bluuebunny/crossref_metadata_2025_split huggingface dataset:
372. Impact of Updated 2020 Public Health Service Guidelines on Deceased Organ Donors and Transplant Recipients
Authors: Handarova Dzhuliyana , Howell Jesse , Danziger-Isakov Lara A , Pouch Stephanie M 
Published: January 2025

Abstract

Background
New guidelines for assessing solid organ donors and recipients for Human Immunodeficiency Virus (HIV), Hepatitis B (HBV), and Hepatitis C (HCV) infection were published by the US Public Health Service (PHS) in 2020 and implemented into Organ Procurement and Transplantation Network (OPTN) policy on 3/1/21. Changes included a shorter risk criteria inclusionary timeframe and the removal of 4 risk criteria.

Methods
We analyzed OPTN deceased donor and transplant data 2 years pre-(3/1/19-2/28/21) and post-(3/1/21-3/1/23) implementation of the updated guidelines. For Kaplan-Meier survival analyses, the post- cohort included recipients transplanted before 1/1/23 to ensure recipients had at least 1 year follow-up plus a 3-month data lag. Utilization rates, defined as number of organs transplanted divided by number of available organs from donors with at least 1 organ recovered for the purpose of transplant, are shown for thoracic organs. Non-use rates, defined as number of organs recovered for the purpose of transplant but not transplanted divided by the total number of organs recovered for the purpose of transplant, are shown for abdominal organs.

Results
The proportion of donors considered to have PHS risk factors decreased by approximately 10% post-policy, both overall and by organ type (Fig. 1). There were no major differences pre- to post- in reported donor HIV, HCV or HBV NAT test results (Fig2. ). Post-policy, utilization rates for heart and lung for donors with risk factors were 34.9% and 17.5% respectively, compared to 34.3% and 20.0% pre-policy; while kidney and liver non-use rates for donors with risk factors were 20.3% and 8.2% respectively, compared to 17.2% and 7.9% pre-policy. There was no significant change in 1-year post-transplant patient survival for recipients who received organs from donors with PHS risk factors (Fig. 3).

Conclusion
Less restrictive PHS guidelines led to fewer donors being classified as having risk factors for disease transmission. Updated guidelines did not significantly affect donor infectious disease test results or post-transplant survival for recipients. Changes in donor organ utilization and non-use may be due to donor pool changes and/or overlapping policy implementations, and further investigation is warranted.

Disclosures
Lara A. Danziger-Isakov, MD, MPH, Aicuris: clinical research contract, paid to institutio|Ansun BioPharma: clinical research contract, paid to institution|Astellas: Advisor/Consultant|Astellas: clinical research contract, paid to institutio|Merck: clinical research contract, paid to institutio|Pfizer: Grant/Research Support|Takeda: clinical research contract, paid to institutio
P-956. Perception of the Fellows/Faculty on Inpatient Expectations and Academic Half-Day
Authors: Osorio Georgina , Vargas Geraldine , Yancovitz Stanley 
Published: January 2025

Abstract

Background
Increased volume of Infectious Diseases (ID) inpatient consults has spear-headed training programs to launch efforts to mitigate burnout for optimal quality patient care and physician well-being including well-structured interventions such as academic half-day (AHD) to protect education time for fellows. This project describes inpatient strategies, electronic medical record (EMR) utilization, and perspectives on implementation of AHD by ID inpatient faculty and fellows at a large academic institution.

Methods
An anonymous survey on daily inpatient schedules, EMR utilization, and AHD feedback was distributed to the ID Section at a NYC urban hospital system in 3/2024.

Results
21 members of the ID section completed the survey (14 fac­ulty, 7 fellows). Daily inpatient schedules: When asked what time fellows should start workday, median response was 8AM-8:30 AM from both fellows (range, 8AM-9AM) and faculty (range, 7AM–9AM). When asked what time fellows should end work day, median response was 4:30PM-5PM from fellows (range, 4:30PM-5:30PM) and 5:30PM-6PM from faculty (range, 4:30PM-6:30PM). Fellows reported starting workday 7:30AM-8AM (range, 7AM-8:30AM) and ending 5:30PM-6PM (range, 4:30PM-6:30PM), while faculty reported starting 8:30AM-9AM (range, 6AM-9AM) and ending 6PM-6:30PM (range, 4:30PM-7PM). EMR utilization: fellows reported taking 4-6 hours to write notes (range, 2-6) and “about half the time” changing secure chat to “offline” when not on call versus faculty reported taking 2-4 hours (range, 1-6) to write notes and “never” setting EPIC secure chat to “offline.” AHD: Both groups reported AHD advantages were protected time for education, ability for fellows to focus on continuity clinic, in-person, and amplification of teamwork/mentorship. Fellows reported no disadvantages with AHD while faculty noted concerns of lost of continuity of care and not preparing fellows for clinical expectations as they transition to faculty.

Conclusion
Both fellows and faculty report different strategies with EMR utilization. AHD feedback was overall positive by both groups, but faculty expressed concerns regarding impact to continuity of care. AHD evaluation and strategies to mitigate burnout are ongoing including leveraging EMR.

Disclosures
All Authors: No reported disclosures
P-962. Designing ID Elective Goal and Learning Objectives Based On Need Assessment From Learners
Authors: Yoon Jungwon , Hatem David S 
Published: January 2025

Abstract

Background
Comprehensive Infectious disease (ID) education is indispensable for clinicians, given challenges posed by antimicrobial resistance, pandemics, expanding immunocompromised population, and the effect of climate change. ID fellowship applications have failed to match the demand for training programs. While numerous factors contribute to the prevailing challenges in ID workforce, enhancing clinical education in ID holds promise for bridging this gap.
Need Assessment Survey Results

Methods
An anonymous survey was conducted to understand the reasons learners in undergraduate (UME) and graduate medical education (GME) choose ID electives, what and how they want to learn during the rotation. In the academic year 2023, there were 59 GME and 10 UME learners enrolled in ID elective at our institution. 38 responded to the survey (55% response rate).

Results
The survey showed 93% of respondents opted for electives to augment their knowledge. 24% sought networking and mentorship from faculty members, and 21% wanted to explore career options in ID. However, only 8% plan to apply to ID fellowship programs. Learners expressed interest in exploring outpatient ID clinics (63%), antimicrobial stewardship initiatives (81%), and infection control activities (42%), alongside inpatient consultation services. Moreover, a majority (87%) expressed a desire for structured didactics.

Conclusion
While most pursue ID electives to address knowledge gaps, 21% of learners seem to be in an exploratory phase, seeking mentorship and contemplating a career in ID. ID electives have potential to serve as a platform for early trainees and students to explore their interests in the field. To optimize their experience, we could provide interactive didactics and diversifying clinical activities such as antimicrobial stewardship initiatives, and subspecialty clinics. Such initiatives not only provide learners with comprehensive insights into the field but also foster a deeper appreciation for the multifaceted nature of infectious diseases. Limitations from this study include small sample size and low response rate which impact generalizability of this finding. Conducting longitudinal surveys and evaluations with elective learners could provide further insights into how to improve the curriculum and better meet the needs of participants.

Disclosures
All Authors: No reported disclosures
P-963. Development, Delivery, and Evaluation of the Texas Epidemic Public Health Institute (TEPHI) Infection Control Lecture Series
Authors: Ruch Kayla , Rodriguez Anabel , Rios Janelle , Ostrosky-Zeichner Luis , Brown Eric L 
Published: January 2025

Abstract

Background
The Texas Epidemic Public Health Institute (TEPHI) is a state agency of higher education headquartered at UTHealth Houston School of Public Health. With a mission to keep Texans healthy and the economy strong by preparing for the next infectious disease outbreak, TEPHI’s Small Rural Healthcare Preparedness working group developed, delivered, and evaluated a pilot infection prevention and control webinar series called Infection Control for rural-serving health organizations.Table 1:Modular Registration, Attendance, and YouTube Views

Methods
Pilot data was collected from year one of the Infection Control series. Data sources included series attendee registration forms and attendance records (stored in WebEx Webinar Platform) and from post-lecture evaluation surveys using Qualtrics. These data were analyzed using Qualtrics software.Table 2:Infection Control series attendee demographic and occupational characteristics

Results
A total of 1105 individuals attended or viewed the Infection Control series. Overall, response rate to the evaluation surveys, in general, was low. Even so, feedback was consistently very positive, noting a “high likelihood of future TEPHI infection prevention and control lecture attendance”. Additionally participant feedback was used to guide the active improvements for year two of the series.Table 3:Infection Preventionist Module Registration Demographics

Conclusion
Infection Control series attendees obtained a deeper understanding of relevant policies, procedures, components, and practices. By offering essential, accessible education on infection prevention and control at no cost to healthcare systems, administrators and healthcare providers working in these systems have gained the knowledge necessary to establish and sustain a safe environment for patients and staff in healthcare settings.Table 4:Modular Post-Survey Evaluations

Disclosures
Luis Ostrosky-Zeichner, MD, FACP, FIDSA, FSHEA, FECMM, CMQ, Cidara: Advisor/Consultant|Enanta: Advisor/Consultant|F2G: Advisor/Consultant|Gilead: Advisor/Consultant|GSK: Advisor/Consultant|Melinta: Advisor/Consultant|Octapharma: Advisor/Consultant|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Pulmocide: Grant/Research Support|Scynexis: Grant/Research Support|Viracor: Advisor/Consultant
P-975. Comprehensive Survey of Current Transplant Infectious Disease Fellowship Programs
Authors: Scolarici Michael J , Tischendorf Jessica S , Filipiak Rachel , Saddler Christopher 
Published: January 2025

Abstract

Background
Adult Transplant Infectious Disease (TID) training is not ACGME accredited, and there is heterogeneity in training offered at transplant centers.

Methods
The American Society of Transplantation ID Community of Practice surveyed current adult TID fellowship programs and tracks regarding required clinical experiences, non-clinical work, fellowship recruitment/funding, and outcomes of TID fellowship training. Respondents could skip questions, and R was used for statistical analysis.

Results
From 149 adult ID fellowship websites, we identified 37 TID tracks and 25 TID fellowships. After soliciting online forums, we had 24 respondents representing 20 active TID training programs and 16 TID fellowships of which 7/16, 44% have existed for at least 10 years.
In these 16 TID fellowships, fellows averaged 50% of their time with solid organ (SOT) and 41% with hematopoietic stem cell transplantation. The SOT centers were comprehensive (95% offering liver, 95% kidney, 90% heart, 75% lung transplantation). TID fellowships required more inpatient TID consult service compared to TID tracks (28 vs 21 weeks, p=0.1), and TID fellows average 392 (sd=202.8) inpatient TID consults per year. All TID fellowships require TID specific clinic, 93% pre-transplant evaluations, 67% attending selection committees, and 88% scholarship.
All 12 TID fellowships who actively recruit rely on both word of mouth and their program’s website, 11/12, 92% use in-person meetings (e.g. IDWeek), and only 7/12, 58% use social media.
To fund TID fellowships, 11/15, 73% use more than one mechanism (e.g. internal ID division funding, grants), and only 4/15, 27% rely on billable services by TID fellows. Six of 15, 40% hire TID fellows as a clinical instructor/lecturer, the other 9/15, 60% hire the TID fellow as a research/advanced fellow. At 12/14, 86% TID fellowships, more than 50% of the graduates sought TID focused clinical careers. At 6/14, 43% and 11/14, 79% of fellowships none of the graduates sought research focused or industry careers respectively.

Conclusion
TID fellowships require significantly more inpatient consult weeks than tracks, all have non-patient care requirements, the funding for these programs is variable, and most graduates seek a clinically focused career. The heterogeneity of TID fellowships is high.

Disclosures
Jessica S. Tischendorf, MD, MS, Merck: Grant/Research Support
P-976. The Effectiveness of Augmented Reality Handouts for Learning Microbiology in Medical Students
Authors: Suwantarat Nuntra , Vanichcharoenchai Vorawan , Vichitvejpaisal Pongsagon , Raksamani Kasana 
Published: January 2025

Abstract

Background
Augmented reality (AR) is a novel technology-enabled active learning for medical education. The goal of this study was to determine effectiveness of self-directed learning AR handouts as a learning material for teaching medical microbiology in the 3rd year medical students, Doctor of Medicine (English Program), Thammasat University.
Example of the traditional handouts and the AR handouts in this study

Methods
A randomized controlled trial study was conducted by comparing academic performances (MCQs scores), the motivation level (Motivation Scores Learning Questionnaire, MSLQ) and satisfaction survey scores in the students after studied AR handouts (intervention group) and traditional handouts (control group). The content of AR handout was similar to the traditional handout (topic: common Gram-positive bacteria).
Study Procedures and Methods

Results
Twenty-four students were enrolled in this study (n = 02 each group). The both groups had no differences on age, gender, total GPA, pre-test scores (means of 5.08). The both groups also had similar increases in the post-test scores means of 11.25 (intervention group) and 10.58 (control group). MSLQ (topic of intrinsic goal orientation) was significantly higher in the intervention group than the control group (5.73 vs 4.81, p = 0.002). Satisfaction survey scores (topic of "Handouts are stimulating" and "Handouts are exciting") were significantly higher in the intervention group than the control group (4.58 vs 3.50, p = 0.025 and 4.42 vs 3.17, p = 0.019).

Conclusion
AR handouts for learning medical microbiology and infectious diseases was effective to improve the knowledge in medical students. Based on cognitive information theory, the AR handouts help learning process by increased students' motivation, and satisfaction.

Disclosures
All Authors: No reported disclosures
P-978. Internal Medicine Resident Perceptions of the Barriers to and Facilitators of Optimal Inpatient Care of Persons who Inject Drugs: A Mixed Methods Study
Authors: Bailey Rosemary C , Tischendorf Jessica S 
Published: January 2025

Abstract

Background
Harm reduction counseling and HIV pre- and post-exposure prophylaxis (PrEP and PEP) can prevent infectious complications among persons who inject drugs (PWID). Hospitalizations are opportunities to provide these services, though these interventions occur infrequently for PWID admitted to our hospital. Little is known about internal medicine resident (IMR) perceptions of these interventions in the inpatient setting despite their frontline role in patient care in our institution.

Methods
In our mixed methods study we describe IMR perceptions of HIV prevention interventions and harm reduction counseling among PWID admitted to the University of Wisconsin Hospital. We conducted a survey examining current practices and perceptions. We explored the barriers and facilitators to optimizing these practices through semi-structured interviews. Transcripts were analyzed via consensus coding using the Systems Engineering Initiative for Patient Safety (SEIPS) model as a guiding conceptual framework. This framework describes the interactions of five components of complex work systems and their individual and overlapping influence on patient outcomes: 1) organization, 2) person, 3) physical environment, 4) task, and 5) technology and tools.

Results
59 IMRs responded to the survey (58% response rate). Residents report offering HIV-PrEP or HIV-PEP to PWID at low frequency; 56% never offer PrEP and 64% never offer PEP. 20% or fewer IMRs report offering PrEP or PEP at least some of the time. IMRs report a high degree of importance and appropriateness of HIV prevention interventions; however, the majority lack comfort, familiarity, or competence in how to counsel patients or prescribe PrEP or PEP (Table 1). 15 residents participated in interviews, all of whom identified barriers and facilitators to these interventions relevant to each component of the work system (Figure 1).

Conclusion
Despite recognizing the importance of HIV prevention services, including PrEP, PEP and harm reduction counseling, IMRs lack knowledge and comfort to do so. Barriers to optimal care span all components of the work system. Facilitators to optimal care and next steps include educational initiatives and EMR-based interventions with assessment of impact.

Disclosures
Jessica S. Tischendorf, MD, MS, Merck: Grant/Research Support
P-982. Online CME Improves Knowledge, Competence and Confidence of Infectious Disease Specialist in the Management of Patients who are Heavily Treatment Experienced
Authors: Thorpe Sara , Blatherwick Donald , Uravich Maria B 
Published: January 2025

Abstract

Background
Heavily Treatment Experience-People Living with HIV (HTE-PLWH) encompass older individuals and perinatally infected adolescents facing challenges with medication adherence. This demographic, dealing with increased lifespans, often struggles with medication adherence, posing a significant challenge. In comparison to PLWH outside the HTE category, HTE individuals typically experience higher rates of comorbidities, AIDS-defining conditions, and elevated healthcare costs. These multifaceted factors collectively limit the available HIV therapies for HTE PLWH, making treatment decisions more complex. Addressing the challenges posed by HTE PLWH requires clinicians to stay informed about advances in antiretroviral therapy, ensuring they can provide optimal, patient-centered care.

Methods
The CME intervention comprised of a 30- minute online text-based article authored by 1 faculty expert faculty. Response to 3 multiple choice, knowledge questions 1 self-efficacy, 5-point Likert scale confidence question were analyzed using a repeated pairs pre-/post-assessment study design. Pre- to post responses were compared using a McNemar’s test to assess statistical significance (P &lt; .001 level). The activity posted on 9/27/2023; data were collected through 11/6/2023.

Results
The analysis consisted of responses of infectious disease specialist (n=122) who answered all pre/post questions. Analysis demonstrated a significant improvement in knowledge and confidence related to managing HTE PLWH
• 91% relative change from 33% to 63% pre vs. post regarding knowledge of issues that can arise with the long-term use of antiretroviral therapy (P&lt; .001)
• 60% relative change from 42% to 67% pre vs. post regarding the competence in applying best practices for managing HIV in aging patients (P&lt; .001)
• 42% improved their confidence in their ability to manage HIV in aging patients- 23% v. 44% pre to post (P&lt; .001)

Conclusion
This study demonstrated the success of online, text-based CME on improving knowledge and confidence related to best practices in caring for people with HIV (PWH) and the subset who are heavily treatment experienced. These findings suggest the benefits of education that addresses clinicians’ individual needs across the continuum of their professional development.

Disclosures
All Authors: No reported disclosures
P-992. Global Estimated CMV Seroprevalence by Age and Sex
Authors: Lally Cathy , Flanders W Dana , Dilley Anne , Diaz-Decaro John D 
Published: January 2025

Abstract

Background
Cytomegalovirus (CMV) infection, while typically subclinical, is a lifelong latent infection that has been implicated in various adverse outcomes, including accelerated immunosenescence, increased cardiovascular risk, and cognitive decline. However, during pregnancy, CMV infection can cause severe complications in neonates infected in utero (congenital CMV [cCMV]). We present modeled age-, sex-, and country-specific CMV seroprevalence estimates.Figure 1.Modeled CMV Seroprevalence Estimates by Country, Age, and Sex

Methods
PubMed and EMBASE searches were conducted in August 2022 to identify English-language literature, published 2005-2022, on CMV seroprevalence. Sex-specific seroprevalence by age category was extracted and smoothed using weighted regression; when ≥ 2 studies were identified, a random-effect meta-regression was used.

Results
Overall, 25 studies were included. Estimated CMV seroprevalence increased with age and varied widely by sex and geographic location (Figure 1). Canada had the lowest seroprevalence estimates: 23.7% for females and 13.7% for males at age 18 years, and 33.5% and 23.5%, respectively, at age 40 years. The highest estimates at age 18 years were in China, with 93.0% for females and 95.3% for males, and at age 39 years in South Korea, with 99.1% and 98.8%, respectively. In Canada, France, Italy, Japan, UK, and USA, estimated seroprevalence was higher in females than in males across all age groups. In Australia, Germany, and Spain, estimated seroprevalence in younger age groups was higher among males than females, but in older age groups was higher among females than males. CMV seroprevalence was &gt; 50% for both sexes in China at age 2 years, Japan at 4 years, and South Korea at 17 years, and for females at 14 years and males at 18 years in Spain.

Conclusion
Modeled CMV seroprevalence estimates increased with age and were higher among females than males in most countries. The highest modeled CMV burden was observed among the Asian countries. This study highlights the seroprevalence of CMV among females during their reproductive years, with potential risk of cCMV in their unborn children. The findings underscore the urgent need for targeted strategies to mitigate the global burden of CMV, particularly among reproductive-age females.

Disclosures
Cathy Lally, MSPH, Epidemiologic Research & Methods, LLC: Ownership Interest W. Dana Flanders, MD, DSc, MPH, MA, Epidemiologic Research & Methods, LLC: Ownership Interest Anne Dilley, PhD, Epidemiologic Research & Methods, LLC: Ownership Interest John D. Diaz-Decaro, PhD, MS, Moderna, Inc.: Employee|Moderna, Inc.: Stocks/Bonds (Public Company)