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89 Two Newly Developed Frontiers CTSI Applications to Support Recruitment and Trial Management: The Frontiers Trial Finder Mobile App and a Predictive Accrual Web-based App 89两款新开发的支持招募和试验管理的Frontiers CTSI应用程序:Frontiers Trial Finder 移动应用程序和基于网络的 Predictive Accrual 应用程序
Pub Date : 2024-04-01 DOI: 10.1017/cts.2024.87
Hanluen Kuo, Vinay Murakonda, Hunter Hines, D. Mudaranthakam, Paula Monaghan-Nichols, Eric Rush, Jeffrey Statland
OBJECTIVES/GOALS: Frontiers CTSI developed applications to ensure its science teams have technological tools to advance their community engagement and trial management. The Trial Finder app is a mobile application that allows users to navigate available trials. The Accrual app will help study teams monitor their recruitment performances in real time. METHODS/STUDY POPULATION: The Data Science team at the University of Kansas Medical Center (KUMC) had previously developed similar applications for The University of Kansas Cancer Center. Both retrieve information from KUMC’s clinical trial management system and ClinicalTrials.gov. This was replicated to include KUMC Pulmonary Critical Care (PCC) and KUMC Neuromuscular (NM) trials. Frontiers CTSI is working with both groups for piloting and feedback. Recruiting and marketing strategies for investigators to add their trials to both apps will be done through existing communication channels and be highlighted on Frontiers trial resource website. Recruiting and marketing strategies of the Frontiers Trial Finder app to the external community will have a focus on, but not limited to, paid social media advertising. RESULTS/ANTICIPATED RESULTS: The Trial Finder app can help providers search for trials their patient may be eligible for during clinic visits and to engage with the community by allowing anyone to download and browse on their Android/iOS device. Built in REDCap forms are used to capture contact information. The Accrual app is a web-based application that helps study teams monitor their recruitment performances in real time and provide an opportunity to adjust strategies. It uses an in-house algorithm to predict if trials will meet timeline goals. This data is conveniently laid out on a single web page so that science teams can overview all their trials’ recruitment performances simultaneously. The next phase of developing these applications is to market their use within Frontiers CTSI and its community catchment area. DISCUSSION/SIGNIFICANCE: Through collaboration, Frontiers CTSI is developing resources to support community engagement and trial management. New innovative applications like these ensure all the main stakeholders involved with clinical trial execution are always engaged and have access to iterative contemporary technologies that support their research.
目的/目标:前沿科学与技术研究所(Frontiers CTSI)开发了应用程序,以确保其科学团队拥有技术工具来推动社区参与和试验管理。试验搜索器 "应用程序是一款移动应用程序,用户可以通过它浏览可用的试验。Accrual 应用程序将帮助研究团队实时监控招募情况。方法/研究对象:堪萨斯大学医学中心(KUMC)的数据科学团队此前曾为堪萨斯大学癌症中心开发过类似的应用程序。这两个应用程序都从 KUMC 的临床试验管理系统和 ClinicalTrials.gov 中检索信息。该应用被复制到 KUMC 肺重症监护 (PCC) 和 KUMC 神经肌肉 (NM) 试验中。前沿科学与技术研究所正与这两个小组合作进行试点和反馈。将通过现有的沟通渠道为研究者在这两个应用程序中添加试验制定招募和营销策略,并在前沿试验资源网站上重点介绍。面向外部社区的 Frontiers Trial Finder 应用程序的招募和营销策略将侧重于但不限于付费社交媒体广告。结果/预期结果:"试验搜索器 "应用程序可帮助医疗服务提供者在病人就诊时搜索其可能符合条件的试验,并通过允许任何人在其安卓/iOS设备上下载和浏览来与社区互动。内置的 REDCap 表单可用于获取联系信息。Accrual 应用程序是一款基于网络的应用程序,可帮助研究团队实时监控招募情况,并提供调整策略的机会。它使用内部算法来预测试验是否能达到时间表目标。这些数据会方便地显示在一个网页上,这样科研团队就可以同时查看所有试验的招募情况。开发这些应用程序的下一阶段是在前沿科学与技术研究所及其社区范围内推广使用。讨论/意义:通过合作,前沿科学与技术中心正在开发支持社区参与和试验管理的资源。像这样的新型创新应用可确保参与临床试验执行的所有主要利益相关者始终参与其中,并获得支持其研究的当代迭代技术。
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引用次数: 0
276 Full Spectrum Town Hall Meetings - Advancing Clinician-Patient-Researcher Engagement for Hidradenitis Suppurativa (HS) 276 全光谱全体会议--推进临床医生-患者-研究人员对扁平苔藓(HS)的参与
Pub Date : 2024-04-01 DOI: 10.1017/cts.2024.252
Rhonda Kost, Anuradha Hashemi-Arend, Athena Gierbolini, Melissa Samanoglu, PaMalick Mbye, Fahim Shahriar, John Frew, Michelle Lowes
OBJECTIVES/GOALS: Full Spectrum Town Halls (FSTH) were organized to bring together patients, scientists, clinicians, advocates and others interested in Hidradenitis Suppurative (HS) – stakeholders across the spectrum of translational research – to infuse patient experiences and voices into designing HS research METHODS/STUDY POPULATION: The Rockefeller University (RU), Clinical Directors Network (CDN), and the HS Foundation organized three hybrid in-person/online HS FSTHs (2018-2023). The 2018 event focused on patients, describing the current state of HS knowledge and new research into HS biology (T2, T3). Patients shared lived experiences in testimonials and a panel discussion. Advocates described community and mental health resources (T4). The 2021 event returned research results (T2, T3) to the community and updates about treatments in the pipeline (T4). The 2023 FSTH targeted clinicians (T4) addressing a critical translational gap in HS care and presenting best practices in diagnosis, surgical, and medical treatments. RESULTS/ANTICIPATED RESULTS: Impact on science: FSTH attendees joined a Community Engagement Studio providing feedback used to refine study variables/procedures. Attendees joined research studies that advanced understanding HS mechanisms of disease, clinical course and treatment.Impact on patient experience: Participants appreciated having a forum to hear/share experiences of shame, mistrust, misdiagnosis and hope. Feedback improved practices for privacy, consenting, and returning study results. Impact on clinical practice and care: FSTH raised awareness of stigma, need for respect and empathy, and advanced learning about in disease mechanisms, effective biologics, importance of epithelial tunnels and surgical care. DISCUSSION/SIGNIFICANCE: HS is a stigmatizing, poorly understood disease. FSTHs fostered bidirectional learning among scientists, clinicians, patients and other stakeholders. Patients engaged with researchers to improve research design and participate in mechanistic and therapeutic clinical research, advancing the field.
目的/目标:组织全光谱大会(FSTH)是为了将患者、科学家、临床医生、倡导者和其他对化脓性扁桃体炎(HS)感兴趣的人--转化研究领域的利益相关者--聚集在一起,将患者的经验和声音注入到HS研究的设计中 方法/研究人群:洛克菲勒大学(RU)、临床主任网络(CDN)和HS基金会组织了三次面授/在线混合式HS全光谱大会(2018-2023年)。2018 年的活动以患者为重点,介绍了房颤知识的现状和房颤生物学的新研究(T2、T3)。患者在证言和小组讨论中分享了生活经验。倡导者介绍了社区和心理健康资源(T4)。2021 年的活动向社区回馈了研究成果(T2、T3)和正在研发中的最新治疗方法(T4)。2023 年的 FSTH 以临床医生为目标(T4),旨在解决协和医院护理方面的关键转化差距,并介绍诊断、手术和药物治疗方面的最佳实践。结果/预期结果:对科学的影响:FSTH 与会者参加了社区参与工作室,提供了用于完善研究变量/程序的反馈意见。与会者参与的研究加深了对 HS 疾病机理、临床过程和治疗的了解:参与者非常感谢有这样一个论坛来倾听/分享羞愧、不信任、误诊和希望的经历。反馈意见改善了有关隐私、同意和返回研究结果的做法。对临床实践和护理的影响:FSTH 提高了人们对耻辱感、尊重和同情的必要性的认识,并促进了对疾病机制、有效生物制剂、上皮隧道重要性和手术护理的学习。讨论/意义:HS 是一种令人耻辱、鲜为人知的疾病。FSTHs 促进了科学家、临床医生、患者和其他利益相关者之间的双向学习。患者与研究人员一起改进研究设计,参与机理和治疗性临床研究,推动了该领域的发展。
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引用次数: 0
531 Transforming a Pilot Grant Program to Advance Clinical & Translational Science 531 改革试点补助金计划,推动临床和转化科学发展
Pub Date : 2024-04-01 DOI: 10.1017/cts.2024.453
Beth LaPensee, Mark Cantrell, Lisa Ahrens, Brad Downey, Elias Samuels, Emily Somers
OBJECTIVES/GOALS: A new mandate for Clinical & Translational Science Award (CTSA) Programs is for pilot grant funding to support clinical and translational science (CTS) projects that study challenges in the translational research pipeline. This pivot requires new structures and supports to help investigators design and implement high-quality CTS projects. METHODS/STUDY POPULATION: The Michigan Institute for Clinical & Health Research (MICHR) at the University of Michigan (U-M) has launched two rounds of pilot funding since March 2023. Faculty and staff across U-M’s three campuses, community members, and those at collaborating institutions and hospitals were eligible to apply. New pre-award supports included a CTS project framework; a recorded webinar that educated about CTS and the funding opportunity; office hours to provide tailored project feedback; a letter of intent to screen for alignment with CTS; and reviewer training for academic and community reviewers. Funded projects operate like 'mini cooperative agreements”, with MICHR experts partnering with awardees to refine evaluation plans, prepare work products, advise on dissemination, and navigate emergent challenges. RESULTS/ANTICIPATED RESULTS: The first round of funding was launched in the absence of pre-award supports; ten applications we received from faculty proposing translational research rather than CTS. We quickly re-released the FOA, expanding eligibility to staff. We received nine applications, ultimately funding four staff and one faculty studying operational challenges in translation and helping them create robust evaluation plans. We piloted the pre-award supports in our second round, with 40 individuals viewing our webinar and 11 attending office hours. Those who watched the webinar before attending office hours better understood how to embed CTS questions within their programs of research. We recently received 19 letters of intent, addressing both operational and scientific challenges, with 16 eligible to submit applications. DISCUSSION/SIGNIFICANCE: Education and personalized feedback seem to elicit a higher yield of CTS projects. Staff are already adept at solving operational challenges, so the pre-award supports were most critical for faculty accustomed to writing traditional translational research proposals. Staff have most benefited from guidance in evaluation and dissemination.
目的/目标:临床与转化科学奖(CTSA)计划的一项新任务是提供试验性拨款,以支持研究转化研究渠道中的挑战的临床与转化科学(CTS)项目。这一转折需要新的结构和支持,以帮助研究人员设计和实施高质量的 CTS 项目。方法/研究对象:密歇根大学(U-M)密歇根临床与健康研究所(MICHR)自 2023 年 3 月起启动了两轮试点资助。密歇根大学三个校区的教职员工、社区成员以及合作机构和医院的人员均有资格申请。新的授标前支持包括 CTS 项目框架、介绍 CTS 和资助机会的录制网络研讨会、提供量身定制的项目反馈的办公时间、筛选是否与 CTS 相符的意向书,以及针对学术和社区评审人员的评审员培训。受资助项目的运作方式类似于 "小型合作协议",由 MICHR 专家与获奖者合作,完善评估计划、准备工作产品、就传播问题提供建议,并应对新出现的挑战。结果/预期结果:第一轮资助是在没有授标前支持的情况下启动的;我们从提出转化研究而非 CTS 的教师那里收到了 10 份申请。我们很快重新发布了 FOA,将申请资格扩大到教职员工。我们收到了 9 份申请,最终资助了 4 名工作人员和 1 名教职员工研究转化过程中的业务挑战,并帮助他们制定强有力的评估计划。我们在第二轮中试行了奖前支持,有 40 人观看了我们的网络研讨会,11 人参加了办公时间。那些在参加办公时间之前观看了网络研讨会的人员更好地理解了如何将 CTS 问题纳入其研究计划。我们最近收到了 19 份意向书,涉及业务和科学挑战,其中 16 份符合提交申请的条件。讨论/意义:教育和个性化反馈似乎能提高 CTS 项目的成果。教职员工已经善于解决操作方面的挑战,因此,对于习惯于撰写传统转化研究提案的教职员工来说,授标前支持最为关键。工作人员从评估和传播方面的指导中获益最多。
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引用次数: 0
482 Improvement of health outcomes and quality of life of Hispanic older adults in Puerto Rico through participation in a Physical Activity (PA) Community-based Program 482 通过参加体育活动(PA)社区计划改善波多黎各西班牙裔老年人的健康状况和生活质量
Pub Date : 2024-04-01 DOI: 10.1017/cts.2024.408
Felix J. Roman - Hernandez, Maria Danet Lapiz - Bluhm, Abdiel Gomez – Santos, Wilnelys M. Montalvo – Caraballo
OBJECTIVES/GOALS: The proposed study aims to improve physical and mental health outcomes among Hispanic older adults who live alone in a low-income San Juan, Puerto Rico community through weekly PA groups. Specific outcomes include measures of loneliness, social isolation, depression, physical mobility, metabolic indicators, and other health indicators. METHODS/STUDY POPULATION: Data will be collected at three time points: Pre (Week 1), Mid (Week 6), and Post (Week 12) intervention. Currently, the community has 50 residents over 65 years old who live under the poverty index and receive multiple social benefits. Various tools will be implemented to measure loneliness (University of California Los Angeles – Loneliness Scale-10 items), social isolation (Lubben Social Network Scale-6 items), depression (Geriatric Depression Scale-10 items), physical mobility (Time Up and Go Test), metabolic health indicators (hemoglobin A1c and glucose) and other health indicators (i.e., blood pressure, cholesterol, as well as body mass index (BMI)). These measurements will determine if participation in PA groups is associated with improvement of the variables measured. RESULTS/ANTICIPATED RESULTS: It is expected that the baseline scores of older Hispanic adults in terms of loneliness, social isolation, depression, physical mobility, metabolic indicators (i.e., cholesterol level and hemoglobin A1c), and other health indicators (blood pressure or BP and BMI) will be lower compared to those after participation in the Physical Activity Program. More frequent participation will be associated with more significant improvement in measured variables. DISCUSSION/SIGNIFICANCE: Results from this study will determine the effectiveness of community-based PA interventions in addressing loneliness, social isolation, depression, physical mobility, and metabolic factors (hemoglobin A1c and glucose) in elderly minority Hispanic populations as a means of improving their health outcomes and quality of life.
目的/目标:拟议的研究旨在通过每周一次的 PA 小组活动,改善波多黎各圣胡安低收入社区独居西班牙裔老年人的身心健康状况。具体结果包括孤独感、社会隔离、抑郁、身体活动能力、新陈代谢指标和其他健康指标。方法/研究对象:将在三个时间点收集数据:干预前(第 1 周)、干预中(第 6 周)和干预后(第 12 周)。目前,该社区有 50 名 65 岁以上的居民,他们生活在贫困线以下,享受多种社会福利。将采用各种工具来测量孤独感(加州大学洛杉矶分校--孤独感量表--10 个项目)、社会隔离(卢本社会网络量表--6 个项目)、抑郁(老年抑郁量表--10 个项目)、身体活动能力(起立和行走时间测试)、代谢健康指标(血红蛋白 A1c 和血糖)以及其他健康指标(即血压、胆固醇以及体重指数 (BMI))。这些测量结果将确定参加体育锻炼小组是否与所测变量的改善有关。结果/预期结果:预计西班牙裔老年人在孤独感、社会隔离、抑郁、身体活动能力、代谢指标(即胆固醇水平和血红蛋白 A1c)以及其他健康指标(血压或 BP 和体重指数)方面的基线分数将低于参加体育锻炼计划后的分数。参与次数越多,测量变量的改善越明显。讨论/意义:本研究的结果将确定社区体育锻炼干预在解决西班牙裔少数民族老年人孤独、社会隔离、抑郁、身体活动能力和代谢因素(血红蛋白 A1c 和血糖)方面的有效性,从而改善他们的健康状况和生活质量。
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引用次数: 0
122 Evaluating the impact of the Translational Research Program at the University of Toronto 122 评估多伦多大学转化研究计划的影响
Pub Date : 2024-04-01 DOI: 10.1017/cts.2024.119
S. Neumark, Janine Noorloos, Joseph Ferenbok
OBJECTIVES/GOALS: There is a need to develop a workforce of translational research professionals with the skills to innovate, mobilize, and commercialize research for unmet needs in the Canadian health system. The objective of this study is to evaluate the impact and value of the master’s degree on the Translational Research Program (TRP) alumni. METHODS/STUDY POPULATION: This study will use a cross-sectional approach and an electronic survey will be administered to alumni. The TRP was established in 2015 and has graduated over 150 students since its inception. Participants will be recruited through convenience sampling via email, social media platforms, and personal communication. Eligible participants must have a conferred Master of Health Science in Translational Research from the University of Toronto. All collected data will remain anonymous and include demographic information about graduation year, race, ethnicity, gender, and employment status. Descriptive statistics will be used to analyze and report the findings. RESULTS/ANTICIPATED RESULTS: The results of this survey will be used to evaluate how the TRP graduate degree helps alumni contribute to healthcare, learn to think differently, and establish their professional networks. The findings will also be used to inform curriculum improvements, enhance competency-based assessments, and understand demographic differences in student cohorts to promote equity, diversity, and inclusion. Investigating the perspectives of alumni reflecting on their degree will support validating the program’s objectives and advance the integration of translational science principles in the healthcare workforce and community. DISCUSSION/SIGNIFICANCE: This research addresses the need to evaluate health sciences education to ensure the program’s novel pedagogical approaches are equipping the next generation of health professionals with the skills to accelerate the transformation of discoveries into interventions that benefit human health, improve clinical medicine, and enhance patient care.
目的/目标:需要培养一支具备创新、动员和商业化研究技能的转化研究专业人员队伍,以满足加拿大卫生系统的未满足需求。本研究旨在评估硕士学位对转化研究计划(TRP)校友的影响和价值。方法/研究对象:本研究将采用横断面方法,对校友进行电子调查。TRP 成立于 2015 年,自成立以来已有 150 多名学生毕业。我们将通过电子邮件、社交媒体平台和个人通信等便利抽样方式招募参与者。符合条件的参与者必须获得多伦多大学转化研究健康科学硕士学位。所有收集到的数据将保持匿名,包括毕业年份、种族、民族、性别和就业状况等人口统计学信息。描述性统计将用于分析和报告研究结果。结果/预期结果:本次调查的结果将用于评估 TRP 研究生学位如何帮助校友为医疗保健事业做出贡献、学会换位思考并建立自己的职业网络。调查结果还将用于改进课程、加强基于能力的评估,以及了解学生群体的人口统计差异,以促进公平、多样性和包容性。调查校友对其学位的反思将有助于验证该计划的目标,并推动转化科学原则在医疗保健队伍和社区中的整合。讨论/意义:这项研究满足了对健康科学教育进行评估的需要,以确保该计划的新颖教学方法能够使下一代卫生专业人员掌握技能,加快将发现转化为干预措施,从而造福人类健康、改善临床医学和加强病人护理。
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引用次数: 0
323 Applying MeSH Tree Structures and Condition-to-MeSH Mapping to Catalog and Characterize Clinical Trials Research Focus Areas 323 应用 MeSH 树状结构和条件到 MeSH 映射来编目和描述临床试验研究重点领域
Pub Date : 2024-04-01 DOI: 10.1017/cts.2024.293
Winfred Wu, Trevor Yuen, Sakshi Mittal, Rosalina Das, Sheela Dominguez, D. Ransford, Micky Simwenyi
OBJECTIVES/GOALS: Characterizing and analyzing research studies presents several challenges given the various ways studies may be labeled or organized. The Medical Subject Headings (MeSH) thesaurus is a hierarchical vocabulary that can index and organize research foci using common business intelligence tools to enable rapid exploration of research portfolios. METHODS/STUDY POPULATION: Metadata from ClinicalTrials.gov on 455,437 trials were downloaded and all MeSH terms associated with trials in the condition_browse section were loaded into a database. The corresponding MeSH trees for each term were then identified and mapped to their ancestor terms within the tree. Trials were then indexed based on top four hierarchical levels for each associated MeSH term. Trials performed at the University of Miami (UM) were identified based on locations associated with the trial as well as matching National Clinical Trial (NCT) numbers identified from internal research administration systems. Business intelligence software (Microsoft PowerBI) was applied to the corresponding dataset to enable end user exploration and analysis of the trials within ClinicalTrials.gov. RESULTS/ANTICIPATED RESULTS: A total of 3,271 studies associated with UM were identified, of which, 3,054 (93.3%) had at least one condition MeSH term linked. A total of 7,711 MeSH terms were associated with the trials overall, representing 1,112 unique MeSH terms; the most common terms were carcinoma (164), lymphoma (155), HIV Infections (139), neoplasms (136), and leukemia (122). Utilizing MeSH hierarchy, trials were characterized were categorized into 36 different trees. The most common top tree nodes were neoplasms (1,181), followed by pathological conditions/signs and symptoms (913), immune system diseases (574), nervous system diseases (513), and digestive system diseases (483). Within trees, a total of 184, 681, and 1057 different MeSH terms were specified at the second, third, and fourth nodes in the hierarchy respectively. DISCUSSION/SIGNIFICANCE: Utilizing existing metadata from trials posted on ClinicalTrials.gov and MeSH tree structures can enable organizations to readily explore the foci of clinical trials research. High rates of MeSH term association to research study conditions are necessary to ensure adequate representation of research foci.
目标/目的:由于研究的标注或组织方式多种多样,对研究进行定性和分析面临着诸多挑战。医学主题词表(MeSH)是一个分层词汇表,可以使用常见的商业智能工具对研究重点进行索引和组织,从而实现对研究组合的快速探索。方法/研究对象:从 ClinicalTrials.gov 中下载了 455,437 项试验的元数据,并将条件浏览部分中与试验相关的所有 MeSH 术语加载到数据库中。然后确定每个术语对应的 MeSH 树,并将其映射到树中的祖先术语。然后根据每个相关 MeSH 术语的前四个层次对试验进行索引。迈阿密大学(UM)进行的试验是根据与试验相关的地点以及从内部研究管理系统中确定的匹配的国家临床试验(NCT)编号确定的。将商业智能软件(Microsoft PowerBI)应用于相应的数据集,以便最终用户在 ClinicalTrials.gov 中探索和分析试验。结果/预期结果:共发现 3,271 项与 UM 相关的研究,其中 3,054 项(93.3%)至少与一个条件 MeSH 术语相关联。共有 7,711 个 MeSH 术语与试验相关联,代表 1,112 个独特的 MeSH 术语;最常见的术语是癌症(164 个)、淋巴瘤(155 个)、HIV 感染(139 个)、肿瘤(136 个)和白血病(122 个)。利用 MeSH 层次结构,将试验特征分为 36 个不同的树。最常见的顶级树节点是肿瘤(1,181 个),其次是病理条件/体征和症状(913 个)、免疫系统疾病(574 个)、神经系统疾病(513 个)和消化系统疾病(483 个)。在树状结构中,第二、第三和第四节点分别指定了 184、681 和 1057 个不同的 MeSH 术语。讨论/意义:利用临床试验网(ClinicalTrials.gov)上发布的现有试验元数据和 MeSH 树状结构,可以让机构随时探索临床试验研究的重点。为确保充分反映研究重点,有必要提高 MeSH 术语与研究条件的关联率。
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引用次数: 0
432 Ligament Engagement and In-Situ Force During Multiplanar Loading of the Medial Knee Ligaments 432 膝关节内侧韧带多平面加载时的韧带参与和原位力
Pub Date : 2024-04-01 DOI: 10.1017/cts.2024.374
Andrew Pechstein, Paul J. Christos, C. Imhauser
OBJECTIVES/GOALS: Load sharing across the arc of knee flexion of the medial knee ligaments (MKLs) is not well understood. The goal of this research is to characterize ligament engagement and in-situ force within the deep and superficial medial collateral ligament (dMCL, sMCL) and the posterior oblique ligament (POL) in response to externally applied multiplanar loads. METHODS/STUDY POPULATION: Ten human cadaveric knees, 5 male and 5 female, age 32±7 (25-42) [mean±SD (range min-max)] years, were mounted to a force sensor and a 6-degree-of-freedom robotic arm. Knee kinematics, before and after serial dissection of the sMCL, dMCL, and POL, were recorded from 0-30 degrees during applied isolated external rotation, valgus angulation, and anterior tibial moments, and the force (Newtons, N) borne by each structure was measured via the principle of superposition. Loads in the dMCL, sMCL, and POL will be compared across each knee and at each flexion angle with paired t-tests and repeated-measures analysis of variance with Tukey post hoc testing. Ten knees will provide >99% power to detect differences of 5N ± 3% at p=0.05, which is considered the threshold for clinically meaningful force differences. RESULTS/ANTICIPATED RESULTS: Our anticipated results include characterization of the means and standard deviations of the in-situ forces within the dMCL, sMCL, and POL in response to externally applied valgus angulation, tibial external rotation, and anterior-directed tibial loading at 0, 15, and 30 degrees of knee flexion. Our statistical analysis will determine if there are clinically meaningful differences (5N ± 3%) in the loads within each ligament at different knee flexion angles and will also provide data regarding differential relative ligament engagement for each applied force scenario, which is an indication of the percentage of contribution that each structure contributes to knee stability during application of forces and torques to the knee. DISCUSSION/SIGNIFICANCE: Data on ligament engagement and in-situ forces will help clinicians better diagnose potentially injured ligaments when they observe pathological knee laxity in an injured patient. Our results will also inform future computer modeling studies on injury mechanisms, individual anatomical variability, and surgical planning.
目的/目标:膝关节内侧韧带(MKL)在膝关节屈曲弧线上的负荷分担情况尚不十分清楚。本研究的目的是描述膝关节内侧副韧带深层和浅层(dMCL、sMCL)以及后斜韧带(POL)在外部施加多平面负荷时的韧带啮合和原位力。方法/研究对象:将 10 个人类尸体膝关节(5 男 5 女,年龄 32±7 (25-42) [平均±SD(范围最小-最大)]岁)安装到力传感器和 6 自由度机械臂上。在对 sMCL、dMCL 和 POL 进行连续解剖之前和之后,在施加孤立外旋、外翻角度和胫骨前力矩时记录 0-30 度的膝关节运动学数据,并通过叠加原理测量每个结构所承受的力(牛顿,N)。将通过配对 t 检验和重复测量方差分析以及 Tukey 后检验,对每个膝关节和每个屈曲角度下的 dMCL、sMCL 和 POL 负荷进行比较。在 p=0.05 的条件下,十个膝关节将提供大于 99% 的力量来检测 5N ± 3% 的差异,这被认为是具有临床意义的力量差异的临界值。结果/预期结果:我们的预期结果包括在膝关节屈曲 0、15 和 30 度时,dMCL、sMCL 和 POL 对外加外翻角度、胫骨外旋和胫骨前向加载的原位力的平均值和标准偏差的特征。我们的统计分析将确定在不同膝关节屈曲角度下,每条韧带内的负荷是否存在有临床意义的差异(5N ± 3%),还将提供每种外力情况下不同韧带相对参与度的数据,这表明在膝关节受力和受扭时,每种结构对膝关节稳定性的贡献百分比。讨论/意义:有关韧带啮合和原位力的数据将帮助临床医生在观察到受伤患者膝关节病理性松弛时更好地诊断潜在的韧带损伤。我们的研究结果还将为未来有关损伤机制、个体解剖变异和手术规划的计算机建模研究提供参考。
{"title":"432 Ligament Engagement and In-Situ Force During Multiplanar Loading of the Medial Knee Ligaments","authors":"Andrew Pechstein, Paul J. Christos, C. Imhauser","doi":"10.1017/cts.2024.374","DOIUrl":"https://doi.org/10.1017/cts.2024.374","url":null,"abstract":"OBJECTIVES/GOALS: Load sharing across the arc of knee flexion of the medial knee ligaments (MKLs) is not well understood. The goal of this research is to characterize ligament engagement and in-situ force within the deep and superficial medial collateral ligament (dMCL, sMCL) and the posterior oblique ligament (POL) in response to externally applied multiplanar loads. METHODS/STUDY POPULATION: Ten human cadaveric knees, 5 male and 5 female, age 32±7 (25-42) [mean±SD (range min-max)] years, were mounted to a force sensor and a 6-degree-of-freedom robotic arm. Knee kinematics, before and after serial dissection of the sMCL, dMCL, and POL, were recorded from 0-30 degrees during applied isolated external rotation, valgus angulation, and anterior tibial moments, and the force (Newtons, N) borne by each structure was measured via the principle of superposition. Loads in the dMCL, sMCL, and POL will be compared across each knee and at each flexion angle with paired t-tests and repeated-measures analysis of variance with Tukey post hoc testing. Ten knees will provide >99% power to detect differences of 5N ± 3% at p=0.05, which is considered the threshold for clinically meaningful force differences. RESULTS/ANTICIPATED RESULTS: Our anticipated results include characterization of the means and standard deviations of the in-situ forces within the dMCL, sMCL, and POL in response to externally applied valgus angulation, tibial external rotation, and anterior-directed tibial loading at 0, 15, and 30 degrees of knee flexion. Our statistical analysis will determine if there are clinically meaningful differences (5N ± 3%) in the loads within each ligament at different knee flexion angles and will also provide data regarding differential relative ligament engagement for each applied force scenario, which is an indication of the percentage of contribution that each structure contributes to knee stability during application of forces and torques to the knee. DISCUSSION/SIGNIFICANCE: Data on ligament engagement and in-situ forces will help clinicians better diagnose potentially injured ligaments when they observe pathological knee laxity in an injured patient. Our results will also inform future computer modeling studies on injury mechanisms, individual anatomical variability, and surgical planning.","PeriodicalId":508693,"journal":{"name":"Journal of Clinical and Translational Science","volume":"381 1","pages":"129 - 129"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140758196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
197 Evaluating Disparities in Management of Solid Organ Injury in Children Treated at Pediatric vs. Adult Trauma Centers 197 评估在儿科与成人创伤中心接受治疗的儿童在实体器官损伤管理方面的差异
Pub Date : 2024-04-01 DOI: 10.1017/cts.2024.188
Carrinton A Mauney, Charbel Chidiac, Mark Slidell
OBJECTIVES/GOALS: Non-operative management is preferred for pediatric solid organ injury (SOI). Despite this children treated at adult trauma centers (ATC) are more likely to be treated surgically and have worse outcomes than those treated at pediatric trauma centers (PTC). We hypothesize there are disparities by sex and race in management of pediatric SOI at ATC vs PTC. METHODS/STUDY POPULATION: Retrospective review of the National Trauma Data Bank (NTDB) from 2010-2018 was conducted. Inclusion criteria were age£18 and injury to spleen, liver or kidney. Outcomes at American College of Surgeons accredited ATC, PTC, and combined ATC/PTC trauma centers were evaluated. The primary outcome was operative management. Secondary outcomes include length of stay, and in-hospital complications. Multivariate logistical regression adjusting for race, sex, and insurance type will be performed. RESULTS/ANTICIPATED RESULTS: 40,111 children were treated for SOI from 2010-2018. 39.3% were treated at an ATC and 26.4% at a PTC. Of children treated at an ATC, 62% were White, 17% were Black, and 1% were Asian. Children treated at the PTC were 60% White, 20% Black, and 0.9% Asian. Primary insurance type was Medicaid for 33% of patients at an ATC and 39% at PTC. Median length of stay at ATC and PTC was 4 days (2-7) and 3 days (2-6) respectively. 3.85% of patients at ATC underwent splenectomy compared to 0.8% at PTC. It is anticipated that further analysis will demonstrate that ICU admission, transfusion, embolectomy, and other operative interventions will be more prevalent at ATC than MTC. Moreover, we anticipate that multivariate logistical regression will show the odds of receiving operative management at each center differ by race, sex and insurance type. DISCUSSION/SIGNIFICANCE: Initial analysis of the NTDB from 2010-2018 shows that children treated for SOI at ATC receive operative interventions more often than those treated at PTC. Elucidating disparities in SOI care is an important step towards minimizing the impact of these disparities and better allocating resources such that they may be eliminated.
目的/目标:小儿实体器官损伤(SOI)首选非手术治疗。尽管如此,与在儿科创伤中心(PTC)接受治疗的儿童相比,在成人创伤中心(ATC)接受治疗的儿童更有可能接受手术治疗,且治疗效果更差。我们假设,在 ATC 与 PTC 对小儿 SOI 的管理中,存在性别和种族差异。方法/研究人群:我们对 2010-2018 年的国家创伤数据库(NTDB)进行了回顾性研究。纳入标准为年龄18岁以下,脾脏、肝脏或肾脏受伤。对美国外科学院认可的 ATC、PTC 和 ATC/PTC 合并创伤中心的结果进行了评估。主要结果是手术治疗。次要结果包括住院时间和院内并发症。将对种族、性别和保险类型进行多变量逻辑回归调整。结果/预期结果:2010-2018年间,有40111名儿童接受了SOI治疗。39.3%在ATC接受治疗,26.4%在PTC接受治疗。在ATC接受治疗的儿童中,62%为白人,17%为黑人,1%为亚裔。在 PTC 接受治疗的儿童中,白人占 60%,黑人占 20%,亚裔占 0.9%。33% 的 ATC 患者和 39% 的 PTC 患者的主要保险类型是医疗补助(Medicaid)。ATC 和 PTC 的中位住院时间分别为 4 天(2-7 天)和 3 天(2-6 天)。ATC 有 3.85% 的患者接受了脾脏切除术,而 PTC 仅有 0.8%。预计进一步的分析将表明,与 MTC 相比,ATC 患者入住 ICU、输血、栓子切除术和其他手术干预的发生率更高。此外,我们预计多变量统计回归将显示,在每个中心接受手术治疗的几率因种族、性别和保险类型而异。讨论/意义:对 2010-2018 年 NTDB 的初步分析表明,在 ATC 接受 SOI 治疗的儿童比在 PTC 接受治疗的儿童更常接受手术干预。阐明 SOI 治疗中的差异是将这些差异的影响降至最低并更好地分配资源以消除这些差异的重要一步。
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引用次数: 0
357 Effects of Dietary Nitrate Supplementation on Vascular Function in Individuals with Prediabetes 357 膳食硝酸盐补充剂对糖尿病前期患者血管功能的影响
Pub Date : 2024-04-01 DOI: 10.1017/cts.2024.319
Ryan Staples, Andrew DeMarco, Peter Turkeltaub
OBJECTIVES/GOALS: Impaired vascular function, a subclinical marker of cardiovascular disease, has been identified in prediabetes. Dietary nitrate supplementation has been shown to improve vascular function. However, this has not been studied in prediabetes. The purpose was to determine the effects of dietary nitrate on vascular function in prediabetes. METHODS/STUDY POPULATION: Five individuals with prediabetes (4 men, 1 woman; 55 ± 17 yr; HbA1c = 5.8 ± 0.2) participated in a double-blind, placebo-controlled, repeated measures study. Participants were randomly assigned to a 3-day nitrate supplementation (nitrate-rich beetroot juice, 12.9 mmol, 140 mL), or a placebo supplementation (nitrate-depleted beetroot juice, 0.05 mmol, 140 mL). Following supplementation, participants reported to the lab for measures of vascular function in the lower limb. Doppler ultrasonography was used to measure flow-mediated dilation (FMD) and post-occlusive reactive hyperemia (RH) of the superficial femoral artery in response to a 5-min bout of leg ischemia. RESULTS/ANTICIPATED RESULTS: FMD did not differ between the nitrate-rich (2.87 ± 2.01%) and placebo (2.24 ± 1.69%) conditions (p = 0.48; d = 0.35). Furthermore, peak RH did not differ between the nitrate-rich (1503 ± 443 ml/min) and placebo (1762 ± 414 ml/min) conditions (p = 0.36; d = 0.46). DISCUSSION/SIGNIFICANCE: These preliminary results suggest that dietary nitrate supplementation in the form of beetroot juice does not improve vascular function in individuals with prediabetes.
目的/目标:已发现糖尿病前期患者的血管功能受损,这是心血管疾病的亚临床标志。膳食中补充硝酸盐已被证明可改善血管功能。然而,尚未对糖尿病前期患者进行过这方面的研究。本研究旨在确定膳食硝酸盐对糖尿病前期患者血管功能的影响。方法/研究对象:5 名糖尿病前期患者(4 名男性,1 名女性;55 ± 17 岁;HbA1c = 5.8 ± 0.2)参加了一项双盲、安慰剂对照、重复测量研究。参与者被随机分配接受为期 3 天的硝酸盐补充(富含硝酸盐的甜菜根汁,12.9 毫摩尔,140 毫升)或安慰剂补充(硝酸盐贫化的甜菜根汁,0.05 毫摩尔,140 毫升)。补充营养后,参与者到实验室进行下肢血管功能测量。多普勒超声波检查用于测量股浅动脉在5分钟的腿部缺血情况下的血流介导扩张(FMD)和闭塞后反应性充血(RH)。结果/预期结果:富含硝酸盐(2.87 ± 2.01%)和安慰剂(2.24 ± 1.69%)条件下的 FMD 没有差异(p = 0.48;d = 0.35)。此外,峰值相对湿度在富含硝酸盐(1503 ± 443 毫升/分钟)和安慰剂(1762 ± 414 毫升/分钟)条件下没有差异(p = 0.36;d = 0.46)。讨论/意义:这些初步结果表明,以甜菜根汁的形式膳食补充硝酸盐并不能改善糖尿病前期患者的血管功能。
{"title":"357 Effects of Dietary Nitrate Supplementation on Vascular Function in Individuals with Prediabetes","authors":"Ryan Staples, Andrew DeMarco, Peter Turkeltaub","doi":"10.1017/cts.2024.319","DOIUrl":"https://doi.org/10.1017/cts.2024.319","url":null,"abstract":"OBJECTIVES/GOALS: Impaired vascular function, a subclinical marker of cardiovascular disease, has been identified in prediabetes. Dietary nitrate supplementation has been shown to improve vascular function. However, this has not been studied in prediabetes. The purpose was to determine the effects of dietary nitrate on vascular function in prediabetes. METHODS/STUDY POPULATION: Five individuals with prediabetes (4 men, 1 woman; 55 ± 17 yr; HbA1c = 5.8 ± 0.2) participated in a double-blind, placebo-controlled, repeated measures study. Participants were randomly assigned to a 3-day nitrate supplementation (nitrate-rich beetroot juice, 12.9 mmol, 140 mL), or a placebo supplementation (nitrate-depleted beetroot juice, 0.05 mmol, 140 mL). Following supplementation, participants reported to the lab for measures of vascular function in the lower limb. Doppler ultrasonography was used to measure flow-mediated dilation (FMD) and post-occlusive reactive hyperemia (RH) of the superficial femoral artery in response to a 5-min bout of leg ischemia. RESULTS/ANTICIPATED RESULTS: FMD did not differ between the nitrate-rich (2.87 ± 2.01%) and placebo (2.24 ± 1.69%) conditions (p = 0.48; d = 0.35). Furthermore, peak RH did not differ between the nitrate-rich (1503 ± 443 ml/min) and placebo (1762 ± 414 ml/min) conditions (p = 0.36; d = 0.46). DISCUSSION/SIGNIFICANCE: These preliminary results suggest that dietary nitrate supplementation in the form of beetroot juice does not improve vascular function in individuals with prediabetes.","PeriodicalId":508693,"journal":{"name":"Journal of Clinical and Translational Science","volume":"46 ","pages":"108 - 109"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140764085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
235 Revitalizing Tenant Wellness: Piloting the Implementation of an In-Building Primary Care Wellness Hub at 100 High Park Avenue for Greater Access to Long-Term Mental Health Services for Underserved Tenants 235 重振租户健康:在高公园大道 100 号试行楼内初级保健中心,为得不到服务的租户提供更多的长期心理健康服务
Pub Date : 2024-04-01 DOI: 10.1017/cts.2024.217
Anabela Esteves Cotovio, Sumaya Bhatti, Julia Kulczyski, Osarumwense Omoruna
OBJECTIVES/GOALS: In a collaborative effort with Toronto Community Housing (TCH), West Toronto Ontario Health Team (WTOHT), and our translational research team, we seek to increase the availability and long-term use of mental health care services through an in-building Wellness Hub for underserved tenants residing in a medical desert, 100 High Park Avenue. METHODS/STUDY POPULATION: In our pilot study, we will use an evaluative framework based on resident feedback to gauge the effectiveness of wellness hub implementation. We will examine both survey results, information from key stakeholder conversation and final interview data from the resident participants. Post wellness hub implementation we will inquire about various aspects of their experience in residence related to the main pillars of our project, including the presence of key wellness resources, accessibility of resources, effectiveness of those resources. Qualitative data management softwares results from the semi-structured interview will be coded and analyzed to extract themes and relevant changes throughout and after intervention implementation. RESULTS/ANTICIPATED RESULTS: The anticipated project results would be based on the following research question findings: How might we develop and integrate accessible mental health services through the wellness hubs for tenants at 100 High Park Avenue to improve the long-term follow-through of their care? The primary outcome of this project would be collective improvement in mental health of tenants at TCH 100 High Park Avenue. Qualitative evidence in the form of semi-structured interviews of tenants at baseline and after wellness hub implementation are expected to indicate an improvement in their mental health. Secondary outcomes for tenants include fewer incidences of feeling unsafe, reduced drug dependency, and improved community cohesion. DISCUSSION/SIGNIFICANCE: A wellness hub will foster well-being and resilience among residents, ultimately enhancing their overall quality of life and community cohesion. Furthermore, the wellness hub model could be scaled across 2,100 TCHC buildings and other metropolitan cities facing similar crisis i.e. New York.
目标/目的:在与多伦多社区住房(TCH)、西多伦多安大略省健康小组(WTOHT)以及我们的转化研究团队的合作努力中,我们寻求通过为居住在医疗荒漠--高公园大道 100 号--中服务不足的租户提供楼内健康中心,来提高心理健康护理服务的可用性和长期使用率。方法/研究对象:在试点研究中,我们将根据住户的反馈意见,采用评估框架来衡量健康中心的实施效果。我们将检查调查结果、主要利益相关者谈话信息以及居民参与者的最终访谈数据。在健康中心实施后,我们将询问他们与项目主要支柱相关的居住体验的各个方面,包括主要健康资源的存在、资源的可及性、这些资源的有效性。我们将利用定性数据管理软件对半结构式访谈的结果进行编码和分析,以提取干预措施实施过程中和实施后的主题和相关变化。结果/预期结果:预期项目结果将基于以下研究问题的发现:我们该如何通过健康中心为高公园大道 100 号的住户开发和整合便捷的心理健康服务,以改善他们的长期后续护理?本项目的主要成果是集体改善 TCH 100 High Park Avenue 租户的心理健康。以半结构化访谈的形式对基线和健康中心实施后的租户进行定性分析,预计会发现他们的心理健康有所改善。租户的次要成果包括减少了不安全感的发生、降低了对毒品的依赖性并增强了社区凝聚力。讨论/意义:健康中心将促进居民的幸福感和复原力,最终提高他们的整体生活质量和社区凝聚力。此外,健康中心模式可推广到 2100 栋 TCHC 大楼以及面临类似危机的其他大都市(如纽约)。
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Journal of Clinical and Translational Science
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