Characteristic Analysis Research Articles

A Bayesian reanalysis of the CULPRIT-SHOCK trial.

The optimal revascularization strategy for patients with acute myocardial infarction (AMI), cardiogenic shock (CS), and multivessel disease remains controversial. The CULPRIT-SHOCK trial compared culprit lesion-only vs. immediate multivessel percutaneous coronary intervention (PCI), providing important data but leaving efficacy questions unresolved. To address lingering uncertainties and gain deeper insights, we performed a Bayesian reanalysis of the CULPRIT-SHOCK trial data. We conducted a Bayesian re-analysis of the CULPRIT-SHOCK trial data using non-informative, sceptical, and enthusiastic priors. Relative risks (RRs) with 95% highest posterior density (HPD) intervals were calculated. We defined the minimal clinically important difference (MCID) as RR < 0.84. We performed subgroup analyses for key patient characteristics and assessed secondary outcomes and safety endpoints. Probabilities of benefit, achieving MCID, and harm were computed. Results are presented as median RR with probabilities of effect sizes. Bayesian reanalysis showed a median RR of 0.82 (95% HPD 0.66-1.04) with a non-informative prior, indicating a 95% probability of benefit and 59% probability of achieving MCID. Subgroup analyses revealed potentially stronger effects in males (RR 0.78, 73% probability of MCID), patients without diabetes (RR 0.76, 79% probability of MCID), and those with non-anterior ST-segment elevation MI (STEMI; RR 0.74, 76% probability of MCID). Secondary outcomes suggested potential benefits in mortality (RR 0.85) and need for renal replacement therapy (RR 0.72) but increased risks of recurrent MI (RR 2.84) and urgent revascularization (RR 2.88). Our Bayesian reanalysis provides intuitive insights by quantifying probabilities of treatment effect sizes, offering further evidence favouring the culprit lesion-only PCI strategy in AMI patients with CS and multivessel disease. The analysis demonstrates a high probability of overall benefit, with a notable chance of achieving a minimally clinically important difference, particularly in specific subgroups. These findings not only support the consideration of culprit lesion-only PCI in certain patient populations but also underscore the need for careful risk-benefit assessment. Furthermore, our hypothesis-generating subgroup analyses, which show varying probabilities of achieving MCID, illuminate promising avenues for future targeted investigations in this critical patient population.

Diagnostic Value of sLR11 and sIL-2R in the Cerebrospinal Fluid for Malignant Central Nervous System Lymphoma.

Objective We previously reported that patients with acute leukemia and malignant lymphoma (ML) demonstrated significantly increased serum soluble LR11 (sLR11) levels compared to normal controls. Accurately diagnosing ML of the central nervous system (CNS ML) using cytology is frequently difficult. Therefore, we evaluated the use of cerebrospinal fluid (CSF) sLR11 and soluble interleukin-2 receptor (sIL-2R) as diagnostic and treatment response markers for CNS ML. Methods We retrospectively evaluated the CSF results for CNS ML using clinical data at our institution, and then analyzed the usefulness of sLR11 and sIL-2R in CSF for both the diagnosis and as surrogate markers that reflect the therapeutic effect. Patients We enrolled patients with CNS ML who received intrathecal anticancer drugs between 2017 and 2023. We analyzed the sLR11 and sIL-2R levels in CSF and cytological malignant grades. We studied 22 patients, including 17 with central nervous system (CNS) clinical conditions and five who received prevention treatment. Results The CSF sLR11 levels were significantly and positively correlated with CSF sIL-2R levels. The CSF sLR11 and sIL-2R levels in patients with CNS ML were significantly higher than those in the prevention group. A receiver operating characteristic (ROC) curve analysis showed the cut-off value of sLR11 for CNS invasion to be 21.7 ng/mL. Moreover, the chemotherapy-responder group demonstrated significantly decreased CSF sLR11 and sIL-2R levels after treatment. Conclusion CSF sLR11 and sIL-2R of CSF were found to be useful biomarkers for the diagnostic and treatment response evaluation in patients with CNS ML.

Features of Forming the Legal Consciousness in the Modern Settings and Its Influence on the State of Lawfulness

Introduction. The Constitution of the Russian Federation defines the benchmarks ensuring an appropriate level of development for the important spheres of life, a high living standard, which requires a comprehensive approach to forming the human potential of the generations of the Russian citizens. The quintessence of the Russian statehood strategic development implies minimisation of the prerequisites inducing formation of the destructive legal consciousness in citizens, which obstructs achievement of the legal order in the country. In the National Security Strategy of the Russian Federation, among the list of national interests, a significant place is allocated to saving the people of Russia, to development of the human potential. The state strategic planning document had defined the following goals: upbringing a harmoniously developed and socially responsible citizen, forming in the society the attitude of intolerance to illegal activities. No doubt, in Russia, the trend of the power exercising mechanism to undergo modern institutional changes is caused by the social modernization and is targeted at the conceptual ideas of the constitutionalism. The economic and socio-political transformations inevitably affect not only formation of the legal environment, but also structuring the public consciousness, which concepts predetermine the development of the reasoned and practically oriented legal solutions. The state of the public perception of the legal phenomena should be constantly monitored due to the continuous impact imposed on it by the transformations in the state structure of the governmental and administrative authorities. The scientific understanding of these processes should not be underestimated, otherwise this can cause the psychological turbulence of a significant part of the population in choosing the behavioural patterns of lawful behaviour. In the context of transformation of the social determination process, which is attributed with a complicated range of the antisocially-motivated impacts, significantly limiting the preventive social and law enforcement potential, the present research is relevant due to the special importance assigned to precise, steady and uniform application of the legislative provisions, the degree of their functional social harmonisation in the social relation regulation mechanism. The deformations of the citizens’ legal consciousness are the factors hindering the achievement of the high efficiency in implementation of the fundamental principles of the supremacy of law. The research aims at investigating the functional role of the legal consciousness in the legal regulation mechanism of the modern social formations, at analysing the problems of exercising the state policy in the frame of forming the positive perception of the legal phenomena among the citizens and revealing the interrelations of the legal consciousness deformations and stimulation of the legitimate behavioural variation.Materials and Methods. The article analyses the results of the research of the native and foreign scientists on the regularities in the public perception of the state and legal phenomena and impact thereof on the legitimate behavioural variation. The general scientific and specific scientific methods were used in the research, such as the statistical method and the method of system analysis of data characteristic of the phenomena affecting the state of lawfulness in Russia.Results. The regularities in the functional role of the legal consciousness within the mechanism of legal regulation of the social relations have been acknowledged. The substance of the legal consciousness interrelations with the legal ideology and legal psychology has been revealed. The problems of efficiency of the state policy in forming the civil legal consciousness have been determined. It has been proposed to integrate into the scholarly discourse such a type of legal consciousness deformation as legal dementia, which predetermines the state of lawfulness in the modern Russian society.Discussion and Conclusion. The practical side of the legal consciousness reflects the behavioural attitudes of a person, his readiness to use in practice his theoretical knowledge and value assessments. The law-related feelings, emotions, ideas, principles, attitudes that have become a part of a person’s legal consciousness, subsequently determine his actions in the legal framework. To ensure protection of the national mental values and to prevent emergence of the destructive attitudes in the society, changes in the educational, scientific, cultural and other spheres should be made taking into account the historical traditions and the experience accumulated by the Russian society. Unfortunately, nowadays, among the main problems of the lawmaking and law enforcement processes in Russia are weak scientific and analytical justification of the draft laws, low quality of laws, acute legal collisions within the law system, violations of the intra-system relations that result in a tendency of citizens’ legal estrangement.

Clinical significance of S100B protein in pregnant woman with early- onset severe preeclampsia.

Preeclampsia is one of the most feared complications of pregnancy, which can progress rapidly to serious complications such as death of both mother and fetus. To present, the leading cause of preeclampsia is still debated. The purpose of this article was to explore the clinical significance of S100B protein, a kind of Ca2+ -sensor protein, in the early-onset severe preeclampsia. Nine pregnant women with early-onset severe preeclampsia (the study group) and 13 healthy pregnant women (the control group) were included in this study. The level of S100B in the amniotic fluid, maternal blood, and umbilical cord blood were detected by enzyme-linked immunosorbent assay (ELISA) and surface plasmon resonance imaging (SPRi) methods. Diagnostic values of S100B for early-onset severe preeclampsia were assessed by Receiver Operating Characteristic (ROC) curve analysis. The levels of S100B in maternal blood and amniotic fluid in the study group were higher than those in the control group (p < 0.05). ROC curve analysis showed that S100B detected by SPRi method (SPRi-S100B) showed a cut-off level of 181 ng/mL with sensitivity of 100%, a specificity of 84.6%, and a Youden index of 0.846 in the maternal blood, which had better clinical significance and diagnostic value (at than that detected by ELISA (ELISA-S100B). The levels of S100B detected by SPRi in maternal blood can indicate early-onset severe preeclampsia and perinatal brain injury.

Abstract B018: Changes in prevalence and correlates of tobacco use in 13 high-risk states in the United States from 2023-2024

Abstract Significance: Overall tobacco use rates are higher in the Midwest and Southern regions of the United States (US) than the rest of the US, yet little is known on correlates of tobacco use, or how rates are changing in recent years. This study examines current correlates of tobacco use among individuals living in the 13 most high-risk states in the US over two years. Methods: First, we examined the prevalence of tobacco use and related correlates in a rapid response survey of 4,550 adults collected between April-May 2023 (18+ years) living in the 13 high-risk states collected by the American Cancer Society. Data were weighted to be representative of the states’ population. Bivariate analyses for demographic characteristics were conducted examining cigarette use, e-cigarette use, and cigar use. Additional data collected from April-May 2024 in a second wave of cross-sectional data (n=4,500) for comparison between years and are currently being analyzed to reflect potential changes in correlates from 2023 to 2024. Results: Respondents in Wave 1 were aged 18-65 (Mean = 41.85; SD=0.32) and were majority Non-Hispanic White (70.9%) and female (51.9%). 47.5% of respondents reported an annual household income of &amp;lt;$75,000 USD. Although most respondents lived in urban (50.2%) or mostly urban areas (26.6%), several participants still resided in mostly rural (11.0%) or all rural (10.2%) as defined by US Census demographic data. The prevalence of any tobacco use was high across all 13 states (33.1%), with 29.5% reporting cigarette, e-cigarette and/or cigar use.21.1% of respondents were persons who currently smoke vs. 11.5% for the national average, while 20.7% were persons who previously smoked and 8.0% were persons who occasionally smoke. 14.0% of respondents reported current e-cigarette use vs 4.5% for the national average and 17.5% reported previous e-cigarette use. 8.7% of respondents reported current cigar use vs 3.5% for the national average and 24.1% reported previous cigar use. Respondents identifying as male (&amp;lt;.001) and with a household income &amp;lt;$75,000 (&amp;lt;.001), a disability (p=.014), or military/veteran status (p=.031) were more likely to currently smoke. Respondents who were male (p=.004) or reported household income &amp;lt;$75,000 (p=.011) were more likely to report current e-cigarettes use; higher use was associated with increasing age (&amp;lt;.001). Respondents who were male (&amp;lt;.001), and nonwhite (&amp;lt;.001) were more likely to report current cigar use; higher use was associated with increasing age. Conclusions: Cigarette use is high among individuals living in this region, and is related to lower household income, military/veteran status, disability status, and male identity. E-cigarette and cigar use increased with age. These high tobacco use rates lead to increased health inequities, with related high rates of cancer and cardiovascular disease. Given that tobacco use continues to be high in these states, tailored cessation programs could help reduce the heavy burden of tobacco use among this population. Citation Format: Minal Patel, Laurel Gibson, Presley Cannon, Shanshan Wang, Nigar Nargis. Changes in prevalence and correlates of tobacco use in 13 high-risk states in the United States from 2023-2024 [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B018.

Security Model for the Detection of Distributed Denial of Service Attack (DDoS) at the Access Layer in Cloud Reference Architecture

DDoS attacks on the cloud have become an emerging problem, which calls for an intelligent protection solution for information, communication and computing resources. Cloud reference architecture as a new technology with wider access facility, the access layer in the reference architecture becomes grave to numerous security challenges, and it is mostly exploited by the attacker using compromised computers to launch DDoS attack which affects its performance by shutting down some services. Many security frameworks have been proposed in the past, but they are not enough to provide security solution for accurate detection and control of DDoS attack at the access layer. Intelligent security model based on artificial neural network was developed to detect and control DDoS attack at the access layer. DDoS dataset obtained online was used to train and test the intelligent security model using MATHLAB workspace. Simulated results implemented and generated with receive operator characteristic analyzer (Roc) showed a true positive rate of 98.2% to detect and control DDoS attack at the access layer and a false negative rate of 0.02%. The inclusion of additional parameters to determined and identifies the source of the attack, whether it is lunch from outside or inherent within the reference architecture is recommended. KEYWORDS: Reference Architecture, Access Layer, Distributed Denial of Service (DDOS), Artificial Neural Network’s (ANN’s)

Numerical Simulation of the Unsteady Airwake of the Liaoning Carrier Based on the DDES Model Coupled with Overset Grid

The wake behind an aircraft carrier under heavy wind condition is a key concern in ship design. The Chinese Liaoning ship’s upturned bow and the island on the deck could cause serious flow separation in the landing and take-off area. The flow separation induces strong velocity gradients and intense pulsations in the flow field. In addition, the sway of the aircraft carrier caused by waves could also intensify the flow separation. The complex flow field poses a significant risk to the shipboard aircraft take-off and landing operation. Therefore, accurately predicting the wake of an aircraft carrier during wave action motion is of great interest for design optimization and recovery aircraft control. In this research, the aerodynamic around an aircraft carrier (i.e., Liaoning) was analyzed using the computational fluid dynamics technique. The validity of two turbulence models was verified through comparison with the existing data from the literature. The upturned bow take-off deck and the right-hand island were the main areas where flow separation occurred. Delayed detached eddy simulation (DDES), which combines the advantages of LES and RANS, was adopted to capture the full-scale spatial and temporal flow information. The DDES was also coupled with the overset grid to calculate the flow field characteristics under the effect of hull sway. The downwash area at 15° starboard wind became shorter when the hull was stationary, while the upwash area and turbulence intensity increased. The respective characteristics of the wake flow field in the stationary and swaying state of the ship were investigated, and the flow separation showed a clear periodic when the ship was swaying. Comprehensive analysis of the time-dependent flow characteristic of the approach line for fixed-wing naval aircraft is also presented.

Incidence, characteristics, and prehospital outcomes of out-of-hospital cardiac arrest in Qatar: a nationwide gender-based investigation

BackgroundResearch on incidence and characteristics of Out-of-Hospital Cardiac Arrest (OHCA) in the Middle East is limited. We assessed the incidence, prehospital characteristics, and outcomes of OHCA in Qatar, a Middle Eastern country. Subsequently, we performed gender-specific analysis.MethodsThis was a retrospective examination of data obtained from the OHCA registry at Hamad Medical Corporation (HMC) in Qatar from 2017 to 2022. We included adults, non-traumatic, EMS-treatment OHCA. We calculated the incidence of adult OHCA and conducted descriptive analyses for prehospital characteristics, and prehospital outcomes presented by return of spontaneous circulation (ROSC). We evaluated gender differences in prehospital characteristics and ROSC using Student’s t-test and the Chi-Square test as appropriate. Furthermore, we conducted a multivariable logistic regression analysis to investigate the correlation between gender and achieving ROSC.ResultsWe included 4,306 adult OHCA patients, with 869 (20.2%) being females. The mean annual incidence of adult OHCA was 27.4 per 100,000 population-year. Males had a higher annual incidence of OHCA than females. Among all cases, 36.3% occurred in a public location, 25.8% had an initial shockable rhythm, and 28.8% achieved ROSC. Males had a higher proportion of bystander CPR, arrests in public locations, and initial shockable rhythms. While unadjusted analysis showed no significant gender differences in achieving ROSC, adjusted analysis revealed that male gender was associated with higher odds of achieving ROSC (adjusted OR male vs. female 1.38, 95% CI 1.15–1.66, p < 0.001).ConclusionsApproximately 720 adults undergo non-traumatic OHCA in Qatar every year, with a higher incidence observed in males. Male gender was associated with higher odds of achieving ROSC. Further gender-specific research in OHCA intervention and outcome in the Middle East is required.

A meta-analysis of coping strategies and psychological distress in rheumatoid arthritis.

Theory and research indicate that coping plays a central role in the experience of psychological distress in people with rheumatoid arthritis (RA). This study meta-analysed the associations of adaptive and maladaptive coping strategies with psychological distress in people with RA to quantify and better understand the proposed differential relationships, as well as the factors that might influence these links. Searches of four databases identified eligible studies according to a pre-registered protocol. Two random effects meta-analyses examined the direction and magnitude of the links between adaptive coping (problem-focused and emotional approach coping) and maladaptive coping (emotional avoidance and pre-occupation coping) and psychological distress (stress, anxiety, and depression). Study quality was evaluated using a bespoke tool. Moderator analyses for sample characteristics and distress type were conducted. Searches identified 16 eligible studies with 46 effects. Meta-analysis of maladaptive coping and distress yielded a significant, medium sized association, k = 12, r = .347, 95% CIs [.23, .46]. Moderator analyses were significant only for type of distress, with effects for depression being larger than that for combined distress. Effects did not vary as a function of age, participant sex, or disease duration. Meta-analysis for adaptive coping was not significant, k = 10, r = -.155, 95% CIs [-.31, .01]. Findings from this first meta-analysis of coping and distress in RA indicate that maladaptive but not adaptive coping is associated with greater distress. Further research is needed to grow the evidence base to verify the current findings especially with respect to adaptive coping.

Integrated analysis reveals an aspartate metabolism-related gene signature for predicting the overall survival in patients with hepatocellular carcinoma.

Deregulating cellular metabolism is one of the prominent hallmarks of malignancy, with a critical role in tumor survival and growth. However, the role of reprogramming aspartate metabolism in hepatocellular carcinoma (HCC) are largely unknown. The multi-omics data of HCC patients were downloaded from public databases. Univariate and multivariate stepwise Cox regression were used to establish an aspartate metabolism-related gene signature (AMGS) in HCC. The Kaplan-Meier and receiver operating characteristic curve analyses were performed to evaluate the predictive ability for overall survival (OS) in HCC patients. Gene set enrichment analysis and immune infiltration analysis were operated to determine the potential mechanisms underlying the AMGS. Single-cell RNA sequencing (scRNA-seq) data of liver cancer stem cells were visualized by t-SNE algorithm. In vivo and in vitro experiments were implemented to investigate the biological function of CAD in HCC. In addition, a nomogram based on the AMGS and clinicopathologic characteristics was constructed by univariate and multivariate Cox regression analyses. Patients in the high-AMGS subgroup exerted advanced tumor status and poor prognosis. Mechanistically, the high-AMGS subgroup patients had significantly enhanced proliferation and stemness-related pathways, increased infiltration of regulatory T cells and upregulated expression levels of suppressive immune checkpoints in the tumor immune microenvironment. Notably, scRNA-seq data revealed CAD, one of the aspartate metabolism-related gene, is significantly upregulated in liver cancer stem cells. Silencing CAD inhibited proliferative capacity and stemness properties of HCC cells in vitro and in vivo. Finally, a novel nomogram based on the AMGS showed an accurate prediction in HCC patients. The AMGS represents a promising prognostic value for HCC patients, providing a perspective for finding novel biomarkers and therapeutic targets for HCC.

Associations between sex, race/ethnicity, and age and the initiation of chronic high-risk medication in US older adults.

High-risk medication use is associated with an increased risk of adverse events, but little is known about its chronic utilization by key demographic groups. We aimed to study the associations between age, sex, and race/ethnicity with new chronic use of high-risk medications in older adults. In this retrospective cohort study, we analyzed data from older adults aged ≥65 years enrolled in a national health insurer who started a high-risk medication between 2017 and 2022 across 16 high-risk medication classes. We used generalized estimating equations to estimate the associations between sociodemographic classifications and the onset of chronic high-risk medication use after initiation (≥90 days' supply across ≥2 fills within 180 days). We adjusted the analyses for sociodemographic and clinical patient characteristics and added three-way interaction terms for race/ethnicity, sex, and age to explore whether the outcome varied across different subgroups of race/ethnicity, age, and sex. Across 2,751,069 patients (mean age: 74 years [SD = 7], 72% White, 60% Female), 406,075 (15%) became new chronic users of ≥1 high-risk medication. Compared to White older adults, Asian (RR = 0.81, 95% CI: 0.79-0.84), Black (RR = 0.92, 95% CI: 0.90-0.94), and Hispanic (RR = 0.85, 95% CI: 0.83-0.86) older adults had a lower risk of becoming new chronic users. Men had a higher risk compared to women (RR = 1.09, 95% CI: 1.08-1.10). Age was not significantly associated with new chronic high-risk medication use (≥75 years: RR = 1.00, 95% CI: 1.00-1.01). We observed differences across some medication classes, like benzodiazepines, first-generation antihistamines, and antimuscarinics for which non-White older adults were at a higher risk. The joint presence of specific age, sex, and race/ethnicity characteristics decreased the risk of becoming a new chronic user (e.g., Hispanic/Female/65-74 years: RR = 0.96, 95% CI: 0.94-0.99). New chronic high-risk medication use varied across older adults by sociodemographic characteristics, suggesting the need to individualize medication optimization approaches and better understand how systematic barriers in access to health care may influence differences in high-risk medication use in older adults.

БИОХИМИЧЕСКАЯ ХАРАКТЕРИСТИКА ТЕХНИЧЕСКИХ ГИБРИДОВ ВИНОГРАДА СЕЛЕКЦИИ АЗОСВиВ

The aim of the study is to investigate new hybrid grape forms by their main biochemical parameters with the prospect of obtaining new high-tech varieties from them. The paper presents the results of scientific studies of biochemical parameters of new technical hybrid grape forms. These forms were obtained by breeders of the Anapa Zonal Experimental Station of Viticulture and Winemaking, a branch of Federal State Budget Scientific Institution North Caucasian FSC of Horticulture, Viticulture, Wine-making (AZOSViV, a branch of the North Caucasus FSC for Horticulture, Viticulture and Winemaking) and are characterized by late ripening, high productivity, winter hardiness and phylloxera tolerance. Biochemical analysis of the berry must of the studied hybrids was carried out at the institute. Sugars, titratable acids, ammonium compounds, cations and organic acids were studied. The technical grape variety of late ripe-ning Krasnostop Anapsky was used as a control for a comparative analysis of the main biochemical cha-racteristics. A pressing issue for breeders has always been the creation of new sustainable and high-tech grape varieties with their subsequent recommendation for implementation in the production process. The research results showed that the studied hybrids 59-39 and 62-23 annually have stable yields, high sugar accumulation compared to the control variety: 59-39 – 24.2 g / 100 cm3, 62-23 – 24.1, control – 24.0 g/100 cm3. The content of ammonium compounds in hybrid forms is small and comparable to the control. For example, in form 59-39, the content of ammonium compounds is 20 mg/dm3, which is at the level of the control variety. The concentration of metal cations in the juice of berries indicates a high content of these compounds in the soil. The content of potassium in the must is especially high. The studied hybrid forms of grapes have prospects for further study in order to obtain a new variety.

Assessing surgical risk calculators on hernia repair candidates with cirrhosis.

Several risk calculators have been developed and deployed to help surgeons estimate the mortality risk that comes with performing hernia repair surgery on patient with severe liver disease. This study seeks to evaluate the accuracy of these risk calculators on patients with cirrhosis and identify the most suitable population of patient to use these calculators on. The American College of Surgeons National Surgery Quality Improvement Program (NSQIP) 2013-2021 datasets were queried for patients who underwent hernia repair surgery. Mayo Clinic's "Post-operative Mortality Risk in Patients with Cirrhosis" risk calculator, Model for End-Stage Liver Disease (MELD) calculator, NSQIP's Surgical Risk Calculator, and a surgical 5-item modified frailty index were assessed to determine whether they accurately predict mortality following abdominal hernia repair. In total, 1368 patients met inclusion criteria. Receiver operating characteristic (ROC) curve analysis of the 4 mortality risk calculators resulted in the following: NSQIP Surgical Risk Calculator = 0.803 (p < 0.001); "Post-operative Mortality Risk in Patients with Cirrhosis" with an etiology of "Alcoholic or Cholestatic" yielded an AUC = 0.722 (p < 0.001); MELD score yielded an AUC = 0.709 (p < 0.001); and the modified 5-item frailty index yielded an AUC = 0.583 (p = 0.04). The NSQIP Surgical Risk Calculator more accurately predicts 30-day mortality in patients with ascites undergoing hernia repair. However, if the patient is missing one of the 21 input variables required by this calculator, Mayo Clinic's 30-day mortality calculator should be consulted before the more widely used MELD score.

Modification effects of immigration status and comorbidities on associations of heat and heatwave with stroke morbidity.

Heat and heatwave have been associated with stroke morbidity, but it is still unclear whether immigrants from different geographic regions and patients with comorbidity are more vulnerable to heat and heatwave. Time-stratified case-crossover design combined with generalized additive quasi-Poisson models were used to quantify the relative risks (RRs) of heat and heatwave on first-ever stroke morbidity during 0-7 lag days. Attributable fractions (AFs) were estimated to assess the first-ever stroke morbidity burden due to heat and heatwave. Stratified analyses for sex, age, disease subtypes, resident characteristics, and comorbidity type were performed to identify potential modification effects. Heat and heatwave were associated with first-ever stroke morbidity, with the AF of 2.535% (95% empirical confidence interval (eCI) = 0.748, 4.205) and 2.409% (95% confidence interval (CI) = 1.228, 3.400), respectively. Among northern and southern immigrants, the AF for heat was 2.806% (0.031, 5.069) and 2.798% (0.757, 4.428), respectively, and the AF for heatwave was 2.918% (0.561, 4.618) and 2.387% (1.174, 3.398), respectively, but the effects of both on natives were statistically insignificant. Among patients with hypertension, dyslipidemia, or diabetes, the AF for heat was 3.318% (1.225, 5.007), 4.237% (1.037, 6.770), and 4.860% (1.171, 7.827), respectively, and the AF for heatwave was 2.960% (1.701, 3.993), 2.771% (0.704, 4.308), and 2.652% (0.653, 4.185), respectively. However, the effects of both on patients without comorbidity were statistically insignificant. Heat and heatwave are associated with an increased risk of first-ever stroke morbidity among immigrants and those with comorbid hypertension, dyslipidemia, or diabetes, with the effects primarily due to non-native individuals. The author(s) are not authorized to share the data.

The Association between GLP-1 Receptor-Based Agonists and the Incidence of Asthma in Patients with Type 2 Diabetes and/or Obesity: A Meta-Analysis

ObjectiveRecent studies have indicated potential anti-inflammatory effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on asthma, which is often comorbid with type 2 diabetes mellitus (T2DM) and obesity. Therefore, we conducted a meta-analysis to assess the association between the administration of glucagon-like peptide-1 (GLP-1) receptor-based agonists and the incidence of asthma in patients with T2DM and/or obesity. MethodsPubMed, Web of Science, Embase, the Cochrane Central Register of Controlled Trials, and Clinicaltrial.gov were systematically searched from inception to July 2023. Randomized controlled trials (RCTs) of GLP-1 receptor-based agonists (GLP-1RA, GLP-1 based dual and triple receptor agonist) with reports of asthma events were included. Outcomes were computed as risk ratios (RR) using a fixedeffects model. ResultsOverall, 39 RCTs with a total of 85,755 participants were included. Compared to non-GLP-1 receptor-based agonist users, a trend of reduced risk of asthma was observed in patients with T2DM or obesity using GLP-1 receptor-based agonist treatments, although the difference was not statistically significant [RR = 0.91, 95% confidence interval (CI): 0.68 to 1.24]. Further Subgroup analyses indicated that the use of light-molecular-weight GLP-1RAs might be associated with a reduced the risk of asthma when compared with non-users (RR = 0.65, 95% CI: 0.43 to 0.99, P = 0.043). We also performed sensitivity analyses for participant characteristics, study design, drug structure, duration of action, and drug subtypes. However, no significant associations were observed. ConclusionCompared with non-users, a modest reduction in the incidence of asthma was observed in patients with T2DM or obesity using GLP-1 receptor-based agonist treatments. Further investigations are warranted to assess the association between GLP-1 receptor-based agonists and the risk of asthma.

The effect of antiplatelet therapy and oral anticoagulants on the accuracy of faecal immunochemical testing.

Faecal immunochemical testing (FIT) has been adopted to identify patients requiring further investigations on the colorectal cancer (CRC) referral pathway. We aimed to investigate the effect of antiplatelet and anticoagulant drugs on the accuracy of FIT results. This observational study categorised patients with suspected CRC symptoms, who completed both FIT and colonic investigations, into two groups (control and exposed) based on their use of antiplatelet and anticoagulant drugs. Two-by-two tables and receiver operating characteristic (ROC) curve analysis were used to determine accuracy. A total of 928 patients were divided into a control (n=683) and an exposed group (n=245). A nonsignificant higher proportion of patients tested positive in the exposed group (24.1% vs 18.4%, p=0.063). For detection of CRC, improved sensitivity of 87% vs 81.2%, specificity of 84.8% vs 79.9% and negative predictive value of 99.2% vs 98.3% was calculated in the control vs exposed groups, respectively. The positive predictive value was comparable between the two groups (21.4% vs 22% in the control and exposed groups, respectively). In ROC analysis, there was no difference between the groups (AUC 90% vs 87%, p=0.56). The use of antiplatelet and anticoagulant drugs did not increase the risk of positive FIT results on multivariate logistic regression analysis. FIT accuracy for CRC detection remained unaffected despite more patients testing positive in the exposed group. FIT should be considered a supplementary tool for triage. Antiplatelet and anticoagulant drugs do not need to be discontinued before collection of FIT.

Recent Patents on Thermal Characteristic Analysis and Modeling of Machine Tools

Abstract: Modern machining machines are becoming more sophisticated and automated, but the problems of thermal deformation caused by machining have also come to the fore. CNC machine tools are used in high-speed, high-feed rate machining conditions, so the impact of thermal deformation factors will lead to a more prominent loss of accuracy. In this context, the design and manufacture of future CNC machine tools need to take further account of the errors caused by thermal deformation and the accompanying loss of accuracy. The principle of thermal characterisation and thermal error modeling of machine tools is to measure and reasonably analyse the machine tool at different temperature points and make corrections to the analysis data in order to get a value as close as possible to the real value and improve machining accuracy. Several representative patents and studies on thermal characterisation and thermal error modeling of machine tools at home and abroad are reviewed. This study presents a selection and summary of a large number of recent patents and studies on machine tool thermal characterisation and thermal error modeling, focusing on the selection of the machine tool thermal error measurement point area, thermal error modeling methods, spindle thermal displacement compensation, and other aspects, and discusses the future trends in the mainstream methods for reducing the thermal error of machine tools. The analysis and modeling of thermal errors in machine tools have an integral influence on further improvements in machining accuracy and efficiency in the future.

The Design and Implementation of a Wide-band Circularly Polarized Conformal Antenna

Background: It gives out the design and verification of single-layer dual-band antenna unit and multi-layer dual-band broadband antenna unit of phased array antenna, and verifies that the multi-layer dual-band broadband antenna unit can meet the design requirements of the receiving frequency band. Objective: It gives out the design and implementation of a wide-band circularly polarized conformal antenna, and presents the characteristics analysis of the antenna. Method: Through related simulation methods, the proposed methods are verified and they can effectively solve the array phase compensation and beam shaping and control in the wide-band circularly polarized conformal antenna. Results: Based on the basic design of the antenna, the active superposition algorithm, phase compensation technology and particle swarm optimization antenna beam shaping technology are both studied. Conclusion: The proposed wide-band circularly polarized conformal antenna can be used in the actual application.

ETMR-29. PRIMARY CNS SARCOMAS IN CHILDREN AND ADOLESCENTS: EXPERIENCE OF AN INSTITUTION

Abstract BACKGROUND Soft tissue sarcomas represent 6% of childhood cancers, less than 0.2% of CNS tumors are primary intracranial sarcomas. Their origin is pluripotential primitive mesenchymal cells. OBJECTIVE to evaluate clinical and genetic characteristics and report the experience of a rare CNS tumor. METHODS review of CNS tumors database at IOP/GRAACC/UNIFESP for the period 2008-2024, searching for all types of sarcomas that involved the CNS. RESULTS case series included 7 male, 2 female patients; average age at diagnosis 11.3 years. Supratentorial was the most common site of occurrence (66.6%), posterior fossa and intramedulary (2 and 1 cases, respectively) were found. One PF sarcoma presented as a second neoplasm after 2 years finished treatment for medulloblastoma, the other was diagnosed just after metilation. The presenting symptoms varied with tumor location, specially hemiparesis, seizure and headache. Gross total resection was achieved in 7 cases (77.7%), 1 after second look surgery. Histology and immunohistochemistry studies revealed: spinocellular sarcoma, fusocellular and myxoid sarcoma, gliosarcoma, meningeal sarcoma, Ewing sarcoma, condrosarcoma and synovial sarcoma. Work-up excluded other primary tumor origin outside CNS. Analyses for genetic characteristics were performed by Next Generation Sequencing in 6 patients (66.6%) and the following alterations were found: NRAS, TP53, JAK3, NF2, C11orf95-RELA fusion, PDGFRA. Some of these, by now, with no significant meaning for the disease. All patients underwent multimodal treatment. Chemotherapy involved mainly ICE Protocol (55.5%), but also Head Start Protocol and Ewing Sarcoma Protocol. Follow-up ranged from 13 months to 12 years, 90% of patients are alive, 2 (28.5%) dealing with endocrinal issues after focal radiotherapy. The mean overall survival was 61.4 months. CONCLUSION CNS primary sarcomas were mostly observed in the supratentorial region and in older children, with male predilection. Multimodal treatment seems to benefit patients’ outcomes. More patients and longer follow-up periods are needed to further elucidate the biological features of these tumors.

Evaluation of Genetic Variability in Different Genotypes of Finger Millet (Eleusine coracan L.) through Path and Multivariate Analysis

The experiment was carried out using a Randomized Block Design (RBD) with three replicates. The trials were entirely composed of fifty-two genotypes for yield and their contributing characters for 13 different characters. For every attribute under study, an analysis of variance showed a highly significant difference. Among the genotypes studied, the evaluated characteristics showed varying degrees of heritability, genetic advancement, and variability. Both the genotypic and phenotypic coefficients of variation (PCV and GCV, respectively) ranged from low to high. The modest GCV and PCV values particular for the percentage of fingers per ear (17.47% and 17.50%), ear weight per plant (g) (13.42% and 16.28%), and 1000 seed weight (g) (11.79% and 14.09%), were observed respectively. Plant height (cm) (81.60%, 28.47) had the greatest wide sense heritability value, with the highest genetic advance, followed by ear weight per plant (g) (67.95%, 20.13). Thus, the findings of this study indicate that these genotypes have diversity in yield and other yield-related features, which should be exploited in subsequent breeding. The correlation and path coefficient analyses for yield and yield characteristics showed that grain yield per plant showed a strong positive relationship both at the genotypic and phenotypic levels, with days to 50% flowering, days to maturity, ear weight per plant, and harvest index. Path analysis exhibited that for genotypic and phenotypic coefficients, harvest index (0.33, 0.46) and ear weight/plant (0.86, 0.39) showed the most positive direct effects. These characteristics might thus be applied as selection criteria to identify finger millet genotypes that show promising results in future breeding. Multivariate approaches such as principal component analysis and cluster analysis are crucial statistical tools for examining genetic diversity in plant breeding programs, as are their significant quantitative features. Based on principal component analysis, the entire variance was provided by six main components, of which PC-1 and PC-2 contributed 21.97% and 18.32%, respectively, to the total variability. Euclidean distance was used to divide the fifty-two genotypes into five groups. The largest number of genotypes (twenty-two) in Cluster I was followed by Cluster III, with 16 genotypes. As a result, genotypes from these clusters may be used as parents for hybridization.