Blue Line Research Articles

Smart watch for the detection of exercise-induced transient ST segment changes

Abstract Background Smartwatches are largely used and allowed to perform electrocardiogram one lead, usually a modified DI, used to diagnose atrial fibrillation. It is unknown whether or not smartwatches could be used to identify electrocardiographic transient ST changes during exercise-induced myocardial ischemia. The present study assessed the feasibility and reliability of using an Apple watch to record V5 in subjects scheduled for standard ECG stress tests. Methods One hundred eighty-nine subjects were included in this study. The mean age was 61+9 years, and 21.6 % were women (41 subjects). A single thoracic lead V5 was obtained with an Apple watch, positioned at the fifth intercostal space anterior axillary line, by creating a circuit between the back of the watch and the right index resting on the crown for 30 seconds. Four subjects were excluded because of the poor quality of the Apple watch signal. Forty-nine patients (25,92%) had a positive stress test with standard 12 lead ECG, 136 (71,96 %) negative stress test, and 4 (2,12%) the ECGs were non-diagnostic. The mean difference or bias between the Apple Watch and standard exercise-induced ST changes was quantified as 0.054, suggesting a generally minimal discrepancy in their readings. This consistency is critically affirmed by Cohen's Kappa (k) coefficient of 0.665. 9-1.0) Results A total of 189 subjects were included in the study; the mean age was 61 years (SD 9), and 21.6 % were women (41 subjects). Insightful outcomes were gleaned from the Bland-Altman analysis, which probed the concordance between the smartwatch ECG and the conventional standard ECG in measuring ST-segment deviations (Bias 0,054; SD 0.31, from -0.56 to 0.67, 95% limits of agreement), as vividly depicted in Figure. The dashed blue lines in Figure demarcate the 95% limits of agreement, which span from -0.56 to 0.67, offering a tangible visualization of the range within which most individual differences resided. A notable harmony was unveiled in the intricate exploration of the concordance between the two diagnostic methodologies, substantiated by an agreement of 87.6%. This demonstrates that, in most instances, the methodologies provided analogous results, exhibiting a commendable consistency between them in a substantial proportion of cases. Assuming the results of standard ECGs as the reference values, Apple Watch ST deviation showed a sensitivity of 69% and specificity of 94 %. The positive predictive value was 0.80952381, and the negative predictive value was 0,8951049. Conclusions In conclusion, this study demonstrated that the Apple Watch could detect transient ST changes with a sensitivity of 69% and a specificity of 94 %. Further prospective studies should be performed to assess the potential role of detecting transient myocardial ischemia with a smartwatch in a general population at risk.

Оценка уровней шума в Санкт-Петербургском метрополитене

Purpose: to assess the impact of noise levels in St. Petersburg metro cars. Identify what types of cars used on various metro lines. Determine what types of rolling stock cars used in the metro. Determine how much the service life of the cars affects the noise level in the car. Conduct measurements of noise levels inside the carriages of rolling stock of various types on various metro lines. Correlate the obtained values with the established requirements of SP 2.5.3650–20 “Sanitary rules for the operation of subways” with the values of maximum permissible noise levels in cars. Conduct an analysis of the level of noise impact on humans in the metro and identify possible measures to reduce the noise level in the metro. Methods: measurements of noise levels at various stations and trains were carried out by a special instrumental method, using a digital integrating meter and an Octave 110A sound spectrum analyzer of 1st accuracy class according to GOST R 53188.1. Results: measurements of noise levels carried out in various types of cars on various branches of the St. Petersburg metro. An analysis of the results of field measurements of noise levels for equivalent and maximum levels in the metro shows that permissible noise levels are exceeded in the “Baltiets” car on the red metro line, in car 81-717/714 on the blue metro line; in car 81-717/714 on the purple metro line; in car 81-556.2/557.2/558.2 “Neva” on the green metro line. Practical significance: identification of the obtained data show necessary measures to reduce noise in the metro. Installation of sound-absorbing materials at stations and on trains. Replacing old trains with newer ones.

An Analysis of Housing Market Dynamics: Evaluating Potential Bubbles and Their Implications on Affordability

Purpose Over the past three years, Canada experienced rapidly increasing inflation. Among the many challenges this brought for Canadians, the issue of the affordability of houses and rents is a fundamental one. The rise in Canada’s ratio of the average house price to average rent has fostered further research regarding how this value has changed during the pandemic and its implications for today. This paper extends the research of Allen Head and Huw Lloyd Ellis's exploration of the speculation that Canada is experiencing a housing bubble. A pricing framework is used to assess whether the growth of house prices in Canadian cities since 1987 can be explained by variations in rents, real interest rates and property taxes, known as the “fundamentals.” The magnitude to which house prices have appreciated is contingent upon how participants in the housing market perceive real interest rates. Methodology Firstly, the relevant data needed to conduct our econometric analysis was collected. Data was updated for 27 central metropolitan areas (CMAs) in Canada from 1987 to 2021. Specifically, some of this raw data included rent prices, mortgage rates, interest rates, inflation rates, average and median income, provincial population, and the Consumer Price Index (CPI). In addition, the MLS price was used. Compiled by the Canadian Real Estate Association (CREA), it is an index that collects monthly statistics for properties sold via the Multiple Listing Service (MLS) and accessed by Canadian realtors. Once the raw data was compiled, we calculated the predicted price using a user cost model and compared it to the actual price. This user cost model considers factors such as rents, property taxes and interest rates. From this, we calculated the price-rent ratio. The predicted price-rent ratio, named “User Cost Model price,” as presented in the red lines in the following graphs, demonstrates what our model predicts for overvaluation in the housing market. Comparatively, the actual price-rent ratio, “MLS Average,” presented as the blue line, depicts what we observe in real-time. We then computed the differences between the predicted measure from our model and the actual observed MLS price for each year and city. This differential we calculated is a time series of “overvaluations’’ and “undervaluations.” Using this data for each city, we used this measure of difference in valuation in 2020 and 2021 and compared it to the average difference in valuation over an updated base period. Results and Conclusions Referencing the series of graphs produced, we observe substantial increases in overvaluations in Ontario cities. For example, St. Catharines, London and Windsor depict sizeable overvaluations, in addition to other cities across Canada, such as Toronto, Montreal, Gatineau, and Vancouver. Comparatively, we observed undervaluations in cities in Quebec, such as Québec City, Trois-Rivières, and Saguenay. Cities in the Prairies and Atlantic, such as Calgary, Edmonton, and Saint John, seem to share a similar result of undervaluation. However, each appears to rise in overvaluation again in 2020. While there are many reasons we can attribute to these trends, for now, we may only speculate what this means. We learn from our analysis that overvaluation continues to grow despite increasing rents. These results are particularly interesting for our study because there was a possibility that these rent increases were actually anticipated by housing market participants, which should have accounted for some overvaluation in the past. However, based on our work, this is not the case. If this were true, the overvaluation gap would have narrowed, not widened, as in our case. With this updated dataset, upcoming researchers will be able to investigate deeper into the reasons behind the widening overvaluation gap in many Canadian cities. As statistics become more publicly available, we can continue to enhance this dataset and examine how government policies and housing market participants affect interest rate expectations.

The Thin Blue Line: Perspectives From Military Veteran Police Officers on Camaraderie and Cooperation

The Thin Blue Line: Perspectives From Military Veteran Police Officers on Camaraderie and Cooperation

Tindak Tutur Ekspresif dalam Novel Dua Garis Biru Karya Lucia Priandarini

The background of this research aims to describe the type of expressive submission in the novel Two Blue Lines of Lucia Priandarini's work. This type of research is qualitative using descriptive methods. The source of data used in this research is the novel Two Blue Lines. This research data is the dialogue-dialogue of the characters found in the novel two blue lines by Lucia Priandarini. Data collected by recording method. The implementation is carried out in several steps as follows: (1) classify the data according to the type of expressive follow-up in the novel Two Blue Lines by Lucia Priandarini (2) analyze the data that has been classified then interpret the data in accordance with the theory used (3) formulate conclusions based on the results of research and interpretation. Based on data analysis, eleven types of expressive behavior were identified: critical, angry, surprised, apologizing, praising, complaining, accusing, feeling happy, expressing gratitude, happiness or pleasure, and feeling ashamed. The most dominant expressive act of exaltation used in the novel Two Blue Lines is expressive expression of criticism and anger.

Narrative Structure of Moral Messages in the Film Two Blue Lines: Pan and Kosicki Framing Analysis

Narrative Structure of Moral Messages in the Film Two Blue Lines: Pan and Kosicki Framing Analysis

Protectors or Enforcers?

This essay examines the complex relationship between contemporary law enforcement practices and Black, Indigenous, and racialized communities in Canada, focusing on hyper-masculine subcultures and militarized tactics. Using case studies, such as the death of Ejaz Chaudry and the criminalization of Wet'suwet'en land defenders, this paper analyzes the historical and colonial roots shaping policing practices. The study finds persistent over-policing and discriminatory practices on marginalized communities, emphasizing the urgent need for reform. Exploring the interplay of hyper-masculinity, militarization, and colonial biases, the essay discusses how symbols like the thin blue line contribute to an 'us versus them' mentality, reinforcing militaristic culture. The transnational dimensions of police militarization, influenced by historical and contemporary ties to settler-colonial practices, reveal how shared colonial legacies contribute to the perpetuation of militaristic approaches in law enforcement. Cases like Chaudry and Wet'suwet'en land defenders highlight the devastating consequences of militarized responses, urging comprehensive reforms. This essay acknowledges that while guardian approaches are more favorable in lieu of the outdated warrior mindset, the former community-oriented models still possess limitations. Despite this recognition, the essay contributes to the discourse on redefining policing practices, rebuilding community relations, and fostering a more just, equitable, and community-focused future in law enforcement.

Heritage and hate in Iceland: speculations about white supremacy, Viking imagery, museums, and care in a changing world

ABSTRACT In late 2020, a photo of a policewoman appeared on an established Icelandic news website. The police officer in question is depicted casually reaching for something in the boot of her police vehicle and used as a stock photo for a regular newspaper featuring some of the incidents the police have recently attended. Three patches were exposed on the officer's security vest. Those depicted the Icelandic flag, the Icelandic flag with the Thin Blue Line symbol, and the Vinland flag with an added picture of the Punisher symbol. The resentment could have revolved around her use of the Icelandic flag, a clear violation of the legislation. Nevertheless, the outrage that ensued was instead directed at the remaining symbols, long connected with police brutality and negative views within police forces towards minority groups, particularly people of African American descent. The image that caught public attention was the Vinland Flag, which closely resembles the Icelandic and Norwegian flags. It engages with Nordic heritage as Vinland is the name Norse (Viking) explorers gave North America when they settled there early in the second millennium. The Goth metal band Vinland designed the flag in the 1990s. Inevitably, it has different meanings for different groups of people. Still, its most notable appropriation is by right-wing populist groups such as white supremacists, who have claimed it as a symbol of their core ideals of white power and white supremacy.

Development of a novel Cas13a/Cas12a-mediated 'one-pot' dual detection assay for genetically modified crops

IntroductionGenetically modified (GM) crops have been widely cultivated across the world and the development of rapid, ultrasensitive, visual multiplex detection platforms that are suitable for field deployment is critical for GM organism regulation. ObjectiveIn this study, we developed a novel one-pot system, termed MR-DCA (Multiplex RPA and Dual CRISPR assay), for the simultaneous detection of CaMV35S and NOS genetic targets in GM crops. This innovative approach combined Multiplex RPA (recombinase polymerase amplification) with the Dual CRISPR (clustered regularly interspaced short palindromic repeat) assay technique, to provide a streamlined and efficient method for GM crop detection. MethodsThe RPA reaction used for amplification CaMV35S and NOS targets was contained in the tube base, while the dual CRISPR enzymes were placed in the tube cap. Following centrifugation, the dual CRISPR (Cas13a/Cas12a) detection system was initiated. Fluorescence visualization was used to measure CaMV35S through the FAM channel and NOS through the HEX channel. When using lateral flow strips, CaMV35S was detected using rabbit anti-digoxin (blue line), whilst NOS was identified using anti-mouse FITC (red line). Line intensity was quantified using Image J and depicted graphically. ResultsDetection of the targets was completed in 35 min, with a limit of detection as low as 20 copies. In addition, two analysis systems were developed and they performed well in the MR-DCA assay. In an analysis of 24 blind samples from GM crops with a wide genomic range, MR-DCA gave consistent results with the quantitative PCR method, which indicated high accuracy, applicability and semi-quantitative ability. ConclusionThe development of MR-DCA represents a significant advancement in the field of GM detection, offering a rapid, sensitive and portable method for multiple target detection that can be used in resource-limited environments.

Spectral features of pristine and irradiated white emitting InGaN LEDs with quantum wells

The emission spectra of InGaN/GaN white light emitting diodes (WLEDs) were measured. The main emission components were a LED blue line with λmax = 443 nm and a wide double band in the range of 500…650 nm of the secondary emission of AIT-YAG phosphor (Ce). The observed non-monotonic temperature dependence of the emission was attributed to the electric-field screening effect by mobile carriers as well as to thermal quenching due to the increased density of the phonon gas. The power conversion factor of phosphor emission increased in the temperature range of 200…290 K. The total energy losses for the Stokes shift were 82% and 77% for the first (blue) and the second band, respectively. The decrement of emission at high injection currents (over 20 mA) was attributed to ballistic transfer of carriers above the quantum wells and subsequent non-radiative recombination in the barrier layers. The existence of long-term relaxation processes in the white LEDs was assumed to be due to the accumulation of In atoms. Electron beam irradiation caused WLED efficiency degradation due to the introduction of deep traps in the quantum well region. The radiation resistance of the AIT-YAG phosphor was ~1.6 times higher than that of the InGaN part.

Theoretical, structural, and electronic analyses of pyridin-based dyes for dye-sensitized solar cells applications.

The new series of donor-π-acceptor dyes have been designed using pyridine derivatives as a donor group and thienothiophene as a π-spacer group, which were linked via 10acceptor groups. The highest occupied molecular orbital energies range from - 6.177 to - 5.786eV, whereas the lowest unoccupied molecular orbital energies range from - 2.181 to - 3.664eV. A6 dye has smaller energy gap, lower hardness, higher electrophilicity index, and good photovoltaic performance than other sensitizers. The lowest dihedral angle is observed in A1, A2, A6, A7, and A8 which are appropriate for intramolecular charge transfer between the molecules. The A8 has higher light harvesting efficiency, which increases the photovoltaic efficiency of the designed dye. The A6, A7, and A8 dyes spend less time in the excited state, which means they emit photons more efficiently than other dyes. The interaction between donor to π-spacer (red line) parts of the dyes has the bonding interaction (positive), and π-spacer to acceptor (blue line) parts of the dyes have the bonding and antibonding (negative) behaviours. The dyes A5 and A9 have 305.79 and 357.71 times higher β0 values than urea (0.781 × 10-30 esu) molecules. The spectral properties of the A6 dye strongly affect the structural modification. The density functional theory (DFT) and time-dependent DFT (TD-DFT) approach B3LYP/6-311G (d,p) basic set were used to optimize the designed dyes. All the calculations are performed using Gauss view 6.0 and Gaussian 09 software. The density of state spectrum is plotted using Gauss sum 2.6.

Malmö in the Public Imaginary: Thin Blue Line, Dialect Television Drama, and Local Patriotism

Malmö in the Public Imaginary: Thin Blue Line, Dialect Television Drama, and Local Patriotism

Cover Picture: Astron. Nachr. 6/2024

Color‐magnitude diagram of the lower mass end of the Main Sequence of globular cluster NGC 6752, as derived from NIR images of a deep field observed under a HST Large Programme led by L.R.Bedin. Three main stellar populations can be reliably distinguished within this cluster. The three isochrones (blue, green, and red lines) were computed with different chemical compositions, adjusted to match the observed colors of the different generations of stars at an age of 12.63 Gy. In the lower left part of the plot, the corresponding isochrone for the White Dwarfs (at an age of 12.5 Gy) is shown in purple, together with the three WD candidates shown as orange crosses. For each isochrone, specific mass values are marked by labeled filled dots. A detailed analysis of the HST data and a discussion of possible scenarios for the formation of multiple stellar populations within NGC 6752 is presented in the article by Scalco et al., this issue e240018. image

Cover Picture: Geomechanics and Tunnelling 3/2024

AbstractIn Stockholm, Implenia builds of one of the world's deepest metro stations. This new metro station is an extension of the Blue Line to Södermalm. Beside the station single‐track tunnels for the subway, lift shafts, and a collateral service tunnel are constructed. Due to the difficult geological conditions and the bad quality rock, the AT – Pipe Umbrella System with squeeze connections were used to reinforce excavations and bolster safety during construction (photo: DSI Underground).

Temporal trends of ischemic stroke rates in atrial fibrillation without anticoagulation: a nationwide cohort study from 2007 to 2018

Abstract Background Atrial fibrillation (AF) is a major risk factor for ischemic stroke (IS), but whether the magnitude of this risk has changed over time is unknown. Purpose To evaluate temporal trends in IS rates in patients with AF who have not initiated oral anticoagulant (OAC) therapy. Methods The registry-linkage Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) study covers all patients with incident AF in Finland from 2007 to 2018. A four-week quarantine period from AF diagnosis was applied and only follow-up time without OAC therapy was included. IS incidence rates were computed in four-year intervals. Results In total, 129 789 patients with new-onset AF (49.2% women; mean age 71.4 years) were identified. The IS incidence rate trends according to sex and the CHA2DS2-VA score are depicted in the Figure, along with the previously estimated treatment thresholds for direct oral anticoagulants (red broken line) and warfarin therapy (blue broken line). Between the calendar year intervals of 2007-2010 and 2015-2018, their mean CHA2DS2-VA score increased from 2.5 to 3.0, while concurrently the overall IS rate decreased by 25% from 36.7 (95% CI 34.5-39.0) to 27.6 (95% CI 26.1-29.0) events per 1000 patient years. This trend was driven by a 32% decrease in women, particularly among those with high CHA2DS2-VA scores. The overall IS rate in patients with a CHA2DS2-VA score of 1 was 8.2 (95% CI 7.2-9.4) events per 1000 patient years and it remained stable across the study period. Conclusions The IS rates in AF patients without OAC therapy have decreased by 25% between 2007 and 2018, despite their rising stroke risk scores. In patients with a CHA2DS2-VA score of 1 the IS rate appears to be lower than previously assumed and approximately at the threshold at which the potential benefits and harms of OAC therapy have been estimated to overlap.

Influence of tissue-electrode distance on unipolar and bipolar voltage for large-tip, ring-, and mini-electrodes

Abstract Background The characteristics of intracardiac unipolar and bipolar voltage electrograms (EGM) acquired by electrophysiological catheters depend on the electrical source and on the electrode design and configuration. Purpose The aim of the study was to assess the impact of the electrode configuration and their distance from the myocardial tissue (electric source) on the unipolar and bipolar intracardiac electrograms recorded with a multi-electrode focal ablation catheter. Methods We retrospectively analyzed left atrial 3D electroanantomical maps (EAMs) of 25 patients performed in sinus rhythm using the IntellaNav Mifi OI catheter (Boston Scientific, USA) with a 4.5 mm tip-electrode, three mini-electrodes and three 2 mm ring electrodes. The unipolar and bipolar EGMs were characterized based on the peak-to-peak amplitude (amp), the signal duration (width), the maximal slope, and the relative high power spectrum (HF_rel) as ratio of the power spectrum of frequencies above and below 50Hz. Distances of the electrode from the tissue were calculated from the electroanatomic reconstruction. Except for the HF_rel with absolute values are reported, all characteristics are normalized using the tip-electrode for unipolar or tip-to-ring electrode values for bipolar measures. EGMs with bipolar voltage amplitude of >0.5 mV were included to focus on healthy tissue. Results We analyzed the EGMs of 5183 catheter positions with horizontal to perpendicular orientation. From horizontal catheter orientation with a similar distance from the tissue for all electrodes, the unipolar EGM of the ring electrodes showed an increased amplitude (140%), slope (150%) and HF_rel (16% vs 11%) compared to the tip- and mini-electrodes. For bipolar EGM, however, the tip- ring pair showed the largest amplitude, width, and slope. The HF_rel was larger for the ring electrode pairs compared to the tip-ring electrode (58% to 39%). The median amplitude (amp), slope, and HF_rel for the ring electrodes showed a strong power-law decay function with distance, whereas the width increases linearly with distance from the surface (Figure, blue dotted lines). The intersection (red circle) of the steep linear decline at close distance to the tissue (reflecting a strong influence on the EGM) with the flat line at larger distances (dash-dotted lines) was considered as nearfield boundary. A HF_rel cutoff of >10% for unipolar (Figure, red arrow) and >30% for bipolar EGMs might be used to identify this boundary. Conclusion We confirmed a higher amplitude for small ring-electrodes compared to larger tip electrodes in unipolar amplitude but not for bipolar electrograms. Furthermore, a strong decay of the amplitude, slope and HF_rel with distance could be observed. The decay functions are suggestive for a nearfield boundary distance below 4mm from the tissue. Further studies are warranted to confirm this observation.Summary of characteristics over distance

Abstract PO2-02-03: Clinical and pathological factors associated with Oncotype DX® 21-Gene recurrence score in patients diagnosed with early stage breast cancer in a low-middle income country

Abstract INTRODUCTION: Oncotype DX® recurrence score (ODX RS) is a 21-gene assay warranted to determine the the prognosis in patients with hormone receptor positive, HER-2 negative early stage breast cancer. In this context, the test is also predictive of benefit of adjuvant chemotherapy.1,2,3 OBJECTIVES: We aimed to correlate the clinical and pathological factors associated with Oncotype DX® 21-Gene in patients diagnosed with early stage Breast Cancer. Additionally, description of adjuvant treatment patterns and survival outcomes were described according to the Oncotype DX® 21-Gene result. METHODS: Data from medical records from a single center in Brazil were collected retrospectively from women over 18 years diagnosed with early breast cancer between 2012 and 2022. Included patients were diagnosed with stage T1-T2 breast cancer, hormone receptor positive, HER-2 negative, with up to three positive lymph nodes. All included patients had an Oncotype DX® test performed after definitive breast surgery. The ODX RS has been categorized into two levels according to menopausal status. Correlation between breast cancer recurrence and clinicopathological characteristics was done. The software SPSS was used for statistical analyzes with the significance of 0.05. RESULTS: From 197 patients, 20 have had breast cancer recurrence (10.15%) whom 10 were premenopausal and 10 were postmenopausal. The median ODX RS in these 20 patients was 15 (ranged from 9 to 31). The most common site of recurrence was breast and regional recurrence in 18 patients (90%). Adjuvant chemotherapy was omitted in 16 patients (80%) who have had breast cancer recurrence. Among premenopausal patients whose ODX RS was >20, 33 patients (91.66%) received adjuvant chemotherapy. Among postmenopausal patients whose ODX RS was >25, 19 (86.36%) received adjuvant chemotherapy. The probability of recurrence free survival was worse in premenopausal patients > 44-years-old compared to those with < =44 years-old (p = 0.036) and also worse in histological grade 3 tumors compared to grade 1 (p=0.0048). Tumor size >14 millimeters (mm) was correlated to worse recurrence free survival in premenopausal patients (p=0.017). Low estrogen and progesterone receptor was associated with a higher ODX RS (p=0.0035 and p< 0.0001, respectively) in premenopausal patients, but not associated with recurrence free survival. Clinicopathological characteristics and recurrence free survival correlation in postmenopausal patients were not significant. CONCLUSION: This retrospective analysis suggests that factors other than the Oncotype DX® score, such as age and grade contributed to worse survival outcomes among our patients population. Of note, age older than 44 years-old, histological grade 3 and tumor size >14 mm were associated with a higher probability of recurrence in premenopausal patients, despite the Oncotype DX® score. REFERENCES: 1. Paik S, Shak S, Tang G, Kim C, Baker J, Cronin M, et al. A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med [Internet]. 2004;351(27):2817–26. Available from: http://dx.doi.org/10.1056/NEJMoa041588. 2. Sparano JA, Gray RJ, Makower DF, Pritchard KI, Albain KS, Hayes DF, et al. Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. N Engl J Med [Internet]. 2018;379(2):111–21. Available from: http://dx.doi.org/10.1056/NEJMoa1804710. 3. Kalinsky K, Barlow WE, Gralow JR, Meric-Bernstam F, Albain KS, Hayes DF, et al. 21-gene assay to inform chemotherapy benefit in node-positive breast cancer. N Engl J Med [Internet]. 2021;385(25):2336–47. Available from: http://dx.doi.org/10.1056/NEJMoa2108873. Table 1 – Clinical and pathological characteristics of 197 hormone receptor positive, HER-2 negative early breast cancer patients who did the Oncotype DX® 21-Gene Recurrence Score assay. Data from medical records collected retrospectively of women diagnosed with early breast cancer between 2012 and 2022 from a single center in Brazil. Figure 1 – Probability of recurrence free survival in premenopausal patients according to age <=44 (blue line) or > 44-years-old (pink line). Data from medical records collected retrospectively of women with hormone receptor positive, HER-2 negative early breast cancer who did the Oncotype DX® 21-gene assay diagnosed between 2012 and 2022 from a single center in Brazil. Figure 2 – Probability of recurrence free survival in premenopausal patients according to histological grade. Tumor with histological grade 1 (blue line) or histological grade 3 (pink line). Data from medical records collected retrospectively of women with hormone receptor positive, HER-2 negative early breast cancer who did the Oncotype DX® 21-gene assay diagnosed between 2012 and 2022 from a single center in Brazil. Citation Format: Carolina Cavalcanti Gonçalves Ferreira, Julio Araujo, Shermann Brandão Rodrigues Moreira, Antônio Buzaid, Débora Gagliato. Clinical and pathological factors associated with Oncotype DX® 21-Gene recurrence score in patients diagnosed with early stage breast cancer in a low-middle income country [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-02-03.

Comprehensive Bioinformatic Investigation of TP53 Dysregulation in Diverse Cancer Landscapes.

P53 overexpression plays a critical role in cancer pathogenesis by disrupting the intricate regulation of cellular proliferation. Despite its firmly established function as a tumor suppressor, elevated p53 levels can paradoxically contribute to tumorigenesis, influenced by factors such as exposure to carcinogens, genetic mutations, and viral infections. This phenomenon is observed across a spectrum of cancer types, including bladder (BLCA), ovarian (OV), cervical (CESC), cholangiocarcinoma (CHOL), colon adenocarcinoma (COAD), diffuse large B-cell lymphoma (DLBC), esophageal carcinoma (ESCA), head and neck squamous cell carcinoma (HNSC), kidney chromophobe (KICH), kidney renal clear cell carcinoma (KIRC), liver hepatocellular carcinoma (LIHC), lung adenocarcinoma (LUAD), lung squamous cell carcinoma (LUSC), and uterine corpus endometrial carcinoma (UCEC). This broad spectrum of cancers is often associated with increased aggressiveness and recurrence risk. Effective therapeutic strategies targeting tumors with p53 overexpression require a comprehensive approach, integrating targeted interventions aimed at the p53 gene with conventional modalities such as chemotherapy, radiation therapy, and targeted drugs. In this extensive study, we present a detailed analysis shedding light on the multifaceted role of TP53 across various cancers, with a specific emphasis on its impact on disease-free survival (DFS). Leveraging data from the TCGA database and the GTEx dataset, along with GEPIA, UALCAN, and STRING, we identify TP53 overexpression as a significant prognostic indicator, notably pronounced in prostate adenocarcinoma (PRAD). Supported by compelling statistical significance (p < 0.05), our analysis reveals the distinct influence of TP53 overexpression on DFS outcomes in PRAD. Additionally, graphical representations of overall survival (OS) underscore the notable disparity in OS duration between tumors exhibiting elevated TP53 expression (depicted by the red line) and those with lower TP53 levels (indicated by the blue line). The hazard ratio (HR) further emphasizes the profound impact of TP53 on overall survival. Moreover, our investigation delves into the intricate TP53 protein network, unveiling genes exhibiting robust positive correlations with TP53 expression across 13 out of 27 cancers. Remarkably, negative correlations emerge with pivotal tumor suppressor genes. This network analysis elucidates critical proteins, including SIRT1, CBP, p300, ATM, DAXX, HSP 90-alpha, Mdm2, RPA70, 14-3-3 protein sigma, p53, and ASPP2, pivotal in regulating cell cycle dynamics, DNA damage response, and transcriptional regulation. Our study underscores the paramount importance of deciphering TP53 dynamics in cancer, providing invaluable insights into tumor behavior, disease-free survival, and potential therapeutic avenues.

Axial Rotation Analysis in Total Ankle Arthroplasty Using Weight-Bearing Computer Tomography and Three-Dimensional Modeling

Introduction/Purpose: Post-operative alignment is the most critical indicator for a successful total ankle arthroplasty (TAA). Total ankle malrotation is associated with an increased risk for polyethylene wear and medial gutter pain. Currently, there is no consensus on the correct way to measure the alignment of the tibial and talar component rotations in the axial plane. In the current study, the post-operative analysis system was assessed using weight-bearing computer tomography and a three- dimensional (3D) model. The purpose of the study was to assess the inter-observer and intra-observer agreement of this system. Methods: Four angles were measured by two raters independently in two separate readings: posterior tibial component rotation angle (PTIRA), posterior talar component rotation angle (PTARA), tibia talar component axial angle (TTAM), and tibial component to the second metatarsal angle (TMRA). Agreement analysis was quantified according to the interclass coefficient. Results: Sixty TAAs across 60 patients were evaluated. A good inter-observer agreement and intra-observer agreement when measuring the PTIRA, PTARA, and TTAM angles was observed along with an excellent inter-observer agreement and intra- observer agreement when measuring the TMRA angle. Conclusion: In conclusion, the current 3D model-based measurement system demonstrates good to excellent inter and intra- agreement. According to these results, 3D modelling can be reliably used to measure and assess the axial rotation of TAA components. Figure 3: Example case of how to measure the angles for assessing axial rotation of TAA and forefoot. 3 A) Posterior TIbial component Rotational Angle (PTIRA). The chosen slice is the one with the straightest posterior wall component of the tibia. The angle is measured on the following steps. First a reference is put on the posterior wall of the tibial component (blue horizontal line). Then the angle is measured starting from the center of the tibial axis (red dot explained on fig. 2), going to the fibular axis (medial part of the red line at the right of the draw), and finally ending 90° to the posterior reference line. 3 B) Posterior TAlar component Rotational Angle (PTARA). The chosen slice is the one with the straightest posterior wall component of the talus. For the angle measurement. The same steps as figure 3 A are followed with the talar component. 3 C) Talar component to 2nd Metatarsal Rotational Angle (TMRA): Defined as an intersection between a line parallel to the lateral border of the tibia component and a line perpendicular to the anatomical axis of the second metatarsal. This was measured using a 3D rendering tool

Is Frank Miller's The Dark Knight Returns Fascist? Resolving the Paradoxes of Heroic Violence

ABSTRACTThe Dark Knight Returns traces the polarizing paradoxes seen between the political left and right in the United States—the right at once advocating for distributed networks of self‐defense in widespread firearm availability and keeping the “thin blue line” of state power intact while the left simultaneously rejects both personal defense and policing as viable forms of mediation from bad actors—and then reimagines Batman as a metaphor by which these paradoxes are resolved.