Trends In Characteristics Research Articles

European Green Deal: Justification of the Relationships between the Functional Indicators of Bioenergy Production Systems Using Organic Residential Waste Based on the Analysis of the State of Theory and Practice

Based on the analysis conducted on the state of theory and practice, the expediency of assessing the relationships between the functional indicators of bioenergy production systems using the organic waste of residential areas is substantiated in the projects of the European Green Deal. It is based on the use of existing results published in scientific works, as well as on the use of methods of system analysis and mathematical modeling. The proposed approach avoids limitations associated with the one-sidedness of sources or subjectivity of data and also ensures complete consideration of various factors affecting the functional indicators of the bioenergy production system from the organic waste of residential areas. Four types of organic waste generated within the territory of residential areas are considered. In our work, we used passive experimental methods to collect data on the functional characteristics of bioenergy production systems, mathematical statistics methods to process and interpret trends in the functional characteristics of bioenergy production systems using municipal organic waste, and mathematical modeling methods to develop mathematical models that reflect the patterns of change in the functional characteristics of bioenergy production systems. The results indicate the presence of dependencies with close correlations. The resulting dependencies can be used to optimize processes and increase the efficiency of bioenergy production. It was found that: (1) yard waste has the highest volume of the total volume of solid organic substances but has a low yield of biogas and low share of methane production; (2) food waste has the highest yield of biogas and, accordingly, the highest share of methane production; (3) mixed organic waste has the lowest volume of the total volume of solid organic substances and the lowest content of volatile organic substances. The amount of electricity and thermal energy production varies by type of organic waste, with mixed organic waste having a higher average amount of electricity production compared to other types of waste. It was established that the production volume of the solid fraction (biofertilizer) is also different for different types of organic waste. Less solid fraction is produced from food waste than from yard waste. The obtained research results are of practical importance for the development of sustainable bioenergy production from organic waste in residential areas during the implementation of the European Green Deal projects. They provide further research on the development of effective models for determining the rational configuration of bioenergy production systems using organic waste for given characteristics of residential areas.

Transient flow analysis of pool-type reactor coolant pump under flow coast-down

When power is off, the flow rate of coolant in the RCP decreases rapidly and irregular phenomena appear. However, the inflow coolant tends to be uneven and unsteady due to the design of coolant pool. To simulate the actual situation of pool-type RCP under flow coast-down, Circulation-loop model and Open-border model were established. It provides two prediction methods of the power-off condition of pool-type RCP. The flow rate of Open-border model drops synchronously with rotation speed, and that of Circulation-loop model is dynamically fed back through calculation. Variation trends of external characteristics of the two models are similar. However, it is found that a large-scale and low-speed vortex appears at the horizontal suction part of the pool in Circulation-loop model, blocking the coolant transport channel. Thus, there is obvious fluctuation and hysteretic nature phenomenon in the decline of flow rate compared to the decline of rotation speed in Circulation-loop model.

Increasing Injury Intensity among 6,500 Violent Deaths in the State of Maryland.

Anecdotal evidence strongly suggests there has been a rise in violent crimes. This study sought to examine trends in injury characteristics of homicide victims in Maryland. We hypothesized that there would be an increase in the severity of wound characteristics. The Office of the Chief Medical Examiner is a statewide agency designated by law to investigate all homicides, suicides, or unusual or suspicious circumstances. Using individual autopsy reports, we collected data among all homicides from 2005 to 2017, categorizing them into 3 time periods: 2005 to 2008 (early), 2009 to 2013 (mid), and 2014 to 2017 (late). Primary outcomes included the number of gunshots, stabs, and fractures from assaults. High-violence intensity outcomes included victims having 10 or more gunshots, 5 or more stabs, or 5 or more fractures from assaults. Of 6,500 homicides (annual range 403 to 589), the majority were from firearms (75%), followed by stabbings (14%) and blunt assaults (10%). Most homicide victims died in the hospital (60%). The average number of gunshots per victim was 3.9 (range 1 to 54), stabs per victim was 9.4 (range 1 to 563), and fractures from assaults per victim was 3.7 (range 0 to 31). The proportion of firearm victims with at least 10 gunshots nearly doubled from 5.7% in the early period to 10% (p < 0.01) in the late period. Similarly, the proportion with 5 or more stabbings increased from 39% to 50% (p = 0.02) and assault homicides with 5 or more fractures increased from 24% to 38% (p < 0.01). In Maryland, the intensity of violence increased across all major mechanisms of homicide. Further follow-up studies are needed to elucidate the root causes underlying this escalating trend.

Long-term trends in incidence, characteristics and prognosis of screen-detected and interval cancers in women participating in the Dutch breast cancerscreening programme.

No studies are available in which changes over time in characteristics and prognosis of patients with interval breast cancers (ICs) and screen-detected breast cancers (SDCs) have been compared. The aim was to study these trends between 1995 and 2018. All women with invasive SDCs (N = 4290) and ICs (N = 1352), diagnosed in a southern mammography screening region in the Netherlands, were included and followed until date of death or 31 December 2022. The 5-year overall survival rate of women with SDCs increased from 91.4% for those diagnosed in 1995-1999 to 95.0% for those diagnosed in 2013-2018 (P < 0.001), and from 74.8 to 91.6% (P < 0.001) in the same periods for those with ICs. A similar trend was observed for the 10-year survival rates. After adjustment for changes in tumour characteristics, the hazard ratio (HR) for overall survival was 0.47 (95% confidence interval (CI): 0.38-0.59) for women with SDCs diagnosed in the period 2013-2018, compared to the women diagnosed in the period 1995-1999. For the women with ICs this HR was 0.27 (95% CI: 0.19-0.40). The prognosis of women with ICs has improved rapidly since 1995 and is now almost similar to that of women with SDCs.

14-Year Epidemiologic study of Pseudomonas aeruginosa bloodstream infection incidence and resistance in the Veterans Health Administration system, 2009-2022.

Multidrug resistant Pseudomonas aeruginosa (PA) represents a serious threat to hospitalized patients. Characterizing the incidence of PA infection and degree of resistance can inform empiric treatment and preventative measures. We sought to describe trends in incidence and resistance characteristics of PA bloodstream infections (BSI) observed within the Veterans Health Administration (VHA) system and identify factors contributing to higher observed mortality within this population. We characterized demographic and clinical features of unique patients among the VHA population presenting with their first episode of PA-BSI between 2009 and 2022 and summarized trends related to mortality and resistance phenotype based on year and geographical location. We additionally used logistic regression analysis to identify predictors of 30-day mortality among this cohort. We identified 8039 PA-BSIs during the study period, 32.7% of which were hospital onset. Annual PA-BSI cases decreased by 35.8%, and resistance among all antimicrobial classes decreased during the study period, while the proportion of patients receiving early active treatment based on susceptibility testing results increased. Average 30-day mortality rate was 23.3%. Higher Charlson Comorbidity Index, higher mAPACHE score, VHA facility complexity 1b and hospital-onset cases were associated with higher mortality, and early active treatment was associated with lower mortality. PA-BSI resistance decreased across the VHA system during the study period. Further investigation of antimicrobial stewardship measures possibly contributing to the observed decreased resistance in this cohort and identification of measures to improve on the high mortality associated with PA-BSI in the VHA population is warranted.

Trends in transcatheter aortic valve implantation practice and clinical outcomes at an Irish tertiary referral centre

ObjectiveA paucity of data exists on how transcatheter aortic valve implantation (TAVI) practice has evolved in Ireland. This study sought to analyse temporal trends in patient demographics, procedural characteristics, and...

Modeling and Analysis of Stress Sensitivity and Changing Trend of Magnetization Characteristics of GO Silicon Steel Cut Along Different Angles to the Rolling Direction

Modeling and Analysis of Stress Sensitivity and Changing Trend of Magnetization Characteristics of GO Silicon Steel Cut Along Different Angles to the Rolling Direction

Changing trends in clinical characteristics and in-hospital mortality of patients with infective endocarditis over four decades

BackgroundInfective endocarditis continues to be a significant concern and may be undergoing an epidemiological transition. MethodsWere studied 1804 consecutive episodes of infective endocarditis between 1978 and 2022. The mean age was 48 ( ± 19), and 1162 (64%) patients were male. Temporal trends in demographic data, comorbidities, predisposing conditions, microorganisms, complications and in-hospital death have been studied over the decades (1978–1988, 1989–1999, 2000–2010 and 2011–2022). The outcomes and clinical characteristics were modeled using nonlinear cubic spline functions. FindingsValve surgery was performed in 50% of the patients and overall in-hospital mortality was 30%. From the first to the fourth decade studied, the average age of patients increased from 29 to 57 years (p < 0.001), with significant declines in the occurrence of rheumatic valvular heart disease (15% to 6%; p < 0.001) and streptococcal infections (46% to 33%; p < 0.001). Healthcare-associated infections have increased (9% to 21%; p < 0.001), as have prosthetic valve endocarditis (26% to 53%; p < 0.001), coagulase-negative staphylococcal infections (4% to 11%; p < 0.001), and related-complications (heart failure, embolic events, and perivalvular abscess; p < 0.001). These changes were associated with a decline in adjusted in-hospital mortality from 34% to 25% (p = 0.019). InterpretationIn the 44 years studied, there was an increase in the mean age of patients, healthcare-related, prosthetic valve, coagulase-negative staphylococci/MRSA infections, and related complications. Notably, these epidemiological changes were associated with a decline in the adjusted in-hospital mortality.

Distribution of stable Н, О and С isotopes in natural waters in the area of the Taz oil and gas condensate field (Yamalo-Nenets autonomous region)

Relevance. The study of isotopic composition of water and dissolved substances makes it possible to determine not only their genesis, but also the fractionation processes occurring in the “water–rock–gas–organic matter” system over time, i. e. as different stages of the evolution of water composition pass through. Interest in the groundwater of the Arctic regions of Western Siberia is additionally associated with the widespread occurrence of oil deposits at the depths of formation waters and the possible influence of cryogenic metamorphization processes on composition of near-surface waters. Aim. To study and compare the isotopic composition of oxygen, hydrogen and carbon in natural waters of the Yamalo-Nenets autonomous region to identify conditional isotopic markers, as well as to be able to trace the evolution of the isotopic composition of waters along a vertical section in the area of the Taz oil and gas condensate field. Objects. Surface (river, soil and lake), underground waters of the active water exchange zone of the Yamalo-Nenets autonomous region and formation waters of oil and gas deposits of the Taz field. Methods. The study of the isotopic composition of oxygen, hydrogen, and carbon of water-dissolved carbon dioxide was carried out in the Research Equipment Sharing Center at the Institute of Geology and Mineralogy SB RAS using Isotope Ratio Mass Spectrometer FinniganTM MAT 253 equipped with H/Device and GasBench II for sample preparation. Results and conclusions. The paper introduces the data on isotopic composition of O, H and C for natural waters of the Yamalo-Nenets autonomous region. The authors have determined the characteristic trends in changes in the isotopic composition of water and dissolved carbon dioxide for various water bodies. Surface and underground waters with active water exchange in terms of isotopic composition (δD and δ18О) are infiltration. As water moves down the section, with an increase in the time of interaction of the “water–rock” system and increase in temperatures, the isotopic composition becomes significantly heavier with a slope from the GMWL to the right. The authors compiled the diagram of the evolution of water-dissolved carbon isotopic composition in the region according to the obtained and some literature data. Despite the wide range of δ13C values from –30.4 to 23.6 ‰, there are, obviously, only two sources of carbon dioxide in the region: biogenic and atmospheric, with biogenic being predominant for groundwater.

Diagnostic Utility of EWSR1 in Clear Cell Odontogenic Carcinoma: A Systematic Review.

In the 2022, World Health Organisation classification of odontogenic tumours, the clear cell odontogenic carcinoma is designated as a malignant odontogenic tumour with high recurrence and aggressive behaviour. Deceptive behaviour in the context of a wide range of differentials presents a significant diagnostic problem. It is the fifth most commom type of malignant odontogenic tumor. A systematic assessment of published cases, case series, and retrospective investigations of diagnostic significance of EWSR1 gene in clear cell odontogenic carcinoma is presented to determine trends in presentation, diagnostic characteristics, treatment, and patient outcome. To locate papers reporting clear cell odontogenic carcinoma and EWSR1, extensive database searches were carried out. Demographics, tumour location, immunohistochemical and molecular tests, treatment, follow-up, and recurrence were the variables. 34 cases were detected; 52.9% (n = 18) of the cases were females. The average age was 62.5years, with a range of 43-82years. The average size ranged from 3.4 to 8cm. The mandibular body was the most common location, followed by the maxilla. Maximum immunohistochemistry positivity revealed by CK 19, CKAE1/3, EMA and p63. Most common gene fusion detected was EWSR1-ATF1 in 62.4% of cases contributing to its diagnostic attributes. Surgical treatment was used in 97% of cases. The average follow-up period was 30.3months, and recurrence was reported in 52.4% of the cases. CCOC can metastasize, and the prognosis is fair. This is first systematic review, where we have attempted to consolidate the mutational expression of EWSR1 in Clear cell odontogenic carcinoma. It is difficult to identify from other clear cell tumours of the head and neck region. It is crucial to distinguish it from other clear cell lesions because of its aggressiveness.

Clinical Features and Outcomes of Patients with Idiopathic Inflammatory Myositis-Associated Interstitial Lung Disease in Rural Appalachia: A Cross-Sectional Study.

Idiopathic inflammatory myopathies (IIMs) are a group of autoimmune disorders often complicated by interstitial lung disease (ILD). The clinical characteristics and outcomes of IIM-associated ILD have been reported variably, but the literature on rural populations is scarce. A retrospective cross-sectional study was conducted at a rural tertiary academic medical center. Twenty-nine patients met the final inclusion criteria. The primary outcome was to assess the disease state and immunological and radiographic features of IIM-associated ILD. Secondary outcomes included disease progression, ILD exacerbation, mortality rate, and factors associated with poor outcome. Dermatomyositis (n = 15, 51.72%) followed by polymyositis (n = 8, 27.58%) were predominant myopathies. The most common autoantibodies were anti-Jo1 antibodies (n = 11, 37.93%). Indeterminate usual interstitial pneumonitis (41.30%, n = 12) was the most common radiographic pattern followed by non-specific interstitial pneumonia (n = 5, 17.24%). ILD exacerbation (n = 14, 66.66%) and mortality rate (n = 6, 20.69%) were high. Albumin levels were significantly lower in patients who died. The clinical characteristics of patients with IIM-associated ILD in rural Appalachia exhibit notable distinctions, and outcomes are worse compared to other populations. Larger studies are needed to investigate other prognostics factors and longitudinal trends of clinical characteristics and outcomes of IIM-associated ILD in rural populations.

Impact of climate change on persistent cold-air pools in an alpine valley during the 21st century

Abstract. When anticyclonic conditions persist over mountainous regions in winter, cold-air pools (i.e. thermal inversions) develop in valleys and persist from a few days to a few weeks. During these persistent cold-air pool (PCAP) episodes the atmosphere inside the valley is stable and vertical mixing is prevented, promoting the accumulation of pollutants close to the valley bottom and worsening air quality. The purpose of this paper is to address the impact of climate change on PCAPs until the end of this century for the alpine Grenoble valleys. The long-term projections produced with the general circulation model MPI (from the Max Planck Institute) downscaled over the Alps with the regional climate model MAR (Modèle Atmosphérique Régional) are used to perform a statistical study of PCAPs over the period 1981–2100. The trends of the main characteristics of PCAPs, namely their intensity, duration, and frequency, are investigated for two future scenarios, SSP2–4.5 and SSP5–8.5. We find that the intensity of PCAPs displays a statistically significant decreasing trend for the SSP5–8.5 scenario only. This decay is explained by the fact that air temperature over the century increases more at 2 m above the valley bottom than in the free air at mid-altitudes in the valley; this might be due to the increase of specific humidity near the ground. The vertical structure of two PCAPs, one in the past and one around 2050, is next investigated in detail. For this purpose, the WRF (Weather Research and Forecasting) model, forced by MAR for the worst-case scenario (SSP5–8.5), is used at a high resolution (111 m). The PCAP episodes are carefully selected from the MAR data so that a meaningful comparison can be performed. The future episode is warmer at all altitudes than the past episode (by at least 4 ∘C) and displays a similar inversion height, which are very likely generic features of future PCAPs. The selected episodes also have similar along-valley wind but different stability, with the future episode being more stable than the past episode. Overall, this study shows that the atmosphere in the Grenoble valleys during PCAP episodes tends to be slightly less stable in the future under the SSP5–8.5 scenario, and statistically unchanged under the SSP2–4.5 scenario, but that very stable PCAPs can still form.

Regional assessment of the historical trends of mercury in sediment cores from Wider Caribbean coastal environments

Spatial and temporal variations of mercury (Hg) concentrations, enrichment, and potential ecological risks were studied in a suite of lead-210 (210Pb) dated sediment cores from 13 Wider Caribbean Region coastal environments. Broad variability of Hg concentrations (19–18761 ng g−1) was observed, encompassing even background levels (38–100 ng g−1). Most Hg concentration profiles exhibited a characteristic upward trend, reaching their peak values in the past two decades. Most of the sediment sections, showing from moderately to very severe Hg enrichment, were found in cores from Havana Bay and Sagua River Estuary (Cuba), Port-au-Prince Bay (Haiti), and Cartagena Bay (Colombia). These were also the most seriously contaminated sites, which can be considered regional Hg ‘hotspots’. Both Havana Bay and Port-au-Prince Bay reportedly receive waste from large cities with populations exceeding 2 million inhabitants, and watersheds affected by high erosion rates. The records from the Sagua River Estuary and Cartagena Bay reflected historical Hg contamination associated with chloralkali plants, and these sites are of very high ecological risk. These results constitute a major contribution to the scarce regional data on contaminants in the Wider Caribbean Region and provide reference information to support the evaluation of the effectiveness of the Minamata Convention.

Abstract TMP63: Blood Pressure (BP) Protocol Violations in IV Tenecteplase Treated Ischemic Stroke Patients is Associated With Early Neurologic Deterioration and Symptomatic Intracranial Hemorrhage

Background: The American Heart Association guidelines recommend BP goal of &lt;180/105 mmHg for the first 24 hours in acute ischemic stroke (AIS) patients treated with IV Alteplase and now adopted for IV Tenecteplase (TNK). Studies suggest increased hemorrhage risk in patients with BP ≥170 mmHg and greater BP variability. Methods: We performed a retrospective study with data from the Get with The Guidelines database and electronic medical record of all adult AIS patients treated with TNK at a Comprehensive Stroke Center from 6/2021 to 6/2023. All BP readings from ED arrival to 24 hours post TNK were queried. We analyzed the temporal trends of BP characteristics and their association with early neurological deterioration (END) and symptomatic intracranial hemorrhage (sICH). The BP characteristics included mean and standard deviation of systolic (SBP) and diastolic (DBP) measurements, intra-patient BP variability and frequency of excessive BP (SBP &gt; 180 mmHg and DBP &gt; 105 mmHg) at each time point. Results: There were 132 TNK treated patients: mean age 68 ± 15 years, 54% male, 73% Caucasian, median admission NIHSS 9, IQR 4-15, 42 (32%) underwent mechanical thrombectomy, 72 (54.5%) treated with IV antihypertensive(s). Of these, 6 (4.5%) developed END and another 6 (4.5%) sICH. Of the 5901 BP measurements, 217 (3.7%) and 99 (1.7%) exceeded systolic of &gt;180 mmHg and diastolic of &gt;105 mmHg respectively. All END and sICH patients had excessive BP within 4 hours post TNK (Figure 1) and during this time there was a strong association of END with excessive SBP (14% vs 4.8%; p=0.05) and DBP (14% vs 1.2%; p &lt; 0.001). sICH had a similar but weaker association: excessive SBP (7.7% vs 4.9%; p=0.3) and excessive DBP (3.8% vs 1.4%; p=0.2). Conclusion: Our findings suggest that excessive BPs within 4 hours of TNK may be associated with patients developing END and sICH. Further exploration of moderate BP parameters deserve further study post thrombolysis, like the BEST II study in post thrombectomy patients.

Different patterns of inter-annual variability in mean vessel area and tree-ring widths of beech from provenance trials in Slovenia and Hungary

Key messageStudied beech provenances showed different patterns of inter-annual variability in mean vessel area and ring widths, indicating influence of intraspecific variability and diverse environment on hydraulic conductivity and carbon storage potential.International provenance trials of ecologically and economically important tree species are crucial to deciphering the influence of environmental factors and intraspecific variability on tree growth and performance under climate change to guide assisted gene flow and assisted migration of tree provenances and species. In this context, we compared inter-annual trends in tree-ring widths (carbon sequestration potential) and vessel characteristics (conductivity optimisation) of four beech provenances in two international provenance trials, one in Slovenia (Kamenski hrib, a core beech growing site) and one in Hungary (Bucsuta, a marginal beech site) in 2009–2019. We found different patterns of inter-annual variability in mean vessel area and tree-ring widths among provenances and sites, pointing to diverse genetic background and environmental influence on these two wood-anatomical traits. The average values of the vessel area varied less between provenances at Kamenski hrib than at Bucsuta. Weather conditions differently affected tree-ring width and mean vessel area. Furthermore, the length of the period of response of vessel area to the analysed weather conditions differed in summer and winter periods. The differences in the mean vessel area within the tree ring were more pronounced in the weather-wise extreme years, regardless of the provenance. Consistent with previous studies, we confirmed that site conditions affect the climate sensitivity of trees, which is more pronounced at marginal sites or in extreme years. The findings on how different environmental conditions affect the radial growth of young beech trees of different origin are very important for future forest management.

Changes in the characteristics and outcomes of high-risk pregnant women who delivered prior to and after China’s universal two-child policy: a real-world retrospective study, 2010–2021

BackgroundIn 2016, the “universal two-child” policy, allowing each couple to have two children, was introduced in China. The characteristic change of the long-term period after the implementation of the universal two-child policy was unclear. We studied trends in the obstetric characteristics and their potential impact on the rates of cesarean section and preterm birth in the era of China’s universal two-child policy.MethodsA tertiary center-based study (2010–2021) retrospectively focused single high-risk pregnancies who delivered from the one-child policy period (OCP, 2010–2015) to the universal two-child policy period (TCP, 2016–2021). A total of 39, 016 pregnancies were enrolled. Maternal demographics, complications, delivery mode and obstetric outcomes were analyzed. Furthermore, logistic regression analysis was used to explore the association between the cesarean section rate, preterm birth and implementation of the universal two-child policy, adjusting maternal age, parity, and fetal distress.ResultsUltimately a total of 39,016 pregnant women met the criteria and were included in this analysis. The proportion of women with advanced maternal age (AMA) increased from 14.6% in the OCP to 31.6% in the TCP. The number of multiparous women increased 2-fold in the TCP. In addition, the overall rate of cesarean section significantly decreased over the policy change, regardless of maternal age, whereas the risk of preterm birth significantly increased in the TCP. Adjusting for maternal age, parity and fetal distress, the universal two-child policy showed a significantly favorable impact on the cesarean section rate (RR 0.745, 95%CI (0.714–0.777), P < 0.001). Compared to the OCP group, a higher increase in fetal distress and premature rupture of membranes (PROM) were observed in the TCP group. In pregnancies with AMA, there was no increase in the risk of postpartum hemorrhage, whereas more women who younger than 35 years old suffered from postpartum hemorrhage in TCP. The logistic regression model showed that the universal two-child policy was positively associated with the risk of postpartum hemorrhage (RR: 1.135, 95%CI: 1.025–1.257, P = 0.015).ConclusionsAfter the implementation of the universal two-child policy in China, the rate of the cesarean section significantly decreased, especially for women under 35 years old. However, the overall risk of postpartum hemorrhage increased in women under 35 years old, while there was no change in women with AMA. Under the new population policy, the prevention of postpartum hemorrhage in the young women should not be neglected.

Status and trends in epidemiologic characteristics of diabetic end-stage renal disease: an analysis of the 2021 Korean Renal Data System.

Korean Renal Data System (KORDS) is a nationwide end-stage renal disease (ESRD) registry database operated by the Korean Society of Nephrology (KSN). Diabetes mellitus is currently the leading cause of ESRD in Korea; this article provides an update on the trends and characteristics of diabetic ESRD patients. The KORDS Committee of KSN collects data on dialysis centers and patients through an online registry program. Here, we analyzed the status and trends in characteristics of diabetic chronic kidney disease stage 5D (CKD 5D) patients using data from 2001 to 2021. In 2021, the dialysis adequacy of hemodialysis (HD) was lower in diabetic CKD 5D patients than in nondiabetic CKD 5D patients, while that of peritoneal dialysis (PD) was similar. Diabetic CKD 5D patients had a higher proportion of cardiac and vascular diseases and were more frequently admitted to hospitals than nondiabetic CKD 5D patients, and the leading cause of death was cardiac disease. From 2001 to 2020, diabetic CKD 5D patients had a higher mortality rate than nondiabetic CKD 5D patients, but in 2021 this trend was reversed. Diabetic PD patients had the highest mortality rate over 20 years. The mortality rate of diabetic HD patients was higher than that of nondiabetic HD patients until 2019 but became lower starting in 2020. There was a decreasing trend in mortality rate in diabetic CKD 5D patients, but cardiac and vascular diseases were still prevalent in diabetic CKD 5D patients with frequent admissions to hospitals. More specialized care is needed to improve the clinical outcomes of diabetic CKD 5D patients.

Trends in clinical characteristics, medication use, and glycemic control in insulin-treated patients with type 1 and type 2 diabetes in Finland in 2012-2019: Nationwide real-world evidence study.

To describe the clinical characteristics and medication purchases of insulin-treated adults in Finland at index (January 1, 2012 or first insulin purchase) and December 31, 2019. Additionally, to describe basal insulin (BI) treatment patterns and associated changes in hemoglobin A1c (HbA1c) values. In this descriptive study using nationwide registries, we included adults with at least two reimbursed insulin purchases within 12 months of the first purchase between January 1, 2012 and December 31, 2019. We formed four study groups: type 1 diabetes (T1D) and type 2 diabetes (T2D)-diagnosed people who were further divided into prevalent or naïve users (start of insulin use before or after January 1, 2012). Insulin treatment patterns were estimated from medication purchase data and glycemic control from HbA1c results. Out of 145 020 people included, 34 359 had T1D and 110 661 T2D. By 2019, in parallel with the adaptation of new noninsulin medications, second-generation basal insulin (BI) analogues were adopted by 45.9% and 21.1% of prevalent T1D and T2D users. At index, HbA1c target (≤53 mmol/mol) was reached by 17% and 35% of T2D naïve and prevalent users, respectively, and by 17% of T1D prevalent users. At study end, the target was reached respectively by 41%, 34%, and 22% of insulin users. Insulin initiation improved and discontinuation worsened glycemic control in T2D, with lesser effects seen after treatment gaps or switches between BIs. Our study showed that glycemic control in insulin users has remained stable or improved between 2012 and 2019 despite aging population and in parallel with introduction of new treatment options, providing valuable insight into Finnish national diabetes care.

Trends of Surgery, Patient, and Surgeon Characteristics for Corneal Transplants in the Medicare Population From 2011 to 2020.

The aim of this study was to describe recent trends in corneal transplants and patient and surgeon characteristics for corneal transplants that occurred in the Medicare population. This was a retrospective, cross-sectional study using Current Procedural Terminology codes. We identified Medicare Fee-For-Service (FFS) claims for different types of corneal transplant procedures performed on Medicare beneficiaries aged 65 years or older from 2011 to 2020. Number and types of corneal transplants performed each year and patient and surgeon demographics and characteristics were analyzed. We analyzed 148,981 corneal transplants performed by 2972 surgeons within the study period. Most corneal transplants performed were endothelial keratoplasties (70.1%). Most patients were women (60.3%) and White (85.8%). 18.2% of patients lived in a rural area, whereas only 3.5% of transplants occurred in a rural area and 5% of surgeons practiced in a rural area. Male surgeons represented 77.8% of all surgeons and performed 84.9% of all corneal transplants in the study period. The proportion of corneal transplants performed by female surgeons gradually increased over time, from 12.1% in 2011 to 19.0% in 2020. The proportion of female surgeons also increased from 16.2% in 2011 to 23.8% in 2020. Most surgeons (67%) performed <6 corneal transplants per year. Although the number of female corneal transplant surgeons has increased over time, women remain underrepresented in the surgical workforce. Further investigation should be conducted to identify the underlying reason and address the identified disparities within the landscape of corneal transplantation.

РАЗВИТИЕ АРХИТЕКТУРЫ ИНТЕЛЛЕКТУАЛЬНЫХ ТРАНСПОРТНЫХ СИСТЕМ

The paper analyzes the role of a complete architecture of intelligent transport systems (ITS) in ensuring their effectiveness. Many countries or groups of countries have ITS architecture with successful results of its application in practice. It is shown that the ITS architecture is constantly being updated and this is a characteristic trend. The paper proposes new approaches to the formation of the architecture of the integration platform within ITS. The scheme of organisation of data flows in different loops of software tools of the integration platform is developed. It is proposed to separate the control loops proper transport system data and identification data, which describe a partisipant of the ITS (digital object) with the expansion of capabilities in a cooperative ITS. It is possible to organise linked chains of identification of ITS digital objects, to participate in the formation of network structures for ITS work processes, describing the behaviour of digital objects during ITS processes and the behaviour of end users in accordance with the properties of network structures.