionization Coupled to Mass Spectrometry

While droplet microfluidics is becoming an effective tool for biomedical research, sensitive detection of droplet content is still challenging, especially for multiplexed analytes compartmentalized within ultrasmall droplets down to picoliter volumes. To enable such measurements, we demonstrate a silicon-based integrated microfluidic platform for multiplexed analysis of neurochemicals in picoliter droplets via nanoelectrospray ionization (nESI)-mass spectrometry (MS). An integrated silicon microfluidic chip comprising downscaled 7 μm-radius channels, a compact T-junction for droplet generation, and an integrated nESI emitter tip is used for segmentation of analytes into picoliter compartments and their efficient delivery for subsequent MS detection. The developed system demonstrates effective detection of multiple neurochemicals encapsulated within oil-isolated plugs down to low picoliter volumes. Quantitative measurements for each neurochemical demonstrate limits of detection at the attomole level. Such results are promising for applications involving label-free and small-volume detection for monitoring a range of brain chemicals.

Highly Sensitive Oxygen Sensing Characteristics Observed in IGZO Based Gasistor in a Mixed Gas Ambient at Room Temperature

Oxygen (O₂) sensing in trace amounts and mixed gas is essential in many types of industries. Semiconductor sensors have proven to be invaluable tools for the O₂ measurements in a wide concentration range, but the sensors are only able to quantify O₂ in a concentration range of subppm, thus far, especially in mixed gas. We present in this paper a new concept for O₂ sensing with incomparable sensitivity using IGZO-films with oxygen vacancy-based conducting filaments (CFs). O₂ sensing relies on rupturing of the CFs, and the proposed device quickly recovers to the initial state using a pulse of 0.6 V/90 μs after the sensing. The proposed device has a high sensitivity of 14 even at an O₂ concentration of 500 ppb, a detection limit of 150 ppb for O₂ at RT, and excellent selectivity for O₂ in mixed gas, which is remarkable compared to other gas sensors. The proposed device can be widely used in gas sensors especially for detecting O₂ at a low ppb level, which is due to excellent sensing characteristics.

Morphological Evolution Trajectory of Multifaceted Palladium Nanoparticles

Precise control over the morphology and facets of Pd nanomaterials has great importance in catalytic and sensing applications. In this study, we synthesized Pd nanoparticles with multiple types of low-Miller-index-faceted morphologies by systematically defining the synthesis conditions of the seed-mediated colloidal preparation method. We discovered the morphological evolution of Pd nanoparticles by following the trajectory of the surface Miller indices, which were determined by the cooperative effects of cetyltrimethylammonium bromide and ascorbic acid. By precise control of the morphological trajectory, Pd nanoparticles with a new cuborhombicube morphology, composed of 36 facets and concave edges, were discovered. This study provides important insight into the design of the surface Miller indices and morphologies of functional nanomaterials.

OS10.6.A What is the initial cell in the subventricular zone for human glioblastoma genesis?

Background

We all have a fundamental question about why glioblastoma (GBM) develops. In order to find the answer to this fundamental question, if you find out what the first cell is, you will get closer to the answer. GBM arises from the subventricular zone (SVZ). GBM is one of the most devastating tumour of human brain as the most optimal treatment barely prolongs the survival, and it does not cure the disease. As the majority of GBM tissues show copy number variations (CNV) of co-altered chromosomal 7 gain and 10 loss, we hypothesized the origin cell (Oc) of SVZ may be traced back with these markers. The cellular identity of the Oc is still unknown and it is different from the tumour-derived progenitor-like cells. We aimed to define these cells from the SVZ that have a potential to get activated into GBM.

Material and Methods

We compared bulk RNA sequencing (RNAseq) data of IDHwt GBM tumor tissue (n=122), tumor free SVZ from GBM patients (n=40), tumor-free control SVZ of non-glial tumor (n=9). Pared single nucleus RNAseq (snRNAseq) or single cell RNAseq (scRNAseq) samples of tumor free SVZ (n=11) and GBM tumor (n=8), were done to see cell specific CNVs. We developed genetically engineered mouse models for GBM genesis introducing three driver mutations (TP53, PTEN, and EGFRviii) into SVZ to isolate mouse Oc (mOc) and mouse cancer cells (mCc). The biological characteristics of separated mOc and mCc were compared. Bulk RNAseq and scRNAseq were performed on these cells (mOc, mCc), and their cellular state was compared with the human gene set.

Results

In this work, we found two types of the Oc in the RNA sequencing of 60 human tumour free-SVZ samples. Furthermore, single-cell level analysis revealed that two Oc types in SVZ harbor ongoing patterns of CNV co-alterations from Oc1 to Oc2, and finally to GBM. The Oc1 type cells contained the CNV signature of Oc2 ancestor with neural progenitor cell (NPC) signature. Oc2 type cells expressed a high level of EGFR than other cells with astrocyte-like cell signature. Both of these cells expressed oligodendrocyte progenitor cell (OPC)-like signatures in the SVZ. We validated the human-based findings by using the P53/PTEN/EGFR-mutant mouse model with EGFR/tdTomato overexpression and P53/PTEN knockout in the SVZ cells. As a result, non-tumourigenic and highly motile Oc-like cell-states are found in the mouse models, supporting the firework-like migration pattern from the SVZ.

Conclusion

Our results demonstrate how members of Oc preoccupy the SVZ, known as the stem cell niche and give rise to the tumour. We anticipate that a new therapy may emerge by targeting the Oc in the SVZ.

P02.01.B The telomere maintenance mechanism spectrum and its dynamics in gliomas

The activation of the telomere maintenance mechanism (TMM) is one of the critical drivers of cancer cell immortality. In gliomas, TERT expression and TERT promoter mutation are considered to reliably indicate telomerase activation, while ATRX mutation indicates alternative lengthening of telomeres (ALT). However, these relationships have not been extensively validated in tumor tissues. Here, we show through the direct measurement of telomerase activity and ALT in a large set of glioma samples that the TMM in glioma cannot be defined in the dichotomy of telomerase activity and ALT, regardless of TERT expression, TERT promoter mutation and ATRX mutation. Moreover, we observed that a considerable proportion of gliomas lack both telomerase activity and ALT (Neither group). And this Neither group exhibited evidence of slow growth potential. From a set of longitudinal samples from a separate cohort of glioma patients, we discovered that the TMM is not fixed but changes with glioma progression. Collectively, these results suggest that the TMM is a dynamic entity and that reflects the plasticity of the oncogenic biological status of tumor cells and that the TMM should be defined by the direct measurement of telomerase enzyme activity and evidence of ALT.