Absolute Rates Research Articles

P142 ADHERENCE TO PHYSICAL ACTIVITY GUIDELINES IN MAY MEASUREMENT MONTH 2021 AND 2022 PARTICIPANTS

Background and Objective: Physical activity (PA) lowers blood pressure (BP) and improves other cardiovascular risk factors, but many adults fail to achieve recommended PA levels. We aimed to evaluate adherence to the World Health Organisation's (WHO) PA guidelines and associations with BP treatment and control rates amongst adults screened in May Measurement Month (MMM) 2021 and 2022. Methods: Adults (≥18 years) were surveyed opportunistically from 74 countries. Each participant had three seated BP readings, using multiple imputation for any missing values. Participants who self-reported (yes/no) adherence to the WHO PA guidelines (75 minutes of vigorous exercise or 150 minutes of moderate exercise per week) were included. Hypertension was defined as a BP ≥140/90mmHg and/or taking BP-lowering medication. Results: Of 1,357,575 participants screened, 1,098,038 (80.9%) provided information on PA adherence. The mean (standard deviation) age was 46.8 (16.8) years and 52.9% were female. 333,214 (30.3%) participants adhered to PA guidelines. Of 394,444 (35.9%) participants with hypertension, PA adherence was higher in the 211,900 (53.7%) treated with BP-lowering medication (33.2% vs 27.4%, p<0.0001) than those untreated. Amongst treated hypertensives, adherence was higher in those with controlled BP (Table) and increased with age (p<0.0001). Of participants not taking BP-lowering medication, higher adherence was reported by the 703,594 (79.4%) normotensive participants (p<0.0001) and adherence was highest in the 18–29 age group. The absolute rates of PA adherence were 40.3%, 37.3% and 36.2% in those with a history of diabetes, stroke and myocardial infarction, respectively, compared to 29.7, 30.3, 30.2% in those without these respective conditions (all p<0.0001). Conclusions: Only 30% of MMM 2021 and 2022 participants worldwide adhered to WHO PA guidelines. Compared with untreated hypertensive participants, adherence was higher amongst those taking BP-lowering medication. PA adherence was significantly higher in those with diabetes. Those adhering to PA guidelines were more likely to have BP <140/90 mmHg, regardless of taking BP-lowering medication, emphasising the importance of PA for BP control.

Hydrogen diffusion and hydrogen embrittlement in iron (steel)

This article examines the diffusion of hydrogen (H-diffusion) and the temperature dependences of the diffusion coefficient of hydrogen (DH) in the metal (M)-hydrogen system. The metal used was iron and low-alloy steel. Taking into account experimental data on hydrogen diffusion in the Fe-H and steel-H systems, the main diffusion parameters were calculated and compared. It is shown that the temperature dependences of the hydrogen diffusion coefficient in metal samples in a one-stage reaction under isothermal conditions are described by the Arrhenius equation. For some M-H systems, experimental data show a deviation of the diffusion coefficient from the ideal one calculated using the Arrhenius equation. This discrepancy can be eliminated using the statistical theory of absolute reaction rates. For the temperature range 25–1250 oС, the pre-exponential coefficient and activation energy of hydrogen diffusion in a body-centered cubic (bcc) lattice of iron (α–Fe) were calculated using the Arrhenius equation. These parameters make it possible to describe the dependence of the rate of hydrogen diffusion in a metal on temperature and to predict the behavior of hydrogen diffusion when changing the conditions of the kinetic process (concentration of substances, pressure, structure, composition, etc.). Tabular values of the calculated pre-exponential factor and activation energy of hydrogen diffusion in previously studied iron-based samples are presented. The temperature dependences of the hydrogen diffusion coefficient in a lattice of iron α–Fe can be divided into low-temperature and high-temperature regions. The calculated diffusion parameters of hydrogen in the metal lattice for the low-temperature 25– 800 oC and high-temperature 800–1250 oC regions differ markedly from each other. In addition, these calculated values are significantly influenced by the structure and composition of the metal. We also studied the diffusion of hydrogen in α-iron using ab initio density functional calculations. Molecular dynamics calculations using transition state theory were used. The calculated diffusion coefficient of hydrogen in α-Fe is consistent with previously obtained experimental data. Hydrogen embrittlement (HE) is considered using internal pressure, hydrogen enhanced localized plasticity (HELP) and hydrogen enhanced decohesion embrittlement (HEDE) theories.

The space occupation and use by tree crowns explain variations of individual growth rates in an old-growth temperate forest in Japan

Relative growth rates (RGR), i.e., growth rates per unit biomass (ΔM/M, where M is plant mass and ΔM is the change in M over a period of time), reflect growth strategies of plant species. Partitioning of RGR to net assimilation rate (ΔM/leaf area) and leaf area ratio (leaf area/M) provides further insights into allocation strategies. To apply this analytical approach to large canopy tree species, we used crown area (Ac) as a proxy for leaf area to understand variations of RGR partitioned to space use efficiency (SUE, ΔM/Ac) and space occupation efficiency (SOE, Ac/M). With UAV imagery, we measured Ac of 226 co-occurring individuals of 14 canopy tree species in a 1-ha stand in a temperate old-growth mixed-forest in Japan, and analyzed how RGR was related to SUE and SOE. The results show that deciduous species exhibited higher SOE and lower SUE compared to evergreen species, even though their RGR values largely overlapped. Late successional species tended to have higher RGR through higher SUE than early-to-middle successional species. We also analyzed the relationship of absolute growth rates (AGR) with several functional traits including DBH (diameter at breast height), Ac, leaf- and stem traits. Both Ac and DBH were strong determinants of AGR across species. Low specific leaf area (SLA, leaf area per unit leaf mass) and high wood density positively contributed to AGR across species, offering long-term growth advantages for old-growth natural forest. The analytical framework introduced in this study may be useful to elucidate the variation of tree growth strategies of canopy trees in natural forest stands.

First climatology of F-region UHF echoes observed by the AMISR-14 system at the Jicamarca radio observatory and comparison with the climatology of VHF echoes observed by the collocated JULIA radar

Coherent backscatter radar observations made at the Jicamarca Radio Observatory (JRO) have contributed significantly to our understanding of equatorial F-region irregularities. Radar observations, however, have been made predominantly at the Very-High Frequency (VHF) band (50 MHz), which corresponds to measurements of 3-m field-aligned irregularities. The deployment of the 14-panel version of the Advanced Modular Incoherent Scatter Radar (AMISR-14) at Jicamarca provided an opportunity for observations of Ultra-High Frequency (UHF - 445 MHz) echoes which correspond to measurements of irregularities with 0.34 m scale sizes. Here, we present what we believe to be the first report describing the quiet-time climatology of sub-meter equatorial F-region irregularities derived from UHF radar measurements. The measurements were made between August 2021 and February 2023 using a 10-beam AMISR-14 mode that scanned the F-region in the magnetic equatorial plane. The results show how F-region sub-meter irregularities respond to variations in season and solar flux conditions. The results also confirm, experimentally, that the occurrence of UHF F-region echoes is controlled by the occurrence of equatorial spread F (ESF). Higher occurrence rates were observed during pre-midnight hours and during Equinox and December solstice. Reduced occurrence rates were observed during June solstice. The results show that an increase in solar flux was followed by an increase in the altitude where noticeable occurrence rates (≳ 10%) start and in the maximum altitude of these occurrence rates. The observations also show that occurrence rates lasted longer (in local time) during low solar flux conditions. Comparisons with collocated VHF radar observations showed that, despite differences in radar parameters, observation days, and the scale size (one order of magnitude) of the scattering irregularities, the two systems show similar climatological variations with only minor differences in the absolute occurrence rates. Finally, the analysis of the occurrence rates for different beams did not show substantial climatological variations over local (within a few 100s of km) zonal distances around JRO. We point out, however, that observations on a single day can show strong local variations in echo detection and intensity within the AMISR-14 field of view due to the intrinsic development and decay of ESF structures.

Harnessing Koelreuteria paniculata Seed Extracts and Oil for Sustainable Woolly Apple Aphid Control

The woolly apple aphid—WAA (Eriosoma lanigerum Hausmann, 1802) poses a significant threat to intensive apple production. Given the limitations of conventional synthetic pesticides, there is an urgent need for effective and sustainable pest management strategies. Botanical extracts derived from plants with insecticidal properties mitigating aphid populations without adverse environmental impacts are scarce where WAA is concerned. Thus, the pertinent study aimed to investigate the aphicidal potential of Koelreuteria paniculata seed ethanolic extract (derived from the seed coat) and mechanically extracted oil (derived from the seed itself). At concentrations of 2.5% and 5%, both solutions expressed undeniable insecticidal potential, providing absolute (100%; oil) or significant (86–100%; ethanolic extract) mortality rates both in vivo and in vitro. Predominant phenolic compounds determined in the ethanolic extract were gallic and protocatechuic acids and three derivates—p-coumaric, quercetin, and luteolin acid derivates—contributing to more than 90% of the total phenolic content, while phenolic compounds were not detected in the oil, indicating activity of different active compounds. Although deriving from different seed parts and distinct extraction methods, both ethanolic extract and oil exhibited significant aphicidal effects against WAA. The integration of botanical extracts from invasive species into pest management practices supports ecological balance and sustainable agricultural productivity, fostering a healthier environment and more resilient agricultural systems.

Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial

Semaglutide, a GLP-1 receptor agonist, reduces the risk of major adverse cardiovascular events (MACE) in people with overweight or obesity, but the effects of this drug on outcomes in patients with atherosclerotic cardiovascular disease and heart failure are unknown. We report a prespecified analysis of the effect of once-weekly subcutaneous semaglutide 2·4 mg on ischaemic and heart failure cardiovascular outcomes. We aimed to investigate if semaglutide was beneficial in patients with atherosclerotic cardiovascular disease with a history of heart failure compared with placebo; if there was a difference in outcome in patients designated as having heart failure with preserved ejection fraction compared with heart failure with reduced ejection fraction; and if the efficacy and safety of semaglutide in patients with heart failure was related to baseline characteristics or subtype of heart failure. The SELECT trial was a randomised, double-blind, multicentre, placebo-controlled, event-driven phase 3 trial in 41 countries. Adults aged 45 years and older, with a BMI of 27 kg/m2 or greater and established cardiovascular disease were eligible for the study. Patients were randomly assigned (1:1) with a block size of four using an interactive web response system in a double-blind manner to escalating doses of once-weekly subcutaneous semaglutide over 16 weeks to a target dose of 2·4 mg, or placebo. In a prespecified analysis, we examined the effect of semaglutide compared with placebo in patients with and without a history of heart failure at enrolment, subclassified as heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, or unclassified heart failure. Endpoints comprised MACE (a composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death); a composite heart failure outcome (cardiovascular death or hospitalisation or urgent hospital visit for heart failure); cardiovascular death; and all-cause death. The study is registered with ClinicalTrials.gov, NCT03574597. Between Oct 31, 2018, and March 31, 2021, 17 604 patients with a mean age of 61·6 years (SD 8·9) and a mean BMI of 33·4 kg/m2 (5·0) were randomly assigned to receive semaglutide (8803 [50·0%] patients) or placebo (8801 [50·0%] patients). 4286 (24·3%) of 17 604 patients had a history of investigator-defined heart failure at enrolment: 2273 (53·0%) of 4286 patients had heart failure with preserved ejection fraction, 1347 (31·4%) had heart failure with reduced ejection fraction, and 666 (15·5%) had unclassified heart failure. Baseline characteristics were similar between patients with and without heart failure. Patients with heart failure had a higher incidence of clinical events. Semaglutide improved all outcome measures in patients with heart failure at random assignment compared with those without heart failure (hazard ratio [HR] 0·72, 95% CI 0·60-0·87 for MACE; 0·79, 0·64-0·98 for the heart failure composite endpoint; 0·76, 0·59-0·97 for cardiovascular death; and 0·81, 0·66-1·00 for all-cause death; all pinteraction>0·19). Treatment with semaglutide resulted in improved outcomes in both the heart failure with reduced ejection fraction (HR 0·65, 95% CI 0·49-0·87 for MACE; 0·79, 0·58-1·08 for the composite heart failure endpoint) and heart failure with preserved ejection fraction groups (0·69, 0·51-0·91 for MACE; 0·75, 0·52-1·07 for the composite heart failure endpoint), although patients with heart failure with reduced ejection fraction had higher absolute event rates than those with heart failure with preserved ejection fraction. For MACE and the heart failure composite, there were no significant differences in benefits across baseline age, sex, BMI, New York Heart Association status, and diuretic use. Serious adverse events were less frequent with semaglutide versus placebo, regardless of heart failure subtype. In patients with atherosclerotic cardiovascular diease and overweight or obesity, treatment with semaglutide 2·4 mg reduced MACE and composite heart failure endpoints compared with placebo in those with and without clinical heart failure, regardless of heart failure subtype. Our findings could facilitate prescribing and result in improved clinical outcomes for this patient group. Novo Nordisk.

Comparison of oral anticoagulants for stroke prevention in atrial fibrillation using the UK clinical practice research Datalink Aurum: A reference trial (ARISTOTLE) emulation study.

Stroke prevention guidance for patients with atrial fibrillation (AF) uses evidence generated from randomised controlled trials (RCTs). However, applicability to patient groups excluded from trials remains unknown. Real-world patient data provide an opportunity to evaluate outcomes in a trial analogous population of direct oral anticoagulants (DOACs) users and in patients otherwise excluded from RCTs; however, there remains uncertainty on the validity of methods and suitability of the data. Successful reference trial emulation can support the generation of evidence around treatment effects in groups excluded or underrepresented in trials. We used linked United Kingdom primary care data to investigate whether we could emulate the pivotal ARISTOTLE trial (apixaban versus warfarin) and extend the analysis to investigate the impact of warfarin time in therapeutic range (TTR) on results. Patients with AF in the UK Clinical Practice Research Datalink (CPRD Aurum) prescribed apixaban or warfarin from 1 January 2013 to 31 July 2019 were selected. ARISTOTLE eligibility criteria were applied to this population and matched to the RCT apixaban arm on baseline characteristics creating a trial-analogous apixaban cohort; this was propensity-score matched to warfarin users in the CPRD Aurum. ARISTOTLE outcomes were assessed using Cox proportional hazards regression stratified by prior warfarin exposure status during 2.5 years of patient follow-up and results benchmarked against the trial results before treatment effectiveness was further evaluated based on (warfarin) TTR. The dataset comprised 8,734 apixaban users and propensity-score matched 8,734 warfarin users. Results [hazard ratio (95% confidence interval)] confirmed apixaban noninferiority for stroke or systemic embolism (SE) [CPRD 0.98 (0.82,1.19) versus trial 0.79 (0.66,0.95)] and death from any cause [CPRD 1.03 (0.93,1.14) versus trial 0.89 (0.80,0.998)] but did not indicate apixaban superiority. Absolute event rates for stroke/SE were similar for apixaban in CPRD Aurum and ARISTOTLE (1.27%/year), whereas a lower event rate was observed for warfarin (CPRD Aurum 1.29%/year, ARISTOTLE 1.60%/year). Analysis by TTR suggested similar effectiveness of apixaban compared with poorly controlled warfarin (TTR < 0.75) for stroke/SE [0.91 (0.73, 1.14)], all-cause death [0.94 (0.84, 1.06)], and superiority for major bleeding [0.74 (0.63, 0.86)]. However, when compared with well-controlled warfarin (TTR ≥ 0.75), apixaban was associated with an increased hazard for all-cause death [1.20 (1.04, 1.37)], and there was no significant benefit for major bleeding [1.08 (0.90, 1.30)]. The main limitation of the study's methodology are the risk of residual confounding, channelling bias and attrition bias in the warfarin arm, and selection bias and misclassification in the analysis by TTR. Analysis of noninterventional data generated results demonstrating noninferiority of apixaban versus warfarin consistent with prespecified benchmarking criteria. Unlike in ARISTOTLE, superiority of apixaban versus warfarin was not seen, possible due to the lower proportion of Asian patients and higher proportion of patients with well-controlled warfarin compared to ARISTOTLE. This methodological template can be used to investigate treatment effects of oral anticoagulants in patient groups excluded from or underrepresented in trials and provides a framework that can be adapted to investigate treatment effects for other conditions.

Bariatric surgery in patients with preoperative therapeutic anticoagulation: a 2015–2021 MBSAQIP database study

BackgroundThe link between obesity and adverse cardiovascular events is well-established. With the rising prevalence of metabolic and bariatric surgery (MBS), a greater number of patients undergoing sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) may present with preoperative therapeutic anticoagulation (AC). ObjectivesThis study evaluated perioperative outcomes of SG and RYGB in patients on preoperative AC. SettingPatients reported to the 2015–2021 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. MethodsAdults undergoing primary SG or RYGB with and without preoperative anticoagulation (SG-AC or RYGB-AC and non-SG-AC or non-RYGB-AC, respectively) were analyzed from the 2015–2021 MBSAQIP database. Differences in baseline characteristics by AC status for each MBS were adjusted using entropy-balanced weights. Multivariable logistic and linear regressions were developed to analyze the independent association between AC and outcomes of interest. ResultsOf 1,178,090 patients included, 72.0% (n = 850,682) had SG and 28.0% (n = 327,408) had RYGB, of which 1.8% (n = 15,021) and 1.9% (n = 6201) had AC, respectively. Compared to non-SG-AC and non-RYGB-AC, both SG-AC and RYGB-AC encountered higher absolute 30-day rates of anastomotic leak, deep vein thrombosis and gastrointestinal bleeding. Following multivariable adjustment, SG-AC was associated with significantly greater odds of adverse cardiovascular events, anastomotic leak, gastrointestinal bleeding, and greater operative length and length of stay. RYGB-AC was associated with higher odds of readmission, unplanned ICU admission, and ED visit. ConclusionsWhile preoperative AC may confer distinct outcomes between SG and RYGB, this 7-year study of MBSAQIP demonstrated an overall association with greater postoperative morbidity. Management of MBS patients with preoperative AC requires consideration of thrombohemorrhagic risks.

Interdisciplinary quality improvement in oculoplastic surgery: transforming biopsy follow-up through PDSA cycles

ObjectiveTo evaluate and improve the quality of periocular biopsy follow-up by determining the absolute compliance rate, examining delays between stages, identifying obstacles to high-quality follow-up, and offering recommendations for improvement. MethodsPhase 1: A retrospective, observational, and descriptive study was conducted using chart reviews of adult patients who underwent periocular biopsies at the Centre Hospitalier Universitaire de Sherbrooke (CHUS) from January 2019 to October 2022. Phase 2: Three simultaneous Plan-Do-Study-Act (PDSA) cycles were implemented, focusing on enhancing communication channels between clinicians and pathologists, introducing a priority system for urgent cases, and establishing an automatic reminder system for pathologists. ResultsPhase 1: Among the 103 patients analyzed, 29 had malignant lesions, while 74 had nonmalignant lesions. The absolute compliance rate was 37.9% for malignant lesions. All of these noncompliances were due to excessive turnaround time (TT) to issue the pathology report. The percentage of cases that had adequate pathology TT (≤ 7 days) were 37.9% for malignant lesions, much lower than the Quebec Ministry of Health's target (80% at ≤7 days). Phase 2: The implemented PDSA cycles led to significant increases in absolute compliance rates and pathology TT compliance rates for malignant lesions. Primary outcomes showed that the absolute compliance rate increased to 93.3%. Secondary outcomes indicated that the pathology TT compliance rate also reached 93.3%. ConclusionsDelayed pathology reporting was identified as the primary cause of suboptimal follow-up. The successful implementation of targeted PDSA cycles improved communication, prioritization, and reminder systems, resulting in considerable improvements in primary and secondary outcomes.

Age Estimation in Sepia officinalis Using Beaks and Statoliths.

Establishing the age of cephalopods is crucial for understanding their life history, which can then be used for assessment and management. This is particularly true for the common cuttlefish Sepia officinalis (Linnaeus, 1758), one of the most important resources for coastal fisheries. For this reason, an age analysis of S. officinalis was performed for the first time in the Mediterranean, using beaks and statoliths from 158 wild specimens (55-222 mm mantle length; 23-1382 g total weight) at different maturity stages (immature to mature). Growth increments were counted in the lateral wall of the upper beaks and the lateral dome of statoliths. In both cases, a good relationship was found between the counts and the sizes of the animals. The low values of coefficients of variation between the readings obtained for beaks (3.96 ± 1.87%) and statoliths (4.00 ± 1.89%) showed a high level of precision and accuracy in the readings. However, the analysis was simpler for beaks, which were all successfully analyzed, while it was more complex for statoliths, with 69% being lost due to rejection or overgrinding. Based on daily increments previously validated in statoliths, the beaks were cross-verified by comparing their counts with those from statoliths extracted from the same 83 specimens, obtaining a statistically significant relationship between the two counts, confirmed by the ANOVA test. Absolute growth rates that were assessed using both beaks and statoliths indicated that the two sexes had a higher growth rate at 122 and 182 days, which subsequently declined in older specimens. Due to the relative simplicity of its processing method, the beak was finally proposed as a suitable hard structure to study the age of S. officinalis. We also confirmed the good readability of increments in the lateral wall of the beak, which could be considered a valid alternative to the rostrum surface.

Efficacy of Upadacitinib and Dupilumab on Achieving Stringent and Composite Skin and Itch Outcomes: an Indirect Comparison of Adults with Moderate-to-Severe Atopic Dermatitis.

Efficacy of upadacitinib has been assessed in trials including Measure Up 1 (NCT03569293), Measure Up 2 (NCT03607422), and Heads Up (NCT03738397). Measure Up 1 and 2 assessed efficacy of upadacitinib 30mg and upadacitinib 15mg against placebo, while Heads Up assessed efficacy of upadacitinib 30mg in a head-to-head trial against dupilumab 300mg. A head-to-head trial of upadacitinib 15mg against dupilumab 300mg has not been conducted. Network meta-analysis has shown that upadacitinib 30mg and upadacitinib 15mg are among the most efficacious targeted systemic therapies, but prior indirect comparisons have not evaluated more stringent outcomes. A population-adjusted indirect comparison was conducted using post hoc individual patient data from Measure Up 1 and 2 and Heads Up to estimate how upadacitinib 15mg would have performed if included in Heads Up by adjusting for patient-level covariates. Absolute response rates at weeks 4, 16, and 24 were estimated for the following outcomes: no/minimal itch [Worst Pruritus Numerical Rating Scale (WP-NRS) score of 0/1], Eczema Area and Severity Index (EASI) score of ≤ 3 (EASI ≤ 3), 100% improvement in EASI (EASI 100), both ≥ 90% improvement in EASI (EASI 90) and WP-NRS 0/1, both EASI ≤ 3 and WP-NRS 0/1, and both EASI 100 and WP-NRS 0/1. The analysis was conducted on adult patients, aligned with the intention-to treat population for the clinical trials, and used non-responder imputation. Across all outcomes assessed, the estimated absolute response rates were greatest for upadacitinib 30mg, followed by upadacitinib 15mg and then dupilumab. This pattern was observed at week 4, week 16, and week 24. For adults with moderate-to-severe AD, upadacitinib 30mg appears to be the most efficacious treatment in attaining more stringent and composite outcomes across multiple timepoints, followed by upadacitinib 15mg and then dupilumab 300mg.

Growth analysis of six lisianthus (Eustoma grandiflorum) cultivars in different growing seasons

The objective of work was to evaluate the growth of six lisianthus cultivars at different times, in a protected environment, in the southern region of Brazil. The experimental design was randomized blocks, in split plots, with three replications. The plots were constituted by the lisianthus cultivars: 'White Excalibur', 'Blue Picotee', 'Blue Echo', 'Arena Red', 'Robella' and 'Echo Champagne'and the subplots by the dates of plant collections (evaluations), which were carried out at the time of transplantation (0) and 21, 42, 63 and 84 days after transplantation (DAT) for seasons 1(October 2017 to January 2018), 2 (November 2017 to February 2018) and 5 (August to December 2018); and at (0) and at 30, 60, 90, 120, 150 and 180 DAT at seasons 3 (April to November 2018), 4 (July to December 2018) and 6 (February to June 2019). All cultivars showed an increasing tendency to accumulate a dry mass of the plants until the harvest of the floral stems. The maximum dry mass value was obtained by the cultivar 'Robella' (20.3 g/plant-1) in season 3. For all cultivars, the absolute and relative growth rates of the crop increased with the advancement of the cultivation period. In seasons 1, 2 and 5 all cultivars showed higher growth velocities between 63 and 84 days after transplanting (DAT). In seasons 3 and 4 the cultivars showed higher growth from 90 to 150 DAT. In seasons 1 and 2 the cultivars showed a higher rate of plant growth, resulting in a shortening of the cycle. The cultivars conducted in seasons 3 and 4 had a longer cultivation time due to the autumn/winter period. The cultivar 'Arena Red' showed the lowest growth rates in all seasons.

Global burden of stroke in adolescents and young adults (aged 15–39 years) from 1990 to 2019: a comprehensive trend analysis based on the global burden of disease study 2019

SummaryIntroductionThe incidence of stroke is rising among individuals aged 15–39. Insufficient research targeting this age group hampers the development of effective strategies. This study analyzes data from the Global Burden of Disease Study 2019 (GBD 2019) to examine trends from 1990 to 2019 and propose future interventions.MethodsData on ischemic strokes, intracerebral hemorrhage, and subarachnoid hemorrhage from 1990 to 2019 was collected from the Global Health Data Exchange (GHDx) platform. We used the Annual Average Percentage Change (AAPC) to assess global trends in incidence, prevalence, Disability-Adjusted Life Years (DALYs), and mortality rates across various stroke categories. Joinpoint models identified significant years of trend inflection. Trend analyses were segmented by age, gender, and Sociodemographic Index (SDI).FindingsFrom 1990 to 2019, the global incidence of ischemic stroke within the adolescents and young adults (AYAs) cohort declined from 1990 to 1999, further decreased from 2000 to 2009, and then increased from 2010 to 2019. The overall AAPC p-value showed no significant difference. Mortality rates for ischemic strokes were consistently reduced during this period. The overall incidence rate of intracerebral hemorrhage has exhibited a downward trend. Meanwhile, the incidence rate of subarachnoid hemorrhage decreased from 1990 to 2009, yet saw a resurgence from 2010 to 2019. Male ischemic stroke incidence grew more than female incidence, but both absolute incidence and rates were higher for females. Differences in SDI levels were observed, with the fastest increase in incidence occurring in low-middle SDI regions, followed by high SDI regions, and the smallest increase in low SDI regions. Conversely, the most rapid decline was noted in high-middle SDI regions, with no significant change observed in middle SDI regions.ConclusionA concerning trend of increasing ischemic stroke incidence, DALYs, and prevalence rates has emerged in the global 15–39 age group, especially among those aged 30–39. This increase is evident across regions with varying SDI classifications. To combat this alarming trend among adolescents and young adults, enhancing preventive efforts, promoting healthier lifestyles, strengthening the healthcare system’s responsiveness, and maintaining vigilant epidemiological monitoring is essential.

Socioeconomic variations in walking rates in the United States: Recent evidence from the 2022 National Household Travel Survey

IntroductionWe use the 2022 National Household Travel Survey for the USA—the first since the peaking of the COVID-19 pandemic—to examine variations in walking rates related to differences in socioeconomic characteristics. Our analysis provides the most recent national estimates of socioeconomic variation in walking, by far the most important form of daily physical activity in the USA. MethodsWe used graphical bivariate analysis and multiple regressions to explore the relationship between each of the socioeconomic variables and the following daily walk rates: the number of walk trips, time walked, and distance walked. We also analyzed three binary variables indicating whether a person made at least one walk trip during the travel day, achieved the equivalent of 150 min of walking per week, and walked on five or more days during the previous 30 days. ResultsHigher education levels, not owning a car, not having a driver's license, not working, working from home, and high density are strongly related to higher levels of walking. We found no significant differences or mixed results for gender, age, race, and income. Because the 2022 NHTS incorporated significant changes in methodology, sample size, survey questions, and variable definitions, its estimated trip rates cannot be compared directly to the 2017 NHTS—the last survey prior to COVID. Moreover, the 2022 NHTS greatly underestimated walk trips because—unlike previous NHTS surveys—it omitted the trip diary as well as multiple prompts to remember short trips, especially walk trips. ConclusionsThe relationships we estimated between various walk rates and the nine socioeconomic variables for 2022 were generally consistent with the results of previous studies, including those examining the 2001, 2009, and 2017 NHTS. That suggests that these relationships have remained stable over time—even if absolute rates of walking have changed, as indicated by other studies.

Performance of three artificial intelligence (AI)-based large language models in standardized testing; implications for AI-assisted dental education.

The emerging rise in novel computer technologies and automated data analytics has the potential to change the course of dental education. In line with our long-term goal of harnessing the power of AI to augment didactic teaching, the objective of this study was to quantify and compare the accuracy of responses provided by ChatGPT (GPT-4 and GPT-3.5) and Google Gemini, the three primary large language models (LLMs), to human graduate students (control group) to the annual in-service examination questions posed by the American Academy of Periodontology (AAP). Under a comparative cross-sectional study design, a corpus of 1312 questions from the annual in-service examination of AAP administered between 2020 and 2023 were presented to the LLMs. Their responses were analyzed using chi-square tests, and the performance was juxtaposed to the scores of periodontal residents from corresponding years, as the human control group. Additionally, two sub-analyses were performed: one on the performance of the LLMs on each section of the exam; and in answering the most difficult questions. ChatGPT-4 (total average: 79.57%) outperformed all human control groups as well as GPT-3.5 and Google Gemini in all exam years (p < .001). This chatbot showed an accuracy range between 78.80% and 80.98% across the various exam years. Gemini consistently recorded superior performance with scores of 70.65% (p = .01), 73.29% (p = .02), 75.73% (p < .01), and 72.18% (p = .0008) for the exams from 2020 to 2023 compared to ChatGPT-3.5, which achieved 62.5%, 68.24%, 69.83%, and 59.27% respectively. Google Gemini (72.86%) surpassed the average scores achieved by first- (63.48% ± 31.67) and second-year residents (66.25% ± 31.61) when all exam years combined. However, it could not surpass that of third-year residents (69.06% ± 30.45). Within the confines of this analysis, ChatGPT-4 exhibited a robust capability in answering AAP in-service exam questions in terms of accuracy and reliability while Gemini and ChatGPT-3.5 showed a weaker performance. These findings underscore the potential of deploying LLMs as an educational tool in periodontics and oral implantology domains. However, the current limitations of these models such as inability to effectively process image-based inquiries, the propensity for generating inconsistent responses to the same prompts, and achieving high (80% by GPT-4) but not absolute accuracy rates should be considered. An objective comparison of their capability versus their capacity is required to further develop this field of study.

Prediction and Interpretability Study of the Glass Transition Temperature of Polyimide Based on Machine Learning with Quantitative Structure-Property Relationship (Tg-QSPR).

The glass transition temperature (Tg) is a crucial characteristic of polyimides (PIs). Developing a Tg predictive model using machine learning methodologies can facilitate the design of PI structures and expedite the development process. In this investigation, a data set comprising 1257 PIs was assembled, with Tg values determined using differential scanning calorimetry. 210 molecular descriptors were computed using RDKit, and subsequently, six distinct feature selection methodologies were employed to refine the descriptor set. Quantitative structure-property relationship models targeting Tg (Tg-QSPR) were then constructed using five ensemble learning algorithms and one deep learning algorithm. These models exhibited high predictive accuracy and robustness, with the CATBoost model demonstrating the highest accuracy, achieving a coefficient of determination of 0.823 for the test set, a mean absolute error of 20.1 °C, and a root-mean-square error of 29.0 °C. The study identified the NumRotatableBonds descriptor as particularly influential on Tg, showing a negative correlation with the property. Additionally, the model's accuracy was validated using ten new PI films not included in the original data set, resulting in absolute errors ranging from 2.5 to 26.9 °C and absolute percentage error rates of 1.0-12.8%. These findings underscore the importance of utilizing extensive and diverse data sets for predictive modeling to enhance accuracy and stability. Furthermore, exploring the interpretability of the model and experimentally validating newly synthesized PIs have augmented the practical utility of the model. Under the guidance of the Tg-QSPR models, it will be possible to accelerate the performance prediction and structural design of PIs in the future.

Comparative study of CF4 + X + He (X = C4F8 or C4H2F6) plasmas for high aspect ratio etching of SiO2 with ACL mask

AbstractThis work compared C4F8 and C4H2F6 gases (as third components in CF4 + He gas mixture) for the high aspect ratio etching of SiO2 through the amorphous carbon layer (ACL) mask. The research scheme included the study of gas‐phase plasma characteristics, etching kinetics, and etching profiles. It was found that CF4 + C4F8 + He and CF4 + C4H2F6 + He gas mixtures are featured by quite close plasma parameters, the kinetics of electron‐impact processes, and ion bombardment intensities. At the same, the use of C4H2F6 provides a bit lower F atom density together with a bit higher polymerizing ability. All these factors cause lower absolute etching rates for both SiO2 and ACL but provide better SiO2/ACL/ACL selectivity and profile features.

Global burden of fungal skin diseases: An update from the Global Burden of Diseases Study 2019.

Fungal skin diseases are the most common and widespread fungal infections, exerting a significant impact on patients' socio-psychological health and the quality of life. To assess and compare the global burden of fungal skin diseases in 2019 and over the past 30 years. Data were retrieved from the Global Burden of Disease Study 2019. Incidence and years lived with disability (YLDs) were used to assess the burden of fungal skin diseases. A total of 204 countries and territories were hierarchically organised into 21 regions and seven super-regions. Data were presented as absolute numbers and rates per 100,000 population, stratified by sex, age, year and location. In 2019, the global incidence rate and YLD rate of fungal skin diseases were 21,277 (95% UI 19 298-23,399) and 42 (95% UI 17-88) per 100,000 population, respectively. Sub-Saharan Africa bore the heaviest disease burden, especially children aged 5-9 years had a significantly higher incidence rate, YLD rate and YLDs to incidence ratio compared to other regions. Moreover, more than half of the incident cases among the elderly came from high-income regions and Southeast Asia, East Asia, and Oceania. Over the past 30 years, the number of incident cases and YLDs of fungal skin diseases has been continuously increasing worldwide, but the incidence rates and YLD rates have not shown significant changes. The global burden of fungal skin diseases has been continuously rising. Children in Sub-Saharan Africa are experiencing higher disease incidence and severity compared to other regions.

Direct oral anticoagulants for stroke prevention in patients with device-detected atrial fibrillation: assessing net clinical benefit.

Subclinical, device-detected atrial fibrillation (AF) is frequently recorded by pacemakers and other implanted cardiac rhythm devices. Patients with device-detected AF have an elevated risk of stroke, but a lower risk of stroke than similar patients with clinical AF captured with surface electrocardiogram. Two randomized clinical trials (NOAH-AFNET 6 and ARTESiA) have tested a direct oral anticoagulant (DOAC) against aspirin or placebo. A study-level meta-analysis of the two trials found that treatment with a DOAC resulted in a 32% reduction in ischaemic stroke and a 62% increase in major bleeding; the results of the two trials were consistent. The annualized rate of stroke in the control arms was ∼1%. Several factors point towards overall net benefit from DOAC treatment for patients with device-detected AF. Strokes in ARTESiA were frequently fatal or disabling and bleeds were rarely lethal. The higher absolute rates of major bleeding compared with ischaemic stroke while on treatment with a DOAC in the two trials are consistent with the ratio of bleeds to strokes seen in the pivotal DOAC vs. warfarin trials in patients with clinical AF. Prior research has concluded that patients place a higher emphasis on stroke prevention than on bleeding. Further research is needed to identify the characteristics that will help identify patients with device-detected AF who will receive the greatest benefit from DOAC treatment.

Variable data structures and customized deep learning surrogates for computationally efficient and reliable characterization of buried objects

In this study, in order to characterize the buried object via deep-learning-based surrogate modeling approach, 3-D full-wave electromagnetic simulations of a GPR model have been used. The task is to independently predict characteristic parameters of a buried object of diverse radii allocated at different positions (depth and lateral position) in various dispersive subsurface media. This study has analyzed variable data structures (raw B-scans, extracted features, consecutive A-scans) with respect to computational cost and accuracy of surrogates. The usage of raw B-scan data and the applications for processing steps on B-scan profiles in the context of object characterization incur high computational cost so it can be a challenging issue. The proposed surrogate model referred to as the deep regression network (DRN) is utilized for time frequency spectrogram (TFS) of consecutive A-scans. DRN is developed with the main aim being computationally efficient (about 13 times acceleration) compared to conventional network models using B-scan images (2D data). DRN with TFS is favorably benchmarked to the state-of-the-art regression techniques. The experimental results obtained for the proposed model and second-best model, CNN-1D show mean absolute and relative error rates of 3.6 mm, 11.8 mm and 4.7%, 11.6% respectively. For the sake of supplementary verification under realistic scenarios, it is also applied for scenarios involving noisy data. Furthermore, the proposed surrogate modeling approach is validated using measurement data, which is indicative of suitability of the approach to handle physical measurements as data sources.