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Abstract Introduction To determine the predictive factors of initial and long-term adherence to positive airway pressure (PAP) therapy and which factors leading a shift of good initial compliance to noncompliance. Methods In this follow-up study, A cohort of 166 adult patients who underwent polysomnography (PSG) between January 2017 and April 2019, newly diagnosed with obstructive sleep apnea (OSA) and were amenable to PAP therapy were selected. Information on basic demographics, comorbidities and sleep-related symptoms was collected. PAP adherence data were collected at the end of the first week and the third month. After 3 months of follow-up, 142 participants were included for final data analysis. Results Pressure levels were stable during 3 months of PAP treatment. Overall average daily usage time and percentage of PAP used days ≥4 hrs were lower for 3 months than that in the first week. After adjustment for age and gender, multinomial logistic regression analysis showed that less number of sleep-related symptoms (OR, 0.69; 95% CI, 0.52-0.91) and low arousal threshold (ArTH) (OR, 4.44; 95% CI, 1.52-12.98) were associated with a higher odds of consistent noncompliance of PAP; Low ArTH (OR, 2.87; 95% CI, 1.09-7.57) and less BIM (OR, 0.88; 95% CI, 0.78-0.99) increased the risk of compliance-to-noncompliance shift. Conclusion Different from the predictors of consistent PAP noncompliance of OSA patients, only less BMI and low ArTH would cause a good PAP compliance shift to noncompliance over time. Support Science and technology Beijing 100 leading talents (Z171100001117168)

Abstract Disclosure: R. Purbey: None. J.G. Daily: None. Primary adrenal insufficiency (PAI),also known as Addison’s disease,is a rare long-term endocrine disorder affecting around 9-14/100000 people in the developed world.It is characterized by the inadequate production of cortisol and mineralocorticoids leading to electrolyte abnormalities including hyponatremia and hyperkalemia. One of the possible complications of PAI is hypercalcemia which is noted in around 5-6 % of patients at the time of diagnosis.Monitoring adequacy of steroid replacement therapy in PAI is mostly based on signs and symptoms.We present a rare case of PAI where elevated calcium levels served as a marker of nonadherence with glucocorticoid (GC) replacement. Our patient is a 20 y/o male with past medical history of autoimmune polyglandular syndrome with PAI and hypothyroidism;who presented for regular follow-up.He was on GC and thyroid hormone replacement.He had a recent fall which resulted in left clavicle fracture.Clinical examination was unremarkable.Labs showed mildly elevated calcium of 10.1 mg/dL(8.6-10),elevated creatinine at 1.2 mg/dL(0.67-1.17) and elevated phosphorus of 4.7 mg/dL(2.5-4.5).He reported compliance with current treatment regimen.On follow-up after 1 month, labs showed persistent elevation in calcium, creatinine and phosphorus levels at 10.2 mg/dL,1.2 mg/dL and 5.3 mg/dL respectively.Patient's mother reported that patient was missing some doses of his hydrocortisone. After counseling, he resumed recommended treatment regimen. Labs were repeated after 1 month and they revealed normalization of calcium ,creatinine and phosphorus levels at 9.1 mg/dL, 1 mg/dL and 4.4 mg/dL respectively.Patients with PAI on GC replacement therapy are regularly monitored for over-replacement or under-replacement based on symptoms and signs including postural hypotension,energy levels, weakness,dizziness and cushingoid features.Our patient was under replaced and he only had lab abnormalities with consistently elevated calcium levels. Hypercalcemia in PAI is postulated to be due to various causes including increased resorption from bone and decrease removal by the kidneys.On resumption of treatment, his calcium levels normalized.His fall could possibly have been due to dizziness resulting from under replacement.There have been numerous case reports of Addison's disease and adrenal crisis initially presenting with hypercalcemia.This case is one of the rare instances where under replacement of GC therapy in PAI was diagnosed on the basis of elevated calcium levels, and not on the basis of signs and symptoms.The implications of nonadherence with therapy in PAI is adrenal crisis which has a high mortality rate.Our case report therefore demonstrates that hypercalcemia can serve as a marker of noncompliance with therapy in PAI and identifying this can help us in increasing compliance and adherence; thereby reducing the incidence of adrenal crisis. Presentation: Sunday, July 13, 2025

This thesis consists of two relatively independent parts. In the first part, we study operads with homological stability, which are topological operads that satisfy a homological stability condition. Despite the fact that these operads are in general very far from being E∞-operads, their algebras give rise to infinite loop spaces upon group completion. We show that under a mild condition on an operad with homological stability, one can naturally associate topologically enriched symmetric strict monoidal categories to its algebras such that the group completion of the algebra is weakly equivalent to the loop space on the classifying space of the associated category, which is evidently an infinite loop space. We also show that this new infinite loop space structure coming from the associated category is equivalent to the previously known infinite loop space structure on the group completion of the algebra. The second part is concerned with quotients of mapping class groups Γg,1 of oriented surfaces with one boundary component by the subgroups ϕg,1(k) in their Johnson filtration. We show that the stable classifying spaces Z × B (Γ∞/ϕ∞(k))+ after Wuillen's plus-construction are infinite loop spaces, fitting into a tower of infinite loop space maps that interpolates between the infinite loop spaces Z × BΓ+∞ and Z × B (Γ∞/ϕ∞(1))+ ≃ Z × BSp(Z)+ . We also show that for each level k in the Johnson filtration, the homology of these quotients with suitable systems of twisted coeficients stabilises as the genus g of the surface tends to infinity.

Abstract Background The American Society of Clinical Oncology (ASCO) Language of Respect (LoR) guidelines were developed to promote the use of patient-centered language in all communications in 2020. The Language of Respect guidelines provide a directive to encourage the highest level of respect in addressing patients with cancer. In this study, we aimed to analyze the adherence to these guidelines in renal cell carcinoma (RCC) abstracts presented at the 2023 ASCO Annual Meeting, the largest international meeting of oncologists. Methods All RCC abstracts published in the 2023 ASCO Annual Meeting were evaluated. Statements from the abstracts were collected and stratified into the three categories of the LoR guidelines: (1) “Do not blame patients”, (2) “Respect the role of patients”, and (3) “Do not dehumanize patients”. Abstract and author data were summarized using descriptive statistics, and univariable and multivariable analyses were utilized to identify factors associated with odds of noncompliance with the guidelines. Results In total, 101 RCC abstracts were assessed. Most abstracts were published as poster presentations (51.5%) followed by online publication only (44.6%) and oral abstracts (4.0%). First authors affiliated with institutions in native English-speaking countries constituted 69.3% of the abstracts. Authors affiliated with institutions from a single country comprised 67.3% of the abstracts, whereas 32.7% of the abstracts were affiliated with authors from multiple countries. 40.6% of abstracts received no funding, 36.6% of abstracts received funding from a pharmaceutical company, and 22.8% received funding from non-profit organizations, institutions, or grants. There were 34 (33.7%) abstracts associated with clinical trials versus 67 (66.3%) associated with non-clinical trials. 51.5% of abstracts remained within 5% of the character count limit. Overall, 60.4% of the abstracts contained at least one statement that violated the guidelines. Abstracts with at least one statement violating “Do not dehumanize patients”, “Do not blame patients”, and “Respect the role of patients” directives were found in 46.5%, 21.8%, and 1.0% of abstracts, respectively. Abstracts within 5% of the character count limit were associated with increased odds of guideline noncompliance in the univariable analysis (OR 0.33 [95% CI 0.14-0.75], p=0.008). By multivariable analysis, abstracts within 5% of the character count limit were also associated with higher odds of violating the guidelines (OR 0.31 [95% CI 0.13-0.71], p=0.006). Conclusions A significant portion of RCC abstracts were found to violate the LoR guidelines. Our results highlight the importance of considering the expansion of the character count limit for abstract submissions to increase adherence to the LoR guidelines. With the incorporation of LoR guidelines in all forms of communication, the scientific community can promote increased use of respectful language in addressing patients, families, and colleagues.

The objective of the study was to analyze researchers’ compliance with their data availability statement (DAS) from manuscripts published in open-access journals with the mandatory DAS. We analyzed all articles from 333 open-access journals published during January 2019 by BioMed Central. We categorized types of the DAS. We surveyed corresponding authors who wrote in the DAS that they would share the data. Consent to participate in the study was sought for all included manuscripts. After accessing raw data sets, we checked whether data were available in a way that enabled reanalysis. Of 3556 analyzed articles, 3416 contained the DAS. The most frequent DAS category (42%) indicated that the data sets are available on reasonable request. Among 1792 manuscripts in which the DAS indicated that authors are willing to share their data, 1669 (93%) authors either did not respond or declined to share their data with us. Among 254 (14%) of 1792 authors who responded to our query for data sharing, only 123 (6.8%) provided the requested data. Even when authors indicate in their manuscript that they will share data upon request, the compliance rate is the same as for authors who do not provide the DAS, suggesting that the DAS may not be sufficient to ensure data sharing.