bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-751. A 10-year retrospective review of Necrotizing Fasciitis at a Tertiary Referral Hospital in a Low/Middle Income Country
Authors: Abdallah Tamara , Challita Caren , Zeid Daou Christopher Abi , Sawaya Tania , Hallal Ali , Madi Naji , Rizk Nesrine 
Published: January 2025

Abstract

Background
Necrotizing fasciitis (NF) is a rare, yet potentially fatal skin and soft tissue infection, with a global annual incidence of 0.3 to 15 per 100,000 cases. Early surgical debridement is crucial as mortality rates can reach up to 76%. there is a notable scarcity of data on the epidemiology of NF in the Eastern Mediterranean region. Our aim is to investigate clinical characteristics and outcomes among patients diagnosed with necrotizing fasciitis in a tertiary referral center in Beirut, Lebanon.
Demographic and Clinical Characteristics in the Study Population

Methods
A retrospective chart review of hospitalized cases between 2011 and 2021. The study population included adult patients diagnosed with NF during this period. Data included demographic and clinical characteristics.
Physical Findings

Results
We identified and included a total of 41 cases of NF in this cohort. The average age of the patients was 54.6 years, with males comprising the majority at 73%. The most prevalent co-morbidity was Diabetes Mellitus (48.78%), followed by hypertension (41.46%), cardiovascular diseases (41.46%), and renal failure (36.59%). Pain (87.80%), erythema (78.80%), and swelling (75.61%) were the most common symptoms. Skin discoloration was present in twenty-four of the forty-one patients (59%). Regarding outcomes, the patients identified were divided in two groups: survivors and deceased. overall mortality rate was 37%, and amputation rate was 10% (Table 3). Patients in both groups underwent a median of 3 surgical debridement’s. Time to diagnosis did not significantly differ between survivors (median 1.75 hours) and non-survivors (median 6 hours), whereas antibiotics were administered with a median time of 30 minutes from diagnosis in the survival group, compared to one hour in the deceased group. Time to surgery showed a 7-hour delay in the deceased group compared to survivors (p=0.096).
Timelines and Clinical Outcomes

Conclusion
To our knowledge, this study represents the first comprehensive review of necrotizing fasciitis (NF) in Lebanon, providing valuable insights into demographics and comorbidities. Our findings reveal a mortality rate of 37%, which is consistent with the ranges reported in existing literature, highlighting the need for continued efforts to improve outcomes for patients with NF in our region.

Disclosures
All Authors: No reported disclosures
P-753. Characterizing Multidrug-Resistant Acinetobacter baumannii Infections among Wartime Casualties
Authors: Frankford Stone A , Stewart Laveta , Sercy Erica , Igo Matthew , Wyatt Andrew , Carson M Leigh , Campbell Wesley , Mende Katrin , Tribble David , Kiley John L 
Published: January 2025

Abstract

Background
Acinetobacter baumannii (ACB) emerged as a key pathogen during the war in Iraq and was designated as a serious threat in the 2013 Centers for Disease Control’s antimicrobial resistance report. We describe the characteristics of wounded military personnel with ACB infections.

Methods
Data were obtained from the Trauma Infectious Disease Outcomes Study, an observational study of US service members injured in Iraq and Afghanistan (6/09-12/14). Patients who had ≥ 1 positive infecting ACB isolate were assessed. Multidrug resistance (MDR) was defined as resistance to ≥ 3 classes of antimicrobials or production of extended-spectrum β-lactamase or carbapenemase. Categorical variables were compared by Chi-square or Fisher’s Exact and continuous variables by Mann-Whitney U.

Results
Among 160 patients with ACB infections, 116 (73%) and 43 (27%) had MDR and non-MDR ACB, respectively. All were male with a median age of 23.5 years and the majority sustained injuries in combat (96%) in Afghanistan (93%) (Table 1). Blast was the primary injury mechanism (86%), resulting in high injury severity. There was a total of 283 ACB infections with 222 (78%) MDR and 61 (22%) non-MDR; 59 patients had ≥ 1 ACB infection (median of 2 [IQR 2-4] infections). Skin and soft-tissue infections (48%) were most common, followed by pneumonia (23%), bloodstream infections (15%), and osteomyelitis (11%) (Table 2). Compared to non-MDR ACB patients, patients with MDR ACB had greater transfusions requirements within 1st 24 hours post-injury (median 25 vs 15 units p=0.01, Table 1). There was a non-significant trend toward more abdominal/pelvic/groin injuries among MDR ACB patients (60% vs 42% with non-MDR p=0.051). Hospital duration was a median 52.5 days and crude mortality was 3% with no significant difference between the groups.

Conclusion
Battlefield casualties with ACB infections were characterized by high injury severity, frequently caused by blast trauma with MDR ACB more often in those with larger volume blood transfusions. Wound infections and pneumonia were most common. Overall, ACB infection patients were critically ill with large resource utilization regardless of MDR status. Further analysis to compare outcomes with non-ACB infection outcomes is warranted.

Disclosures
David Tribble, MD, DrPH, AstraZeneca: The IDCRP and HJF were funded to conduct an unrelated phase III COVID-19 monoclonal antibody immunoprophylaxis trial as part of US Govt COVID Response
P-754. Retrospective Study of Necrotizing Fasciitis: A Review of 99 Cases in a Tertiary Care Center in Eastern Thailand from 2022 to 2023
Authors: Lohawatcharagul Tuntanut , Jamjittrong Supaschin , Suenghataiphorn Thanathip , Kasemsantitham Arp-Arpa , Tangsirisatian Ponphisudti , Rojasavastera Sarita , Hongboontry Tinn , Kamonvarapitak Tunyaporn , Sasipong Nuttarak , Luerithiphong Sichon 
Published: January 2025

Abstract

Background
Necrotizing fasciitis (NF) is a rare and fatal soft tissue infection that requires immediate diagnosis and management. Data on microbiological aspects, clinical features, and outcomes of NF remain unexplored, particularly in certain global regions. With its high mortality rate, comprehensive understanding of NF is crucial.Figure 1.Inclusion Flow Diagram of Patients Diagnosed with Necrotizing Fasciitis between 2022-2023

Methods
All NF cases diagnosed at a tertiary care center in Eastern Thailand between January 2022 - December 2023 were retrospectively reviewed. Patient’s demographic, comorbidities, clinical presentations, laboratory data, treatment modalities, and clinical outcomes were evaluated.Table 1.Microbial Profile and Organism Distribution in Necrotizing Fasciitis Cases

Results
Among 99 NF cases identified, the mean age was 54.85 years (SD = 13.5), and 52.5% were males. Most common comorbidities were hypertension (48.5%), diabetes (44.4%), and dyslipidemia (38.4%). Wound cultures revealed 52.7% monomicrobial, 14% polymicrobial, and 33.3% no growth, with Streptococcus pyogenes being the most prevalent (28.6%). Average number of debridements per case was 3.06, and 53.5% of the patients underwent vacuum dressing with an average duration of 24.07 days (SD = 18.8). Significantly fewer patients underwent debridement within 24 hours if the initial diagnosis was cellulitis prior to being diagnosed with NF (21/43 (48%) versus 44/56 (78.5%), p = 0.002). The most common antibiotic regimen was ceftriaxone plus clindamycin (78.8%). Mortality occurred in 8 cases (8.08%), while 11 cases (11.1%) had amputations and 26 cases (26.3%) experienced severe sepsis.Table 2.Treatment Modalities and Their Attributes in Patients Diagnosed with Necrotizing Fasciitis

Conclusion
Our cohort exhibits a notably low mortality rate, compared to existing literature. Here, we present the first study exploring NF characteristics in Eastern Thailand. With findings indicating delayed debridement among patients initially diagnosed with cellulitis, this emphasizes the significance for prompt diagnosis of NF.Table 3.Clinical Outcomes in Study Cohort of 99 patients with Necrotizing Fasciitis

Disclosures
All Authors: No reported disclosures
P-758. A Comprehensive Analysis of Multi-Drug Resistant Tuberculosis: A Population-Based Time-Trend Analysis
Authors: Husain Ahmed , Alsakarneh Saqr , Malkawi Lujain , Alghizzawi Mohd , Brychel Christopher 
Published: January 2025

Abstract

Background
Due to the significant morbidity and mortality that it carries, Multi-Drug resistant Tuberculosis (MDR-TB) remains a pressing concern for public health. The aim of this study was to conduct a time-trend analysis of age and gender-specific MDR-TB incidence rates in the United States (US) using the Global Burden Diseases (GBD) 2019 database.

Methods
Data was obtained from the GBD 2019 database, an international database that encompasses ∼100% of TB diagnosed cases in the US. TB incidence rates, age-adjusted to the standard US population, were calculated using SEER*Stat software (v.8.4.0.1, National Cancer Institute “NCI”) and were additionally stratified according to sex. Time-trends were estimated as an Annual Percentage Change (APC) and Average APC (AAPC) using Joinpoint Regression Software (v.4.9.0.1, NCI) utilizing Monte Carlo permutation analysis to generate the simplest trend. Pairwise comparison was conducted between gender-specific trends using the tests of parallelism and coincidence. Age-specific trends were also assessed in two age sub-groups: younger adults 15-49 years of age and older adults 50-74 years of age. A two-sided P-value cut-off of 0.05 was utilized for statistical significance.

Results
6,820 patients were diagnosed with MDR TB in the US between 1990-2019. Overall, MDR-TB incidence rates have decreased in all study groups, with a more substantial decrease in older adults than younger adults (AAPC= -8.7 vs -6.6; AAPC difference=1.2, P&lt; 0.0001). Age-specific trends were neither identical (P&lt; 0.001) nor parallel (P&lt; 0.001) (Figure 1), suggesting that MDR-TB incidence rates are different and decreasing at a greater rate in older adults compared to younger adults. Similarly, the incidence of MDR-TB has shown a greater reduction in females than males over the review time period (AAPC= -7.7 vs -6.6; AAPC difference= 1.1, P&lt; 0.0001) (Figure 2).

Conclusion
Our nationwide study demonstrated that MDR-TB incidence trends have been decreasing in the United States over the past three decades, with a greater reduction noted in older adults and females.

Disclosures
All Authors: No reported disclosures
P-768. Gene Expression Profiles for Classifying Clinical Spectrum and Monitoring Treatment Responses in Tuberculoid and Lepromatous Leprosy
Authors: Mitra Debdeep 
Published: January 2025

Abstract

Background
Leprosy ranks as the second most prevalent mycobacterial disease worldwide. Various host genetic factors have been implicated in leprosy's sustained prevalence. Over the last decade, genetic epidemiology methodologies, such as genome-wide association studies (GWAS), have pinpointed over 30 loci associated with leprosy susceptibility. Nevertheless, GWAS loci typically encompass multiple genes, presenting a challenge in identifying causal candidates for each locus. Validating previously identified candidate biomarkers and discovering additional gene expression profiles are essential steps towards enhancing the diagnosis of Leprosy (Hansen's Disease) and monitoring treatment responses

Methods
The study involved assessing the expression levels of 126 immune-related genes in the skin biopsy samples of 96 individuals diagnosed with Leprosy, with a positive slit skin smear for acid-fast bacilli, and 20 healthy controls without Mycobacterium leprae. This evaluation was conducted using focused gene expression profiling via dual-color Reverse-Transcription Multiplex Ligation-dependent Probe Amplification assay. Additionally, gene expression levels were monitored twelve months post-Multi-Drug Therapy in 88 Leprosy patients as part of the follow-up assessment.

Results
Expression patterns of 31 host genes effectively distinguished between Pauci and multibacillary cases compared to both slit skin positive individuals and healthy controls at baseline. Notably, despite completion of multi-drug therapy at 12 months, the expression levels of most discriminating genes did not return to baseline (except for TLR10, BLK, CD38, SLAMF7, HS3ST2, and CD40LG mRNA), with full normalization observed only at the 24-month follow-up.

Conclusion
Our findings suggest that comprehensive gene expression signatures are necessary to assess transcriptomic responses in skin biopsies during and after successful multi-drug therapy for Hansen’s disease. This approach is crucial for accurate diagnosis and the characterization of drug-induced relapse-free cure. It involves integrating genes that normalize completely during the 12-month treatment phase with those that only fully return to baseline levels during the post-treatment resolution phase.

Disclosures
All Authors: No reported disclosures
P-779. Macronutrient Status and Risk of Tuberculosis vs. Other Lower Respiratory Tract Infections
Authors: Wu Joanne , Cegielski Peter 
Published: January 2025

Abstract

Background
Nutritional status is a major risk factor for incident tuberculosis disease (TB), but the underlying biological mechanisms remain unknown. If this effect is mediated immunologically, then other lower respiratory tract infections (LRTI) that elicit different immune responses would differ in this regard. If it is due to “body habitus,” then a similar association might be seen in anatomically similar infections. We compared the effect of nutritional status on TB, pneumococcal pneumonia (pneumonia), and influenza pneumonia (flu).

Methods
The first National Health and Nutrition Examination Survey (NHANES-I) provided data on baseline nutritional status of a probability sample of the US population, 1971-1975. Nutrition indicators included body mass index (BMI), skinfold thickness (SFT), cross-sectional upper arm muscle area (AMA), serum albumin, serum vitamin A, and iron status. The NHANES-I Epidemiological Follow-up Study provided follow-up data through 1992. Incident TB, pneumonia, and flu were ascertained through ICD9 codes in medical records and death certificates. For each nutrition indicator, we compared population-estimated percentages of those who later develop TB, pneumonia, and flu.

Results
An estimated 1.2% of the population developed TB: 9.6% (95% CI: 4.3, 15.0) of those with BMI &lt; 18.5 kg/m2) developed TB compared with 1% (0.5, 1.4) of those with normal BMI, 18.5-25 kg/m2, and 0.4% (0.1, 0.6) of those with BMI 25-30 kg/m2 (Table 1). In contrast, BMI was not associated with developing pneumonia or flu. Like BMI, SFT and AMA were also inversely associated with incident TB but not with flu or pneumonia. In fact, pneumonia had an “U”-shaped association with AMA (Table 1). Among those with hypoalbuminemia (≤3.5 g/dL), 12.8% (0, 32.5) developed TB versus 0.8% (0.4, 1.2) of those with normal albumin &gt;3.5 g/dL. Serum albumin was not associated with incident pneumonia or flu. Serum Vitamin A and iron deficiency were not associated with any of these three LRTI.

Conclusion
These differences suggest host defenses against TB, mainly adaptive cell-mediated immune responses, are sensitive to macronutrient status while the acute granulocytic and innate humoral defenses against other LRTI pathogens are not affected in the same way.

Disclosures
All Authors: No reported disclosures
P-782. Nontuberculous Mycobacterial Infections among Lung Transplant Recipients: A Nine-Year Cohort Study
Authors: Soneda Keiko , Yamamoto Shinya , Okamoto Koh , Higurashi Yoshimi , Ikeuchi Kazuhiko , Ikeda Mahoko , Okugawa Shu , Kawashima Mitsuaki , Konoeda Chihiro , Sato Masaaki , Tsutsumi Takeya 
Published: January 2025

Abstract

Background
The epidemiology, microbiology, and clinical course of nontuberculous mycobacterial (NTM) infection among lung transplant recipients vary considerably by geographic location. Their data is still scarce.

Methods
This single-center retrospective study was conducted at one of the major transplant centers in Japan. Medical records and microbiological test results of all the lung transplant recipients who underwent lung transplants between 2015 to 2023 were reviewed through December 31, 2023. Per institutional protocol, tracheal aspirates or sputum have been sent for mycobacterial cultures at the time of transplant and when clinically indicated thereafter. The definition of pulmonary NTM disease was based on the ATS/ERS/ESCMID/IDSA guidelines.

Results
In total, 175 lung transplants were performed during the study period (Table 1). Before transplant, 7 recipients had NTM isolation from the sputum and 5 of these 7 recipients had received bilateral lung transplants. While only 2 of these 7 recipients met the diagnosis of NTM pulmonary disease, 6 recipients received antimycobacterial treatment for a median duration of 25 months before transplant and only one case had NTM isolation after transplant (Figure 1). At the time of lung transplant, 169/175 (97%) recipient’s sputum were collected. Six species of NTM were isolated in 18 patients (10%, 18/175) at various times; at the time of transplant, between 0-1 month, 1-6 months, 6-12 months, and after 12 months in 2, 7, 3, 2, and 5 recipients, respectively (Figure 1, 2). Twenty-two isolates were recovered at the time of and after transplant, slowly growing mycobacteria accounted for 86% (19/22), including M. avium complex (N = 12) and M. gordonae (N = 4), whereas rapidly growing mycobacteria, M. fortuitum (N = 2) and M. chelonae (N = 1), accounted for the rest. Although 2 of 18 recipients with NTM isolation died, one recipient died directly from NTM infection complicated by Aspergillus coinfection.

Conclusion
NTM were isolated in 10% of recipients at the time of and after lung transplant. NTM, isolated before and at the time of transplant, rarely required treatment after transplant.

Disclosures
All Authors: No reported disclosures
Pulse Shape Discrimination in JSNS2
Authors: Dodo T , Cheoun M K , Choi J H , Choi J Y , Goh J , Haga K , Harada M , Hasegawa S , Hwang W , Iida T , Jang H I , Jang J S , Joo K K , Jung D E , Kang S K , Kasugai Y , Kawasaki T , Kim E J , Kim J Y , Kim S B , Kim W , Kinoshita H , Konno T , Lee D H , Lim I T , Little C , Marzec E , Maruyama T , Masuda S , Meigo S , Moon D H , Nakano T , Niiyama M , Nishikawa K , Pac M Y , Park H W , Park J S , Park R G , Peeters S J M , Rott C , Sakai K , Sakamoto S , Shima T , Shin C D , Spitz J , Suekane F , Sugaya Y , Suzuya K , Takeuchi Y , Yamaguchi Y , Yeh M , Yeo I S , Yoo C , Yu I 
Published: January 2025

Abstract
JSNS2 (J-PARC Sterile Neutrino Search at J-PARC Spallation Neutron Source) is an experiment that is searching for sterile neutrinos via the observation of $\bar{\nu }_{\mu } \rightarrow \bar{\nu }_e$ appearance oscillations using neutrinos from muon decay-at-rest. For this search, rejecting cosmic-ray-induced neutron events by Pulse Shape Discrimination (PSD) is essential because the JSNS2 detector is located above ground, on the third floor of the building. We have achieved 94.95%$\pm$0.15% rejection of neutron events while keeping 92.82%$\pm$1.77% of signal, electron-like events using a data-driven likelihood method. This article will report the PSD technique using the full fiducial volume of the JSNS2 detector.
An unbreakable bond? Maternal adverse childhood experiences and mothers’ relationships with adult children
Authors: Stacey Lawrence , Reczek Rin , Williams Kristi , Hays Jake , Beth Thomeer Mieke 
Published: January 2025

Abstract
Adverse childhood experiences (ACEs)—the constellation of experiences of abuse, neglect, and household dysfunction in childhood—affect the subsequent formation and maintenance of social relationships. Yet to date, there is limited knowledge on the potential consequences of maternal ACEs for the mother–adult child tie, one of the most important relationships across the life course. Insights from a life course perspective and research on the deleterious effects of ACEs suggest that mothers’ experiences of ACEs in childhood are so powerful that they may shape mother–adult child relationship quality decades later. To test this possibility, we draw on nationally representative, longitudinal cohort data from the National Longitudinal Survey of Youth 1979 (NLSY79) and the NLSY79 Child and Young Adult Supplement to examine associations between maternal ACEs and mother–adult child estrangement, contact, and closeness. Multi-level logistic and ordinal logistic regression models show that greater maternal ACEs exposure is associated with greater odds of estrangement from, less frequent contact with, and lower levels of closeness to the mother as reported by the adult child. Our findings highlight and extend research on intergenerational relationships by demonstrating that a mother’s ACEs exposure may be a fundamental determinant of her relationships with her adult children, documenting lengthier intergenerational consequences of ACEs than uncovered by prior research.
A Serum- and Feeder-Free System to Generate CD4 and Regulatory T Cells from Human iPSCs
Authors: Fong Helen , Mendel Matthew , Jascur John , Najmi Laeya , Kim Ken , Lew Garrett , Garimalla Swetha , Schock Suruchi , Hu Jing , Villegas Andres Gordillo , Conway Anthony , Fontenot Jason D , Zompi Simona 
Published: January 2025

Abstract
iPSCs can serve as a renewable source of a consistent edited cell product, overcoming limitations of primary cells. While feeder-free generation of clinical grade iPSC-derived CD8 T cells has been achieved, differentiation of iPSC-derived CD4sp and regulatory T cells requires mouse stromal cells in an artificial thymic organoid. Here we report a serum- and feeder-free differentiation process suitable for large-scale production. Using an optimized concentration of PMA/Ionomycin, we generated iPSC-CD4sp T cells at high efficiency and converted them to Tregs using TGFβ and ATRA. Using genetic engineering, we demonstrated high, non-viral, targeted integration of an HLA-A2 CAR in iPSCs. iPSC-Tregs +/- HLA-A2-targeted CAR phenotypically, transcriptionally and functionally resemble primary Tregs and suppress T cell proliferation in vitro. Our work is the first to demonstrate an iPSC-based platform amenable to manufacturing CD4 T cells to complement iPSC-CD8 oncology products and functional iPSC-Tregs to deliver Treg cell therapies at scale.