GROUPS AND THEIR EFFECTS IN ORGANIZATIONS

The human is a social being and survives as the part of a group in every field of life from the birth. Group is a community consisting of one or more individuals who interact with each other in order to accomplish a certain goal. The groups are created formally and informally within the organization at different times and for different goals. Those groups have the negative and positive influences on the organization structure and function. In this work, the group concept in the organizations is studied and the influence of group behaviors within the organizations is discussed conceptually

Spatial and temporal heterogeneity in human mobility patterns in Holocene Southwest Asia and the East Mediterranean

We present a spatiotemporal picture of human genetic diversity in Anatolia, Iran, Levant, South Caucasus, and the Aegean, a broad region that experienced the earliest Neolithic transition and the emergence of complex hierarchical societies. Combining 35 new ancient shotgun genomes with 382 ancient and 23 present-day published genomes, we found that genetic diversity within each region steadily increased through the Holocene. We further observed that the inferred sources of gene flow shifted in time. In the first half of the Holocene, Southwest Asian and the East Mediterranean populations homogenized among themselves. Starting with the Bronze Age, however, regional populations diverged from each other, most likely driven by gene flow from external sources, which we term “the expanding mobility model.” Interestingly, this increase in inter-regional divergence can be captured by outgroup-f$_3$-based genetic distances, but not by the commonly used F$_{ST}$ statistic, due to the sensitivity of F$_{ST}$, but not outgroup-f$_3$, to within-population diversity. Finally, we report a temporal trend of increasing male bias in admixture events through the Holocene

An international effort towards developing standards for best practices in analysis, interpretation and reporting of clinical genome sequencing results in the CLARITY Challenge

There is tremendous potential for genome sequencing to improve clinical diagnosis and care once it becomes routinely accessible, but this will require formalizing research methods into clinical best practices in the areas of sequence data generation, analysis, interpretation and reporting. The CLARITY Challenge was designed to spur convergence in methods for diagnosing genetic disease starting from clinical case history and genome sequencing data. DNA samples were obtained from three families with heritable genetic disorders and genomic sequence data were donated by sequencing platform vendors. The challenge was to analyze and interpret these data with the goals of identifying disease-causing variants and reporting the findings in a clinically useful format. Participating contestant groups were solicited broadly, and an independent panel of judges evaluated their performance. RESULTS: A total of 30 international groups were engaged. The entries reveal a general convergence of practices on most elements of the analysis and interpretation process. However, even given this commonality of approach, only two groups identified the consensus candidate variants in all disease cases, demonstrating a need for consistent fine-tuning of the generally accepted methods. There was greater diversity of the final clinical report content and in the patient consenting process, demonstrating that these areas require additional exploration and standardization. CONCLUSIONS: The CLARITY Challenge provides a comprehensive assessment of current practices for using genome sequencing to diagnose and report genetic diseases. There is remarkable convergence in bioinformatic techniques, but medical interpretation and reporting are areas that require further development by many groups

Care and Management of Aegean University HIV Cohort: Change Over Time

Objective: The primary aim of the study was to analyze the changes in time in HIV care and management and virologic success rates. The secondary aims were to analyze the epidemiological features, clinical and laboratory findings, and factors affecting survival. Methods: HIV-infected individuals aged ≥ 18 years presenting to our clinic between January 1996 and December 2015 were included. Data were collected retrospectively from medical records, and two decades (1996-2005 and 2006-2015) were analyzed. Results: Overall, 80% were male; the median age (min; max) was 36.43 (17; 77) years. Patients with stage 3 disease were significantly higher in the first decade compared to the second decade (p=0.00). The median (min; max) CD4+ T lymphocyte count at baseline was 160 (3; 650) and 355 (0; 1800) cells/mm3 in the first and second decades, respectively (p=0.00). The treatment initiation rate was 94.2%; virologic suppression rates at six months of treatment and throughout the total follow-up time were 70.1% and 78.1%, respectively. The difference between the two decades in virologic suppression was significant (p=0.004). AIDS-defining disease developed in 12.9% (52.6% in the first and 11% in the second decade) (p=0.01). The adverse event rate was 60.8%; hyperlipidemia was the most common (60.2%). The death rate was 6.5% and lymphoma (14.3%) and tuberculosis (10.9%) were the most common causes of death. The estimated survival time was 272 months (95% confidence interval 225-320). The inability to achieve virologic suppression, an AIDS-defining disease, and a baseline CD4+ T lymphocyte count &lt;200 cells/mm3 was inversely correlated with survival time. Conclusion: Significant improvements in HIV care and management were recorded in time in our cohort in line with the improvements in global HIV care. Treatment and viral suppression rates were above the Joint United Nations Programme on HIV/AIDS – UNAIDS 90-90-90 target in the second decade. This may be attributed to the recent developments in antiretroviral treatment and the competence of the HIV team in the Aegean University Medical Faculty Infectious Diseases and Clinical Microbiology Department.</jats:p

691. Infective Endocarditis with an Indication for Cardiac Surgery in a Tertiary Care Educational Hospital: Does Cardiac Surgery Improve Outcomes?

Abstract Background In this retrospective cohort study, it was aimed to compare the clinical characteristics and outcomes of IE cases without and with an indication for cardiac surgery in terms of whether they have been operated or not, in a tertiary-care educational hospital. Methods Patients that were followed up for definite IE (diagnosed according to modified Duke criteria between March 2007 and November 2020) with an indication for cardiac surgery according to European Society of Cardiology Guidelines, comprised the study group. Subjects were evaluated in terms of whether these cases have been operated or not, demographic features, underlying diseases, risk factors, clinical and laboratory findings, therapy responses, complications, and mortality. The timing of surgery is defined as emergency; surgery performed within 24 hours, urgent; within a few days, elective; after at least one-two weeks of antibiotic therapy. Statistical analysis was performed via Chi square and Student T tests and a p value &amp;lt; 0.05 was considered significant. Results A total of 90 patients with an indication for surgery, 33.3% patients in underwent surgery, 66.6% patients in not underwent surgery group fulfilled the study criteria. The most frequently seen complaints in patients were fever (91.1%), cold-shiver (56.6%), weight-loss (27.7%), dyspnea (25.5%), and tachycardia (20%). Heart murmur was detected during cardiac auscultation of 44 patients. Mean blood leukocyte count, C-reactive protein and erythrocyte sedimentation rate were 12324 ± 6558/mm3 (1408-30330), 11.46 ± 8.38 mg/dl (0.18-34.6) and 61.43 ± 33.4 mm/h (2-130), respectively. There was no significant difference between two groups in terms of cardiac/non-cardiac risk factors, age, gender, etiologic agents, laboratory findings, septic embolisms and complaints (Table 1). In total IE with an indication for surgery mortality was 27.7%. Mortality rate was significantly less and heart murmur was significantly higher in cases who underwent surgery than those did not undergo surgery (p: 0.0447). Table 1. Comparison of basic characteristics of patients in the two operated / unoperated cohorts. Conclusion These data support the importance of the guidelines’ criteria for cardiac surgery in the management of IE. Assuming that only 1/3 of the surgery needing cases received surgery, more interventions are needed to decrease the barriers against surgery. Disclosures All Authors: No reported disclosures </jats:sec

532. Can Saccharomyces boulardii Therapy Be Effective in Decolonizing Rectal Carbapenem-Resistant Enterobacteriaceae (CRE) Colonization?

Abstract Background CRE are globally important pathogens associated with significant morbidity and mortality. The problem of carrying CRE may continue to create a problem in discharged cases in the community. Saccharomyces boulardii sachet therapy (SBST) is reported to cause decolonization in several MDR bacteria carriers. Herein, it is aimed to present the decolonizing rates of rectal CRE colonized cases after SBST treatment. Methods The study period was August 2018–March 2019. Inclusion criteria were: (i) age &gt;18, (ii) receiving Saccharomyces boulardii 250 mg sachets q12h for 7 days, (iii) being proven CRE carrier on rectal swab culture (RSC) up to 5 days period before SBST. The first repeated RSC was performed 3–5 days after the end of SBST. Data were retrieved from the hospital electronic database. Cases with three consecutive weekly performed negative RSC were considered to be decolonized. RSC were processed according to CDC protocol; briefly, the swab was inoculated into 10 mL of trypticase soy broth (bioMérieux Inc., Marcy-l’Étoile, France) with the addition of one 10-μg ertapenem disk (Oxoid, Altrincham, UK) and incubated at 35°C for 18–20 h. The next day, after vortexing, 100 μL of the inoculum was subcultured (8) onto chromID CARBA agar plates (bioMérieux) and incubated at 35°C for 18–20 h. Suspected CRE colonies on chromID CARBA (blue/green to blue/gray in color) were identified by the VITEK MS system (bioMérieux). Susceptibility testing of the isolates was performed with the VITEK 2 system (bioMérieux). Isolates were tested for their resistance phenotypes to imipenem, ertapenem, and meropenem by E-test (bioMérieux). The results were interpreted according to the EUCAST criteria. Results Fifteen cases [2 women, mean age 60.6 ± 18.3 (min. 18–max. 83)] fulfilled the inclusion criteria. All had a history of carbapenem usage. Five cases (33%) had three consequent negative RSC after SBST and were considered to be decolonized. Twelve cases were receiving concomitant antibiotic during SBST (10 carbapenem based regimens). Three cases who received no concomitant antibiotic were decolonized. Conclusion SBST may be a promising tool for decolonizing CRE carriers. These data need to be validated in larger cohorts preferably via randomized-controlled trials. Disclosures All authors: No reported disclosures. </jats:sec

Penicillin/gentamicin vs ampicillin/sulbactam/gentamicin vs vancomycin/gentamicin in the empirical therapy of native valve infective endocarditis

AIM: The aim of this studt to compare the therapy responses of native valve IE patients in whom empirical penicillin +gentamicin, ampicillin/sulbactam + gentamicin, or vancomycin + gentamicin were initiated. BACKGROUND: Despite developments in antibiotics and medicine,infective endocarditis (IE) is associated with significant morbidity and mortality METHODS: Outcomes of patients in whom empirical penicillin + gentamicin (PENG),ampicillin/sulbactam + gentamicin (SAMG), or vancomycin + gentamicin (VANG) were initiated for native valve IE (according tomodified Duke criteria) between March 2007 and November 2023 were evaluated retrospectively. Of note, antistaphylococcal penicillins have never been available in our setting/country. Patients were analyzed in terms of demographic features, clinical and laboratory findings, therapy responses and mortality. Patients were given ampicillin/sulbactam 12 gr + gentamicin 3 mg/kg/daily, penicillin 24 MU+ gentamicin 3 mg/kg/daily, and vancomycin 2 gr/daily + gentamicin 3 mg/kg/daily. We used Chi-square,Fisher Exact and One Way Anova tests for statistical comparison. RESULTS: There were 38, 40 and 11 patients in PENG, SAMG and VANG cohorts,respectively. While S. viridans were significantly more common in PENG cohort, there was no significant difference between the three cohorts in terms of age, gender, fever, presence of vegetation, IE with microbiological evidence, culture-negative IE, S.aureus and Enterococcus spp. successful outcome without antimicrobial modification and end of treatment mortality (Table 1). Conculisons: Despite the relatively low number of cases in both arms, there was no significant difference between the three therapy cohorts in our series. The possible reason may be the relatively few S.aureus in the etiology

Infective endocarditis in a developing country: evaluation of 230 cases

AIM: In this study it was aimed to analyse the clinical characteristics and outcomes of IE cases in our hospital. BACKGROUND: Despite developments in antibiotics and medicine, infective endocarditis (IE) is associated with significant morbidity and mortality. METHODS: Patients that were followed up for definite IE (diagnosed according to modified Duke criteria) in ourhospital between March 2007 and September 2023 were analyzed retrospectively. Patients were evaluated in terms of demographic features,underlying diseases, risk factors, clinical and laboratory findings, therapy responses, complications, and mortality. RESULTS: There were 230 patients diagnosed with IE [79-52.6% femaie, aged 53.3±16.9 years, ranging 18-92 years] fulfilling the study inclusion criteria. Risk factors, complaints, laboratory findings and complications of patients was shown in Table 1. Blood culture was positive in 175 patients (75,5%). The most common etiologic agents were; S. viridans (26.08%), S. aureus (18.6%) and E. feacalis (10.8%). The antibiotherapy of 40 patients with native valve endocarditis comprised ampicillin/sulbactam and gentamicin (other therapy combinations were vancomycin and gentamicin [n=11], penicillin and gentamicin[n=38]). Nine of 49 patients with prosthetic valve endocarditis were treated with vancomycin, rifampicin and gentamicin while other nine were treated with daptomycin including therapy. In hospital mortality was (20%-46/230). Mortality rates between blood culture positive and negative cases were similar (Chi-square test p=1) while mortality in S. viridans was less than S. aureus or enterococci (Chi-square test p=0.0085, Table 2). CONCLUSIONS: IE is still associated with significant mortality. More interventions are needed to further decrease the complication and mortality rates