Multi-Dimensional Project Based Learning on Understanding Petrophysical Properties by Utilizing Image Processing and 3D Printing

We present a project-based learning prototype for visual analysis of petrophysical properties using 2D cross-sections and micro-models of porous media. Micro-computed Tomography (CT) scans are used to create the quasi-2D micro-models that are printed using Stereolithography (SLA) 3D printers to study petrophysical properties in porous media. The methodology involves obtaining 8 different cross-sections of rocks either from micro-CT scans or online libraries. 2D cross-sections are segmented into black and white binary images and then skeletonized to create quasi-2D models. The flow of oil and water in initially water saturated pores in the printed 2D models mimics the drainage and imbibition processes, respectively. High definition photography is used to capture still and dynamic photographs of flow processes. The binary images are used to analyze porosity and grain size distribution while the still and dynamic photographs are used to analyze fluid saturation and displacement efficiency. The images are analyzed using open source software where a systematic tutorial is provided. The primary outcome of this project is to improve the understanding of petrophysical concepts and 3D printing by the utilization of imagery to create porous media. This project has been tested in teaching and showed major improvements in students’ understanding of petrophysical concepts when compared to pre-project. The data and tutorials used in this project are made available for the community to use through a link in the paper.

Seroprevalence of low avidity anti-Toxoplasma IgG in pregnant women and its relationship with their age and contact with cats

Toxoplasma gondii is a protozoan parasite that can infect all mammals, serving as intermediate hosts. The cause of congenital toxoplasmosis is transplacental transmission of the parasite to the foetus, resulting in wide range of manifestations from mild chorioretinitis to miscarriage. Its frequency can be reduced by early screening of pregnant women which is based mainly on tests for anti-Toxoplasma antibodies. We collected serum samples of 594 pregnant women (subjects) after taking their consent over a period of two years (2016-2018) and analyzed them for anti-Toxoplasma IgG by ELISA. The positive samples were then analyzed for IgG avidity test which could differentiate between recent and past infections. The seroprevalence was also correlated with the age of the subjects and their contact with cats. 162 subjects were found positive out of which only three showed a recent infection. After following up until delivery, one of them delivered a baby who had jaundice and was diagnosed with anti-Toxoplasma IgM at birth. The foetus of the second subject died in-utero, while the third woman delivered a normal baby after being given spiramycin when diagnosed with toxoplasmosis in the first trimester. It was found that most of the positive subjects had frequent contact with cats. Invasion of the parasite during third trimester resulted in death in-utero and jaundice. Most common cause of pregnancy wastage during our study was spontaneous abortions while pregnancy loss due to congenital anomalies was rare.

The effect of maize-alfalfa intercropping on the physiological characteristics, nitrogen uptake and yield of maize

In Northeastern China, the intensive cropping system and increased use of chemical fertilizer has caused severe problems in terms of sustainable agricultural development. Therefore, to improve agricultural sustainability and crop productivity the farming system needs to be modified in the region. A pot experiment was conducted to evaluate the effect of maize-alfalfa intercropping on the physiological characteristics, nitrogen (N) uptake and yield of the maize crops in northeast China in 2017-2018. The study findings showed that intercropping under N fertilization progressively improved the physio-agronomic indices of the maize crop as compared to mono-cropping. The grain yield, 100 seed weight and biomass dry matter of maize crop improved in intercropping when it was practiced with N fertilizer. Furthermore, intercropping with N fertilization increased the chlorophyll content of the maize crop at bell-mouthed, silking, filing and mature stages by 19%, 44%, 12%, and 9% in 2017 and by 23%, 43%, 15%, and 11% in 2018, respectively, as compared with the monocropping system. Unlike monocropping, intercropping with N fertilization increased the photosynthesis rate (14% and 15%), stomatal conductance (74% and 98%) and transpiration rate (74% and 75%) in 2017 and 2018, respectively. However, intercropping reduced intercellular CO₂ (C_i ). Moreover, intercropping with N fertilization increased the maize N content of grain and leaves as well as total N uptake by 49%, 31% and 93% in 2017 and 53%, 34% and 132%, respectively, in 2018 as compared to monocropping. In conclusion, our results suggest that maize-alfalfa intercropping with optimal N fertilization provides a practical method for improving growth, yield and N accumulation in the maize crop.

THU0594 A CASE OF TAKAYASU’S ARTERITIS IN A PATIENT WITH TUBERCULOUS LYMPHADENITIS

Background:

Takayasu’s arteritis (TA) is a large vessel vasculitis that principally affects the aorta and its main branches. The incidence has been reported at between 1.2 – 2.3 cases per million per year, more commonly in the Asian population. The age of onset is typically between tenth and fourth decade; between 80 and 90 percent of the cases are female.

The relationship between Mycobacterium Tuberculosis (mTB) and TA has long been considered; both demonstrate chronic inflammatory changes on histological examination and some granuloma formation in arterial walls. There is increasing evidence implicating mTB in the pathogenesis of TA through molecular mimicry between the mycobacterium heat shock protein -65 (mHSP-65) and the human homologue HSP -60 (hHSP-60). However, no definitive link between the two diseases has been explained.

Objectives:

Case presentation.

Results:

A 23-year-old lady was referred to our outpatient rheumatology clinic with a twelve-month history of persistently enlarged cervical lymph nodes on the left side for which she had received six months of anti-Tuberculosis medication. She had been referred to the respiratory physicians who had diagnosed presumed Tuberculous Lymphadenitis, with caseating granulomas demonstrated on biopsy, positive acid-fast bacilli smear but a negative culture. The patient had been initiated six months of anti-Tuberculosis medication; however, her lymphadenopathy showed no improvement. More recently she described a five-month history of weakness, paraesthesia and claudication symptoms in her left upper limb with episodes of dizziness and blurred vision, episodes occurring 2-3 times per day and lasting between a few minutes to a few hours.

Her examination at this presentation revealed an unrecordable blood pressure in the left upper limb and 104/67mmHg in the right. There was significant tender lymphadenopathy of the left cervical lymph nodes and diminished pulses in the left upper limb. Right sided pulses were normal. The rest of her examination was normal.

Investigations at presentation revealed elevated inflammatory markers with C- reactive protein (CRP) of 116mg/dL and erythrocyte sedimentation rate (ESR) of 128mm/h. Complete blood count (CBC) found her to be anaemic with a haemoglobin of 100g/L, with a mean cell volume of 71.3fl, and have elevated platelet count of 649x 109/L. Recent computerized tomography scan with contrast of the thorax demonstrated features consistent with Takayasu Arteritis. Marked left subclavian stenosis was found on magnetic resonance imaging. High dose prednisolone at 60mg once daily along with Azathioprine 2mg/kg/day was started with a follow up appointment in two weeks.

Conclusion:

There is increasing evidence implicating mTB in the development of TA and a few cases recognising this link have been reported. We report a case of TA in a patient recently diagnosed and treated for Tuberculous lymphadenitis who then developed symptoms of TA. There should be a low threshold for suspecting a diagnosis of Takayasu’s arteritis in patients previously or actively infected with Mycobacterium Tuberculosis. Further research exploring the relationship between mTB and TA is required.

References:

[1]Espinoza JL, Ai S, Matsumura I. New Insights on the Pathogenesis of Takayasu Arteritis: Revisiting the Microbial Theory. Pathogens. 2018;7(3):73.

[2]Aggarwal A, Chag M, Sinha N, et al. Takayasu’s arteritis: role of Mycobacterium tuberculosis and its 65 kDa heat shock protein. International Journal of Cardiology. 1996; 55: 49–55.

[3]Reshkova V, Kalinova D, Rashkov R. Takayasu’s Arteritis associated with Tuberculosis Infections. Journal of Neurology and Neuroscience. 2016; 3:114.

[4]Moritz K, Jansson Hilte F, Antje Kangowski, Christian Kneitz, Emil C. Reisinger. Tuberculosis and Takayasu arteritis: case-based review Rheumatology International 2019 39:345–351

[5]D Misra, A Wakhlu, V Agarwal, D Danda. Recent advances in the management of Takayasu arteritis International Journal of Rheumatic Diseases 2019; 22: 60–68

Disclosure of Interests:

None declared

Discovery of Potent, Selective, and State-Dependent NaV1.7 Inhibitors with Robust Oral Efficacy in Pain Models: Structure-Activity Relationship and Optimization of Chroman and Indane Aryl Sulfonamides

Voltage-gated sodium channel Na_V1.7 is a genetically validated target for pain. Identification of Na_V1.7 inhibitors with all of the desired properties to develop as an oral therapeutic for pain has been a major challenge. Herein, we report systematic structure-activity relationship (SAR) studies carried out to identify novel sulfonamide derivatives as potent, selective, and state-dependent Na_V1.7 inhibitors for pain. Scaffold hopping from benzoxazine to chroman and indane bicyclic system followed by thiazole replacement on sulfonamide led to identification of lead molecules with significant improvement in solubility, selectivity over Na_V1.5, and CYP2C9 inhibition. The lead molecules 13, 29, 32, 43, and 51 showed a favorable pharmacokinetics (PK) profile across different species and robust efficacy in veratridine and formalin-induced inflammatory pain models in mice. Compound 51 also showed significant effects on the CCI-induced neuropathic pain model. The profile of 51 indicated that it has the potential for further evaluation as a therapeutic for pain.

Vulnerability of Common Urban Forest Species to Projected Climate Change and Practitioners Perceptions and Responses

While urban forests are often identified as part of climate change adaptation and mitigation strategies, less attention has been given to vulnerabilities urban trees may have to a changing climate and practitioners' response to those vulnerabilities. Yet, current planting and management decisions will impact how urban forests fare under future climatic conditions. We explore a case study of Mississauga (Ontario, Canada) to examine (1) if common urban forest species are vulnerable to two scenarios of projected climate change, (2) the experiences and responses of urban forestry practitioners to climate change, and (3) whether urban forestry practitioners' experience and practice are aligned with the vulnerability assessment. Vulnerabilities of 27 common species were examined based on 2071-2100 regional climate projections. Interviews were then conducted with practitioners working in the public and private sectors. The results suggest that the majority of examined species will be vulnerable to multiple conditions associated with projected climate. Practitioners all perceive recent changes in climate and extreme weather patterns, but do not prioritize future climate conditions in their species selection decisions. Moreover, they expressed uncertainty about how to make species selection decisions in light of climate change. Given the predicted vulnerabilities, alternative species need to be considered or more management resources (e.g., for watering) will be required to maintain the current composition. However, the lack of focus on future conditions by practitioners raises concerns, while also highlighting the need for more information about appropriate management strategies.

OP4 Accessing unplanned and emergency health services – experiences of asylum seekers, refused asylum seekers and refugees living in wales

Background

Numbers of asylum seekers and refugees living in Wales have increased sharply. Many are liable to have unmet health needs and difficulty accessing services. We investigated the experience of, and access to, unplanned and emergency health services by asylum seekers, refugees and those refused asylum living in Wales.

Method

We surveyed 210 asylum seekers, refused asylum seekers and refugees and conducted eight focus groups with 57 participants (with interpreters present when necessary) to explore experiences. We used descriptive statistics to analyse survey data and framework analyses to analyse interview data.

Results

Survey data showed awareness of unscheduled health services was mixed. Best known was the 999 ambulance service (72% reportedly had heard of and could contact this outside daytime hours). NHS111 was familiar to 36% but just a quarter (26%) had heard of and could contact GP out-of-hours services. Fewer than half of respondents (44%) knew of the Emergency Department. 26% reported using a health service out-of-hours. Focus group respondents with little English reported difficulty explaining their health needs, particularly in emergencies and when seeking telephone help through 999 and 111 calls. Others said they used emergency services if they did not know how to access routine and out-of-hours care or if they felt their efforts to see a GP did not resolve their problem.

Conclusion

Language barriers and poor knowledge of UK health systems mean asylum seekers, refused asylum seekers and refugees use emergency health services to meet needs which could be seen and treated in routine primary services. Language barriers using phone lines may also result in paramedic attendance or conveyance to Emergency Departments because health needs are not clearly identified. Better information and support may help this population access services which match their needs and support their health more effectively.

Complete Measurement of the Λ Electromagnetic Form Factors

The exclusive process e^{+}e^{-}→ΛΛ[over ¯], with Λ→pπ^{-} and Λ[over ¯]→p[over ¯]π^{+}, has been studied at sqrt[s]=2.396  GeV for measurement of the timelike Λ electric and magnetic form factors, G_{E} and G_{M}. A data sample, corresponding to an integrated luminosity of 66.9  pb^{-1}, was collected with the BESIII detector for this purpose. A multidimensional analysis with a complete decomposition of the spin structure of the reaction enables a determination of the modulus of the ratio R=|G_{E}/G_{M}| and, for the first time for any baryon, the relative phase ΔΦ=Φ_{E}-Φ_{M}. The resulting values are R=0.96±0.14(stat)±0.02(syst) and ΔΦ=37°±12°(stat)±6°(syst), respectively. These are obtained using the recently established and most precise value of the asymmetry parameter α_{Λ}=0.750±0.010 measured by BESIII. In addition, the cross section is measured with unprecedented precision to be σ=118.7±5.3(stat)±5.1(syst)  pb, which corresponds to an effective form factor of |G|=0.123±0.003(stat)±0.003(syst). The contribution from two-photon exchange is found to be negligible. Our result enables the first complete determination of baryon timelike electromagnetic form factors.

Amplitude Analysis of D_{s}^{+}→π^{+}π^{0}η and First Observation of the W-Annihilation Dominant Decays D_{s}^{+}→a_{0}(980)^{+}π^{0} and D_{s}^{+}→a_{0}(980)^{0}π^{+}

We present the first amplitude analysis of the decay D_{s}^{+}→π^{+}π^{0}η. We use an e^{+}e^{-} collision data sample corresponding to an integrated luminosity of 3.19  fb^{-1} collected with the BESIII detector at a center-of-mass energy of 4.178 GeV. We observe for the first time the W-annihilation dominant decays D_{s}^{+}→a_{0}(980)^{+}π^{0} and D_{s}^{+}→a_{0}(980)^{0}π^{+}. We measure the absolute branching fraction B(D_{s}^{+}→a_{0}(980)^{+(0)}π^{0^{(}+)},a_{0}(980)^{+(0)}→π^{+(0)}η)=(1.46±0.15_{stat}±0.23_{sys})%, which is larger than the branching fractions of other measured pure W-annihilation decays by at least one order of magnitude. In addition, we measure the branching fraction of D_{s}^{+}→π^{+}π^{0}η with significantly improved precision.

Experiments and modeling of nonlinear frequency response of oscillations of a sessile droplet subjected to horizontal vibrations

In this paper, we experimentally studied the response frequency of oscillations of a sessile water droplet, subjected to horizontal vibrations at varying excitation frequency (5-250 Hz and 40 kHz) and amplitude (0.015 mm to 0.5 mm for low frequencies and 600nm for ultrasonic frequency), as well as static contact angle of the glass substrate ([Formula: see text], [Formula: see text] , [Formula: see text], [Formula: see text]). The droplets were pinned during the experiments and non-axisymmetric oscillation modes were excited due to the horizontal vibrations. For the first time, we observed that at a sufficiently high vibration amplitude, when the excitation frequency is lower than the smallest natural frequency of the sessile droplet, the droplet oscillates at a response frequency multiple of the excitation frequency. At higher excitation frequencies up to several hundreds of Hz, the droplet oscillates nearly at the excitation frequency. At ultrasonic excitation frequency, however, the droplet cannot follow the excitations, since there is a physical limitation for forming infinite modes (infinite wavenumber) on the surface of a small droplet. We have modeled these behaviors with a nonlinear mass-spring-damper system by combining two established models: the Duffing and Van der Pol equations, in order to simulate both nonlinear damping and stiffness.

Experimental analysis of one-dimensional Faraday waves on a liquid layer subjected to horizontal vibrations

In this paper, we experimentally show the synchronous (harmonic) nature of the primary surface waves formed on a layer of water (∼1 mm) pinned to a glass substrate and subjected to horizontal (lateral) vibrations. With well-controlled experiments, we attenuated cross-waves and studied the primary standing waves in a one-dimensional wave configuration, with a high precision mechanical vibrator, capable of generating a range of forcing frequencies (100–500 Hz) and amplitudes (1–5 µm). We demonstrate that the emergence of instability (in the form of standing waves) depends upon the forcing amplitude and frequency and the average thickness of the liquid layer. Experiments reveal that the surface remains stable for sufficiently thin and thick layers of the liquid, while instability appears for thicknesses in between the two mentioned lower and upper limits. We show and analyze that, for the average liquid thickness of h = 1.5 mm, asymmetric modes of oscillations appear on the liquid surface; however, with a change in the film thickness and length of the surface profile, symmetric modes may occur as well (h = 2 mm). The problem studied here, i.e., a liquid film with pinned contact lines subjected to horizontal vibrations, shows some of the characteristics of an infinitely extended lateral liquid film, a liquid layer in a container with walls, and a sessile droplet.

Study of e^{+}e^{-}→γωJ/ψ and Observation of X(3872)→ωJ/ψ

We study the e^{+}e^{-}→γωJ/ψ process using 11.6  fb^{-1} e^{+}e^{-} annihilation data taken at center-of-mass energies from sqrt[s]=4.008  GeV to 4.600 GeV with the BESIII detector at the BEPCII storage ring. The X(3872) resonance is observed for the first time in the ωJ/ψ system with a significance of more than 5σ. The relative decay ratio of X(3872)→ωJ/ψ and π^{+}π^{-}J/ψ is measured to be R=1.6_{-0.3}^{+0.4}±0.2, where the first uncertainty is statistical and the second systematic (the same hereafter). The sqrt[s]-dependent cross section of e^{+}e^{-}→γX(3872) is also measured and investigated, and it can be described by a single Breit-Wigner resonance, referred to as the Y(4200), with a mass of 4200.6_{-13.3}^{+7.9}±3.0  MeV/c^{2} and a width of 115_{-26}^{+38}±12  MeV. In addition, to describe the ωJ/ψ mass distribution above 3.9  GeV/c^{2}, we need at least one additional Breit-Wigner resonance, labeled as X(3915), in the fit. The mass and width of the X(3915) are determined. The resonant parameters of the X(3915) agree with those of the Y(3940) in B→KωJ/ψ and of the X(3915) in γγ→ωJ/ψ observed by the Belle and BABAR experiments within errors.

Observation of the Decay X(3872)→π^{0}χ_{c1}(1P)

Using a total of 9.0  fb^{-1} of e^{+}e^{-} collision data with center-of-mass energies between 4.15 and 4.30 GeV collected by the BESIII detector, we search for the processes e^{+}e^{-}→γX(3872) with X(3872)→π^{0}χ_{cJ} for J=0, 1, 2. We report the first observation of X(3872)→π^{0}χ_{c1}, a new decay mode of the X(3872), with a statistical significance of more than 5σ for all systematic fit variations. Normalizing to the previously established process e^{+}e^{-}→γX(3872) with X(3872)→π^{+}π^{-}J/ψ, we find B(X(3872)→π^{0}χ_{c1})/B(X(3872)→π^{+}π^{-}J/ψ)=0.88_{-0.27}^{+0.33}±0.10, where the first error is statistical and the second is systematic. We set 90% confidence level upper limits on the corresponding ratios for the decays to π^{0}χ_{c0} and π^{0}χ_{c2} of 19 and 1.1, respectively.

Precision Measurement of the Branching Fractions of η^{'} Decays

Based on a sample of (1310.6±7.0)×10^{6}J/ψ events collected with the BESIII detector, we present measurements of J/ψ and η^{'} absolute branching fractions using the process J/ψ→γη^{'}. By analyzing events where the radiative photon converts into an e^{+}e^{-} pair, the branching fraction for J/ψ→γη^{'} is measured to be (5.27±0.03±0.05)×10^{-3}. The absolute branching fractions of the five dominant decay channels of the η^{'} are then measured for the first time and are determined to be B(η^{'}→γπ^{+}π^{-})=(29.90±0.03±0.55)%, B(η^{'}→ηπ^{+}π^{-})=(41.24±0.08±1.24)%, B(η^{'}→ηπ^{0}π^{0})=(21.36±0.10±0.92)%, B(η^{'}→γω)=(2.489±0.018±0.074)%, and B(η^{'}→γγ)=(2.331±0.012±0.035)%, where the first uncertainties are statistical and the second systematic.

Measurement of the Dynamics of the Decays D_{s}^{+}→η^{(')}e^{+}ν_{e}

Using e^{+}e^{-} annihilation data corresponding to an integrated luminosity of 3.19  fb^{-1} collected at a center-of-mass energy of 4.178 GeV with the BESIII detector, we measure the absolute branching fractions B_{D_{s}^{+}→ηe^{+}ν_{e}}=(2.323±0.063_{stat}±0.063_{syst})% and B_{D_{s}^{+}→η^{'}e^{+}ν_{e}}=(0.824±0.073_{stat}±0.027_{syst})% via a tagged analysis technique, where one D_{s} is fully reconstructed in a hadronic mode. Combining these measurements with previous BESIII measurements of B_{D^{+}→η^{(')}e^{+}ν_{e}}, the η-η^{'} mixing angle in the quark flavor basis is determined to be ϕ_{P}=(40.1±2.1_{stat}±0.7_{syst})°. From the first measurements of the dynamics of D_{s}^{+}→η^{(')}e^{+}ν_{e} decays, the products of the hadronic form factors f_{+}^{η^{(')}}(0) and the Cabibbo-Kobayashi-Maskawa matrix element |V_{cs}| are determined with different form factor parametrizations. For the two-parameter series expansion, the results are f_{+}^{η}(0)|V_{cs}|=0.4455±0.0053_{stat}±0.0044_{syst} and f_{+}^{η^{'}}(0)|V_{cs}|=0.477±0.049_{stat}±0.011_{syst}.

Evidence of a Resonant Structure in the e^{+}e^{-}→π^{+}D^{0}D^{*-} Cross Section between 4.05 and 4.60 GeV

The cross section of the process e^{+}e^{-}→π^{+}D^{0}D^{*-} for center-of-mass energies from 4.05 to 4.60 GeV is measured precisely using data samples collected with the BESIII detector operating at the BEPCII storage ring. Two enhancements are clearly visible in the cross section around 4.23 and 4.40 GeV. Using several models to describe the dressed cross section yields stable parameters for the first enhancement, which has a mass of 4228.6±4.1±6.3  MeV/c^{2} and a width of 77.0±6.8±6.3  MeV, where the first uncertainties are statistical and the second ones are systematic. Our resonant mass is consistent with previous observations of the Y(4220) state and the theoretical prediction of a DD[over ¯]_{1}(2420) molecule. This result is the first observation of Y(4220) associated with an open-charm final state. Fits with three resonance functions with additional Y(4260), Y(4320), Y(4360), ψ(4415), or a new resonance do not show significant contributions from either of these resonances. The second enhancement is not from a single known resonance. It could contain contributions from ψ(4415) and other resonances, and a detailed amplitude analysis is required to better understand this enhancement.

Determination of the Pseudoscalar Decay Constant f_{D_{s}^{+}} via D_{s}^{+}→μ^{+}ν_{μ}

Using a 3.19  fb^{-1} data sample collected at an e^{+}e^{-} center-of-mass energy of E_{cm}=4.178  GeV with the BESIII detector, we measure the branching fraction of the leptonic decay D_{s}^{+}→μ^{+}ν_{μ} to be B_{D_{s}^{+}→μ^{+}ν_{μ}}=(5.49±0.16_{stat}±0.15_{syst})×10^{-3}. Combining our branching fraction with the masses of the D_{s}^{+} and μ^{+} and the lifetime of the D_{s}^{+}, we determine f_{D_{s}^{+}}|V_{cs}|=246.2±3.6_{stat}±3.5_{syst}  MeV. Using the c→s quark mixing matrix element |V_{cs}| determined from a global standard model fit, we evaluate the D_{s}^{+} decay constant f_{D_{s}^{+}}=252.9±3.7_{stat}±3.6_{syst}  MeV. Alternatively, using the value of f_{D_{s}^{+}} calculated by lattice quantum chromodynamics, we find |V_{cs}|=0.985±0.014_{stat}±0.014_{syst}. These values of B_{D_{s}^{+}→μ^{+}ν_{μ}}, f_{D_{s}^{+}}|V_{cs}|, f_{D_{s}^{+}} and |V_{cs}| are each the most precise results to date.

Abstract P5-09-20: Improved patient compliance and genetic screening efficiency following implementation of an electronic pedigree survey (PROGENY)

Introduction

Patients referred for genetic counseling do not consistently complete a family history questionnaires (FHQ), which is required before scheduling a genetic counseling appointment (GCA). A paper survey has traditionally been used to collect this FHQ data. This requires the genetic counselor to manually input the patient's FHQ information into a pedigree generator prior to scheduling their GCA, thereby delaying the genetic screening process. Some genetic counseling centers have switched from using this paper survey to a web-based pedigree-generator, like PROGENY, for collecting patient's FHQ data. No literature to date has evaluated the impact of this change on patient compliance with completing the required FHQ, the genetic screening process, or patient outcomes. This study assesses changes in patient compliance and genetic screening efficiency with the implementation of PROGENY compared to traditional surveying as a means of collecting FHQ data.

Hypothesis

More patients will complete the FHQ and GCA and there will be reduced time between patient referral and completion of the FHQ and GCA with the use of PROGENY compared to the traditional paper survey.

Methods

This is a retrospective chart review of patients referred for genetic counseling six months before and after implementation of PROGENY. Independent t-tests assuming unequal variances were conducted using JMP to compare genetic screening efficiency with and without the use of PROGENY.

Results

This study found that 41% more patients completed the FHQ and 25% more patients completed a GCA when using PROGENY. Further, there was a statistically significant reduction in the time between referral and completion of the FHQ (t(311)=9.14, p<.0001) as well as the GCA (t(280)=3.04, p<.0001). Specifically, the average time for patients to complete the FHQ was 84.45 days faster with PROGENY and the time for patients to complete a GCA was 34.83 days faster with PROGENY than without PROGENY.

Conclusions

These results support our hypothesis and suggest that utilizing PROGENY in collecting patient FHQ data correlates with improved patient compliance and genetic screening efficiency. Future work should investigate how quality improvement such as this impacts patient outcomes, such as the timeliness of finding an actionable genetic mutation and detecting cancerous and precancerous lesions. Some limitations of this study include high variability. This is likely due to factors such as appointment cancellations, geneticist availability and workload, and patient age, ethnicity, gender, and socioeconomic status. Future work should assess the impact of these factors on variables such as patient compliance and efficiency of the genetic screening process.

Citation Format: Hennick TM, Khan T, Moroose R, Bisson R. Improved patient compliance and genetic screening efficiency following implementation of an electronic pedigree survey (PROGENY) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-09-20.

First Measurement of the Form Factors in D_{s}^{+}→K^{0}e^{+}ν_{e} and D_{s}^{+}→K^{*0}e^{+}ν_{e} Decays

We report on new measurements of Cabibbo-suppressed semileptonic D_{s}^{+} decays using 3.19  fb^{-1} of e^{+}e^{-} annihilation data sample collected at a center-of-mass energy of 4.178 GeV with the BESIII detector at the BEPCII collider. Our results include branching fractions B(D_{s}^{+}→K^{0}e^{+}ν_{e})=[3.25±0.38(stat)±0.16(syst)]×10^{-3} and B(D_{s}^{+}→K^{*0}e^{+}ν_{e})=[2.37±0.26(stat)±0.20(syst)]×10^{-3}, which are much improved relative to previous measurements, and the first measurements of the hadronic form-factor parameters for these decays. For D_{s}^{+}→K^{0}e^{+}ν_{e}, we obtain f_{+}(0)=0.720±0.084(stat)±0.013(syst), and for D_{s}^{+}→K^{*0}e^{+}ν_{e}, we find form-factor ratios r_{V}=V(0)/A_{1}(0)=1.67±0.34(stat)±0.16(syst) and r_{2}=A_{2}(0)/A_{1}(0)=0.77±0.28(stat)±0.07(syst).

Observation of D^{+}→f_{0}(500)e^{+}ν_{e} and Improved Measurements of D→ρe^{+}ν_{e}

Using a data sample corresponding to an integrated luminosity of 2.93  fb^{-1} recorded by the BESIII detector at a center-of-mass energy of 3.773 GeV, we present an analysis of the decays D^{0}→π^{-}π^{0}e^{+}ν_{e} and D^{+}→π^{-}π^{+}e^{+}ν_{e}. By performing a partial wave analysis, the π^{+}π^{-} S-wave contribution to D^{+}→π^{-}π^{+}e^{+}ν_{e} is observed to be (25.7±1.6±1.1)% with a statistical significance greater than 10σ, besides the dominant P-wave contribution. This is the first observation of the S-wave contribution. We measure the branching fractions B(D^{0}→ρ^{-}e^{+}ν_{e})=(1.445±0.058±0.039)×10^{-3}, B(D^{+}→ρ^{0}e^{+}ν_{e})=(1.860±0.070±0.061)×10^{-3}, and B(D^{+}→f_{0}(500)e^{+}ν_{e},f_{0}(500)→π^{+}π^{-})=(6.30±0.43±0.32)×10^{-4}. An upper limit of B(D^{+}→f_{0}(980)e^{+}ν_{e},f_{0}(980)→π^{+}π^{-})<2.8×10^{-5} is set at the 90% confidence level. We also obtain the hadronic form factor ratios of D→ρe^{+}ν_{e} at q^{2}=0 assuming the single-pole dominance parametrization: r_{V}={[V(0)]/[A_{1}(0)]}=1.695±0.083±0.051, r_{2}={[A_{2}(0)]/[A_{1}(0)]}=0.845±0.056±0.039.

Study of the D^{0}→K^{-}μ^{+}ν_{μ} Dynamics and Test of Lepton Flavor Universality with D^{0}→K^{-}ℓ^{+}ν_{ℓ} Decays

Using e^{+}e^{-} annihilation data of 2.93  fb^{-1} collected at center-of-mass energy sqrt[s]=3.773  GeV with the BESIII detector, we measure the absolute branching fraction of D^{0}→K^{-}μ^{+}ν_{μ} with significantly improved precision: B_{D^{0}→K^{-}μ^{+}ν_{μ}}=(3.413±0.019_{stat}±0.035_{syst})%. Combining with our previous measurement of B_{D^{0}→K^{-}e^{+}ν_{e}}, the ratio of the two branching fractions is determined to be B_{D^{0}→K^{-}μ^{+}ν_{μ}}/B_{D^{0}→K^{-}e^{+}ν_{e}}=0.974±0.007_{stat}±0.012_{syst}, which agrees with the theoretical expectation of lepton flavor universality within the uncertainty. A study of the ratio of the two branching fractions in different four-momentum transfer regions is also performed, and no evidence for lepton flavor universality violation is found with current statistics. Taking inputs from global fit in the standard model and lattice quantum chromodynamics separately, we determine f_{+}^{K}(0)=0.7327±0.0039_{stat}±0.0030_{syst} and |V_{cs}|=0.955±0.005_{stat}±0.004_{syst}±0.024_{LQCD}.

Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study

BACKGROUND

Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery.

METHODS

This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy.

RESULTS

Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI.

CONCLUSIONS

After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.

Purple Urine Bag Syndrome in a Patient with an Ileal Conduit and Clostridium Difficile Infection

Purple urine bag syndrome is a potentially alarming phenomenon caused by bacterial metabolism of urinary tryptophan into indigo (blue) and indirubin (red) pigments. We report the case of a 46-year-old female with an ileal conduit who presented with a 2 week history of abdominal pain and purple discolouration of her urine. In addition, we review the literature on purple urine bag syndrome, and identify potential new risk factors and management considerations.

Measurement of the Absolute Branching Fraction of the Inclusive Semileptonic Λ_{c}^{+} Decay

Using a data sample of e^{+}e^{-} collisions corresponding to an integrated luminosity of 567  pb^{-1} collected at a center-of-mass energy of sqrt[s]=4.6  GeV with the BESIII detector, we measure the absolute branching fraction of the inclusive semileptonic Λ_{c}^{+} decay with a double-tag method. We obtain B(Λ_{c}^{+}→Xe^{+}ν_{e})=(3.95±0.34±0.09)%, where the first uncertainty is statistical and the second systematic. Using the known Λ_{c}^{+} lifetime and the charge-averaged semileptonic decay width of nonstrange charmed mesons (D^{0} and D^{+}), we obtain the ratio of the inclusive semileptonic decay widths Γ(Λ_{c}^{+}→Xe^{+}ν_{e})/Γ[over ¯](D→Xe^{+}ν_{e})=1.26±0.12.

Measurement of the Branching Fraction For the Semileptonic Decay D^{0(+)}→π^{-(0)}μ^{+}ν_{μ} and Test of Lepton Flavor Universality

Using a data sample corresponding to an integrated luminosity of 2.93  fb^{-1} taken at a center-of-mass energy of 3.773 GeV with the BESIII detector operated at the BEPCII collider, we perform an analysis of the semileptonic decays D^{0(+)}→π^{-(0)}μ^{+}ν_{μ}. The branching fractions of D^{0}→π^{-}μ^{+}ν_{μ} and D^{+}→π^{0}μ^{+}ν_{μ} are measured to be (0.272±0.008_{stat}±0.006_{syst})% and (0.350±0.011_{stat}±0.010_{syst})%, respectively, where the former is of much improved precision compared to previous results and the latter is determined for the first time. Using these results along with previous BESIII measurements of D^{0(+)}→π^{-(0)}e^{+}ν_{e}, we calculate the branching fraction ratios to be R^{0}≡B_{D^{0}→π^{-}μ^{+}ν_{μ}}/B_{D^{0}→π^{-}e^{+}ν_{e}}=0.922±0.030_{stat}±0.022_{syst} and R^{+}≡B_{D^{+}→π^{0}μ^{+}ν_{μ}}/B_{D^{+}→π^{0}e^{+}ν_{e}}=0.964±0.037_{stat}±0.026_{syst}, which are compatible with the theoretical expectation of lepton flavor universality within 1.7σ and 0.5σ, respectively. We also examine the branching fraction ratios in different four-momentum transfer square regions, and find no significant deviations from the standard model predictions.